Experimental investigation of the effects of naturalistic dieting on bulimic symptoms: Moderating effects of depressive symptoms

Development and psychometric evaluation of an empirically-derived daily checklist of weight control: Consumption-reduction strategies and health-focused strategies in college students

Objective: Many college women report engaging in weight control strategies, yet little is known about which strategies are used and how often. The current study's goal was to evaluate the factor structure of a comprehensive list of weight control behaviors used in the previous 24-hours. Participants: Undergraduate women (N = 286) were recruited from a southwestern university. Methods: Participants reported their weight control strategies for the previous 24 hours on a checklist compiled from previous studies. Results: Exploratory and confirmatory factor analyses indicated that a 14-item, 2-factor ("Consumption-reduction", "Health-focused" Strategies) structure was a good fit of the data. Tests of longitudinal measurement invariance found support for using the checklist to make meaningful comparisons across time. Conclusions: This study developed a checklist of past 24-hour weight-control strategy usage, thereby providing a step toward developing an instrument that may be used for weight control or early intervention for disordered eating.

"An Important Part of Who I am": The Predictors of Dietary Adherence among Weight-Loss, Vegetarian, Vegan, Paleo, and Gluten-Free Dietary Groups

Weight-loss diets are notorious for their low adherence, which is a barrier to efforts to reduce population rates of overweight and obesity. However, there is some evidence that adherence is better among people on other kinds of diets, such as vegan and gluten free. This study aimed to explore the predictors of dietary adherence across five restrictive dietary patterns (vegan, vegetarian, paleo, gluten free, and weight loss). This study used both qualitative and quantitative methods among 292 adult community members who were following a restrictive dietary pattern. Personality, mental health, and motivational predictors of adherence were examined. Substantial differences in adherence were found between dietary groups, with vegans and vegetarians being particularly high in adherence and gluten-free and weight-loss dieters being comparably low. Four consistent predictors of adherence across different dietary patterns were supported in both the quantitative and qualitative analyses. Self-efficacy and social identification with one's dietary group positively predicted adherence. Conversely, being motivated in one's dietary choices by mood or by weight control negatively predicted adherence. These findings speak to the importance of social and motivational factors in determining adherence. The results also illustrate the utility of looking beyond weight-loss dieters and virtuous individual traits for insights into how adherence may be improved.

What does self-reported "dieting" mean? Evidence from a daily diary study of behavior

Dieting is often recommended as a means of weight loss, yet research consistently shows that self-reported dieting does not result in weight loss. Toward resolving this discrepancy, this study assessed the daily dietary intake and weight control strategies of people who self-identified as dieting. College women (N = 266) provided a report of their eating pattern (dieting, "watching what I eat," and/or "eating healthy") followed by three daily diaries (24-hour recalls of dietary intake and weight control strategies) elicited on randomly selected days during a one-month period. Dieters were expected to report fewer daily calories, more daily exercise, and more daily weight control strategies than non-dieters. At baseline, 122 participants (45.9%) endorsed both "watching" and "eating healthy" ("Concerned Eaters") while 55 (20.7%) endorsed current dieting along with "watching" and "eating healthy" ("Dieters"). Just 3 (1.1%) endorsed dieting only, and 31 (11.7%) endorsed no eating pattern ("Unconcerned Eaters"). Dieters' mean BMI was in the overweight range; the mean BMIs of other groups were in the normal weight range. Dieters did not consistently endorse dieting across diaries. Nevertheless, Dieters reported fewer daily calories, and more overall weight control strategies, including more healthy weight control strategies, than Concerned Eaters. Across groups, participants' weights did not change significantly during the study. Dieters appear to engage in weight control strategies which could result in weight loss; however, their reports of whether they are dieting vary across days, suggesting a need for more consistent behavior. These results have clinical and research implications in the area of weight loss.

Dietary restraint: what's the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology

Dietary restraint has historically been implicated as a risk factor for the development of eating pathology. Despite existing findings, recent research suggests that many individuals are capable of practicing dietary restraint without negative effects. In order to successfully incorporate the positive aspects of dietary restraint into interventions for healthy weight management, a nuanced examination of the relationship between dietary restraint and resulting eating patterns is necessary. Accordingly, the current review seeks to clarify the existing literature with regard to dietary restraint. First, this review examines the construct of dietary restraint and differentiates dietary restraint from related constructs, such as weight loss dieting. Second, it identifies situations in which dietary restraint has been linked with positive outcomes, such as healthy weight management and prevention of eating pathology. Altogether, it appears that dietary restraint can prove a beneficial strategy for those attempting to control their weight, as it does not relate to increased levels of eating pathology when practiced as part of a well-validated weight management programme.

Gender Differences in Risk Factors for Stice’s Bulimia in a Non-Clinical Sample

Some females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p < .05), but no gender differences were found in their degree of body thin internalization (p > .05), a key predictor of body dissatisfaction (r = .33; p < .01). Participants with higher BMI reported greater social pressure to be thin than those with lower BMI (p < .05). However, females engaged in dietary restraint, the main risk factor for eating disorders, regardless of their BMI (p > .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed.

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating.

Double trouble: restrained eaters do not eat less and feel worse

OBJECTIVE

While high levels of dietary restraint do not appear to reflect actual caloric restraint, it has been found to be a risk factor for a wide array of maladaptive eating patterns. These findings raise the question what, if not caloric restriction, dietary restraint entails. We propose that the very finding that restrained eaters do not eat less than they intend to do can provide an answer. Based on this disparity between the intention to restrain oneself and actual behaviour, we therefore hypothesised that high levels of restraint are associated with eating-related guilt.

METHOD

Three studies (N = 148) using unobtrusive measures of food intake; different restraint scales; and different measures of guilt tested whether restraint is related to eating-related guilt.

RESULTS

Results indicated that restraint was not associated with food intake, but instead was associated with increased levels of guilt after eating. Guilt was explicitly related to food intake. Moreover, the observed guilt could not be attributed to a general increase in negative affect.

CONCLUSION

The results of these studies suggest that restraint is not an indicator of actual restricted food intake, but rather a reflection concerns about food and eating manifested in eating-related guilt.

Which dieters are at risk for the onset of binge eating? A prospective study of adolescents and young adults

PURPOSE

Dieting is a well-established risk factor for binge eating, yet the majority of dieters do not develop binge eating problems. The purpose of the current study was to examine psychosocial factors involved in the relation between dieting and binge eating over a 10-year follow-up period.

METHODS

A population-based sample (n = 1,827) completed surveys assessing eating habits, psychological functioning, and weight status at 5-year intervals spanning early/middle adolescence (time 1), late adolescence/early young adulthood (time 2), and early/middle young adulthood (time 3). Dieting, along with depression symptoms, self-esteem, and teasing experiences at time 1 and time 2, was used to predict new onset binge eating at time 2 and time 3, respectively. Interactions between dieting status and varying degrees of these psychosocial factors in relation to binge eating onset were also tested.

RESULTS

Dieters were two to three times more likely than nondieters to develop binge eating problems over 5-year follow-ups. At most time points, depression symptoms and self-esteem predicted binge eating onset beyond the effects of dieting alone. Detrimental levels of these factors among dieters (relative to nondieters) increased the likelihood of binge eating onset only during the later follow-up period.

CONCLUSIONS

Depression and self-esteem appear to be particularly salient factors involved in the relation between dieting and binge eating onset among adolescents and young adults. Early identification of these factors should be a priority to prevent the development of binge eating problems among already at-risk individuals.

Free will and the obesity epidemic

The increase in body weight in the USA over the past several decades is now commonly referred to as the 'obesity epidemic'. An empirical analysis of the literature suggests that the increased weight can be accounted for by an increase in food intake. The solution to the obesity epidemic, therefore, must centre on a reduction in food consumption, a position well accepted by the American population who think that they, as individuals, are responsible for their adiposity by holding the belief that the decision as to what and how much to eat is determined by their own free will. The evidence demonstrates, however, that this is not true. Variables such as portion size, variety of foods offered, fat content of the diet, the number of people eating, the location where eating occurs and even watching food advertisements act as 'food primes' causing individuals to increase their energy intake. Despite the plethora of diets, weight-loss clubs, drugs and mechanical devices available to facilitate weight loss, once treatment is terminated and people return to the 'free' environment, their weight returns to pre-treatment levels. Only when individuals are protected from environmental variables by gastric surgery or limited to consume only portion-controlled meals can they successfully maintain a reduced weight. Combining the technique of daily weight monitoring with accepting that our eating behaviour is not determined totally by our free choice, we may be able to curb the obesity epidemic.

Are dietary restraint scales valid measures of dietary restriction? Additional objective behavioral and biological data suggest not

Prospective studies find that individuals with elevated dietary restraint scores are at increased risk for bulimic symptom onset, yet experiments find that assignment to energy-deficit diet interventions reduce bulimic symptoms. One explanation for the conflicting findings is that the dietary restraint scales used in the former studies do not actually identify individuals who are restraining their caloric intake. Thus, we tested whether dietary restraint scales showed inverse relations to objectively measured caloric intake in three studies. Four dietary restraint scales did not correlate with doubly labeled water estimates of caloric intake over a 2-week period (M, r=.01). One scale showed a significant inverse correlation with objectively measured caloric intake during a regular meal ordered from an ecologically valid menu (M, r=-.30), but a significant positive relation that was qualified by a significant quadratic effect, to objectively measured caloric intake during multiple eating episodes in the lab (M, r=.32). In balance, results suggest that dietary restraint scales are not valid measures of dietary restriction, replicating findings from prior studies that examined objective measures of caloric intake.

Can we apply the dual-pathway model of overeating to a population of weight-preoccupied overweight women?

OBJECTIVE

The aim of the study is to verify the applicability of the dual-pathway model among weight-preoccupied overweight women and to document the restraint pathway, the negative affect pathway, and the possibility of a direct pathway from body dissatisfaction to overeating.

METHOD

Structural equations were performed to test the model on baseline data of 153 weight-preoccupied overweight women recruited to participate in a randomized trial.

RESULTS

Findings suggest that the model obtains satisfactory fit. Although the restraint pathway is partially supported, the negative affect pathway is confirmed. A third pathway linking directly body dissatisfaction to overeating is also evidenced.

DISCUSSION

The dual-pathway model of overeating seems to be representative of the reality of weight-preoccupied overweight women, which could be pointed as a population in need of clinical attention, particularly considering the dramatically increasing rates of obesity.

Egg breakfast enhances weight loss

OBJECTIVE

To test the hypotheses that an egg breakfast, in contrast to a bagel breakfast matched for energy density and total energy, would enhance weight loss in overweight and obese participants while on a reduced-calorie weight loss diet.

SUBJECTS

Men and women (n=152), age 25-60 years, body mass index (BMI) >or=25 and <or=50 kg m(-2).

DESIGN

Otherwise healthy overweight or obese participants were assigned to Egg (E), Egg Diet (ED), Bagel (B) or Bagel Diet (BD) groups, based on the prescription of either an egg breakfast containing two eggs (340 kcal) or a breakfast containing bagels matched for energy density and total energy, for at least 5 days per week, respectively. The ED and BD groups were suggested a 1000 kcal energy-deficit low-fat diet, whereas the B and E groups were asked not to change their energy intake.

RESULTS

After 8 weeks, in comparison to the BD group, the ED group showed a 61% greater reduction in BMI (-0.95+/-0.82 vs -0.59+/-0.85, P<0.05), a 65% greater weight loss (-2.63+/-2.33 vs -1.59+/-2.38 kg, P<0.05), a 34% greater reduction in waist circumference (P<0.06) and a 16% greater reduction in percent body fat (P=not significant). No significant differences between the E and B groups on the aforementioned variables were obtained. Further, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, did not differ between the groups.

CONCLUSIONS

The egg breakfast enhances weight loss, when combined with an energy-deficit diet, but does not induce weight loss in a free-living condition. The inclusion of eggs in a weight management program may offer a nutritious supplement to enhance weight loss.