Decreasing food fussiness in children with obesity leads to greater weight loss in family-based treatment.
Food fussiness (FF), or the frequent rejection of both familiar and unfamiliar foods, is common among children and, given its link to poor diet quality, may contribute to the onset and/or maintenance of childhood obesity. This study examined child FF in association with anthropometric variables and diet in children with overweight/obesity participating in family-based behavioral weight loss treatment (FBT). Change in FF was assessed in relation to FBT outcome, including whether change in diet quality mediated the relation between change in FF and change in child weight.



Child (N = 170; age = 9.41 ± 1.23) height and weight were measured, and parents completed FF questionnaires and three 24-h recalls of child diet at baseline and post-treatment. Healthy Eating Index-2005 scores were calculated.



At baseline, child FF was related to lower vegetable intake. Average child FF decreased from start to end of FBT. Greater decreases in FF were associated with greater reductions in child body mass index and improved overall diet quality. Overall, diet quality change through FBT mediated the relation between child FF change and child body mass index change.



Children with high FF can benefit from FBT, and addressing FF may be important in childhood obesity treatment to maximize weight outcomes.
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA. hayesj@psychiatry.wustl.edu.
Jacqueline F
JF
Hayes
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
Myra
M
Altman
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Rachel P
RP
Kolko
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
Katherine N
KN
Balantekin
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
Jodi Cahill
JC
Holland
Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Richard I
RI
Stein
Seattle Children's Research Institute, Seattle, Washington, USA.
Brian E
BE
Saelens
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
R Robinson
RR
Welch
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA.
Michael G
MG
Perri
Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, USA.
Kenneth B
KB
Schechtman
Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Leonard H
LH
Epstein
Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
Denise E
DE
Wilfley
D001521:Behavior Therapy; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002648:Child; D004032:Diet; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005502:Food; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D008297:Male; D010290:Parents; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D015431:Weight Loss / Q000502:physiology*