NEW YORK - Fathers are important influences on their daughters' perceptions of their weight and shape during childhood, and can increase their risk of developing an eating disorder in adolescence, research shows.

"Fathers have been mostly ignored in previous research on eating disorders," Dr. W. Stewart Agras, who led the research, told Reuters Health. Based on his findings, Agras said fathers "should avoid criticizing their daughter's weight or shape. Rather they should build up their daughter's confidence by emphasizing other positive attributes."

Weight concerns and preoccupation with being thin, together with social pressure to be thin, are strong risk factors for eating disorders in later adolescence. In an effort to throw light on what factors during childhood contribute to weight concerns and thin body preoccupation, Agras and colleagues from Stanford University in California followed 134 children (68 girls and 66 boys) from birth to age 11 and their parents.

Annual questionnaires beginning at age 2 assessed parents' concerns about their children's weight and eating habits as well as their own weight.

The results show, Agras said, that "fathers are important in influencing their daughters toward bulimia, particularly fathers who were overweight and wanted to be thinner." These influences may be direct - such as criticizing the daughter's weight or shape - or indirect, by expressing their own concerns about weight and shape.

"Parents who exhibit concern or criticism about their daughter's weight and shape and who push their daughter toward dieting may increase the risk of their daughter developing bulimia," added Agras.

'Influences occur before adolescence'
The study also found that parental behaviors such as over-control of what their child eats, together with parent and peer pressure to be thin, also raises the risk of eating disorders.

Importantly, this study shows that "all these influences occur before adolescence," Agras said.

"Concerns about weight and shape emerge as early as the third grade," he and his colleagues point out in Journal of the American Academy of Child and Adolescent Psychiatry. Therefore, it may be that prevention programs for eating disorders should begin early in childhood and perhaps should include education for the parents, they add.

Summing up, Agras said: "Children learn by observing their parents. Hence, weight control behaviors, such as dieting and expressed concerns about weight, should not form an important aspect of family life. It is more important to develop positive healthy family lifestyles."