Search Results (189)

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Background/Objectives: Feeding difficulties in childhood can persist over time, affecting health and family dynamics. Timely identification is crucial to prevent atypical eating behaviors and nutrition-related consequences. However, data on childhood feeding difficulties remain limited. This study provides the first pilot characterization of eating behaviors among Italian children aged 5–11 years in order to characterize feeding difficulties, identify protective or detrimental factors, and assess relationships with anthropometric indices or blood pressure. Methods: In 2023, a 1-year cross-sectional pilot study was launched by the Società Italiana delle Cure Primarie Pediatriche involving child–parent dyads. Family pediatricians collected anthropometric data and blood pressure, after which parents completed an online questionnaire purposely developed for this study. The questionnaire generated a feeding difficulty score (0–10) where higher values reflected greater risk of atypical eating behaviors. Scores were categorized as follows: low risk (0–1), intermediate risk (2–6), and high risk (7–10). Results: A total of 742 questionnaires were collected. Overall, 19.8% of the children were categorized as high risk (7–10) for atypical behavior, 43.8% as intermediate risk (2–6), and 36.4% as low risk (0–1). Children with two omnivorous parents showed significantly lower odds of feeding difficulty scores at or above any threshold (OR 0.46, 95% CI 0.30–0.71; p < 0.0001). Borderline associations were observed for a breastfeeding duration of at least 9 months (OR 0.79, 95% CI 0.61–1.02; p = 0.075) and baby-led weaning (OR 0.72, 95% CI 0.52–1.00; p = 0.053). High-risk children had a significantly lower BMI percentile with respect to the other groups. Conclusions: A significant proportion of Italian children aged 5–11 years exhibited moderate to severe risk of atypical behaviors. Parental eating appears to play a key role in shaping children’s eating behaviors in middle childhood, underscoring the pivotal role of pediatricians in guiding families. Further research and targeted strategies are needed to prevent childhood feeding difficulties. Full article

Background: Childhood obesity is a persistent global health challenge, often rooted in early-life dietary patterns shaped within the home environment. Objective: To investigate the association between parents’ culinary skills, children’s eating behavior, and the degree of child involvement in family culinary practices. Methods: A cross-sectional, analytical study. In the public and private schools in southern Brazil. A total of 205 families with children aged 3 to 13 years participated. Parents or caregivers answered a structured questionnaire on culinary skills and sociodemographic variables. Children’s eating behavior was assessed through the validated Brazilian version of the Children’s Eating Behaviour Questionnaire (CEBQ). Student’s T test was used to compare means, and Pearson’s chi-square or Fisher’s exact test to compare proportions. Multivariate linear regression was applied to control for potential confounders. Analyses were conducted using SPSS version 27.0 and R software. Results: Most parents (90.7%) reported cooking regularly, and 65.9% involved children in cooking activities. The predominant culinary profile (40%) was classified as “convenience cooking,” marked by frequent use of processed ingredients. Healthier parental cooking practices were positively associated with adaptive eating behaviors in children, reflected by lower food fussiness, satiety responsiveness, food responsiveness and food refusal scores and higher enjoyment of food scores domains of the CEBQ. Conclusions: Despite the high prevalence of routine cooking, convenience-oriented practices remain dominant, reflecting broader sociocultural patterns. Engagement in healthier cooking practices was positively associated with more favorable eating behaviors in children. These findings underscore the importance of promoting culinary education and parental involvement in cooking as strategies to support healthy childhood eating behaviors. Full article

Mothers’ behavior strongly influences children’s eating habits, with family attitudes and feeding practices playing a key role in dietary development. In accordance with the previous literature, this study examined these aspects, including also mothers’ use of social media to stay informed about nutrition as an innovative element. The main goal was to validate the Italian version of the PSEPAD scale (Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children), which is a valid and reliable tool for assessing parental self-efficacy in encouraging healthy lifestyles in children, through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The sample was composed of 217 mothers. Results were interpreted through groups comparisons (chi-square, ANOVA, and t-test). The findings confirmed the central role of mothers in managing children’s diets and using strategies against picky eating behaviors. The study also highlighted the growing use of social media among mothers, especially younger ones, as a source of nutritional information, meal planning, and peer support, despite a generally low level of satisfaction with the content available on pediatric nutrition. Finally, the results showed a positive link between maternal self-efficacy and healthier child behaviors: mothers with higher self-esteem and confidence were more effective in promoting healthy habits. These findings underscore the importance of targeted interventions to strengthen maternal self-efficacy and the development of digital tools to support healthy family lifestyles. Full article

Background: Parents play a central role in shaping children’s eating behaviors. While previous research has documented associations between parental attitudes and feeding practices, fewer studies have examined how mothers’ own eating styles may contribute to their perceptions of their children’s eating attitudes and behaviors and how these may influence subsequent feeding practices. Objectives: To our knowledge, this is the first study to examine whether mothers’ eating styles predicted their self-reported restrictive feeding practices indirectly through their perceptions of their children’s appetite and subsequently through their concern about their children’s weight. Methods: A total of 488 mothers (M_age = 33.87 years, SD = 4.81, range = 20–49) of children aged 2–7 years (M_age = 3.85 years, SD = 1.33) completed self-report measures, including the Dutch Eating Behavior Questionnaire (DEBQ) for maternal eating styles, the Child Feeding Questionnaire (CFQ) for parental concerns and restrictive practices, and the Children’s Eating Behavior Questionnaire (CEBQ) for perceptions of child eating attitudes. Structural equation modeling (SEM) was employed to test the hypothesized mediation model, with model fit evaluated using CFI, TLI, RMSEA, and SRMR indices. Results: Our proposed model demonstrated good fit (CFI = 0.94, RMSEA = 0.07) and showed that maternal eating styles were positively associated with perceived child appetite (β = 0.44, p < 0.001). Perceived appetite predicted both maternal concern about child weight (β = 0.39, p < 0.001) and restrictive feeding practices (β = 0.28, p < 0.001), while maternal concern strongly predicted restriction (β = 0.65, p < 0.001). The total indirect effect from maternal eating styles to restriction was significant (β = 0.23, p < 0.001), and the model explained 56% of the variance in restrictive feeding. Conclusions: Our findings suggest that maternal eating styles may bias mothers’ perceptions of their children’s appetite and indirectly influence restrictive feeding practices primarily through increased concern about child weight. Given the cross-sectional design, reliance on maternal self-report, and online convenience sampling, results should be interpreted cautiously. Nonetheless, the study provides the first evidence for a sequential pathway linking maternal eating styles, child appetite perceptions, and weight concern to restrictive feeding, highlighting cognitive and perceptual processes as intervention targets. Full article

Background: Childhood obesity is a global issue, influenced by energy-dense foods and powerful cues that affect brain areas regulating food intake. The olfactory system, linked to food preferences and consumption, is inversely related to body mass index. However, no studies have assessed the possible effect of eating behavior traits on the relationship between olfactory capacity and obesity. Objectives: The aim of this study was to examine whether olfactory capacity, eating behavior traits, and body mass index are associated with obesity in adolescents. Methods: An analysis of 204 Chilean adolescents was undertaken in a cross-sectional study. The proportion of participants with normal weight was found to be 39.2%, that of overweight was 25.9%, and that of obesity was 34.8%. Anthropometric measurements (weight, height, BMI Z-score), eating behavior, and olfactory capacity were evaluated. The Child Eating Behavior Questionnaire (CEBQ) and Food Reinforcement Value Questionnaire (FRVQ) were used to assess eating behavior. The Sniffing sticks test was used to assess olfactory capacity. Results: In the global sample, 1.0% had anosmia, 20.5% had hyposmia, 61.0% had normosmia, and 17.5% were supersmellers. Girls showed higher odor identification percentages than boys (p = 0.01). No gender differences were found in olfactory threshold, discrimination, identification, or TDI (threshold–discrimination–identification) scores, nor nutritional status. Stratified analysis revealed that girls with obesity had significantly lower odor discrimination capacity compared to those with normal weight. Conclusions: the study highlights a potential link between olfactory function and obesity, with obese girls showing reduced odor discrimination compared to normal-weight girls. Further research is needed to explore these mechanisms and their implications for targeted obesity interventions. Full article

Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative review is based on literature searches conducted in April 2025 across PubMed, Web of Science, Embase, Medline, and Google Scholar. Articles published between 2015 and 2025 were included if they addressed the epidemiology, etiology, assessment, or management of PE in children aged 0–18 years. Additional seminal references predating this period were also considered. Results: Prevalence estimates of PE vary widely (13–50%), with peak incidence between ages two and six. Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, environmental influences, and adverse feeding experiences. Distinction from avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) is essential, as these conditions carry greater risk of nutritional and psychosocial impairment. Assessment relies on caregiver-report instruments, clinical observation, growth monitoring, and targeted nutritional evaluation. Effective management integrates parental education, responsive feeding strategies, repeated exposure to novel foods, and, when indicated, nutritional supplementation or referral to multidisciplinary teams. Sensory-based therapies, behavioral interventions, and psychoeducational programs show particular benefit in persistent cases. Conclusions: While most children outgrow PE without adverse outcomes, a subset remains at risk of long-term nutritional compromise and psychosocial difficulties. Early recognition, family-centered guidance, and evidence-based interventions are essential. Future research should refine diagnostic criteria, develop culturally sensitive assessment tools, and evaluate innovative therapies to improve outcomes. Full article

Background: Children with autism spectrum disorder (ASD) frequently experience eating-related behavioral difficulties; however, the relationships among these difficulties, core ASD deficits, and executive function remain poorly understood. The present study examined how core ASD characteristics—restrictive and repetitive behaviors (RRBs) and social impairments—relate to eating behaviors, including food approach and avoidance tendencies. In addition, the study explored whether executive function serves as a mediating mechanism underlying these associations. Methods: A total of 184 children aged 3–12 years participated in this cross-sectional study. All variables were measured using parent-reported questionnaires, and data were analyzed through path modeling. The Social Responsiveness Scale–Second Edition (SRS-2) and the Repetitive Behavior Scale–Revised (RBS-R) were employed to assess social impairments and RRBs, respectively. Eating behaviors—comprising food approach and food avoidance dimensions—were evaluated with the Children’s Eating Behavior Questionnaire (CEBQ), while executive function was measured using the Child Executive Functioning Inventory (CHEXI). Results: The analysis revealed significant associations between RRBs and both food approach and food avoidance behaviors in children with ASD. Crucially, follow-up regression analyses specifying RRBs subtypes showed that Stereotyped Behavior independently predicted both food approach (β = 0.305, p < 0.001) and avoidance (β = 0.217, p = 0.002), while Compulsive Behavior specifically predicted food avoidance (β = 0.173, p = 0.021). Furthermore, executive function appeared to serve as a potential mediator in these relationships, suggesting that impairments in executive control may partially explain how repetitive behaviors influence eating patterns. Although social impairments showed weaker direct associations with eating behaviors, they indirectly affected both food approach and avoidance behaviors through deficits in executive function, highlighting the complex interplay among behavioral, cognitive, and social domains in ASD. Conclusions: These findings indicate that RRBs—one of the core characteristics of ASD—can predict children’s eating behaviors and are concurrently linked to two seemingly opposite eating patterns. Both social impairments and RRBs appear to influence eating behaviors through executive dysfunction. This study provides new insights into the mechanisms underlying atypical eating behaviors in children with ASD and identifies executive function as a promising target for interventions aimed at improving eating-related outcomes in this population. Full article

Background: Picky eating behaviors among children challenge nutritional intake and healthy development and place considerable stress on parents. Parenting approaches play a critical role in shaping young children’s dietary behaviors. Mindful parenting, which refers to parents responding to their child’s needs with awareness, acceptance, attention, and mindful discipline, has gained increasing attention. Parental dietary competence may determine whether mindful parenting effectively discourages picky eating behavior in children. Objectives: This study explored whether mindful parenting and parental dietary competence are associated with picky eating behaviors in young children. The mediating role of parental dietary competence in this association was also investigated. Methods: A total of 412 parents of children enrolled in six preschools across six administrative districts in New Taipei City, Taipei City, and Taoyuan City, Taiwan, were invited and recruited. Data were collected using three validated parent-reported instruments, including a mindful parenting scale, parental dietary competence scale, and children’s picky eating behaviors scale. Results: Mindful parenting influenced children’s picky eating behaviors through the full mediation of parental dietary competence. The identification of parental dietary competence as a mediator underscores the need for early preventive interventions and parenting education that integrate parental mindfulness and dietary competence to foster healthy eating habits from the outset of early childhood. Conclusions: Practical recommendations and future research directions are provided regarding mindful parenting, parental dietary competence, and picky eating behaviors in young children. Full article

Background/Objectives: Eating disorders (EDs) often affect fertility, yet many women with ED still become mothers. The pattern of ED symptoms during pregnancy and postpartum, along with their effects on maternal and child health, is not yet fully understood. This longitudinal study aimed to (1) examine the course of ED symptoms from conception to postpartum, (2) evaluate pregnancy outcomes and children’s health and developmental milestones, and (3) assess ED status approximately four years after the initial evaluation. Methods: Thirty women with a prior ED diagnosis (21 with anorexia nervosa, 9 with bulimia nervosa) were evaluated at two time points. Time 1 with the Eating Disorders Examination and the Oxford Risk Factors for Eating Disorders: Interview Schedule; Time 2, approximately four years later, with the Eating Disorders Examination and the Clinical Interview on Reproductive History and Eating Behavior that also included clinical data related to mother’s health and baby’s health and development accessed through the Pregnant Women’s Health Bulletin and the Child and Youth Health Bulletin using the national health records. Results: ED symptoms (dietary restriction, self-induced vomiting, laxative misuse) persisted from conception through postpartum. BN participants reported more severe symptoms and higher rates of pregnancy complications (hyperemesis gravidarum, gestational diabetes, preeclampsia), while premature births occurred only in AN participants. Children of mothers with AN more frequently showed delays in developmental milestones (sitting, walking, speaking, sphincter control) compared to those of BN mothers. Conclusions: A substantial proportion of women with prior ED continued to experience symptoms during and after pregnancy, and nearly half still met diagnostic criteria four years later and are still in treatment. Cognitive features such as body dissatisfaction persisted despite partial symptom remission. These findings highlight the chronicity of ED and underscore the need for systematic screening, psychological support, and interdisciplinary follow-up during pregnancy and early motherhood. Full article

Background/Objectives: Parental weight stigma and bias can shape how parents talk about weight and health with their children, yet their interplay in Romania is unexplored. We examined how parents’ experienced stigma, internalized bias, and explicit antifat attitudes relate to weight- and health-focused conversations with 5–17-year-olds, and whether these links vary by child weight status. Methods: In a cross-sectional survey of 414 Romanian parents, we assessed stigma (teasing/unfair treatment), internalized bias (WBIS-M), antifat attitudes (AFA, UMBFAT), and frequency of health (healthy eating/PA) versus weight-focused talks and comments. BMI-derived child weight status was classified via WHO percentiles. Multivariate regressions and mediation analyses tested predictors and indirect effects. Results: Nearly 80% of parents discussed weight at least sometimes; higher child BMI percentile and parental internalized bias independently predicted more weight conversations (β = 0.44 and β = 0.25, both p < 0.001). Internalized bias mediated the effect of experienced stigma on weight talk (indirect effect = 0.105, 95% CI [0.047, 0.172]). Explicit antifat attitudes drove comments about others’ weight (β = 0.17, p = 0.002). Health-focused talks were unrelated to stigma or bias but were more frequent among parents with higher education, better self-rated health, and lower BMI. Conclusions: Parents’ internalized weight bias—shaped by stigma—fuels weight-focused conversations, especially when children have higher BMI, while antifat attitudes underlie negative comments about others. Interventions should reduce parental internalized bias and train supportive, health-centered communication to curb weight stigma transmission. Full article

Introduction: Children and adolescents with autism spectrum disorder (ASD) often present sleep and eating problems. However, the relationship between these two factors has seldom been studied. Objective: This paper aimed to examine the association between sleep disturbances and feeding problems in children and adolescents with ASD. Methods: This cross-sectional observational study assessed feeding behaviors using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and assessed sleep problems with the Sleep Disturbance Scale for Children (Bruni scale). Bivariate analyses and multivariate logistic and linear regression analyses were performed. Results: Sleep disturbances were significantly associated with autism severity (p = 0.003), but not with BPFAS subscale scores. Multivariate logistic regression indicated that sleep disturbances were independently associated with autism severity (p = 0.01; OR = 0.23; 95% CI: 0.06–0.77) and the BPFAS frequency subscale score (p = 0.01; OR = 1.04; 95% CI: 1.01–1.07). A secondary logistic regression identified five BPFAS items significantly associated with sleep disturbances: difficulty chewing (p = 0.02, OR = 0.12, 95% CI 0.02–0.74), voluntary attendance at meals (p = 0.01, OR = 0.60, 95% CI 0.39–0.90), tantrums during meals (p < 0.001; OR = 2.08, 95% CI 1.21–3.56), poor appetite (p < 0.001; OR = 2.63, 95% CI 1.43–4.82), and the caregiver’s perception that the child’s eating habits negatively affected their health (p = 0.03; OR = 1.53, 95% CI 1.03–2.40). No significant associations were found with age, sex, medical comorbidities, behavioral disorders or genetic factors. Conclusions: The findings suggest that greater autism severity and more pronounced feeding behaviors are independently associated with an increased risk of sleep disturbances in children and adolescents with ASD. Specific maladaptive mealtime behaviors, such as poor appetite, tantrums, and chewing difficulties, may serve as predictors of sleep problems, highlighting the need for integrated screening and early intervention strategies. Full article

Recent years have witnessed a concerning rise in early-onset eating disorders (EDs), prompting a re-evaluation of their etiology, diagnosis, and treatment within pediatric populations. This perspective article synthesizes emerging evidence on the multifactorial origins of EDs in children, emphasizing a biopsychosocial framework that integrates genetic, epigenetic, psychological, and environmental factors. While early manifestations often diverge from adolescent or adult profiles—marked by somatic complaints, selective eating, and ritualistic behaviors—the disorders significantly interfere with developmental milestones. The COVID-19 pandemic has further exacerbated vulnerabilities, acting as a catalyst for disordered eating behaviors through increased familial stress, isolation, and disrupted routines. Central to this framework is the role of parental psychopathology and parent–child feeding interactions, which profoundly shape children’s emotional regulation and attachment patterns. Recent studies also underscore genetic susceptibilities—especially variants in the DRD4 and DAT1 genes—and epigenetic modifications that may mediate the transmission of risk across generations. The article reviews evidence from observational and genomic studies, highlighting how altered gene expression linked to early environmental stress contributes to the heterogeneity of EDs. Finally, it evaluates prevention and intervention strategies, including family-based treatments, digital health tools, and school-based programs. These strategies are essential for timely detection, individualized care, and reducing long-term impairment. Overall, the paper advocates for a nuanced understanding of EDs in children—recognizing their complex origins and developmental implications—to inform clinical practice, public health policy, and future research in pediatric mental health. Full article

Background: Refractory epilepsy refers to a type of epilepsy in which anti-epileptic medications do not yield results, necessitating alternative medical interventions. The ketogenic diet (KD) is utilized as a non-pharmacologic treatment for refractory epilepsy. This study aims to assess details regarding caregivers’ awareness and practices, challenges faced, and other details regarding the KD as a treatment option for children with refractory epilepsy. Methods: A cross-sectional study included 15 caregivers of children with refractory epilepsy who adhere to the KD. Data were collected using an online, self-administered questionnaire including socio-demographic characteristics and descriptive aspects of KD on 15 caregivers. Results: Caregivers’ awareness scores varied, over half of the caregivers (53.3%) demonstrated low awareness levels, scoring below the midpoint on the awareness scale, while both caregivers’ adherence (t value = 31.5; p < 0.001) and patients’ adherence levels (t value = 26.1; p < 0.001) significantly exceeded the minimum expected thresholds, indicating effective implementation of the diet protocols. Challenges faced by caregivers were categorized as follow: logistical challenges (e.g., issues related to KD availability, cost, and weighing (15.6%)), behavioral challenges (e.g., avoiding prohibited foods (18.8%), feelings of hunger, the social environment, and never eating without caregivers), and medical challenges (e.g., frequent blood glucose monitoring (25%)). The most common side effects of the KD were gastrointestinal symptoms, including constipation (33.3%) and gastroesophageal reflux disease (GERD). Physical symptoms such as dyslipidemia were also reported by 13.3% of participants. In terms of neurological and behavioral improvements, the three most reduced symptoms following KD adoption were hyperactive attention deficit (25%), tremors (20%), and insomnia (20%). Conclusions: This study reveals a significant gap between high adherence and low awareness of the KD among caregivers of children with refractory epilepsy. While adherence is crucial for the success of KD, this discrepancy highlights the need for comprehensive caregiver education that not only focuses on practical implementation but also on the underlying rationale of the diet. This study underscores the importance of multidisciplinary support, by including dietitians, to bridge the knowledge gap. These findings suggest that dietary education programs should aim to improve caregivers’ understanding, ultimately enhancing adherence and long-term outcomes. Future research should explore the psychosocial factors influencing adherence and the role of trust in healthcare professionals in shaping caregiver behaviors. The findings also call for further exploration into the impact of caregiver education on child health outcomes in the long term. The varied knowledge among caregivers indicates a need for further educational interventions or increased visits from dietitians. Strategies need to be framed to overcome the challenges faced and improve adherence. Full article

Background/Objectives: Pseudohypoparathyroidism (PHP) is a group of genetic disorders characterized by end-organ resistance to multiple hormones, short stature, brachydactyly, subcutaneous ossifications, obesity, and developmental delays. The tissue specific imprinting of GNAS in the hypothalamus may lead to different eating behavior phenotypes in maternally inherited (PHP1A, PHP1B) vs. paternally inherited (PPHP) variants. In this exploratory study, we aimed to evaluate differences in eating behaviors in a cohort of patients with PHP1A, PPHP and PHP1B. Methods: Assessments included caregiver-reported measures (hyperphagia questionnaire, children’s eating behavior questionnaire, child feeding questionnaire) and self-reported measures (three factor eating behavior questionnaire). Results: A total of 58 patients with PHP1A, 13 patients with PPHP and 10 patients with PHP1B contributed data, along with 124 obese pediatric controls. An increased risk of obesity was found in PHP1A vs. PPHP (adult body mass index (BMI) 39.8 ± 8.7 vs. 30.2 ± 7.4 kg/m², p = 0.03). Parents reported significantly earlier onset of interest in food in children with PHP1A (2.0 ± 2.3 years) and PHP1B (1.1 ± 1.3 years) compared with controls (5.2 ± 3.2 years, p < 0.001). Measures of hyperphagia, satiety and other feeding behaviors were all similar to controls. The highest hyperphagia questionnaire scores were seen prior to adolescence. In a multi-year, longitudinal assessment of 11 pediatric patients with PHP1A, hyperphagia scores were stable and 25% showed an improvement in symptoms. Conclusion: Patients with PHP1A/1B may have hyperphagia symptoms from a young age but they do not worsen over time. Patients may overeat when allowed access to food, but do not usually have disruptive food seeking behaviors. Early diagnosis can give clinicians the opportunity to provide anticipatory diagnosis on the increased risk of obesity in PHP1A/1B and need for scheduled meals and controlled portions. Further studies with larger cohorts are needed to confirm these findings. Full article