Background

Parents often report difficulty discussing food and eating-related issues with teens at-risk for obesity. Observing parent-teen communication has rarely been undertaken and may offer insight. We assessed parent-teen communication during a food-related conflict and tested relations with parent-reported feeding practices, teen food reward sensitivity, disordered eating, and metabolic risk.

Methods

Participants (N=30), age 14±2y (57% male; 73% non-Hispanic White) at-risk for adult obesity (BMIz 1.6±0.7), and their parents participated. Dyads discussed a food-related conflict; videos were consensus coded using the Interactional Dimensions Coding System. Parents reported feeding practices on the Child Feeding Questionnaire-Adolescent Version. Teen food reward sensitivity was measured with a behavioral task and disordered eating with the Eating Disorder Examination Questionnaire. Metabolic risk was assessed from insulin resistance (HOMA-IR). Regressions described relations accounting for age, sex, and BMIz.

Results

Observed parent pressure to be thin, dominance, and parent-teen dyadic negative escalation related to more, and observed parent support related to less, parent-reported pressure in feeding (ps<.05). Observed parent pressure to be thin was associated with teens’ higher food reward (p<.05). Observed parent communication related to teens’ eating concern (p<.01), whereas teen problem-solving related to global disordered eating, shape, and weight concern (ps<.05). Dyadic mutuality inversely related to HOMAIR (p<.05).

Conclusions

Observed communication during food-related conflict corresponds to parent-reported pressure in feeding. Parent-teen communication also related to teens’ food reward sensitivity, disordered eating, and insulin resistance. Dyadic food conflict in teens at-risk for adult obesity may provide a nuanced understanding of potentially modifiable parent-teen communication qualities to facilitate eating and metabolic health. Longitudinal follow-up with a larger sample is needed.