Obesity and Eating Disturbance: the Role of TFEQ Restraint and Disinhibition

A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI

The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.

Emotional Eating and Uncontrolled Eating as Risk Predictors for Disordered Eating Attitudes in Candidates for Bariatric Surgery Treated at a Public Hospital in the Amazon

This study analyzes the eating behavior and factors associated with the presence of disordered eating attitudes in patients undergoing bariatric surgery. It is a cross-sectional, descriptive, and analytical study conducted at a hospital in the Amazon region of Brazil. The Disordered Eating Attitude Scale reduced version (DEAS-s) was used to assess the risk of eating disorders and the Three-Factor Eating Questionnaire (TFEQ-R21) was used to characterize eating behavior. A total of 205 patients participated, with a mean age of 37.5 ± 8.6 years. The majority of participants were female (93.7%; p < 0.001), and the mean BMI was 45.3 ± 6.7 kg/m2. It was found that cognitive restraint had the highest mean (52.6 ± 19.9; p < 0.001). As for the DEAS-s, the question with the highest mean response was "spending one or more days without eating or consuming only liquids to lose weight" (2.80 ± 1.99). Female participants had a higher score for emotional eating (p = 0.016). Disordered eating attitudes showed a correlation with emotional eating and uncontrolled eating. These results suggest that candidates for bariatric surgery may have susceptibility to eating disorders. The importance of a multidisciplinary team conducting monitoring during the preoperative period is highlighted.

Parent-offspring similarity in hunger and thirst sensations

The internal (i.e., interoceptive) sensations that characterise hunger vary between people, and this may also be the case for thirst, although it has not been so well explored. There are probably both heritable and learning-based causes for this interoceptive variability. Consequently, it would seem plausible that parents and their offspring would have more similar patterns of hunger and thirst than pairs of strangers. We tested this idea, in addition to exploring its potential moderating variables, by studying the similarity of self-reported hunger and thirst sensations in 170 students and their primary caregivers from childhood. Both students and caregivers completed the same online-survey, covering hunger and thirst sensations, beliefs about the causes of hunger and thirst, the Three Factor Eating Questionnaire (revised) and demographic data. We find evidence of robust student-caregiver similarity in interoceptive hunger and thirst sensations (medium effect sizes), with these being moderated by caregiver beliefs about the homeostatic nature of each state (medium effect sizes). This suggests a potential role for caregivers in the development of their offspring's interoceptive cues for hunger and for thirst. In addition, thirst, like hunger, appears to be multidimensional, and varies between people. The implications of these findings are discussed.

Development of Momentary Appetite Capture (MAC): A versatile tool for monitoring appetite over long periods

Understanding how an intervention impacts appetite in real-life settings and over several days remains a challenging and under-explored research question. To this end, we developed Momentary Appetite Capture (MAC), a form of ecological momentary assessment that combines automated text messaging with an online platform. Participants report their appetite using visual analogue scales (hunger, desire to eat, and fullness) and a virtual portion-size selection task. In two separate studies, we assessed the feasibility and test-retest reliability of MAC. Participants were prompted every 2 hours over a 14-hour window, and they repeated this assessment over two consecutive weekdays. For each participant, we calculated a daily time-averaged area under the curve (AUC) for each appetite measure. In Study One (N = 25) time-averaged AUC was significantly positively correlated across test days for hunger (r = 0.563, p = .003), desire to eat (r = 0.515, p = .008) and prospective portion size (r = 0.914, p < .001), but not for fullness (r = 0.342, p = .094). Participants completed 95% of MACs (380 of 400), and we used participant feedback to improve the MAC tool and study protocol for Study Two. In Study Two (N = 31), 94% of MACs were completed (468 of 496). Across days, time-averaged AUC was significantly positively correlated for hunger (r = 0.595, p = < .001), fullness (r = 0.501, p = .004), desire to eat (r = 0.585, p < .001), and prospective portion size (r = 0.757, p < .001). Together, these studies suggest that MAC could be an acceptable and reliable tool to track appetite throughout the day. In the future, MAC could be used to explore the impact of weight-loss interventions on natural fluctuations in appetite.

The Tamil Version of the Three-Factor Eating Questionnaire-R18V2: Reliability and Factor Structure Among Persons with Schizophrenia

Background

Persons with schizophrenia (PwS) are vulnerable to developing disordered eating behaviors. However, standardized tools to assess disordered eating patterns are unavailable in the regional language, Tamil. Different versions of the Three-Factor Eating Questionnaire (TFEQ) have been used to measure disordered eating patterns among PwS worldwide. This study aimed to assess the factor structure and reliability of the Tamil version of TFEQ-R18V2 among Tamil-speaking PwS.

Methods

Over three months, 135 PwS, aged 18-65 years, who attended the outpatient department of a tertiary mental health service provider in Chennai, completed the Tamil version of TFEQ-R18V2. Thirty PwS completed the tool after two weeks to assess its test-retest reliability. The factor structure of the tool was explored using principal component analysis.

Results

The sample included 75 (55.6%) males and 60 (44.4%) females with a mean (±SD) age of 40.1 (±9.8) years and a mean duration of illness of 11.99 (± 8.72) years. Internal consistency and test-retest reliability of the Tamil version were 0.84 and 0.532, respectively. A five-factor structure emerged from the factor analysis, with 65.67% of the variance.

Conclusion

The Tamil version of TFEQ-R18V2 emerged as a reliable tool to assess disordered eating patterns among Tamil-speaking PwS.

Conventional weight loss therapy in morbid obesity during COVID-19 pandemic: degree of burdens at baseline and treatment efficacy

Introduction

COVID-19 affected global physical and psychological health. The purpose of this study was to explore the pandemics impact on health-related quality of life (HRQoL), mental health (anxiety, depression, and perceived stress) and eating behavior in people with severe obesity participating in a multimodal conservative behavioral weight loss (BWL) program conducted via videoconferencing. Additionally, the efficacy of the six-month BWL program in a virtual video-based setting during the pandemic was examined.

Methods

297 participants of a face-to-face multimodal behavioral weight loss program prior to the pandemic (PrePAN, May 2014-September 2019) and 146 participants of the in terms of content same intervention in a videoconference-based setting during the pandemic (PAN, July 2020-April 2022) were questioned and compared using standardized questionnaires for HRQoL, symptoms of depressive and anxiety disorders, perceived stress, and eating behavior at baseline and at the end of treatment.

Results

Symptoms for anxiety, depression and perceived stress were similar between PrePAN and PAN at baseline. In addition, PAN tended to show lower disinhibition of eating behavior and feelings of hunger than PrePAN. During the pandemic, the BWL intervention resulted in body weight loss (67%) or stabilization (16%) in most of the participants. It also contributed by improving physical HRQoL, lower worries, and improved eating behaviors compared to baseline.

Conclusion

During the COVID-19 pandemic, baseline mental health of people with morbid obesity was not worse than before the pandemic. Additionally, the BWL intervention in the virtual video-based setting stabilized and improved physical and mental health during the COVID-19 pandemic.

Fasting diets: what are the impacts on eating behaviors, sleep, mood, and well-being?

Fasting diets (FDs) have drawn great attention concerning their contribution to health and disease over the last decade. Despite considerable interest in FDs, the effect of fasting diets on eating behaviors, sleep, and mood-essential components of diet satisfaction and mental health- has not been addressed comprehensively. Understanding the critical role that fasting plays in these elements will open up potential treatment avenues that have not yet been explored. The aim of the present paper was to conduct a comprehensive critical review exploring the effects of fasting on eating behaviors, sleep, and mood. There is currently a lack of clarity regarding which fasting option yields the most advantageous effects, and there is also a scarcity of consistent trials that assess the effects of FDs in a comparable manner. Similarly, the effects and/or treatment options for utilizing FDs to modify eating and sleep behaviors and enhance mood are still poorly understood. Further researches aiming at understanding the impacts of various fasting regimes, providing new insights into the gut-brain axis and offering new treatment avenues for those with resistant anxiety and depression, are warranted. Alteration of eating behaviors can have lasting effects on various physiological parameters. The use of fasting cures can underpin ancient knowledge with scientific evidence to form a new approach to the prevention and treatment of problems associated with co-morbidities or challenges pertaining to eating behaviors. Therefore, a thorough examination of the various fasting regimens and how they impact disease patterns is also warranted.

Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences

Introduction

This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior.

Methods

The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview.

Results

After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts.

Discussion

The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.

Furthering development of the Eating Disorder Examination-Pregnancy Version (EDE-PV): Exploratory factor analysis and psychometric performance among a community sample of pregnant individuals with body mass index ≥ 25

Psychometrically sound measures of disordered eating during pregnancy are needed, particularly for pregnant individuals with body mass index (BMI) ≥ 25, who are at high risk for disordered eating attitudes/behaviors. We previously adapted the Eating Disorder Examination (EDE) for use among pregnant individuals with BMI ≥ 25. This study examined the factor structure of the EDE-Pregnancy Version (EDE-PV) in a community sample of pregnant individuals with BMI ≥ 25. The EDE-PV was administered to 257 pregnant individuals with pre-pregnancy BMI ≥ 25 between 12 and 20 weeks gestation. The EDE-PV factor structure was determined using an exploratory factor analysis with oblique geomin rotation, internal consistency coefficients were calculated, and convergent and discriminant validity of the EDE-PV factors were assessed. An 11-item, two-factor solution produced an acceptable model fit. The subscales did not replicate those of the EDE and were interpreted as Pregnancy Eating and Weight Change Concerns and Pregnancy Shape and Weight Concerns (αs=.67 and .85; ωs=.70 and .85, respectively). These subscales showed small-to-moderate, positive correlations with weight and psychosocial distress measures and differentiated between participants with and without lifetime histories of any eating disorder diagnosis, demonstrating adequate convergent and discriminant validity. The results indicate that the EDE-PV can more reliably identify factors associated with disordered eating attitudes/behaviors among pregnant individuals with BMI ≥ 25 compared to the EDE and support our call for the development and use of new and/or adapted measures to appropriately assess disordered eating during pregnancy.

The Psychological Impact of the Widespread Availability of Palatable Foods Predicts Uncontrolled and Emotional Eating in Adults

This study aimed to investigate the role of the psychological impact of environments rich in palatable foods on three aspects of eating behavior: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). The hypotheses were as follows: (a) The psychological impact (i.e., motivation to eat) of an environment rich in palatable foods will positively predict CR, UE, and EE; (b) dieting will predict CR, UE, and EE; and (c) CR, UE, and EE will positively predict body mass index (BMI). This study had a cross-sectional design in which data were collected online from 413 subjects. The psychological impact of food-rich environments (food available, food present, and food tasted) was assessed using the Power of Food Scale (PFS), and CR, UE, and EE were assessed using the Three-Factor Eating Questionnaire (TFEQ-R18). Both instruments were tested for confirmatory factor analysis. The relationship between constructs was measured using partial least-square structural equation modeling (PLS-SEM). "Food available" positively predicted all TFEQ-R18 factors (p < 0.01). "Food present" positively predicted UE (p < 0.001) and EE (p = 0.01). People currently on a diet showed higher levels of CR (p < 0.001) and EE (p = 0.02). UE and EE positively predicted BMI. Thus, CR, UE, and EE were positively predicted by the motivation to consume palatable foods in varying proximity, suggesting that the presence of food and, more importantly, its general availability may be important determinants of eating behavior, particularly UE and EE. Health strategies should consider the influence of the food environment to prevent and better manage impairments in eating behavior. Sex differences suggest that special attention should be paid to women. Furthermore, dieting was associated with higher levels of EE, which in turn was associated with higher BMI. Weight loss interventions should consider this vulnerability.

Exploring the association between self-compassion, mindfulness and mindful eating with eating behaviours amongst patients with obesity

Background: People who have obesity often experience problematic eating behaviours, contributing towards their excessive weight gain. Aims: Understanding problematic eating behaviours and their association to self-compassion, mindfulness and mindful eating is important for the development of future interventions that improve weight-loss and weight-regulation. Methods: One hundred and one participants attending their first session of a 6-session dietetic programme within a Tier 3 medical weight management service in the West Midlands, UK were recruited to complete questionnaires on self-compassion, mindfulness, mindful eating and eating behaviours, such as, emotional, restrained, external, fat and sugar consumption and grazing. Results: The findings suggested all three constructs, self-compassion, mindfulness and mindful eating were significantly and negatively associated with grazing and emotional eating, but mindful eating was the only construct that also displayed a significant and negative association with other eating behaviours that are often barriers to successful weight regulation, such as external eating and fat consumption. Further investigation suggested mindful eating had an indirect effect on fat consumption and grazing via external eating. Conclusion: Whilst, self-compassion, mindfulness and mindful eating displayed a negative relationship with grazing and emotional eating, mindful eating also displayed a negative relationship with fat consumption and external eating. Possible explanations and directions for future work are discussed with an emphasis on the need for more empirical work.

Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model

We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.

Mental Health Variables Impact Weight Loss, Especially in Patients with Obesity and Binge Eating: A Mediation Model on the Role of Eating Disorder Pathology

BACKGROUND

Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI).

METHODS

General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without.

RESULTS

In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect.

DISCUSSION

Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.

Behavioral and Psychological Factors Affecting Weight Loss Success

PURPOSE OF REVIEW

There is a large variability between individuals in the weight loss response to any given diet treatment, which fuels interest into personalized or precision nutrition. Although most efforts are directed toward identifying biological or metabolic factors, several behavioral and psychological factors can also be responsible for some of this interindividual variability.

RECENT FINDINGS

There are many factors that can influence the response to dietary weight loss interventions, including factors related to eating behavior (emotional eating, disinhibition, restraint, perceived stress), behaviors and societal norms related to age and sex, psychological and personal factors (motivation, self-efficacy, locus of control, self-concept), and major life events. The success of a weight loss intervention can be influenced by many psychological and behavioral constructs and not merely by physiological factors such as biology and genetics. These factors are difficult to capture accurately and are often overlooked. Future weight loss studies should consider assessing such factors to better understand the underlying reasons for the large interindividual variability to weight loss therapy.

Neuro-Vulnerability in Energy Metabolism Regulation: A Comprehensive Narrative Review

This comprehensive narrative review explores the concept of neuro-vulnerability in energy metabolism regulation and its implications for metabolic disorders. The review highlights the complex interactions among the neural, hormonal, and metabolic pathways involved in the regulation of energy metabolism. The key topics discussed include the role of organs, hormones, and neural circuits in maintaining metabolic balance. The review investigates the association between neuro-vulnerability and metabolic disorders, such as obesity, insulin resistance, and eating disorders, considering genetic, epigenetic, and environmental factors that influence neuro-vulnerability and subsequent metabolic dysregulation. Neuroendocrine interactions and the neural regulation of food intake and energy expenditure are examined, with a focus on the impact of neuro-vulnerability on appetite dysregulation and altered energy expenditure. The role of neuroinflammation in metabolic health and neuro-vulnerability is discussed, emphasizing the bidirectional relationship between metabolic dysregulation and neuroinflammatory processes. This review also evaluates the use of neuroimaging techniques in studying neuro-vulnerability and their potential applications in clinical settings. Furthermore, the association between neuro-vulnerability and eating disorders, as well as its contribution to obesity, is examined. Potential therapeutic interventions targeting neuro-vulnerability, including pharmacological treatments and lifestyle modifications, are reviewed. In conclusion, understanding the concept of neuro-vulnerability in energy metabolism regulation is crucial for addressing metabolic disorders. This review provides valuable insights into the underlying neurobiological mechanisms and their implications for metabolic health. Targeting neuro-vulnerability holds promise for developing innovative strategies in the prevention and treatment of metabolic disorders, ultimately improving metabolic health outcomes.

Associations of timing of food intake with energy intake, eating behaviour traits and psychosocial factors in adults with overweight and obesity

Introduction

Whether a late distribution of food intake impacts obesity through increased energy intake remains uncertain and the behavioural characterization of late eating needs to be further investigated. The first objective of this study was to assess the associations between late eating and body mass index (BMI) and total energy intake (TEI), and whether TEI mediates the association between late eating and BMI. The second objective was to assess the associations between late eating and eating behaviour traits or psychosocial factors and whether eating behaviour traits mediate the association between late eating and TEI.

Methods

Baseline data from 301 individuals (56% women, age = 38.7 ± 8.5 years; BMI = 33.2 ± 3.4 kg/m²), who participated in four weight loss studies were used in this cross-sectional study. Total energy intake was assessed using a three-day food record from which the percentage of TEI after 17:00 and after 20:00 was calculated. Eating behaviour traits and psychosocial factors were assessed with questionnaires. Pearson correlations and mediation analyses adjusted for age, sex, underreporting of energy intake, sleep duration and bedtime were performed.

Results

Percent TEI after 17:00 and after 20:00 were associated with TEI (r = 0.13, p = 0.03 for both), and TEI mediated the association between percent TEI after 17:00 and BMI (β = 0.01 ± 0.01, 95% CI: 0.001, 0.02). Percent TEI after 17:00 was associated with disinhibition (r = 0.13, p = 0.03) and percent TEI after 20:00 was associated with susceptibility to hunger (r = 0.13, p = 0.03), stress (r = 0.24, p = 0.002) and anxiety (r = 0.28, p = 0.0004). In women, disinhibition mediated the association between percent TEI after 17:00 and TEI (β = 3.41 ± 1.43, 95% CI: 0.92, 6.47). Susceptibility to hunger mediated the association between percent TEI after 20:00 and TEI (β = 0.96 ± 0.59, 95% CI: 0.02, 2.34) in men and women.

Conclusion

Late eating is associated with TEI and suboptimal eating behaviours which could contribute to explaining the association between timing of food intake and obesity.

Impulsivity dimensions and their associations with disinhibited and actual eating behaviour

BACKGROUND

Previous research has suggested that there is an association between impulsivity, assessed via self-report measures and behaviourally, and disinhibited eating patterns, but it remains unclear which specific dimension of impulsivity is the most salient in this relationship. Furthermore, it remains uncertain whether any such associations would extend to actual eating behaviours and food consumption.

AIMS

The present study aimed to examine whether impulsivity, assessed both behaviourally and via self-report, is associated with self-reported disinhibited and actual eating behaviour in a controlled eating task.

METHOD

70 women from a community sample (aged 21-35) completed the Disinhibition subscale of the Three Factor Eating Questionnaire (TFEQ), the Barratt Impulsiveness Scale (BIS-11), the Matching Familiar Figures Task (MFFT-20), and a behavioural food consumption task.

RESULTS

Bivariate correlational analyses revealed significant associations between self-report measure of impulsivity, the scores on the MFFT-20 (assessing reflection impulsivity), and self-report measure of disinhibited eating. All these measures were associated with overall food consumption in a taste task, with reflection impulsivity, that is poor ability to reflect on information before making a decision, having the strongest association with the amount of food consumed. Self-reported impulsivity was most strongly associated with disinhibited eating. Partial correlations controlling for BMI and age did not diminish any significant correlations within these relationships.

CONCLUSIONS

Significant associations between both trait and behavioural (reflection) impulsivity, and self-reported disinhibited eating and actual eating behaviour were demonstrated. The implications of these findings on uncontrolled eating patterns in real life are discussed.

Developing and validating a Japanese version of the Weight Self-Stigma Questionnaire

PURPOSE

Weight bias internalization (WBI) is significantly associated with negative physiological and psychological consequences. Given its negative effects, appropriate measurement of WBI is required for weight management and mental and physical health in people with weight problems. One of the most reliable and frequently used questionnaires to assess WBI is the Weight Self-Stigma Questionnaire (WSSQ). However, a Japanese version of the WSSQ has not yet been developed. Thus, the current study aimed to develop a Japanese version of the WSSQ (WSSQ-J) and validate its psychometric properties in the Japanese context.

METHODS

A total of 1454 Japanese participants (age 34.44 ± 6.92; male = 498) with diverse weight statuses (Body mass index: 21.44 ± 3.52, 13.79-41.40 kg/m²) completed an online survey for the WSSQ-J. The internal consistency of the WSSQ-J was estimated by calculating Cronbach's α. Confirmatory factor analysis (CFA) was then carried out to confirm that the factor structure of the WSSQ-J was the same as that of the subscales of the original WSSQ.

RESULTS

The WSSQ-J had a Cronbach's α of 0.917, indicating good internal consistency. In CFA, the comparative fit index was 0.945, the root mean square error of approximation was 0.085, and the standardized root mean square residual was 0.040, indicating that the two-factor model showed satisfactory goodness-of-fit.

CONCLUSION

This study replicated the original findings related to the WSSQ, showing that the WSSQ-J is a reliable WBI questionnaire consisting of two factors. Therefore, the WSSQ-J would be a reliable tool for assessing WBI among Japanese.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Are Emotional Eating and Other Eating Behaviors the Missing Link in the Relationship between Inadequate Sleep and Obesity? A Systematic Review

Evidence is emerging to explain that the relationship between inadequate sleep and obesity could be influenced by emotional eating and other eating behaviors such as disinhibition. Therefore, our aim was to conduct a systematic review to analyze the potential role of emotional eating and other eating behaviors in the relationship between inadequate sleep and obesity. We conducted a comprehensive search on 2 databases (Medline and Scopus) looking for records from 1 January 2011 until 31 December 2022 without language restrictions. Cross-sectional, longitudinal, and interventional studies were included if they assessed the association between sleep and emotional eating, as well as the role of emotional eating on the relationship between inadequate sleep and obesity. Secondary outcomes included studies analyzing the link between sleep and other eating behaviors as well as their role in the sleep-obesity relationship. Our results showed that emotional eating and disinhibition play a significant role in the relationship between inadequate sleep and obesity, especially in women. Furthermore, we provide evidence of other eating behaviors (e.g., external eating, eating competence, and hunger), which are also associated with poor sleep outcomes. However, these behaviors do not seem to be determinants of the association between sleep and obesity. In conclusion, our results suggest that individuals with inadequate sleep who are prone to emotional eating and/or disinhibition may require tailored approaches for obesity prevention and treatment.

Eating behavior dimensions and 9-year weight loss maintenance: a sub-study of the Finnish Diabetes prevention study

BACKGROUND

Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period.

METHODS

Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Eating Questionnaire assessing cognitive restraint of eating with flexible and rigid components, disinhibition and susceptibility to hunger was completed. This was a sub-study of the Finnish Diabetes Prevention Study, conducted in Kuopio research center.

RESULTS

During the first year of the intervention total cognitive (4.6 vs. 1.7 scores; p < 0.001), flexible (1.7 vs. 0.9; p = 0.018) and rigid (1.6 vs. 0.5; p = 0.001) restraint of eating increased, and body weight decreased (-5.2 vs. -1.2 kg; p < 0.001) more in the intervention group compared with the control group. The difference between the groups remained significant up to nine years regarding total (2.6 vs. 0.1 scores; p = 0.002) and rigid restraint (1.0 vs. 0.4; p = 0.004), and weight loss (-3.0 vs. 0.1 kg; p = 0.046). The first-year increases in total, flexible and rigid restraint statistically mediated the impact of intervention on weight loss during the 9-year study period.

CONCLUSIONS

Lifestyle intervention with intensive and individually tailored, professional counselling had long-lasting effects on cognitive restraint of eating and body weight in middle-aged participants with overweight and IGT. The mediation analyses suggest that early phase increase in cognitive restraint could have a role in long-term weight loss maintenance. This is important because long-term weight loss maintenance has various health benefits, including reduced risk of T2DM.

High-Fat-Sugar Diet is Associated with Impaired Hippocampus-Dependent Memory in Humans

Overconsumption of high-fat and high-sugar (HFS) diet may affect the hippocampus, and consequently, memory functions. Yet, converging evidence is needed to demonstrate that the type of memory affected by HFS diet consumption is indeed hippocampus dependent. Moreover, the extent to which HFS diet can also affect executive functioning, and indirectly affect memory requires further examination. In this online study, we asked 349 young adults to report their HFS diet consumption and complete a word memory task, the Everyday Memory Questionnaire, and importantly two memory tasks that have been shown to robustly engage the hippocampus, i.e., the Pattern Separation and Associative Memory Tasks. Participants also completed two executive functioning tasks, the Trail Making Task (TMT) and the Stroop Task. These measures assess attention/cognitive flexibility and the ability to inhibit cognitive interference, respectively. After controlling for confounding variables, we found that participants who reported higher level consumption of a HFS diet performed worse on the Pattern Separation Task and that higher HFS intake was significantly associated with poorer TMT task performance and longer Stroop average reaction time (RT). TMT and Stroop RT scores indicative of reduced executive function also partially mediated the relationship between HFS diet and memory performance on the pattern separation task. Taken together, our results provide converging evidence that HFS diet may impair hippocampus-dependent memory. HFS diet may also affect executive functioning and indirectly impair memory function. The findings are consistent with human subject and animal studies and call for further investigations on the psychological and neural mechanisms underlying the dietary effects on cognitive processes.

The impact of time restricted eating on appetite and disordered eating in adults: A mixed methods systematic review

This mixed-methods systematic review evaluated the effect of Time Restricted Eating (TRE) on adult participants' experience of hunger, appetite, and disordered eating. PubMed, CINAHL Plus with Full Text, PscyINFO, and Web of Science were searched for quantitative and qualitative original research articles in human adults that had an intervention with a daily eating window of ≤12 h and outcome measures related to hunger, appetite, or disordered eating. Differences in quantitative measures during TRE and qualitative themes were summarized. Qualitative and quantitative data were synthesized by assessing for convergence and divergence. Sixteen studies were included. TRE was associated with higher appetite at bedtime, and lower or unchanged morning fasting appetite. Evening results were mixed. Disordered eating questionnaires were not different as a result of TRE except in one study that found TRE associated with lower hunger. Qualitative themes converged with these findings, however also showed fear of hunger, eating in the absence of hunger, and eating-related stressors. TRE did not result in major changes to appetite or disordered eating symptoms. Bedtime hunger was higher in TRE. Assessment of subtle alterations in eating behavior, such as eating in the absence of hunger, would be beneficial for future research and intervention design.

Characterizing the Course of Loss of Control Eating and Prognostic Factors Following Bariatric Surgery: an Exploratory Analysis

PURPOSE

Postoperative loss of control eating (LOCE) has detrimental associations with weight outcomes and mental health following bariatric surgery. However, little is known regarding LOCE course following surgery and preoperative factors that predict remittance, continuance, or development of LOCE. The present study aimed to characterize LOCE course in the year following surgery by identifying four groups: individuals with (1) postoperative de novo LOCE, (2) maintained LOCE (endorsed at pre- and post-surgery), (3) remitted LOCE (endorsed only at pre-surgery), and (4) those who never endorsed LOCE. Exploratory analyses examined group differences in baseline demographic and psychosocial factors.

MATERIALS AND METHODS

A total of 61 adult bariatric surgery patients completed questionnaires and ecological momentary assessment at pre-surgery and 3-, 6-, and 12-month postoperative follow-ups.

RESULTS

Results showed that 13 (21.3%) never endorsed LOCE prior to or after surgery, 12 (19.7%) developed LOCE after surgery, 7 (11.5%) evidenced remittance from LOCE after surgery, and 29 (47.5%) maintained LOCE prior to and after surgery. Relative to those who never endorsed LOCE, all groups who evidenced LOCE before and/or after surgery reported greater disinhibition; those who developed LOCE reported less planned eating; and those with maintained LOCE reported less satiety sensitivity and greater hedonic hunger.

CONCLUSION

These findings highlight the importance of postoperative LOCE and need for longer-term follow-up studies. Results also suggest a need to examine the longer-term impact of satiety sensitivity and hedonic eating on LOCE maintenance, and the extent to which meal planning may buffer risk for de novo LOCE following surgery.

The moderating role of eating behaviour traits in the association between exposure to hot food takeaway outlets and body fatness

BACKGROUND

Previous studies demonstrated a relation between takeaway outlet exposure and health outcomes. Individual characteristics, such as eating behaviour traits, could make some people more susceptible to the influence of the food environment. Few studies have investigated this topic. We aimed to investigate the moderating role of eating behaviour traits (cognitive restraint, uncontrolled eating and emotional eating) in the association between neighbourhood exposure to hot food takeaway outlets (hereafter referred to as takeaway outlets), and takeaway food consumption and adiposity.

METHODS

We used cross-sectional data from a cohort in Cambridgeshire, UK (The Fenland study). Takeaway outlet exposure was derived using participants' residential address and data from local authorities and divided into quarters. The Three Factor Eating questionnaire (TFEQ-R18) was used to measure eating behaviour traits. Primary outcomes were consumption of takeaway-like foods (derived from food frequency questionnaire), and body fat percentage (measured using dual-energy X-ray absorptiometry).

RESULTS

Mean age of participants (n = 4791) was 51.0 (SD = 7.2) and 53.9% were female. Higher exposure to takeaway outlets in the neighbourhood and higher eating behaviour trait scores were independently associated with greater takeaway consumption and body fat percentage. Uncontrolled eating did not moderate the associations between takeaway outlet exposure and takeaway consumption or body fat percentage. The association between takeaway outlet exposure and takeaway consumption was slightly stronger in those with higher cognitive restraint scores, and the association between takeaway outlet exposure and body fat percentage was slightly stronger in those with lower emotional eating scores.

CONCLUSION

Eating behaviour traits and exposure to takeaway outlets were associated with greater takeaway consumption and body fat, but evidence that individuals with certain traits are more susceptible to takeaway outlets was weak. The findings indicate that interventions at both the individual and environmental levels are needed to comprehensively address unhealthy diets.

TRIAL REGISTRY

ISRCTN72077169.

Factors Affecting BMI Changes in Mothers during the First Year Postpartum

We tested the hypotheses that mothers of infants who exclusively breastfed would differ in the trajectories of postpartum BMI changes than mothers of infants who exclusively formula fed, but such benefits would differ based on the maternal BMI status prepregnancy (primary hypothesis) and that psychological eating behavior traits would have independent effects on postpartum BMI changes (secondary hypothesis). To these aims, linear mixed-effects models analyzed measured anthropometric data collected monthly from 0.5 month (baseline) to 1 year postpartum from two groups of mothers distinct in infant feeding modality (Lactating vs. Non-lactating). While infant feeding modality group and prepregnancy BMI status had independent effects on postpartum BMI changes, the benefits of lactation on BMI changes differed based on prepregnancy BMI. When compared to lactating women, initial rates of BMI loss were significantly slower in the non-lactating women who were with Prepregnancy Healthy Weight (β = 0.63 percent BMI change, 95% CI: 0.19, 1.06) and with Prepregnancy Overweight (β = 2.10 percent BMI change, 95% CI: 1.16, 3.03); the difference was only a trend for those in the Prepregnancy Obesity group (β = 0.60 percent BMI change, 95% CI: −0.03, 1.23). For those with Prepregnancy Overweight, a greater percentage of non-lactating mothers (47%) gained ≥ 3 BMI units by 1 year postpartum than did lactating mothers (9%; p < 0.04). Psychological eating behavior traits of higher dietary restraint, higher disinhibition, and lower susceptibility to hunger were associated with greater BMI loss. In conclusion, while there are myriad advantages to lactation, including greater initial rates of postpartum weight loss regardless of prepregnancy BMI, mothers who were with overweight prior to the pregnancy experienced substantially greater loss if they breastfed their infants. Individual differences in psychological eating behavior traits hold promise as modifiable targets for postpartum weight management.

Disinhibition augments thirst perception from two dehydrating stimuli in men

Physiological systems controlling water and energy ingestion are coordinated. Whether maladaptive eating behavior and appetite for water are linked is unknown. Thus, we sought to investigate the association between maladaptive eating and both thirst and water drinking behavior with two dehydrating conditions. Twenty-two lean men and 20 men with obesity (mean age 32.3 ± 8.4 years and 30.0 ± 11.1 years, respectively) completed the Three-Factor Eating Questionnaire (TFEQ) and Gormally Binge Eating Scale. On separate days, volunteers were dehydrated by a 2-h hypertonic saline infusion and a 24-h water deprivation, and thirst was measured on a 100-mm visual analogue scale (VAS) during each procedure. After each dehydrating condition, ad libitum water intake was measured. In the saline infusion, higher Disinhibition on the TFEQ was associated with thirst in the lean group (β = 4.2 mm VAS, p = 0.03) but not in the group with obesity (p = 0.51). In the water-deprivation condition, higher Disinhibition was also associated with thirst in the lean group (β = 5.6 mm VAS, p = 0.01) with the strength of relationship being 3.5-fold stronger than that observed in the group with obesity (β = 1.6 mm VAS, p = 0.0003). Hunger, Restraint, and binge-eating scores were not associated with thirst in either dehydrating condition (all p > 0.05). Maladaptive eating behaviors were not associated with ad libitum water intake (all p > 0.05). Disinhibition is associated with higher thirst perception in healthy weight individuals and may be attenuated in obesity. The characteristics of disinhibition which typically includes a heightened readiness to eat, may reflect a more general phenotype that also reflects a readiness to drink.

Eating behaviour traits mediate the association between satiety responsiveness and energy intake among individuals with overweight and obesity

Whether eating behaviour traits represent factors that could explain the susceptibility to overeating in individuals with low satiety responsiveness remain to be extensively examined. This study aimed to assess if eating behaviours mediate the association between satiety responsiveness and energy intake. Baseline data from individuals with overweight or obesity (n = 303; age = 38.7 ± 8.4 years; BMI = 33.2 ± 3.4 kg/m², 56% women) who participated in four weight-loss studies were included in this cross-sectional study. Satiety responsiveness was determined by the satiety quotient (SQ) based on fullness sensations in response to a standardized breakfast. Energy intake was self-reported in a three-day food record and measured by an ad libitum buffet meal. Eating behaviours were assessed with questionnaires. Mediation analyses adjusted for age and sex, and for underreporting for the food record, were performed using a regression-based and bootstrapping approach. The association between SQ and self-reported total energy intake was mediated by susceptibility to hunger (β = -2.51 ± 1.26, 95% CI, -5.38 to -0.52) and its subscales, internal and external locus of hunger (β = -2.00 ± 1.10, 95% CI, -4.50 to -0.28 and β = -2.42 ± 1.29, 95% CI, -5.30 to -0.30, respectively). Susceptibility to hunger (β = -2.71 ± 1.13, 95% CI, -5.29 to -0.84), internal and external locus of hunger (β = -1.84 ± 0.95, 95% CI -4.00 to -0.30 and β = -3.42 ± 1.31, 95% CI, -6.39 to -1.24, respectively), cues that may trigger food cravings (β = -5.43 ± 2.91, 95% CI, -11.83 to -0.44) and state-craving as a physiological state (β = -4.31 ± 2.51, 95%CI, -10.14 to -0.44) also mediated the association between SQ and measured energy intake. These results suggest that susceptibility to hunger and food cravings partly explained the susceptibility to overeating among individuals with low satiety responsiveness. Interventions targeting susceptibility to hunger and food cravings may thus be helpful to prevent overeating among these individuals.

Interoceptive hunger, eating attitudes and beliefs

Interoceptive individual differences have garnered interest because of their relationship with mental health. One type of individual difference that has received little attention is variability in the sensation/s that are understood to mean a particular interoceptive state, something that may be especially relevant for hunger. We examined if interoceptive hunger is multidimensional and idiosyncratic, if it is reliable, and if it is linked to dysfunctional eating and beliefs about the causes of hunger. Participants completed a survey just before a main meal, with most retested around 1 month later. We found that interoceptive hunger has 11 dimensions, and while people differ considerably in their combinations of interoceptive hungers, these represent only 4% of all possible permutations. Hunger reports were reliable. We found relationships between variability in hunger interoception and dysfunctional eating, especially for uncontrolled eating. We also found that hunger beliefs were in some cases strongly related to aspects of hunger interoception. The implications of these findings are discussed.

Perceived stress as a predictor of eating behavior during the 3-year PREVIEW lifestyle intervention

Background

To better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger).

Methods

The present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m²) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements.

Results

Perceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was −1.1 (2.1) in participants with frequent stress and −0.7 (1.8) in participants without frequent stress (Cohen’s d_s (95% CI) = 0.24 (0.04–0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001).

Conclusions

Perceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.

Mindful Eating Questionnaire: Validation and Reliability in Romanian Adults

Mindful eating may play an important role in long-term weight maintenance. In interventions aiming at weight reduction, increasing the levels of mindful eating was associated with higher levels of success and lower levels of weight rebound in the long run. This study aimed to determine the validity and reliability of a mindful eating questionnaire for Romanian adults using Framson's Mindful Eating Questionnaire (MEQ). To calculate the internal (n = 495) and external (n = 45) reliability, a general population sample was taken. Construct validity was assessed using the "known groups" method: dietitians (n = 70), sports professionals (n = 52), and individuals with overweight and obesity (n = 200). Convergent validity tested the association between the MEQ score and demographic characteristics of the total sample (n = 617). The internal (0.72) and external (0.83) reliability were adequate. Dietitians and sports professionals had overall lower scores, meaning more mindful eating compared to the group of individuals with overweight and obesity. The lower mindful eating practice was associated with the presence of excess weight, suboptimal health status perception, higher levels of stress and younger age. The Romanian version of the MEQ is a reliable and valid tool for measuring mindfulness of eating in adults.

The Effect of Chronotype on Addictive Eating Behavior and BMI among University Students: A Cross-Sectional Study

The aim of this study was to examine the effect of chronotype on addictive eating behavior and BMI in university students. A questionnaire on their sociodemographic characteristics and eating habits, as well as the three-factor eating questionnaire (TFEQ) and the morningness-eveningness questionnaire (MEQ), were given to students at Üsküdar University. Data were analyzed with IBM SPSS 26.0. This study included a total of 850 students, 46.8% of whom were male and 53.2% were female. The mean BMI was 22.94 ± 3.30 kg/m2. As the BMI values of students increased, there was a decrease of 25.6% in the TFEQ scores, regardless of gender (s = −0.256; p < 0.001), and an increase of 10.6% in their chronotype scores, meaning that the students tended to be morning types (s = 0.106; p < 0.01). A significantly negative, very weak correlation was found between the students’ TFEQ and MEQ scores (s = −0.123; p < 0.001). The students’ BMI (p < 0.01) and TFEQ scores (p < 0.001) were affected by their MEQ scores in a statistically significant way. It was found that each 1-point increase in the MEQ score led to a 4.0% increase in the BMI score and a 15.8% decrease in the TFEQ score. It was observed that the morning-type students tended to be obese in terms of their BMI, and these students demonstrated fewer addictive eating behaviors.

Examination of three-factor eating questionnaire subscale scores on weight loss and weight loss maintenance in a clinical intervention

Background

The purpose of this study is to examine three-factor eating questionnaire (TFEQ) scores at baseline and post-intervention (6 months) on successful weight loss and weight maintenance in an 18-month behavioral weight management intervention for adults with overweight and obesity.

Methods

TFEQ and weight were assessed at baseline, 6, and 18 months. Logistic regression models were used to examine scores at baseline on disinhibition, restraint, and perceived hunger factors in the TFEQ on 5% body weight loss at 6 months and 6-month scores to predict 5% weight maintenance at 18 months while controlling for age, sex, and baseline weight.

Results

Participants (n = 287; age = 43.8 ± 10.36 years; female = 64.1%; weight = 222.5 ± 39.02 pounds; BMI = 34.73 ± 4.56) were included for analysis. Dietary restraint at baseline was the only significant predictor of 5% weight loss at 6 months. None of the TFEQ subscale scores at 6 months predicted 5% weight maintenance at 18 months. The model examining weight loss at 6 months accounted for 7% of the variance of the outcome and 11% of the variance of weight maintenance at 18 months.

Conclusion

Dietary restraint is a unique eating behavior associated with weight loss at 6 months beyond other eating behaviors measured by the TFEQ in an adult sample enrolled in a weight loss intervention. No other subscale scores were significant at 6 months or at 18 months. Future research should consider how to promote flexible control and discourage adoption of rigid restraint behaviors since the latter is associated with disordered eating patterns.

Motivation to consume palatable foods as a predictor of body image dissatisfaction: Using the Power of Food Scale in a Brazilian sample

The Power of Food Scale (PFS) is a questionnaire for self-assessing the motivation to consume palatable foods, especially in environments where food is abundant and constantly available. This study aimed to a) assess the factorial structure of the PFS in a Brazilian sample and b) examine the relationship between the power of food and body image dissatisfaction and BMI. The PFS and Body Shape Questionnaire (BSQ) were applied to a sample of 300 adults. Data were analysed using confirmatory factor analysis. Composite reliability (CR) was used to verify factor reliability. A partial least squares structural equation model was used to verify the effect of the PFS score on body image dissatisfaction. The PFS had an adequate factorial structure in this Brazilian sample, showing three well-defined factors: food available (CR = 0.91), food tasted (CR = 0.84), and food present (CR = 0.87). The BSQ showed one reliable factor (CR = 0.97). The power of the food aggregate factor significantly predicted body mass index (β = 0.16; p = .01) and body image dissatisfaction (β = 0.46; p < .001). The effect size was small for body mass index (f² = 0.02) and medium for body image dissatisfaction (f² = 0.26). The food present factor also had a slightly higher average among the three PFS factors. Women had higher PFS scores than men. Understanding the role that this motivation plays in physical and psychological outcomes such as body dissatisfaction can contribute to developing treatment strategies and support health professionals' performance in clinical settings.

Validation of the Adult Eating Behaviour Questionnaire adapted for the French-speaking Canadian population

PURPOSE

The Adult Eating Behaviour Questionnaire (AEBQ) is a newly developed questionnaire adapted from the widely used Child Eating Behaviour Questionnaire. This questionnaire assesses four food approach scales, namely hunger, food responsiveness, emotional overeating (EOE) and enjoyment of food, and four food avoidance scales, namely satiety responsiveness (SR), emotional undereating (EUE), food fussiness and slowness in eating (SE). This study aimed to validate a French version of the AEBQ in controlled conditions among French-speaking adults from Quebec, Canada.

METHODS

The AEBQ was pre-tested through structured interviews with 30 individuals. Participants of the validation study (n = 197, aged 19-65 years) had their height and weight measured and completed the AEBQ, Three-Factor Eating Questionnaire (TFEQ) and Intuitive Eating Scale-2 to assess factorial structure, internal consistency and construct validity. Test-retest reliability over 2 weeks was assessed among 144 participants.

RESULTS

Confirmatory factor analysis indicated an excellent model fit (NNFI = 0.98, CFI = 0.98, RMSEA = 0.03, χ²/df = 1.17) and provided support for the use of the original 8-factor questionnaire. Internal consistency was adequate for most scales (Cronbach's alpha = 0.66-0.94) and moderate to excellent test-retest reliability was observed for all scales (ICC = 0.70-90). Women showed higher levels of EOE and SR, and individuals with overweight and obesity showed higher levels of EOE and lower levels of EUE and SE. Construct validity was also supported by expected correlations with disinhibition and susceptibility to hunger from the TFEQ and intuitive eating.

CONCLUSION

This study indicates that the French AEBQ is a valid and reliable tool to measure eating behaviours in the adult population of Quebec.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies. The data are cross-sectional, but all measurement were undertaken in controlled laboratory conditions and the study provided new information.

Translation and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17) in French-speaking Canadian children and adolescents

OBJECTIVE

To translate and validate the Child Three-Factor Eating Questionnaire (CTFEQr17), assessing cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE), among French-speaking Canadian young individuals.

DESIGN

Phase 1 comprised a translation and the evaluation of the comprehension of the questionnaire. Phase 2 comprised a confirmatory factor analysis (CFA), the evaluation of internal consistency (Cronbach's α), test-retest reliability (intra-class correlation coefficients (ICC)) and construct validity, including correlations among the CTFEQr17 and Eating Attitudes Test (EAT-26), anthropometrics, dietary intake and diet quality.

SETTING

Primary and secondary schools, Québec City, Canada.

PARTICIPANTS

Phases 1 and 2 included 20 (40 % boys, mean age 11·5 (sd 2·4) years) and 145 (48 % boys, mean age 11·0 (sd 1·9) years) participants, respectively.

RESULTS

Phase 1 resulted in the questionnaire to be used in Phase 2. In Phase 2, the CFA revealed that the seventeen item, three-factor model (CTFEQr17) provided an excellent fit. Internal consistency was good (Cronbach's α: 0·81-0·90). Test-retest reliability was moderate to good (ICC = 0·59, (95 % CI 0·48, 0·70), ICC = 0·78, (95 % CI 0·70, 0·84), ICC = 0·50, (95 % CI 0·38, 0·62) for CR, UE and EE, respectively). CR correlated with EAT-26 score (r = 0·43, P < 0·0001). UE and EE correlated negatively with BMI Z-scores (r = -0;·26, P = 0·003; r = -0;·19, P = 0·03, respectively). CR correlated with the proportion of energy intake from protein and diet quality (r = 0·18, P = 0·04; r = 0·20, P = 0·02, respectively).

CONCLUSION

The CTFEQr17 is suitable to use among French-speaking Canadian young individuals.

The role of material and psychosocial resources in explaining socioeconomic inequalities in diet: A structural equation modelling approach

We examined whether material and psychosocial resources may explain socioeconomic differences in diet quality. Cross-sectional survey data from 1461 Dutch adults (42.5 (SD 13.7) years on average and 64% female) on socio-demographics, diet quality, psychosocial factors and perceptions of and objective healthiness of the food environment were used in a structural equation model to examine mediating pathways. Indicators for socioeconomic position (SEP) were income, educational, and occupational level and the 2015 Dutch Healthy Diet (DHD15) index assessed diet quality. Material resources included food expenditure, perceptions of healthy food accessibility and healthfulness of the food retail environment. Psychosocial resources were cooking skills, resilience to unhealthy food environments, insensitivity to food cues and healthy eating habits. Higher SEP was associated with better diet quality; Beducation 8.5 (95%CI 6.7; 10.3), Bincome 5.8 (95%CI 3.7; 7.8) and Boccupation 7.5 (95%CI 5.5; 9.4). Material resources did not mediate the association between SEP and diet quality and neither did the psychosocial resources insensitivity to food cues and eating habits. Cooking skills mediated between 13.3% and 19.0% and resilience to unhealthy food environments mediated between 5.9% and 8.6% of the relation between SEP and the DHD15-index. Individual-level factors such as cooking skills can only explain a small proportion of the SEP differences in diet quality. On top of other psychosocial and material resources not included in this study, it is likely that structural factors outside the individual, such as financial, work and living circumstances also play an important role.

Identification of several eating habits that mediate the association between eating behaviors and the risk of obesity

Objective

Eating behaviors play important roles in the development of obesity. A better knowledge of the psychological aspects of eating behaviors in individuals with and without obesity and their consequences on daily eating and lifestyle habits would be informative. The Three‐Factor Eating Questionnaire (TFEQ)‐R21 assesses the psychometrics of eating behavior. The objectives of the study were to establish which eating habits were or were not associated with TFEQ eating behaviors, and to quantify the extent to which those eating habits mediated the association between TFEQ eating behaviors and obesity risk.

Methods

Data were obtained from the Gene and Environment Case‐Control Obesity Study from northern France. It included 2237 individuals with obesity and 403 individuals without obesity. Eating behaviors were assessed according to the TFEQ‐R21. Two activity levels (physical activity and television watching) and six eating habits (e.g., plate size, having one serving or at least two servings of the main meal, …) were evaluated. Regression and mediation analyses were performed.

Results

Higher cognitive restraint, higher uncontrolled eating (UE) and higher emotional eating (EE) were associated with a higher risk of obesity, independently of each other and of age, sex, socio‐economic status and physical activity. Cognitive restraint was negatively associated with having at least two servings, while UE and EE were associated with several obesogenic habits such as eating in front of the television or eating at night. Each of these obesogenic habits mediated between 3% and 20% of the association between UE or EE and obesity.

Conclusions

Psychological eating behaviors were associated with several lifestyle and eating habits in both individuals with and without obesity. Moreover, some eating habits partially mediated (between 3% and 20%) the association between TFEQ eating behaviors and obesity risk. For clinicians, this study shows that simple, easy‐to‐ask questions on specific daily eating habits can provide essential information to better understand and manage patients with obesity.

Life before and after COVID-19: The 'New Normal' Benefits the Regularity of Daily Sleep and Eating Routines among College Students

After the COVID-19 lockdown, a 'new normal' was established, involving a hybrid lifestyle that combined face-to-face with virtual activity. We investigated, in a case-control study, the impact of the 'new normal' on daily sleep and eating routines, compared with pre-pandemic conditions. To do this, we propose using social and eating jet lag as markers of the regularity in daily routines. Additionally, we studied whether the 'new normal' had an impact on the body mass index (BMI), diet quality, and other health-related variables. This study included 71 subjects in the pre-pandemic group, and 68 in the 'new normal' group (20-30 years). For all participants, we evaluated social and eating jet lag, BMI, diet and sleep quality, eating behaviors, physical activity, and well-being. General linear models were used to compare outcome variables between pre-pandemic and 'new normal' groups. The results revealed that the 'new normal' was associated with greater regularity in daily sleep and eating routines (-0.7 h of social jet lag (95% CI: -1.0, -0.4), and -0.3 h of eating jet lag (95% CI: -0.5, -0.1)), longer sleep duration on weekdays (1.8 h (95% CI: 1.5, 2.2)), and lower sleep debt (-1.3 h (95% CI: -1.7, -0.9)). Regarding BMI and other health-related variables, we observed that these variables were similar between 'new normal' and pre-pandemic groups. These findings indicate that the 'new normal' had a positive impact on daily sleep and eating routines. Additionally, our results indicated that the 'new normal' offered college students a more sustainable lifestyle, which was associated with more hours of sleep during the week and lower sleep debt. This, in the long run, could have a positive impact on BMI and overall health.

A questionnaire to assess eating behavior: Structure, validity and responsiveness of a new German eating behavior scale (SEV)

Numerous weight-loss interventions promoting healthy and weight-reducing eating behavior have been developed over the past years. To evaluate the effectiveness of such interventions for eating behavior change, short, validated and sensitive instruments are needed. In this study series, we developed and validated a new outcome measure to assess health-conscious and weight-controlling eating behavior for the evaluation of weight-loss interventions. The preliminary version of the German eating behavior scale (Skala zumErnährungsverhalten [SEV]) included 40 items. Three studies were conducted to (a) reduce the preliminary item pool, (b) investigate structural validity and internal consistency using exploratory and confirmatory factor analyses (EFA, CFA), as well as McDonald's ω, and (c) test construct validity with physiological and behavioral parameters. Responsiveness to change was also assessed after a 12-week weight-loss intervention. EFA indicated a two-factor solution with health-conscious (hc-EB) and weight-controlling eating behavior (wc-EB) as subscales, CFA confirmed the two-factor solution with acceptable model fit. Internal consistencies of both subscales were also acceptable to good (hc-EB: ω = 0.88; wc-EB: ω = 0.78). Significantly small to moderate correlations to the Healthy Eating Index (r = 0.51) as well as blood glucose (r = 0.31), blood lipids (r = 0.23), and vascular age (r = 0.31) were found, supporting the construct validity of the SEV and its subscales. Both subscales detected intervention-related changes in eating behavior among subjects of a weight-loss intervention with Standardized Response Means of 0.52 and 0.67, indicating good responsiveness of the SEV. In sum, findings provide evidence that the SEV is a valid and responsive measure to assess health-conscious and weight-controlling eating behavior.

Emotional eating and cognitive restraint mediate the association between sleep quality and BMI in young adults

This cross-sectional study was designed to investigate whether diet quality and eating behaviors could mediate the association between sleep quality and body mass index (BMI) in young adults. For all participants (n = 925; aged 21.4 ± 2.5 years; 77.8% women) we evaluated: BMI, sleep quality, diet quality, and eating behavior dimensions (emotional eating, cognitive restraint, and uncontrolled eating). Linear regression models were used to test associations between exposure and outcome variables. Path analysis was conducted with all potential mediators and covariates entered at the same time. Results showed that emotional eating (β = 0.04 [95% CI: 0.03; 0.06]), cognitive restraint (β = 0.03 [95% CI: 0.01; 0.04]), uncontrolled eating (β = 0.02 [95% CI: 0.01; 0.04]) and diet quality (β = -0.14 [95% CI: 0.19;-0.08]) were significantly associated with sleep quality. Additionally, BMI was significantly associated with PSQI score (β = 0.09 [95% CI: 0.01; 0.17]), emotional eating (β = 0.89 [95% CI: 0.60; 1.18]), and cognitive restraint (β = 1.37 [95% CI: 1.02; 1.71]). After testing for mediation, results revealed that emotional eating and cognitive restraint evidenced a significant mediating effect on the association between sleep quality and BMI. Additionally, diet quality was significantly associated with emotional eating (β = -0.35 [95% CI: 0.56;-0.13]), cognitive restraint (β = 0.53 [95% CI: 0.27; 0.79]), and uncontrolled eating (β = -0.49 [95% CI: 0.74;-0.25]). In conclusion, young adults with poor sleep quality are more likely to deal with negative emotions with food, which, in turn, could be associated with higher cognitive restraint, becoming a vicious cycle that has a negative impact on body weight. Our results also emphasize the role of eating behaviors as determinants of diet quality, highlighting the importance of considering sleep quality and eating behaviors when designing obesity prevention strategies in this population.

Negative urgency and central adiposity in a community sample: Moderated mediation by depressive symptoms and eating behaviors

Negative urgency - acting rashly in response to negative emotions - is a risk factor for central adiposity. We examine whether the relationship between negative urgency and waist-to-height ratio (WHtR) is mediated by eating behaviors (emotional eating, external eating, and cognitive restraint) and moderated by depressive symptom severity, factors that could be targeted to reduce risk associated with negative urgency. Using baseline data from the Nathan Kline Institute-Rockland Sample (N = 872; mean age = 42.4 years, SD = 15.3; 65% female; 27% non-White; mean body mass index = 27.9 kg/m², SD = 5.9), we conducted a series of mediation and moderated mediation analyses controlling for age, sex, race, and socioeconomic status. Overall, there was a positive association between negative urgency and WHtR. Emotional eating (ab = 0.02, SE = 0.003, 95% CI [0.02, 0.03]) and uncontrolled eating (ab = 0.008, SE = 0.002, 95% CI [0.004, 0.01]) were partial mediators of the relationship between negative urgency and WHtR, while cognitive restraint was not. In a parallel mediation model, emotional eating remained significant, while uncontrolled eating did not. Depressive symptom severity moderated the indirect effect of negative urgency on WHtR through emotional eating (b_int = -0.08, p < .001) but not the direct effect of negative urgency on WHtR. Our results indicate that emotional eating is a viable potential mechanism explaining the relationship between negative urgency and WHtR, and the indirect effect of negative urgency on WHtR through emotional eating becomes stronger as depressive symptom severity decreases.

Quality of life and eating habits of patients with obesity during the COVID-19 pandemic

Objective:

to verify the quality of life and eating habits of patients with obesity during the COVID-19 pandemic.

Method:

cross-sectional study with 68 outpatients, candidates for bariatric surgery, at university hospital in the Southern Brazil. Data collection was carried out by telephone, with questions about the profile of the participants and social distancing; questionnaires on quality of life and eating habits were also used. The data analysis, the logistic regression model, Spearman correlation, Mann-Whitney U and Student t-tests were used for independent samples.

Results:

the general quality of life was 57.03 points and the eating habit with the highest score was cognitive restraint (61.11 points). Most patients (72.1%) were socially distancing themselves and 27.9% had not changed their routine. The chance of isolation was 3.16 times greater for patients who were married. There is a positive correlation between the domains of the Quality of Life questionnaire and cognitive restraint from the questionnaire about eating habits.

Conclusion:

we found that the participants tended to have a better quality of life as cognitive restraint increased.

Acculturative stress and eating disinhibition among Asian young adults: The role of depressive symptoms and gender

Acculturative stress is associated with health behaviors that have downstream consequences for health outcomes. Eating disinhibition, a behavior characterized by eating emotionally and uncontrollably in the presence of disinhibiting stimuli, has been consistently associated with acculturative stress, but the underlying mechanism is not well-understood. The current study sought to test the role of depressive symptoms and gender on these associations. Asian undergraduate students (N = 477; 78% female) participated in an online cross-sectional study. Higher acculturative stress was associated with higher eating disinhibition (b = 3.45, 95% CI = [0.75, 6.15]), and depressive symptoms showed a partial indirect effect on this association (indirect effect = 0.57, 95% CI_boot = [0.13, 1.34]). Among male young adults (b = 0.98, 95% CI_boot = [0.24, 2.39]), the indirect correlation was stronger than among female young adults (b = 0.44, 95% CI_boot = [0.05, 1.20]; non-significant trend), implying individual differences underlying the indirect effect of depressive symptoms in the acculturative stress and eating disinhibition correlation. The Intercultural Relations dimension of acculturative stress appeared to drive the observed associations. This study is among the first highlighting the role of acculturative stress, depressive symptoms, and gender in eating disinhibition and provides evidence that can inform health professionals to target at-risk Asian individuals with eating problems.

Eating Behaviour among University Students: Relationships with Age, Socioeconomic Status, Physical Activity, Body Mass Index, Waist-to-Height Ratio and Social Desirability

Eating behaviour is of particular interest for research focusing on body weight status. However, little is known about the relationships of certain factors, especially social desirability, with self-reported eating behaviour such as cognitive restraint, uncontrolled eating, and emotional eating among young adult males and females. This study aimed to evaluate the relationships between eating behaviour and age, socioeconomic status (SES), physical activity (PA), body mass index (BMI), waist-to-height ratio (WHtR), and social desirability among university students. A cross-sectional study was conducted among 353 university students (59.2% females). Eating behaviour was assessed using the 13-item Three-Factor Eating Questionnaire (TFEQ-13). SES and PA were determined using self-reporting, and the Marlowe–Crowne Social Desirability Scale assessed social desirability. BMI and WHtR were calculated based on measured parameters. Associations between self-reported eating behaviour and other variables were assessed using Pearson’s correlation coefficient and multivariate general linear models. Cognitive restraint was positively correlated with BMI and WHtR in both males (r = 0.174, P = 0.036 and r = 0.194, P = 0.020, respectively) and females (r = 0.239, P < 0.001 and r = 0.165, P = 0.017, respectively), and emotional eating was positively correlated with BMI among females (r = 0.184, P = 0.008). Social desirability was negatively correlated with uncontrolled eating (r = −0.287, P < 0.001) and emotional eating (r = −0.301, P < 0.001) among females. There were no significant correlations between eating behaviour and age or socioeconomic status (P > 0.05). Multivariate analysis showed that, among males, PA had a main effect on emotional eating (ηp² = 0.044, F = 6.276, P = 0.013). Among females, cognitive restraint was positively associated with PA (ηp² = 0.034, F = 7.127, P = 0.008) and BMI (ηp² = 0.038, F = 7.959, P = 0.005), and emotional eating with BMI (ηp² = 0.032, F = 6.638, P = 0.011). Social desirability had the highest main effect on eating behaviour among females, being negatively associated with uncontrolled eating (ηp² = 0.077, F = 16.754, P < 0.001) and emotional eating (ηp² = 0.082, F = 18.046, P < 0.001). This study showed that PA, BMI, WHtR, and social desirability were associated with self-reported eating behaviour among university students. Social desirability bias should be considered when evaluating uncontrolled eating and emotional eating among females.

Anxiety, stress, and binge eating tendencies in adolescence: a prospective approach

BACKGROUND

Recent years have witnessed an increasing prevalence of binge eating tendencies in adolescence-warranting a clearer understanding of their underlying predisposing and precipitating factors. The current study investigated whether the interaction between high levels of anxiety and stress predicted increased levels of binge eating tendencies in a prospective cohort of adolescents (N = 324).

METHODS

Measurements were taken over three waves (M ages: 13.33, 14.48, 15.65) as part of the CogBIAS Longitudinal Study. Longitudinal associations between levels of anxiety and stress with binge eating tendencies were estimated using a random intercept cross-lagged panel model (RI-CLPM), which calculates within-person fluctuations over time while accounting for individual trait-like stability and between-person variations. Binge eating tendencies were measured by the Cognitive Restraint, Uncontrolled Eating, and Emotional Eating styles from the Three-Factor Eating Questionnaire-R18. Two models were created for each binge eating tendencies variable: (1) a basic model with anxiety and stress as independent variables; (2) an interaction model with an additional anxiety*stress interaction term. Model fit was assessed by SEM fit indices: X², CFI, NFI, TLI, RMSEA, SRMR. Superior model fit was ascertained by a chi-square difference test (p < .05).

RESULTS

For Cognitive Restraint, the interaction model demonstrated superior fit to the data (p < .05). The anxiety*stress interaction at Waves 1 and 2 was significantly negatively associated with Cognitive Restraint at Waves 2 (β = -0.18, p = .002) and 3 (β = -0.14, p = .002)-suggesting that anxiety and stress interacted to predict increased binge eating tendencies linked with cognitive restraint over and above their independent effects. In contrast, the interaction term between anxiety*stress did not predict levels of Uncontrolled Eating or Emotional Eating over time.

CONCLUSIONS

The results highlight the importance of increasing awareness of the interaction between concurrently high anxiety and stress as a potential risk factor for binge eating tendencies in young people.

TRIAL REGISTRATION

Not applicable.

The Development of Feeding and Eating Disorders after Bariatric Surgery: A Systematic Review and Meta-Analysis

Background: Patients in the postoperative period following bariatric surgery are at risk of developing eating disorders. This study aims to analyze the relation between bariatric surgery and the development and recurrence of eating disorders. Material and methods: A literature review was carried out on 15 November 2020. Fourteen studies that met the eligibility criteria were included for qualitative synthesis, and 7 studies for meta-analysis. Results: The prevalence of eating disorders in the postoperative period was 7.83%, based on the 7 studies in the meta-analysis. Binge eating disorder alone was 3.81%, which was the most significant factor, and addressed in 6 of these studies. Conclusion: The investigated studies have significant methodological limitations in assessing the relation between bariatric surgery and eating disorders, since they mostly present data on prevalence. PROSPERO CRD42019135614.

Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention

OBJECTIVE

Stress, sleep, eating behavior, and physical activity are associated with weight change and insulin resistance (IR). The aim of this analysis was the assessment of the overall and sex-specific associations of psychobehavioral variables throughout the 3-year PREVIEW intervention using the homeostatic model assessment of IR (HOMA-IR), BMI, and length of time in the study.

RESEARCH DESIGN AND METHODS

Associations of psychobehavioral variables, including stress, mood, eating behavior, physical activity (PA), and sleep, with BMI, HOMA-IR, and time spent in the study were assessed in 2,184 participants with prediabetes and overweight/obesity (n = 706 men; n = 1,478 women) during a 3-year lifestyle intervention using linear mixed modeling and general linear modeling. The study was a randomized multicenter trial using a 2 × 2 diet-by-PA design.

RESULTS

Overall, cognitive restraint and PA increased during the intervention compared with baseline, whereas BMI, HOMA-IR, disinhibition, hunger, and sleepiness decreased (all P < 0.05). Cognitive restraint and PA were negatively, whereas disinhibition, hunger, stress, and total mood disturbance were positively, associated with both BMI and HOMA-IR. Sleep duration, low sleep quality, total mood disturbance, disinhibition, and hunger scores were positively associated with HOMA-IR for men only. Participants who dropped out at 6 months had higher stress and total mood disturbance scores at baseline and throughout their time spent in the study compared with study completers.

CONCLUSIONS

Eating behavior and PA, control of stress, mood disturbance, and sleep characteristics were associated with BMI, HOMA-IR, and time spent in the study, with different effects in men and women during the PREVIEW lifestyle intervention study.

Dietary Restraint Related to Body Weight Maintenance and Neural Processing in Value-Coding Areas in Adolescents

BACKGROUND

There is an alarming increase in the obesity prevalence among children in an environment of increasing availability of preprocessed high-calorie foods. However, some people maintain a healthy weight even in such obesogenic environments. This difference in body weight management could be attributed to individual differences in dietary restraint; however, its underlying neurocognitive mechanisms in adolescents remain unclear.

OBJECTIVES

This study aimed to elucidate these neurocognitive mechanisms in adolescents by examining the relationships between dietary restraint and the food-related value-coding region located in the ventromedial prefrontal cortex (vmPFC).

METHODS

The association between dietary restraint and BMI was tested using a multilinear regression analysis in a large early adolescent cohort (n = 2554; age, 12.2 ± 0.3 years; BMI, 17.9 ± 2.5 kg/m2; 1354 boys). Further, an fMRI experiment was designed to assess the association between the vmPFC response to food images and dietary restraint in 30 adolescents (age, 17.6 ± 1.9 years; BMI, 20.7 ± 2.2 kg/m2; 13 boys). Additionally, using 54 individuals from the cohort (age, 14.5 ± 0.6 years; BMI, 18.8 ± 2.6 kg/m2; 31 boys), we assessed the association between dietary restraint and intrinsic vmPFC-related functional connectivity.

RESULTS

In the cohort, adolescents with increased dietary restraint showed a lower BMI (β = -0.38; P < 0.001; B = -0.06; SE = 0.003). The fMRI results showed a decreased vmPFC response to high-calorie food were correlated with greater dietary restraint. Moreover, there was an association of attenuated intrinsic vmPFC-related functional connectivity in the superior and middle frontal gyrus and the middle temporal gyrus with greater dietary restraint.

CONCLUSIONS

Our findings suggest that dietary restraint in adolescents could be a preventive factor for weight gain; its effect involves modulating the vmPFC, which is associated with food value coding.

Identifying behavioral types of dietary lapse from a mobile weight loss program: Preliminary investigation from a secondary data analysis

Success in behavioral weight loss (BWL) programs depends on adherence to the recommended diet to reduce caloric intake. Dietary lapses (i.e., deviations from the BWL diet) occur frequently and can adversely affect weight loss outcomes. Research indicates that lapse behavior is heterogenous; there are many eating behaviors that could constitute a dietary lapse, but they are rarely studied as distinct contributors to weight outcomes. This secondary analysis aims to evaluate six behavioral lapse types during a 10-week mobile BWL program (eating a large portion, eating when not intended, eating an off-plan food, planned lapse, being unaware of caloric content, and endorsing multiple types of lapse). Associations between weekly behavioral lapse type frequency and weekly weight loss were investigated, and predictive contextual characteristics (psychological, behavioral, and environmental triggers for lapse) and individual difference (e.g., age, gender) factors were examined across lapse types. Participants (N = 121) with overweight/obesity (M_BMI = 34.51; 84.3% female; 69.4% White) used a mobile BWL program for 10 weeks, self-weighed weekly using Bluetooth scales, completed daily ecological momentary assessment of lapse behavior and contextual characteristics, and completed a baseline demographics questionnaire. Linear mixed models revealed significant negative associations between unplanned lapses and percent weight loss. Unplanned lapses from eating a large portion, eating when not intended, and having multiple "types" were significantly negatively associated with weekly percent weight loss. A lasso regression showed that behavioral lapse types share many similar stable factors, with other factors being unique to specific lapse types. Results add to the prior literature on lapses and weight loss in BWL and provide preliminary evidence that behavioral lapse types could aid in understanding adherence behavior and developing precision medicine tools to improve dietary adherence.