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Updated: Jul 3, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Adiposity and 'eating in the absence of hunger' in children
C Hill1, C H Llewellyn, J Saxton
1Department of Epidemiology and Public Health, Cancer Research UK Health Behavior Research Centre, University College London, London, UK.
Insights
Eating in the absence of hunger (EAH) is linked to increased adiposity in boys, showing a graded association across weight categories. This behavior was less pronounced in girls, possibly due to social factors.
Area of Science:
- Pediatric Nutrition
- Behavioral Science
- Childhood Obesity Research
Background:
- Eating in the absence of hunger (EAH) is a complex behavior potentially influencing childhood adiposity.
- Understanding EAH's relationship with weight status is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate the association between eating in the absence of hunger (EAH) and adiposity in children.
- To explore potential sex differences in the EAH-adiposity relationship.
Main Methods:
- Two cross-sectional studies involving 348 children (aged 7-9) and 316 children (aged 9-12).
- EAH operationalized as intake of palatable snacks post-meal; adiposity assessed via BMI standard deviation scores.
- Children categorized into underweight, healthy weight, and overweight/obese groups.
Main Results:
- EAH demonstrated a significant positive association with adiposity in boys across all weight categories.
- No significant association was found between EAH and adiposity in girls.
- A quadratic trend in girls suggested EAH increased then decreased across weight ranges.
Conclusions:
- EAH is a behavioral phenotype associated with adiposity across the weight spectrum, particularly in boys.
- The weaker association in girls may be influenced by social desirability pressures affecting food intake.
- Findings highlight the need for sex-specific considerations in EAH research and interventions.
Objective:
To examine the association between eating in the absence of hunger (EAH) and adiposity in children.
Design:
Two cross-sectional studies in community settings.
Subjects:
For study 1, 348 children (178 girls and 170 boys) aged 7-9 years were recruited as part of the Physical Exercise and Appetite in Children Study. In study 2, participants were a subsample of children aged 9-12 years (N=316; 192 girls and 124 boys) from the Twins Early Development Study.
Measurements:
EAH was operationalized as intake of highly palatable sweet snacks after a mixed meal at school (study 1) or home (study 2). Weight (kg) and height (m) measurements were used to calculate the body mass index (BMI) s.d. scores. Children were grouped using the standard criteria for underweight, healthy weight, overweight and obesity. The healthy weight range was further subdivided into lower healthy weight (
Results:
In both studies, EAH showed a significant positive association with adiposity in boys after adjusting for covariates (P<0.001), with a linear increase in the intake across underweight, healthy weight and overweight groups. The association between EAH and adiposity was not significant in girls in either study, although in study 1, results showed a quadratic trend, with EAH increasing through the underweight and healthy weight ranges and decreasing in overweight and obese groups.
Conclusion:
EAH is a behavioural phenotype that is not specific to overweight children but instead shows a graded association with adiposity across the weight continuum, particularly in boys. In this study, the effect was less pronounced in girls, which may reflect social desirability pressures constraining food intake among heavier girls.
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