Using structural equation modeling to understand family and psychological factors of childhood obesity: from socioeconomic disadvantage to loss of control eating.

Purpose: Current study aimed to empirically test the Hemmingsson's theoretical model of childhood obesity which emphasizing the importance of family environment and the emotional distress of parents as influential variables in the emotional distress of the child and subsequent weight gain. This study also tested the hypothesis that the emotional distress of the child triggers a weight gain-inducing behavior (loss of control eating) to suppress negative emotions.

Methods: Families of 220 Spanish children participated in the study (28.2% normal, 35.1% overweight and 32.2% obesity), aged between 8 and 12. The evaluation included a clinical interview and a battery of questionnaires.

Results: Structural equation models were computed according to the steps proposed by theoretical model. Fit indices were acceptable suggesting that the data adequately fit the hypothesized model. Path coefficients in the final model were statistically significant showing a relationship between socioeconomic status, the emotional distress of parents, family environment, the emotional distress of children, loss of control eating and child's BMI Z-score.

Conclusion: Considering this relation between emotional distress and child weight status, childhood obesity intervention programs may benefit from targeting family environment and the potential role that food is playing in the regulation of children's distress.

Level Of Evidence: Level III: Cohort analytic study.