Mothers With Eating Disorders Project Research Proposal

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" The Eating Disorder Inventory or the Eating Disorder Inventory for Children surveys were completed. Findings in this study report that the results "indicate that...before puberty there appear to be virtually no significant relationships between mothers' and daughters' eating attitudes and behaviors." (Sanftner, 1993) However, as the girls progressed through puberty "some relationships begin to emerge between mothers' weight preoccupation, dieting, and bulimic behaviors and their daughters' dieting and drive for thinness." (Sanftner, 1993) F

Following puberty, the daughters were found to be "somewhat more likely to exhibit interpersonal distrust and interoceptive awareness." (Sanftner, 1993) It is reported that "at first glance these results may seem to support the contention that mothers are an important determinant of eating-related problems in their daughters and that they should be indeed targeted in treatment. However, careful interpretation of these data suggests otherwise." (Sanftner, 1993) It is reported that it appears from the data that "mothers and daughters are using similar means in their attempts to manage challenges they are faced with as females in this culture -- challenges that become more salient as girls reach adolescence." (Sanftner, 1993) The results indicate that mothers have very little influence on the disordered eating behaviors of their daughters.

The work of Benninghoven, Tetsch, Kunzendorf, and Jantschek (2007) entitled: "Body Image in Patients with Eating Disorders and Their mothers and the role of family functioning" reports a study using a computer program that enabled modeling perceived and desired body images of mothers and daughters with eating disorders." (Benninghoven, Tetsch, Kunzendorf, and Jantschek, 2007) It is reported that patients and their mothers both estimated their own body images and that the mothers in the study "estimated the images they have of their daughters with eating disorders." (Benninghoven, Tetsch, Kunzendorf, and Jantschek, 2007)

Results of the study reported by Benninghoven, Tetsch, Kunzendorf, and Jantschek (2007) show that in patients with anorexia nervosa and in patients with bulimia "aspects of family functioning were associated with mothers' and daughters' perceptual body size distortion and dissatisfaction. Mothers' perception of family functioning predicted daughters' perceptual body sizes distortion and body dissatisfaction in the total sample of 49 patients." (Benninghoven, Tetsch, Kunzendorf, and Jantschek, 2007) The mothers' perception of family functioning i9mpacts the body dissatisfaction of patients which was predicted by the BMI of patients. Furthermore family functioning does appear to play a critical role in body image-related problems.

The work of Agras, Hammer, and McNicholas (1997) entitled: "A Prospective Study of the Influence of Eating-Disordered Mothers on Their Children" reports a study that examined the effects of "eating disordered mothers on their children." Agras, Hammer, and McNicholas state that eating disorders have a tendency to "aggregate in families. Part of this aggregation may be explained by genetic transmission. Although other factors appear important." (Agras, Hammer, and McNicholas, 1997) Additionally, it is stated that studies that investigated the family environment through use of questionnaire methods "have generally found that eating disordered individuals report their families to be less cohesive, less supportive and more conflicted than those of control groups." (Agras, Hammer, and McNicholas, 1997)

The study reported by Agras, Hammer, and McNicholas involved 216 newborns and their parents Questionnaires were collected annually concerning the aspects of the mother-child relationship. Stated as findings from this prospective study from birth to five years of age are that ED mothers and their offspring and most specifically their daughters "interact differently than NED mothers and their children in the areas of feeding, food uses and weight concerns. Two factors are stated to contribute to these differences: (1) the daughters of ED mothers appear to have a greater avidity for feeding early in development than the comparison groups; and (2) there is evidence that ED mothers behave differently toward their offspring in that they use food for purposes other than nutrition including for providing rewards, calming the child and in a feed schedule that is much less organized.

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(Agras, Hammer, and McNicholas, 1997)

The work of Hirokane, Tokumura, Kimura, and Saito (2005) entitled: "Influences of Mothers' dieting behaviors on Their Junior High School Daughters" reports a study that investigated "the influences of mothers' dieting behaviors on their junior high school daughters." The study reports assessing dieting behaviors and eating habits in 221 pairs of mothers and the junior high school daughters using questionnaires." Participants were classified into an extraordinary-diet (Ex-D) group, who attempted to diet gradually with health methods and non-diet (N-D) group using the questionnaire scores.

Findings in the study report: (1) A significant correlation was observed in the distribution of dieting behavior groups between the mothers and their daughters; (2) The scores for dieting behavior of the mothers whose daughters were classified into the Ex-D group were significantly higher in several question items compared with those of the mothers whose daughters were classified into the N-D group; (3) the scores for eating consciousness of the mothers whose daughters were classified in the Ex-D group were significantly lower for the item; and (4) the number of experiences of conversation with daughters about diet for the mothers whose daughter were in the Ex-D group was significantly higher than that for the mothers whose daughters were classified into the N-D group. (Hirokane, Tokumura, Kimura, and Saito, 2005)

The dieting behavior of mothers, as well as eating consciousness and the number of conversations that they had with their daughters concerning diet is demonstrated to have had an influence on the dieting behaviors in their junior high school daughters" indicating that proper education of mothers is needed for prevention of eating disorders in junior high daughters. (Hirokane, Tokumura, Kimura, and Saito, 2005)

Summary & Rationale

The majority of studies reviewed in this literature review have indicated that mothers with eating disorders do in fact project unhealthy eating habits on their daughters and in fact that family dysfunction is predicative of eating disorders in adolescent girls. The studies reviewed herein note that proper education of mothers with eating disorders relating to dieting behavior is necessary to reduce the negative influence of these mothers on their daughters.

Research Question(s)

Research questions at focus in this review of literature has included those of:

(1) Do mothers with eating disorders project unhealthy eating habits on their daughter? And

(2) Do mothers with eating disorders have daughters with eating disorders?

Theoretical Literature

The learning theory of anorexia holds that anorexia is a set of behaviors that the individual acquires from their environment through means of operant conditioning and social learning. Two predictions are characteristic of learning theory including: (1) eating disorders are more common where people receive exposure to images of people who are thin and that being thin connotes attractiveness; (2) eating disorder symptoms are more prevalent in places that individuals have the opportunity to learn more about these disorders of eating. (Sammons, nd, paraphrased)

Another theory of eating disorders is that of 'brain theory' of eating disorders. This theory is based upon findings that "the female brain responds different than a man's when exposed to certain words concerned with body image." (Sammons, nd)

The 'Unified Theory of the Nervous System and Behavior' reported in the work of Harris (2004) holds that "Anxiety disorders in childhood may be a prelude to eating disorders that often strike young women in their teens and 20s, according to a new study.

Researchers at the University of Pittsburgh found that two thirds of people with eating disorders had experienced some sort of clinical anxiety, such as social phobia, panic attacks or obsessive compulsive disorder, at some point in their lives......

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