The standard advice for weight loss is to eat less and exercise more. Although a sound approach, this strategy appears to be falling short in the war against obesity, particularly among children. A recent study proposed a very different take on overweight prevention starting in early childhood. Instead of focusing on the body’s energy balance, the researchers suggest improving the mother-toddler relationship, often called attachment.

The researchers explored the effect of maternal-child bonding during the preschool years on the likelihood of obesity during adolescence. Their results were striking.

There are many factors that influence maternal/child attachment and maternal sensitivity, that are not under the mother’s control. The socio-economic environment, maternal mental and physical health, and the child’s temperament are all key players in the nature of the parent child interaction.

There were 977 participants in the study group. The researchers used standardized direct observation methods to evaluate the mother-child interactions at 15, 24, 36 months and to characterize the quality of the relationship. If the children were able to use their mothers as sources of comfort and support when faced with new challenges and be comforted by their mothers following stressful experiences, they were designated as having solid attachment.

When the participants reached adolescence their weight was evaluated. The researchers found that children who had the poorest quality mother-child relationships were 2.45 times as likely to be obese teens.

The researchers offer many explanations for their finding. They note that the behavioral strategies and neurophysiologic responses for dealing with stress develop in early childhood and are strongly influenced by early interactions with parents. Excess stress and poor development of positive coping strategies could lead to poorly regulated eating behaviors.

The researchers found that children who had the poorest quality mother-child relationships were 2.45 times as likely to be obese teens.

As the authors write in the study, “The areas of the brain that govern energy balance are also involved with stress response and emotion regulation, and extreme and/or sustained stress is associated with dysregulation of these areas of the brain. Animal studies have shown that stress preferentially increases consumption of highly palatable foods, and eating these foods acts to calm the stress perceiving areas of the brain.” Chronic stress may also affect the physiologic systems that regulate weight by increasing cortisol levels.

They researchers suggest that maternal sensitivity may help children learn to modulate their responses to stress, “they may be less likely to eat in response to emotional distress, and may have longer sleep duration which could also affect their risk for obesity.”

The researchers maintain that addressing the maternal/ child relationship is an unexplored strategy for overweight prevention. They note that the there are many factors that influence maternal/child attachment and maternal sensitivity, that are not under the mother’s control. The socio-economic environment, maternal mental and physical health, and the child’s temperament are all key players in the nature of the parent child interaction. Strategies to improve the maternal child bond must then encompass education and therapeutic intervention with parents and children as well as societal programs to decrease family stressors and improve family mental health. The researchers note that improving the maternal-child bond would have many benefits for emotional and physical well-being beyond healthy weight.