Overprotective Parents May Contribute to Child’s Anorexia Nervosa

It’s long been suspected that overprotective parents may play a role in the development of anorexia nervosa, but this has been very difficult to prove. Now, results of a controlled study suggest that overprotective parenting in early childhood is associated with development of anorexia nervosa (Br J Psychiatry 2000;176:132). Such high-concern parenting may be linked to unresolved grief.

After evaluating 40 consecutive adolescent girls referred with anorexia nervosa and matched controls, Drs. Philip Shoebridge and Simon G. Gowers found that mothers of anorectic teens had distinct characteristics. First, they rarely allowed others to care for their infants and children. They felt severe distress when they were separated from their children, and had high anxiety levels when they first allowed their daughters to spend a night away from home. Their daughters were also older than controls when they first stayed overnight with friends.

Earlier obstetric losses

Another component that distinguished families with anorectic daughters was a severe obstetric loss before their daughter’s birth. In fact, 9 of the 10 daughters in the subgroup of severe obstetric loss were the next-born child after their parents had lost a child.

Five of the index patients and 8 control patients reported having a previous first-trimester miscarriage. Fifteen percent (6/40) of the index mothers had a perinatal or infant death prior to the birth of their child with anorexia nervosa, compared with 2.5% (1/40) of their matched normal controls.

The authors suggest that sympathetic questions about parental experiences that might have led to early and heightened concern about the next child should be included in the routine clinical assessment. Also, by explicitly acknowledging the early effects of these factors, clinicians may help families recognize and move away from excessive overprotection of their child.