Eating disorders such as anorexia nervosa and bulimia nervosa represent a significant public health problem for young women in particular, affecting an estimated 2.4% of women of childbearing age in the United States. The children of mothers with eating disorder histories appear to be at especially high-risk for developing eating problems themselves. Yet, very little research has investigated how mothers with such histories interact with their young children in the feeding environment. An important component of early feeding is maternal responsiveness. Increased maternal responsiveness to child hunger and fullness cues is associated with the development of greater self-regulation of eating in childhood and decreased loss of control over eating or binge eating. Mothers with eating disorders may find it difficult to be responsive to their child during feeding due to heightened anxiety at mealtimes and fears about child weight gain. Despite the great importance of maternal feeding responsiveness for development of healthy child eating behavior, it remains unstudied in eating disorders. This proposed Kirschstein-NRSA individual fellowship (F30) aims to determine if mothers with histories of eating disorders differ from healthy mothers in their ability to recognize and respond to their child's hunger and fullness cues through the combined use of observational, self-report, and physiologic methods. This fellowship will provide the applicant with a uniquely integrated training in nutrition, eating disorders, and developmental psychology to further her career goals as a physician-scientist investigating the developmental origins of mental illness and the role of early nutrition in development of eating disorders.
The specific aims of this F30 are: 1) to determine if mothers with histories of eating disorders display different responsiveness to child cues during a feeding episode that is video-recorded compared to mothers with no history of eating disorders;2) to compare self-report of feeding style, parenting self-efficacy, and parenting stress in women with histories of eating disorders and healthy control mothers;and 3) to determine the extent to which mothers with histories of eating disorders differ from healthy control mothers in their physiologic response to feeding interactions with their child. This study will contribute to our understanding of the maternal emotional and physiologic response to the feeding environment in mothers with histories of eating disorders. Ultimately, this work will provide guidance on how best to target specific problematic feeding behaviors in interventions for these mothers designed to help reduce the risk of eating disorder development in their offspring.

Public Health Relevance

Through this research, we determine if mothers with eating disorders respond differently than mothers without eating disorders to child feeding situations across behavioral, psychological, and physiological domains. This work will provide valuable background for the development of future interventions in mothers with eating disorders to promote healthier mealtimes and potentially decrease risk of disordered eating in their offspring.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Individual Predoctoral NRSA for M.D./Ph.D. Fellowships (ADAMHA) (F30)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-F12B-C (20))
Program Officer
Rubio, Mercedes
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of North Carolina Chapel Hill
Schools of Public Health
Chapel Hill
United States
Zip Code
Runfola, Cristin D; Zucker, Nancy L; Von Holle, Ann et al. (2014) NURTURE: development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder. Int J Eat Disord 47:1-12
Hoffman, Elizabeth R; Gagne, Danielle A; Thornton, Laura M et al. (2012) Understanding the association of impulsivity, obsessions, and compulsions with binge eating and purging behaviours in anorexia nervosa. Eur Eat Disord Rev 20:e129-36
Hoffman, Elizabeth R; Zerwas, Stephanie C; Bulik, Cynthia M (2011) Reproductive issues in anorexia nervosa. Expert Rev Obstet Gynecol 6:403-414