A brief summary of the article Eating and Emotions in Obese Toddlers: Facilitating Self-regulation by Irene Chatoor (Journal of Zero to Three September 2007)

The rate of childhood obesity in the US continues to rise, and has in fact tripled in the past thirty years. It is stated that one in five children in 2010 is obese (worldhealth.net). Studies have shown that while obesity does have a genetic component that environmental factors also make a difference as to whether or not a child will indeed become obese.

Studies have shown that young children ages 2-5 actually have an innate ability to adjust their caloric intake to suit their energy needs, but parents do play a role in this self-regulation. In some fascinating studies by Birch and colleagues (1997) they showed that children who ate a high calorie first course meal, ate less later and children who ate a low calorie first course ate more later to make up for the energy difference. But, when children were rewarded for eating, all differences related to the energy content of the food disappeared and the kids increased their food intake significantly. Two different studies reported that parents who controlled what and how much their children ate correlated to low self-regulation in children. Researchers have found that self-regulation patterns established between the ages of 6 months and 3 years will have a lasting effect on a child's ability to limit caloric intake.

A big component in feeding is for the infant to distinguish internal sensations related to eating (being hungry vs being full) from emotional experiences (happiness, anger, frustration, sadness). I am sure as adults you have heard overweight people say that they eat to fulfill emotional needs, not because they are hungry. Curiously, infants can learn this early on, that they are being fed to meet an emotional need, not a physical need. Most infants have clear cues for hunger, but for children with poor cues or a parent with the inability to read cues, a parent can begin to soothe a child emotionally by feeding him. Parents may use food as a reward or a way of expressing their love for a child. This causes children to become confused and begin to use food as a way to alleviate negative emotional experiences.

Intervention is possible and the article cites a successful intervention with a family of a morbidly obese two year old. The goal of the intervention is to guide parents toward helping their children master their internal regulation of eating and emotions. When children (just as adults) learn to regulate their eating based on the feelings of hunger and fullness and then learn to master their emotions without eating, their weight will normalize. The two year old in the study was first able to normalize her weight learning hunger and fullness cues, but she needed additional therapy in order to regulate her emotions. After her weight was normalized, her parent's still described her as a time bomb and said they tip-toed around her fearing a temper tantrum. In therapy the child was asked why she was having tantrums and she screamed that she did not want to talk about it. She was then allowed to tantrum for over 30 minutes while the therapist patiently waited her out. When she was finally calm the therapist told her something like "You were able to calm yourself, that was really hard, your mom will be so proud that you were able to calm yourself". Her mother praised her for being able to calm herself and once the child had learned that she was indeed able to calm herself, her tantrums diminished. She could calm herself and feel satisfied by her own internal self-regulation, not by the use of food.

In conclusion, for children to learn to maintain healthy eating habits throughout their lives they need to first be able to listen to their own bodies cues of hunger and fullness and also learn to identify, feel and express their various emotions separately from food/eating.

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