Eating, feeling, and feeding: Does maternal binge eating predict use of child feeding practices through emotional responsiveness?
Authors: Saltzman Jaclyn A. , Pineros‐Leano Maria , Liechty Janet M. , Bost Kelly K. , Fiese Barbara H. 
Published: June 2021

The purpose of this study was to assess whether maternal emotion responses mediate the association between maternal binge eating (BE) and child feeding practices, in order to elucidate potential risk and protective factors for feeding practices that influence maternal and child weight. In a sample of (n = 260) diverse, Midwestern mothers of preschool‐age children (M[SD] = 37 [6.94] months) from the STRONG Kids Panel Survey, 10.7% (n = 28) indicated engaging in any BE episodes over the course of the previous three months at Wave 1. The Coping with Children's Negative Emotions Scale, the Comprehensive Feeding Practices Questionnaire, the Eating Disorder Diagnostic Scale, and the Depression, Anxiety, and Stress Scale were used to assess mothers’ self‐reported responses to negative emotion, feeding practices, binge eating frequency, depressive, and anxiety symptoms respectively. Using bias‐corrected bootstrapping procedures and maximum likelihood estimation, we tested the hypothesis that Wave 1 maternal BE predicts child feeding practices 18–24 months later (Wave 2) indirectly through responses to children's negative emotions, while statistically controlling for parent BMI, child BMI percentile, and change from Wave 1 to Wave 2 feeding practices. First, maternal BE predicted use of more Emotion Regulation, Restriction for Health, and Food as Reward feeding practices indirectly through more Distress responses to children's negative emotions (Table 1). Maternal BE also predicted use of fewer Pressure to Eat feeding practices, but the pathway was not mediated by Distress responses. Second, maternal BE did not predict use of Balance/Variety, Modeling, or Involvement feeding practices directly, or indirectly, through Problem‐Focused responses (Table 2). Finally, maternal BE predicted use of fewer Balance/Variety and Modeling feeding practices indirectly, through less Emotion‐Focused responses to children's negative emotion (Table 3). Neither depressive nor anxiety symptoms moderated these results. These results suggest that maternal BE and emotion responsiveness are important for understanding the interpersonal context of feeding behaviors. Distress reactions may serve as a risk factor for use of unhealthful feeding practices among mothers with BE, and Problem‐Focused reactions may serve as a protective factor against use of unhealthful feeding practices among mothers with BE.Support or Funding InformationThis material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2011‐67001‐30101. This research was funded, in part, by grants from the Illinois Council for Agriculture Research to Kristen Harrison (PI), the University of Illinois Health and Wellness Initiative to Barbara Fiese and Sharon Donovan, the United States Department of Agriculture (Hatch 793‐328) to Barbara Fiese (PI), and the Agriculture and Food Research Initiative of the United States Department of Agriculture National Institute of Food and Agriculture as part of the AFRI Childhood Obesity Prevention Challenge. The STRONG Kids Team includes Kristen Harrison, Kelly Bost, Brent McBride, Sharon Donovan, Diana Grigsby‐Toussaint, Juhee Kim, Janet Liechty, Angela Wiley, Margarita Teran‐Garcia, and Barbara Fiese.
Direct effects of maternal binge eating, and indirect effects through maternal distress reactions to negative emotions, on child feeding practices using bias‐corrected bootstrapped (n=10,000) confidence intervals (CI) and maximum likelihood estimation procedures.

Indirect effect
Direct effect
Total effect

B
SE
95%CI (LLCI, ULCI]
B
SE
95%CI (LLCI, ULCI]
B
SE
95%CI [LLCI, ULCI]

Emotion Regulation
.029
.022
[.003, .073]
.005
.041
[−.072, .080]
.034
.030
[−.027, .089]

Food Reward
.048
−.025
[.015, .132]
.060
.085
[−.109, .216]
.109
.089
[−.053, .291]

Restriction for Health
.070
.032
[.024, .157]
.126
.078
[.010, .312]
.196
.083
[.070, .395]

Pressure to Eat
.028
.041
[−.015, .126]
−.166
.068
[−.338, −.066]
−.138
.052
[−.262, −.051]

Balance/Variety
−.018
.017
[−.060, .004]
.044
.043
[−.041, .130]
.026
.040
[−.057, .100]

Involvement
−.010
.021
[−.046, .045]
.000
.070
[−.152, .127]
−.010
.067
[−.145, .118]

Note. Statistically controlled for maternal body mass index (BMI) at Wave 1 (W1) and Wave 2 (W2), and change in feeding practice from Wave 1 to Wave 2 in all analyses. In analyses estimating effects on Pressure to eat, additional controls included parent age, child BMI percentile at W1 and W2, and parent race.
LLCI= Lower level confidence interval, ULCI= Upper level confidence interval.

Direct effects of maternal binge eating, and indirect effects through maternal problem‐focused reactions to negative emotions, on child feeding practices using bias‐corrected bootstrapped (n=10,000) confidence intervals (CI) and maximum likelihood estimation procedures.

Indirect effect
Direct effect
Total effect

B
SE
95%CI [LLCI, ULCI]
B
SE
95%CI [LLCI, ULCI]
B
SE
95%CI [LLCI, ULCI]

Balance/Variety
−.031
.034
[−.124, .019]
.054
.038
[−.012, .138]
.023
.039
[−.065, .091]

Involvement
−.033
.026
[−.111, .002]
.027
.062
[−.097, .148]
−.007
.072
[−.164, .120]

Modeling
−.045
.040
[−.143, .018]
−.044
.072
[−.198, .080]
−.089
.094
[−.286, .071]

Note. Statistically controlled for maternal body mass index (BMI) at Wave 1 (W1) and Wave 2 (W2), child age at W1 and W2, and change in feeding practice from W1 to W2 in all analyses.
LLCI= Lower level confidence interval, ULCI= Upper level confidence interval.

Direct effects of maternal binge eating, and indirect effects through maternal problem‐focused reactions to negative emotions, on child feeding practices using bias‐corrected bootstrapped (n=10,000) confidence intervals (CI) and maximum likelihood estimation procedures.

Indirect effect
Direct effect
Total effect

B
SE
95%CI [LLCI, ULCI]
B
SE
9S%CI [LLCI, ULCI]
B
SE
95%CI [LLCI, ULCI]

Balance/Variety
−.036
.023
[−.103, −.007]
.062
.040
[−.012, .144]
.026
.039
[−.058, .097]

Modeling
−.043
.027
[−.111, −.006]
−.041
.074
[−.201, .086]
−.084
.084
[−.259, .061]

Note. Statistically controlled for maternal body mass index (BMI) at Wave 1 (W1) and Wave 2 (W2), child age at W1, and change in feeding practice from W1 to W2 in all analyses.
LLCI= Lower level confidence interval, ULCI= Upper level confidence interval.