Loss of Control Eating

LOC eating refers to a perception of eating without the ability to stop. LOC eating can occur with or without episodes of overeating. The notion that the experience of LOC is the most relevant component of a binge episode in comparison to the consumption of objectively large amounts of food is often adopted in studies with youths, likely because of the difficulty involved in making a size criterion determination for youths of different ages because physically developing boys and girls have vastly varying energy needs. For example, the consumption of an entire large pizza by a child or adolescent of any age would likely be considered unambiguously large. By contrast, five slices of pizza eaten by a growing adolescent might be less clear. Furthermore, in younger children, the size of eating episodes may be limited by parental controls, masking how much a child might have eaten given the opportunity.

The prevalence rates of LOC eating range from 4% to 45%, with higher estimates among overweight youths and when rates are self-reported versus assessed in structured interviews (Tanofsky-Kraff, 2008). Youths with LOC eating are more likely to be heavier and have greater fat mass than youths with no LOC episodes (Goossens et al., 2007; Shomaker et al., 2009). Children and adolescents with LOC eating also exhibit greater psychological symptoms, disordered eating cognitions and behaviors (Goossens et al., 2007; Morgan et al., 2002; Tanofsky-Kraff et al., 2004, 2008), and dysfunctional emotion regulation strategies (Czaja, Rief, & Hilbert, 2009) than their counterparts without LOC eating. Prospective data have shown that youths who report LOC eating gain more weight over time than their counterparts without LOC (Tanofsky-Kraff et al., 2009). Thus, accumulating evidence has suggested that the experience of loss of control is a critical aspect of binge eating in youths and may have more predictive and diagnostic validity in comparison to assessing full binge eating episodes that require both overeating and the experience of LOC. Although both of these eating behaviors have been shown to cause distress in youths who report them, relatively few youths meet criteria for BED, suggesting that diagnostic criteria may need to be modified to better account for the importance of LOC. Furthermore, although it is clear that LOC eating and binge eating occur at greater rates in overweight and obese youths, these behaviors only occur in a subset of overweight and obese youths.

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