1
|
Grilo CM, Pittman B. Exploring Dietary Restraint as a Mediator of Behavioral and Cognitive-Behavioral Treatments on Outcomes for Patients With Binge-Eating Disorder With Obesity. Int J Eat Disord 2024. [PMID: 39247962 DOI: 10.1002/eat.24288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE To explore dietary-restraint as a mediator of binge eating and weight-loss outcomes within a randomized controlled trial comparing cognitive-behavioral therapy (CBT) and behavioral weight loss (BWL) for binge-eating disorder (BED) with obesity. METHODS Ninety participants were randomly assigned to CBT or BWL and assessed by evaluators blinded to conditions at pretreatment, throughout-, and post-treatment (6 months). Three dietary-restraint measures (Eating Disorder Examination-Questionnaire [EDE-Q]-Restraint, Three-Factor Flexible-Restraint and Rigid-Restraint) were administered at pretreatment and after 2 months of treatment. Regression models examined whether changes at 2-months in the restraint scales mediated the effects of treatment (CBT versus BWL) on binge eating and weight-loss outcomes at post-treatment. RESULTS CBT and BWL had similar binge-eating outcomes and similar changes in EDE-Q-restraint and flexible-restraint. BWL had greater 2-month increases in rigid-restraint and greater weight-loss at posttreatment than CBT, with results suggesting 2-month changes in rigid-restraint mediated the greater difference (>7 pounds) in weight-loss. The observed mediation effect of 2.92 suggests 39% of total treatment-effect on weight-loss was mediated through 2-month increases in rigid-restraint. DISCUSSION This secondary analysis within a trial comparing CBT and BWL for BED suggests early-change in rigid-restraint has a mediating effect of BWL on weight-loss. Findings indicate that BWL improves binge eating and challenge views that dietary-restraint might exacerbate binge eating in BED with obesity. Findings require confirmation using hypothesis-testing in future trials. TRIAL REGISTRATION Clinicaltrials.gov: NCT00537758 ("Treatment for Obesity and Binge Eating Disorder").
Collapse
Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
2
|
Tabiś K, Maćków M, Nowacki D, Poprawa R. Adapting the Dietary Fat and Free Sugar Short Questionnaire: A Comprehensive Polish Modification for Enhanced Precision in Nutritional Assessments. Nutrients 2024; 16:503. [PMID: 38398827 PMCID: PMC10892036 DOI: 10.3390/nu16040503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This study aimed to investigate whether The Dietary Fat and Free Sugar-Short Questionnaire (DFS) is a reliable and valid measure that can be used in Polish conditions. It involved 291 participants, aged 14 to 70 (M = 25.9, SD = 10.1), the majority of whom were women (75%). METHODS The questionnaire consisted of, among others, Polish DFS version, FFQ-6, TFEQ, and SCOFF. Test-retest reliability was established on the group of 26 students with a 2-week interval. Participants' percentage of energy intake from both free sugars and saturated fats based on FFQ was correlated with DFS total and subscales scores. To investigate convergent and divergent validity, DFS scores with TFEQ correlations were performed. Diagnostic validity was established based on difference analysis between groups with the risk of eating disorders and those without the risk of those based on SCOFF. RESULTS Test-retest reliability (rtr = 0.856) and internal consistency (α = 0.797) indicated excellent reliability. DFS correlated significantly with FFQ for both total scores (r = 0.82) and each subscale: sugar (0.79), fat (0.75), and fat-sugar (0.59). The correlations of DFS and TFEQ were statistically significant for cognitive restraint (r = 0.32) and uncontrolled eating (r = 0.19). There also have been found significant differences based on SCOFF regarding DFS. CONCLUSIONS The results suggest good reliability and validity of the Polish version of DFS.
Collapse
Affiliation(s)
- Katarzyna Tabiś
- Institute of Psychology, University of Wroclaw, 50-137 Wroclaw, Poland;
| | - Monika Maćków
- Department of Human Nutrition, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland; (M.M.); (D.N.)
| | - Dorian Nowacki
- Department of Human Nutrition, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland; (M.M.); (D.N.)
| | - Ryszard Poprawa
- Institute of Psychology, University of Wroclaw, 50-137 Wroclaw, Poland;
| |
Collapse
|
3
|
Dakin C, Beaulieu K, Hopkins M, Gibbons C, Finlayson G, Stubbs RJ. Do eating behavior traits predict energy intake and body mass index? A systematic review and meta-analysis. Obes Rev 2023; 24:e13515. [PMID: 36305739 PMCID: PMC10078190 DOI: 10.1111/obr.13515] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 12/27/2022]
Abstract
At present, it is unclear whether eating behavior traits (EBT) predict objectively measured short-term energy intake (EI) and longer-term energy balance as estimated by body mass index (BMI). This systematic review examined the impact of EBT on BMI and laboratory-based measures of EI in adults ( ≥ 18 years) in any BMI category, excluding self-report measures of EI. Articles were searched up until 28th October 2021 using MEDLINE, PsycINFO, EMBASE and Web of Science. Sixteen EBT were identified and the association between 10 EBT, EI and BMI were assessed using a random-effects meta-analysis. Other EBT outcomes were synthesized qualitatively. Risk of bias was assessed with the mixed methods appraisal tool. A total of 83 studies were included (mean BMI = 25.20 kg/m2 , mean age = 27 years and mean sample size = 70). Study quality was rated moderately high overall, with some concerns in sampling strategy and statistical analyses. Susceptibility to hunger (n = 6) and binge eating (n = 7) were the strongest predictors of EI. Disinhibition (n = 8) was the strongest predictor of BMI. Overall, EBT may be useful as phenotypic markers of susceptibility to overconsume or develop obesity (PROSPERO: CRD42021288694).
Collapse
Affiliation(s)
- Clarissa Dakin
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Hopkins
- School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R James Stubbs
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| |
Collapse
|
4
|
Mohorić T, Pokrajac-Bulian A, Anić P, Kukić M, Mohović P. Emotion regulation, perfectionism, and eating disorder symptoms in adolescents: the mediating role of cognitive eating patterns. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36406848 PMCID: PMC9644388 DOI: 10.1007/s12144-022-03824-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 11/10/2022]
Abstract
Poor emotion regulation, along with elevated perfectionism, is recognised as a risk factor for the development of eating disorder (ED) symptoms. Therefore, the aim of our study was to examine the relationship between emotion regulation difficulties and perfectionism with ED symptoms, while controlling for emotional eating, uncontrolled eating, and cognitive restraint as mediators. In total, 482 adolescents (246 girls and 236 boys; M = 15.00, SD = 0.31) participated in this study. Based on the participants' body height and weight measured by the medical team during their regular preventive health examinations, the body mass index (BMI) was calculated. Participants also answered the Difficulties in Emotion Regulation Scale, Multidimensional Perfectionism Scale, Three-Factor Eating Questionnaire, and Eating Disorder Examination Questionnaire. According to the results obtained, adolescent girls in our sample reported more difficulties in emotion regulation, more uncontrolled and emotional eating, and more ED symptoms. A significant direct effect was found for difficulties in emotion regulation and ED symptoms but not for perfectionism. In addition, only emotional eating and cognitive restraint (not uncontrolled eating) mediated the relationship between difficulties in emotion regulation and perfectionism and ED symptoms. The results suggest that difficulties in emotion regulation may be more important than perfectionism in explaining ED symptoms in a sample of healthy adolescents. When adolescents experience problems in emotion regulation in combination with emotional or uncontrolled eating, they might be at a higher risk of experiencing concerns about weight and a variety of other ED symptoms, and this should be considered when planning preventive interventions for adolescents.
Collapse
Affiliation(s)
- Tamara Mohorić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Alessandra Pokrajac-Bulian
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Petra Anić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Miljana Kukić
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| | - Patrizia Mohović
- Faculty of Humanities and Social Sciences, Department of Psychology, University of Rijeka, Sveučilišna avenija 4, 51 000 Rijeka, Croatia
| |
Collapse
|
5
|
Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review. Br J Nutr 2022; 128:1565-1586. [PMID: 34658329 DOI: 10.1017/s0007114521004219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.
Collapse
|
6
|
Foerde K, Schebendach JE, Davis L, Daw N, Walsh BT, Shohamy D, Steinglass JE. Restrictive eating across a spectrum from healthy to unhealthy: behavioral and neural mechanisms. Psychol Med 2022; 52:1755-1764. [PMID: 33046142 PMCID: PMC8449514 DOI: 10.1017/s0033291720003542] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Restriction of food intake is a central feature of anorexia nervosa (AN) and other eating disorders, yet also occurs in the absence of psychopathology. The neural mechanisms of restrictive eating in health and disease are unclear. METHODS This study examined behavioral and neural mechanisms associated with restrictive eating among individuals with and without eating disorders. Dietary restriction was examined in four groups of women (n = 110): healthy controls, dieting healthy controls, patients with subthreshold (non-low weight) AN, and patients with AN. A Food Choice Task was administered during fMRI scanning to examine neural activation associated with food choices, and a laboratory meal was conducted. RESULTS Behavioral findings distinguished between healthy and ill participants. Healthy individuals, both dieting and non-dieting, chose significantly more high-fat foods than patients with AN or subthreshold AN. Among healthy individuals, choice was primarily influenced by tastiness, whereas, among both patient groups, healthiness played a larger role. Dorsal striatal activation associated with choice was most pronounced among individuals with AN and was significantly associated with selecting fewer high-fat choices in the task and lower caloric intake in the meal the following day. CONCLUSIONS A continuous spectrum of behavior was suggested by the increasing amount of weight loss across groups. Yet, data from this Food Choice Task with fMRI suggest there is a behavioral distinction between illness and health, and that the neural mechanisms underlying food choice in AN are distinct. These behavioral and neural mechanisms of restrictive eating may be useful targets for treatment development.
Collapse
Affiliation(s)
- Karin Foerde
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Janet E. Schebendach
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Lauren Davis
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
| | - Nathaniel Daw
- Department of Psychology, Princeton Neuroscience Institute, Princeton University, Princeton, USA
| | - B. Timothy Walsh
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Daphna Shohamy
- Psychology Department and Zuckerman Mind Brain and Behavior Institute, Columbia University, New York, USA
| | - Joanna E. Steinglass
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| |
Collapse
|
7
|
Zsoldos I, Sinding C, Chambaron S. Using event-related potentials to study food-related cognition: An overview of methods and perspectives for future research. Brain Cogn 2022; 159:105864. [PMID: 35397314 DOI: 10.1016/j.bandc.2022.105864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/02/2022]
Abstract
Electroencephalography (EEG), and the measure of event-related potentials (ERPs) in particular, are useful methods to study the cognitive and cerebral mechanisms underlying the perception and processing of food cues. Further research on these aspects is necessary to better understand how cognitive functioning may influence food choices in different populations (e.g. obese individuals, individuals with eating disorders). To help researchers in designing future studies, this article provides an overview of the methods used in the current literature on ERPs and food-related cognition. Several methodological aspects are explored to outline interesting perspectives for future research, including discussions on the main experimental tasks used, the cognitive functions assessed (e.g. inhibitory control, attentional processing), the characteristics of the participants recruited (e.g. weight status, eating behaviors), and the stimuli selected (e.g. food pictures, odors). The issues generated by some of these methodological choices are discussed, and a few guidelines are provided.
Collapse
Affiliation(s)
- Isabella Zsoldos
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France.
| | - Charlotte Sinding
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Stéphanie Chambaron
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| |
Collapse
|
8
|
Aylward L, Lilly C, Tabone L, Szoka N, Abunnaja S, Cox S. Anxiety Predicts Reduced Weight Loss 30 Months after Bariatric Surgery. Surg Obes Relat Dis 2022; 18:919-927. [DOI: 10.1016/j.soard.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
|
9
|
Bottera AR, Kambanis PE, De Young KP. Persistence: A key factor in understanding the circumstances under which dietary restraint predicts restriction of caloric intake. Eat Behav 2021; 43:101563. [PMID: 34517278 DOI: 10.1016/j.eatbeh.2021.101563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 07/15/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Dietary restraint refers to the intention to restrict caloric intake, whereas dietary restriction refers to the actual intentional and sustained restriction of caloric intake for weight-control purposes. Findings regarding the relation between dietary restraint and restriction to date are inconsistent. Our study sought to clarify this complex relationship using a novel laboratory task. Participants (N = 103; 56.3% female) completed a Paced Visual Serial Addition Task (PVSAT). Participants were provided a choice between ending each of eight PVSAT rounds at any time and drinking a high-calorie Kool-Aid® mixture or correctly completing 10 consecutive computations to access to a zero-calorie mixture for each round. We measured participants' dietary restraint using the Three-Factor Eating Questionnaire - Restraint Subscale and measured persistence and dietary restriction using the PVSAT. Results indicated a positive association between persistence and restriction. Female participants demonstrated higher eating disorder psychopathology, dietary restraint, and dietary restriction compared to male participants. Restraint was positively associated with restriction the more individuals persisted, indicating that persistence is a potentially important modifier of the relation between dietary restraint and restriction. Our findings highlight the complexity of the relation between dietary restraint and restriction; that is, measures of dietary restraint alone may not reliably predict short-term dietary restriction during laboratory consumption tasks; however, other factors, such as persistence, may play critical roles.
Collapse
Affiliation(s)
| | | | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, WY, USA
| |
Collapse
|
10
|
Sommer LM, Halbeisen G, Erim Y, Paslakis G. Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder. Nutrients 2021; 13:3813. [PMID: 34836069 PMCID: PMC8625654 DOI: 10.3390/nu13113813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.
Collapse
Affiliation(s)
- Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| |
Collapse
|
11
|
Tang C, Cooper M, Wang S, Song J, He J. The relationship between body weight and dietary restraint is explained by body dissatisfaction and body image inflexibility among young adults in China. Eat Weight Disord 2021; 26:1863-1870. [PMID: 33034869 DOI: 10.1007/s40519-020-01032-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/24/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Eating disorders and obesity are commonly recognized as key public health concerns worldwide. Although rates of obesity and disordered eating have traditionally been lower in China than Western countries, these rates are on the rise. As such, interest is growing in identifying mechanisms that may address these conditions. While associations between body weight and dissatisfaction are well established, burgeoning research aims to examine how these factors are related to dietary restraint and body image inflexibility. This study aimed to explore the possible mediation effect of body dissatisfaction and body image inflexibility between body weight (body mass index) and dietary restraint. Furthermore, we explored how these relationships differed across men and women. METHODS A sample of 1068 young adults (563 females and 505 males) in China participated in the study. Participants completed the Eating Disorder Inventory and Three-Factor Eating Questionnaire as well as the Body Image-Acceptance and Action Questionnaire. RESULTS Results showed that: (1) body dissatisfaction and body image inflexibility fully mediated the relationship between body mass index and dietary restraint; (2) this model fit both genders, although differences were found in the regression coefficients between the mediation model for men and women. CONCLUSION These findings support body image dissatisfaction and inflexibility as mediators of the relationship between body weight and dietary restraint, highlighting these as potential mechanisms for treatment. LEVEL OF EVIDENCE Level III, case-control analytic study.
Collapse
Affiliation(s)
- Chanyuan Tang
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Marita Cooper
- Eating Disorders Program, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, US
| | - Saihai Wang
- College of Economics and Management, Northeast Forestry University, Harbin, China
| | - Jianwen Song
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, China.
| |
Collapse
|
12
|
Yong C, Liu H, Yang Q, Luo J, Ouyang Y, Sun M, Xi Y, Xiang C, Lin Q. The Relationship between Restrained Eating, Body Image, and Dietary Intake among University Students in China: A Cross-Sectional Study. Nutrients 2021; 13:nu13030990. [PMID: 33808609 PMCID: PMC8003413 DOI: 10.3390/nu13030990] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/22/2022] Open
Abstract
This study aims to explore the association between restrained eating, body image, and dietary intake among Chinese college students. This cross-sectional study included 1301 college students at two universities in Hunan Province. Electronic questionnaires were used to collect information including students’ demographic characteristics, restrained eating, perception of body weight, body satisfaction, and dietary intake. Anthropometric measurements were collected to calculate body mass index (BMI). The prevalence of high restrained eating was 52.8%. Students who were dissatisfied with their bodies or overestimated their body weight showed a higher tendency toward high restrained eating (p < 0.05). Students with high restrained eating tended to eat fruits and eggs more frequently, while the frequency of eating domestic animals and poultry, sugar-sweetened beverages, and fast food were the opposite. Moreover, high restrained eating was a risk factor for low dietary diversity (odds ratio (OR) = 1.384, 95% confidence interval: 1.002~1.912). The high incidence of restrained eating among Chinese college students and its energy-restricted diets that may lead to possible health implications require attention. Further studies are needed to investigate the characteristics of college students’ restrained eating to tailor appropriate interventions for forming positive body images and promoting healthy eating behaviors, thus, improving dietary quality.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Qian Lin
- Correspondence: ; Tel.: +86-1387-482-0173
| |
Collapse
|
13
|
Barragán R, Zuraikat FM, Tam V, Scaccia S, Cochran J, Li S, Cheng B, St-Onge MP. Actigraphy-Derived Sleep Is Associated with Eating Behavior Characteristics. Nutrients 2021; 13:nu13030852. [PMID: 33807690 PMCID: PMC8001707 DOI: 10.3390/nu13030852] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
Poor sleep is a determinant of obesity, with overconsumption of energy contributing to this relationship. Eating behavior characteristics are predictive of energy intake and weight change and may underlie observed associations of sleep with weight status and obesity risk factors. However, relationships between sleep and dimensions of eating behavior, as well as possible individual differences in these relations, are not well characterized. Therefore, the aim of this study was to evaluate whether sleep behaviors, including duration, timing, quality, and regularity relate to dietary restraint, disinhibition, and tendency towards hunger and to explore whether these associations differ by sex. This cross-sectional study included 179 adults aged 20–73 years (68.7% women, 64.8% with BMI ≥ 25 kg/m2). Sleep was evaluated by accelerometry over 2 weeks. Eating behavior dimensions were measured with the Three-Factor Eating Questionnaire. Prolonged wake after sleep onset (WASO) (0.029 ± 0.011, p = 0.007), greater sleep fragmentation index (0.074 ± 0.036, p = 0.041), and lower sleep efficiency (−0.133 ± 0.051, p = 0.010) were associated with higher dietary restraint. However, higher restraint attenuated associations of higher WASO and sleep fragmentation with higher BMI (p-interactions < 0.10). In terms of individual differences, sex influenced associations of sleep quality measures with tendency towards hunger (p-interactions < 0.10). Stratified analyses showed that, in men only, higher sleep fragmentation index, longer sleep onset latency, and lower sleep efficiency were associated with greater tendency towards hunger (β = 0.115 ± 0.037, p = 0.003, β = 0.169 ± 0.072, p = 0.023, β = −0.150 ± 0.055, p = 0.009, respectively). Results of this analysis suggest that the association of poor sleep on food intake could be exacerbated in those with eating behavior traits that predispose to overeating, and this sleep-eating behavior relation may be sex-dependent. Strategies to counter overconsumption in the context of poor quality sleep should be evaluated in light of eating behavior traits.
Collapse
Affiliation(s)
- Rocío Barragán
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; (R.B.); (F.M.Z.); (S.S.); (J.C.)
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Faris M. Zuraikat
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; (R.B.); (F.M.Z.); (S.S.); (J.C.)
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Victoria Tam
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Samantha Scaccia
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; (R.B.); (F.M.Z.); (S.S.); (J.C.)
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Justin Cochran
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; (R.B.); (F.M.Z.); (S.S.); (J.C.)
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Si Li
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (S.L.); (B.C.)
| | - Bin Cheng
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA; (S.L.); (B.C.)
| | - Marie-Pierre St-Onge
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; (R.B.); (F.M.Z.); (S.S.); (J.C.)
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Correspondence: ; Tel.: +1-212-342-5607
| |
Collapse
|
14
|
Psychometric characteristics of the Three-Factor Eating Questionnaire-18 and eating behavior in undergraduate students. Eat Weight Disord 2021; 26:525-536. [PMID: 32166658 DOI: 10.1007/s40519-020-00885-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/28/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To assess the psychometric characteristics of the Three-Factor Eating Questionnaire-18 (TFEQ-18) and to estimate the prevalence of cognitive restraint (CRes), uncontrolled eating (UE), and emotional eating (EE) among Brazilian undergraduate students. METHODS A total of 775 students completed TFEQ-18 (62.1% females; total mean age = 20.9 years [SD = 2.8]; females mean age: 20.8 years [SD = 2.8]; males mean age: 21.2 years [SD = 2.7]). Total sample was randomly separated in test/validation samples. An assessment of psychometric characteristics was conducted to each subsample with confirmatory factor analysis considering the indices: chi-square per degree of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA). The mean score of each TFEQ-18 factor was estimated. The prevalence of CRes, UE, and EE was calculated with 95% confidence intervals (95%CI) and compared by sex and weight status. RESULTS The psychometric characteristics of the TFEQ-18 were adequate in both samples (test/validation: χ2/df = 3.58/2.86; CFI = 0.938/0.958; TLI = 0.928/0.951; RMSEA = 0.081/0.069). The prevalence of students with moderate to exacerbated scores of CRes, UE, and EE was 34.4% (95%CI 31.1-37.7%), 35.6% (95%CI 32.2-39.0%), and 43.1% (95%CI 39.6-46.6%), respectively. There were no statistically significant differences in prevalence according to sex or weight status. CONCLUSIONS The TFEQ-18 presented adequate psychometric characteristics and indicated a high prevalence of CRes, UE, and EE among the students. This research emphasizes the importance of investigating aspects of eating behavior to best direct clinical and educational strategies for reducing the risk of adopting unhealthy eating behaviors among undergraduate students. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
|
15
|
Compensatory health beliefs and unhealthy snack consumption in daily life. Appetite 2020; 157:104996. [PMID: 33058952 DOI: 10.1016/j.appet.2020.104996] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/03/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
Compensatory health beliefs (CHBs) are beliefs that an unhealthy behavior (unhealthy eating) can be compensated for by engaging in a healthy behavior (physical activity). Previous research focused on CHBs as rather stable beliefs (trait). Some studies indicated that situation-specific CHBs (state) might be important in situations, in which people are confronted with an unhealthy snack. This study aims to investigate the association between CHBs and unhealthy snack consumption in daily life with a special focus on the distinction between trait and state CHBs. Overall, N = 45 participants (66.7% female; age: 18-45 years, M = 21.9) received a link to an online questionnaire five times daily for seven consecutive days (n = 1575 possible diary entries). They reported unhealthy snack consumption, state and trait CHBs concerning the compensation with subsequent eating behavior and physical activity. The results showed that trait and state CHBs were significantly positively related to unhealthy snack consumption in daily life. Different effects appeared for CHBs concerning the compensation with subsequent eating behavior compared to the compensation with physical activity. This study demonstrates that both, state and trait CHBs are important for unhealthy snack consumption in daily life. Findings emphasize the need for further daily diary approaches to understand the temporal sequence of state CHBs that could further explain the use of CHBs as a maladaptive strategy for unhealthy eating.
Collapse
|
16
|
Yen JY, Lin HC, Lin PC, Liu TL, Long CY, Ko CH. Leptin and ghrelin concentrations and eating behaviors during the early and late luteal phase in women with premenstrual dysphoric disorder. Psychoneuroendocrinology 2020; 118:104713. [PMID: 32460195 DOI: 10.1016/j.psyneuen.2020.104713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES In this study, we evaluated the changes in leptin and ghrelin concentrations, eating behavior, depression, and impulsivity and their correlations within the luteal phase among women with premenstrual dysphoric disorder (PMDD). METHODS In 63 women with PMDD and 53 healthy controls, we prospectively evaluated serum levels of leptin and ghrelin, Body Mass Index(BMI), and self-reported sweet cravings, cognitive restraint, uncontrolled eating, emotional eating, depression, and impulsivity during the early luteal (EL) and late luteal (LL) phases. RESULTS Compared with the controls, the women with PMDD had higher BMI, higher leptin concentrations in the EL and LL phase, and leptin concentrations increased from the EL to the LL phase. However, there is no significant difference in ghrelin. Women with PMDD increased sweet cravings and uncontrolled eating from EL to LL phase. No significant correlation was observed between the EL-LL changes in leptin or ghrelin concentrations and those in eating behaviors. Both depression and impulsivity correlated with sweet craving and uncontrolled eating. Depression mediated the association between PMDD and uncontrolled eating. The BMI of women with PMDD positively correlated with their EL-LL change in leptin, and LL depression levels and emotional eating. CONCLUSION Young women with PMDD had higher leptin concentrations and BMI in the luteal phase. The LL leptin level was not the primary factor responsible for the increased uncontrolled eating of PMDD. Whether the increased eating and depression in the LL phase contribute to the risk of obesity or hyperleptinemia among women with PMDD need to be evaluated in the future.
Collapse
Affiliation(s)
- Ju-Yu Yen
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Yu Long
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Substance Addiction and Behavior Addiction, Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
17
|
Knoll-Pientka N, Bühlmeier J, Peters T, Albrecht M, Adams F, Wustrau K, Teufel M, Hebebrand J, Föcker M, Libuda L. Risk factors for a low weight gain in the early stage of adolescent anorexia nervosa inpatient treatment: findings from a pilot study. Eat Weight Disord 2020; 25:911-919. [PMID: 31168729 DOI: 10.1007/s40519-019-00705-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/27/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Body weight restoration is a major treatment aim in juvenile inpatients with anorexia nervosa (AN) (i.e., 500-1000 g/week according to the German guidelines). Several studies suggest the early weight gain to be crucial for remission. The identification of patients at risk of a low early weight gain could enable an adequate adaptation of treatment. Thus, we aimed at detecting risk factors of a low weight gain during inpatient treatment. METHODS The presented work analyzes data from a pilot study in 30 female adolescent inpatients with AN (restricting subtype; age range at admission: 12.6-17.6 years). Premorbid characteristics, history of symptomatology, anthropometric data, and eating-disorder psychopathology were compared between those who gained at least an average of 500 g/week during the first 7 weeks of treatment (high weight gainers, HWG) and those who did not (low weight gainers, LWG). RESULTS At admission, LWG (n = 15) had a significantly higher BMI(-SDS) and scored significantly higher in the eating-disorder examination questionnaire (EDE-Q) than HWG (n = 15). A logistic regression analysis indicated both parameters to be independently associated with a low weight gain. CONCLUSION Higher EDE-Q scores seem to be a major risk factor for a low weight gain at the beginning of treatment. Moreover, a higher BMI(-SDS) at admission does not necessarily indicate a less severe AN symptomatic, as it was associated with a lower weight gain in our sample during the first 7 weeks of treatment. Reassessment of our results in larger studies is required to draw firm conclusions for clinical practice. LEVEL OF EVIDENCE Level V.
Collapse
Affiliation(s)
- Nadja Knoll-Pientka
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany. .,Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Judith Bühlmeier
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Muriel Albrecht
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Frederike Adams
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Katharina Wustrau
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Martin Teufel
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Lars Libuda
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|