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Dicker-Oren SD, Gelkopf M, Greene T. Anxiety and restrained eating in everyday life: An ecological momentary assessment study. J Affect Disord 2024; 362:543-551. [PMID: 39019225 DOI: 10.1016/j.jad.2024.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 07/08/2024] [Accepted: 07/14/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Restrained eating has been related to psychological distress like anxiety and eating disorder symptomatology, but little is known about this relationship in daily life in non-clinical populations. We aimed to understand concurrent and temporal associations between momentary anxiety and restrained eating in everyday life within and across persons in a non-clinical sample, and examined whether this association remains after controlling for eating disorder symptomatology. METHODS We used a 10-day ecological momentary assessment (EMA) protocol. Participants (n = 123) completed a baseline survey with demographics and eating disorder symptomatology questions, and three EMA surveys per day reporting anxiety and restrained eating intentions. We applied mixed-effects and random intercept cross-lagged models to analyze the data. RESULTS Momentary anxiety and restrained eating were concurrently significantly positively associated within and between persons. When participants had more anxiety than was typical for them, they were more likely to intend to restrain eating, and people with overall higher anxiety symptoms tended to report greater restrained eating over the study period. These associations remained significant after adjusting for eating disorder symptomatology. There were no significant temporal cross-lagged effects. Anxiety-restrained eating association did not spill over into the next assessment window. LIMITATIONS The time window between prompts may have been too long to capture potential temporal effects, and we did not examine actual behavioral food restrictions. CONCLUSION Daily-life anxiety may be related to concurrent restrained eating intentions, above and beyond baseline eating disorder symptomatology. Research is needed exploring daily-life anxiety as a potential intervention target to address restrained eating.
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Affiliation(s)
- S D Dicker-Oren
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - M Gelkopf
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - T Greene
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
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Hildebrandt T, Boyar A, Chen X, Holland K, Silverman E, Webb D, Wolk S, Schulz K, Sysko R. Phase-Transitions in Disgust During Self-Initiated Eating Among Adolescents With Anorexia Nervosa and Related Low-Weight Eating Disorders and Matched Controls. Int J Eat Disord 2024. [PMID: 38958505 DOI: 10.1002/eat.24254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Understanding the emotional context of feeding behavior may help identify causal mechanisms of food avoidance among individuals with anorexia nervosa. Although predominant food avoidance models assume fear of fat drives feeding behavior, disgust may be more theoretically and proximally relevant to moment-to-moment experiences of feeding. This study, therefore, aimed to examine affect and food avoidance using automated affect analysis from facial response by measuring time-specific transitions in disgust during a laboratory eating paradigm. We hypothesized that phase transitions in disgust would distinguish temporally self-initiated eating from food avoidance. METHODS Sixty-three adolescents with anorexia nervosa or another low-weight eating disorder (LWED) and 27 age- and sex-matched controls were recruited as part of a larger study; 45 patients and 22 controls provided data on autonomous eating and facial affect during a laboratory meal. Dynamic structural equation models quantified moment-to-moment relationships between disgust and feeding behavior. RESULTS Self-initiated eating was associated with greater increases in disgust, but not fear, intensity among those with LWED relative to control participants and greater disgust intensity predicted lower likelihood of self-initiated eating. DISCUSSION Phasic transitions in disgust provide moment-to-moment evidence of affective influence on self-initiated eating and lend credibility to the hypothesis that disgust contributes to food avoidance and initiation in individuals with LWED.
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Affiliation(s)
- Tom Hildebrandt
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Allison Boyar
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Xi Chen
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katherine Holland
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Elena Silverman
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Desiree Webb
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sophia Wolk
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kurt Schulz
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robyn Sysko
- Center of Excellence in Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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3
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Parker MN, Moursi NA, Adekola PE, Bloomer BF, Te-Vazquez J, Nwosu EE, Lazareva J, Jones JL, Yang SB, Turner SA, Brady SM, Chen KY, Tanofsky-Kraff M, Yanovski JA. Youth's energy intake during a laboratory-based loss-of-control eating paradigm: Associations with reported current dieting. Eat Behav 2024; 53:101877. [PMID: 38640597 PMCID: PMC11144072 DOI: 10.1016/j.eatbeh.2024.101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/26/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
Dieting is theorized as a risk factor for loss-of-control (LOC)-eating (i.e., feeling a sense of lack of control while eating). Support for this association has largely relied on retrospective self-report data, which does not always correlate with objectively assessed eating behavior in youth. We hypothesized that during a laboratory-based LOC-eating paradigm, children and adolescents who reported current (at the time of the visit) dieting would consume meals consistent with LOC-eating (greater caloric intake, and intake of carbohydrates and fats, but less intake of protein). Participants were presented with a buffet-style meal and instructed to "Let yourself go and eat as much as you want." Current dieting (i.e., any deliberate change to the amount or type of food eaten to influence shape or weight, regardless of how effective the changes are) was assessed via interview. General linear models were adjusted for fat mass (%), lean mass (kg), height, sex, protocol, race and ethnicity, pre-meal hunger and minutes since consumption of a breakfast shake. Of 337 participants (Mage 12.8 ± 2.7y; 62.3 % female; 45.7 % non- Hispanic White and 26.1 % non-Hispanic Black; MBMIz 0.78 ± 1.11), only 33 (9.8 %) reported current dieting. Current dieting was not significantly associated with total energy intake (F = 1.63, p = .20, ηp2 = 0.005), or intake from carbohydrates (F = 2.45, p = .12, ηp2 = 0.007), fat (F = 2.65, p = .10, ηp2 = 0.008), or protein (F = 0.39, p = .53, ηp2 = 0.001). Contrary to theories that dieting promotes LOC-eating, current dieting was not associated with youth's eating behavior in a laboratory setting. Experimental approaches for investigating dieting are needed to test theories that implicate dieting in pediatric LOC-eating.
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Affiliation(s)
- Megan N Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Nasreen A Moursi
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Praise E Adekola
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Bess F Bloomer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Jennifer Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Ejike E Nwosu
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Julia Lazareva
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Jeremiah L Jones
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Shanna B Yang
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sara A Turner
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, & Obesity Branch, National Institute of Diabetes and Digestive and Kidney Disorders, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
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Berebbi S, Naftalovich H, Weinbach N, Kalanthroff E. Fostering positive attitudes toward food in individuals with restrained eating: the impact of flexible food-related inhibition. J Eat Disord 2024; 12:41. [PMID: 38509611 PMCID: PMC10956199 DOI: 10.1186/s40337-024-00995-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Individuals exhibiting restrained eating behaviors demonstrate increased inhibitory control when exposed to food-related stimuli, indicating the presence of an automatic food-inhibition association. Existing literature proposes that this association contributes to the devaluation of food within this population. Efforts to disrupt this association by promoting the complete elimination of the inhibition of food responses have resulted in increased food consumption but have also led to heightened food-related anxiety in individuals with restrained eating behaviors. In the current investigation, we investigated whether a novel flexible food response/inhibition computerized task could yield favorable changes in attitudes toward food in individuals with restrained eating. We randomly assigned 78 females who engage in restrained eating to one of three training groups. In the flexible response/inhibition group, participants were instructed to equally inhibit or respond to food stimuli. In the response group, participants consistently responded to food stimuli, while in the inhibition group, participants consistently inhibited their response to food cues. Implicit attitudes toward food were assessed both before and after the manipulation. To examine the stability of the effect of the training, participants also engaged in a seemingly unrelated bogus taste test. Our results revealed that only the flexible response/inhibition group demonstrated a significant improvement in positive attitudes toward high-calorie foods after eating, while there were no observable changes in negative attitudes among the other two groups. These findings suggest that promoting a balance between the responding and inhibiting responses to food stimuli can increase positive attitudes toward food amongst individuals with restrained eating.
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Affiliation(s)
- Shir Berebbi
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Hadar Naftalovich
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Noam Weinbach
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Eyal Kalanthroff
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Psychiatry, Columbia University Medical Center, New York, USA
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Hinton EC, Beesley V, Leary SD, Ferriday D. Associations between body mass index and episodic memory for recent eating, mindful eating, and cognitive distraction: A cross-sectional study. Obes Sci Pract 2024; 10:e728. [PMID: 38187125 PMCID: PMC10768738 DOI: 10.1002/osp4.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre-registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self-reported BMI. The timing of data collection (April-May 2020) during the SARS-CoV-2 pandemic enabled an investigation of the impact of stay-at-home restrictions imposed on the UK population on the measures of eating behavior. Methods An online survey was completed, including: (i) demographic data (e.g., self-reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID-19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ). Results A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ-total score) was associated with a lower self-reported BMI (β = -0.12; 95% CI = -0.20, -0.04; p = 0.004), whereas disinhibited eating was associated with a higher self-reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating. Conclusions These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.
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Affiliation(s)
- Elanor C. Hinton
- NIHR Bristol Biomedical Research Centre Diet and Physical Activity ThemeUniversity of BristolBristolUK
| | - Victoria Beesley
- Nutrition and Behaviour UnitSchool of Psychological ScienceUniversity of BristolBristolUK
| | - Sam D. Leary
- NIHR Bristol Biomedical Research Centre Diet and Physical Activity ThemeUniversity of BristolBristolUK
| | - Danielle Ferriday
- NIHR Bristol Biomedical Research Centre Diet and Physical Activity ThemeUniversity of BristolBristolUK
- Nutrition and Behaviour UnitSchool of Psychological ScienceUniversity of BristolBristolUK
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Cooper M, Mears C, Heckert K, Orloff N, Peebles R, Timko CA. The buffet challenge: a behavioral assessment of eating behavior in adolescents with an eating disorder. J Eat Disord 2024; 12:8. [PMID: 38238787 PMCID: PMC10797715 DOI: 10.1186/s40337-024-00968-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE Eating disorders are characterized by disturbances in nutritional intake and abnormal mealtime behaviors. Laboratory eating paradigms offer a unique opportunity to accurately measure dietary intake and eating behaviors, however, these studies have predominantly occurred in adults. This paper describes the development and preliminary psychometric examination of the Buffet Challenge, a laboratory-based meal task for youths with an eating disorder. METHOD We recruited and assessed 56 participants as part of a randomized controlled trial of Family-Based Treatment for adolescents with anorexia nervosa. Adolescents completed the Buffet Challenge at baseline, midway through treatment (~ week 16 of a 6 months course), and end of treatment. Participants and their parents also reported eating disorder symptomatology and treatment related variables of interest were recorded. RESULTS All adolescents were willing to complete the Buffet Challenge at all time points, although one refused to give up their cellphone, and there were no significant adverse events recorded. Preliminary results are presented. CONCLUSIONS Our initial pilot of this task in adolescents with anorexia nervosa demonstrates its acceptability, although investigation of our hypotheses was hindered by significant missing data due to COVID-related research shutdowns. Future studies should replicate procedures in a larger sample to ensure analyses are adequately powered.
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Affiliation(s)
- Marita Cooper
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Connor Mears
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, West Chester University, West Chester, PA, USA
| | - Kerri Heckert
- Department of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Natalia Orloff
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Equip Health, Philadelphia, USA
| | - Rebecka Peebles
- The Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Monte Nido & Affiliates, Philadelphia, USA
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA.
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Srivastava P, Presseller EK, Chen JY, Clark KE, Hunt RA, Clancy OM, Manasse S, Juarascio AS. Weight status is associated with clinical characteristics among individuals with bulimia nervosa. Eat Disord 2023; 31:415-439. [PMID: 36419352 PMCID: PMC11253114 DOI: 10.1080/10640266.2022.2145258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent studies have found increasing rates of overweight and obesity in bulimia nervosa (BN). However, the relationships between body mass index (BMI) and BN symptoms and other clinically relevant constructs are unknown. Participants (N = 152 adults with BN) were assigned to three groups by BMI: group with no overweight or obesity (NOW-BN; BMI <25; N = 32), group with overweight (OW-BN; BMI ≥25 and <30; N = 66), and group with obesity (O-BN; BMI ≥30; N = 54). We compared the groups on demographics, diet and weight histories, body esteem, BN symptoms, and depression using chi square, analysis of variance, analysis of covariance, and Poisson regression models. The O-BN group was older (d = 0.57) and OW-BN and O-BN groups had greater proportions of race/ethnic minorities than NOW-BN group. The O-BN group was significantly younger at first diet (d = 0.41) and demonstrated significantly higher cognitive dietary restraint (d = 0.31). Compared to NOW-BN, O-BN participants had lower incidence of objective binge eating (incidence rate ratio [IRR] = 4.86) and driven exercise (IRR = 7.13), and greater incidence of vomiting (IRR = 9.30), laxative misuse (IRR = 4.01), and diuretic misuse (d = 2.08). O-BN participants also experienced higher shape (d = 0.41) and weight (d = 0.42) concerns than NOW-BN and OW-BN, although NOW-BN experienced higher shape (d = 0.44) and weight (d = 0.39) concerns than OW-BN. Groups did not differ on depression scores. These results were replicated when examining BMI as a continuous predictor across the full sample, with the exception of objective binge eating and driven exercise, which were not significantly associated with BMI. Individuals with BN and comorbid obesity have distinct clinical characteristics. Existing interventions may need to be adapted to meet clinical needs of these individuals.
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Affiliation(s)
- Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Emily K. Presseller
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Joanna Y. Chen
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Kelsey E. Clark
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Rowan A. Hunt
- University of Louisville, Department of Psychological and Brain Sciences, Louisville, Kentucky, USA
| | - Olivia M. Clancy
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Stephanie Manasse
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - Adrienne S. Juarascio
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
- Department of Psychology, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
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Trolio V, Racine SE. Exploring latent profiles of disordered eating using an indicator of dietary restriction in an undergraduate sample of men and women. Int J Eat Disord 2023; 56:1603-1613. [PMID: 37158655 DOI: 10.1002/eat.23985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Latent class or latent profile analysis (LPA) studies in patients with eating disorders consistently identify a low-weight, restrictive eating subgroup that does not endorse weight/shape concerns. To date, similar studies in samples unselected for disordered eating symptoms have not identified a high restriction-low weight/shape concerns group, which may be due to a lack of inclusion of measures of dietary restriction. METHOD We conducted an LPA using data from 1623 college students (54% female) recruited across three different studies. The Eating Pathology Symptoms Inventory Body Dissatisfaction, Cognitive Restraint, Restricting, and Binge Eating subscales were used as indicators, and body mass index, gender, and dataset were covaried. Purging, excessive exercise, emotion dysregulation, and harmful alcohol use were compared across resulting clusters. RESULTS Fit indices supported a 10-class solution, including five disordered eating groups (largest to smallest): "Elevated General Disordered Eating", "Body Dissatisfied Binge Eating," "Most Severe General Disordered Eating," "Non-Body Dissatisfied Binge Eating," and "Non-Body Dissatisfied Restriction." The "Non-Body Dissatisfied Restriction" group scored as low on other measures of traditional eating pathology and harmful alcohol use as non-disordered eating groups but scored as high on a measure of emotion dysregulation as other disordered eating groups. DISCUSSION This study is the first to identify a latent restrictive eating group that does not endorse traditional disordered eating cognitions in an unselected sample of undergraduate students. Results underscore the importance of using measures of disordered eating behaviors without implied motivation to capture overlooked problematic eating patterns in the population that are distinct from our "traditional" understanding of disordered eating. PUBLIC SIGNIFICANCE We identified a group of individuals with high levels of restrictive eating but low body dissatisfaction and intent to diet in an unselected adult sample of men and women. Results underscore the need to investigate restrictive eating outside of the traditional lens of body shape concerns. Findings also suggest that individuals with nontraditional eating difficulties may struggle with emotion dysregulation, putting them at risk of poor psychological and relational outcomes.
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Affiliation(s)
- Vittoria Trolio
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Wang Y, Wang J, Geng J, Wang H, Lei L. Body talk on social networking sites and restrained eating among adolescents: A test of a multiple mediation model. Body Image 2023; 45:145-152. [PMID: 36924748 DOI: 10.1016/j.bodyim.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
The present study aimed to examine the link between body talk on social networking sites (SNS body talk) and restrained eating as well as the mediating roles of fear of negative appearance evaluation (FNAE) and body shame in this relationship. Furthermore, the moderating role of gender in the mediation model was also examined. A sample of 1481 Chinese middle and high school students (720 girls, mean age = 15.49 ± 1.84) completed self-reported measures of SNS body talk, FNAE, body shame, and restrained eating. Results showed that SNS body talk was positively associated with restrained eating. FNAE and body shame mediated the association between SNS body talk and restrained eating, separately and serially. Furthermore, gender difference emerged in the path from SNS body talk to body shame and the path from FNAE to body shame. Findings of the present study enrich the literature on social media and body image and eating behaviors, and have important implications for reducing negative body image and disordered eating among adolescents.
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Affiliation(s)
- Yuhui Wang
- Faculty of Humanities and Social Sciences, Beijing University of Technology, Beijing 100124, China; Beijing Social Governance Research Center, Beijing University of Technology, Beijing 100124, China
| | - Jing Wang
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Jingyu Geng
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Hongxia Wang
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Li Lei
- School of Education, Renmin University of China, Beijing 100872, China.
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Anastasiades E, Argyrides M. Exploring the role of positive body image in healthy orthorexia and orthorexia nervosa: A gender comparison. Appetite 2023; 185:106523. [PMID: 36871603 DOI: 10.1016/j.appet.2023.106523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
Current scholarship on orthorexia nervosa remains undecided about the role of body image in this novel eating disorder. This study aimed to explore the role of positive body image in differentiating between healthy orthorexia and orthorexia nervosa and assess how this might differ for men and women. A total of 814 participants (67.1% women; age M = 40.30, SD = 14.50) completed the Teruel Orthorexia scale, as well as measures of embodiment, intuitive eating, body appreciation and functionality appreciation. A cluster analysis revealed four distinct profiles characterized by high healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and high orthorexia nervosa; and high healthy orthorexia and high orthorexia nervosa. A MANOVA identified significant differences for positive body image between these four clusters, as well as that there were no significant differences between men and women for healthy orthorexia and orthorexia nervosa, despite men scoring significantly higher than women on all measures of positive body image. Cluster × gender interaction effects were found for intuitive eating, functionality appreciation, body appreciation and experience of embodiment. These findings indicate that the role of positive body image in healthy orthorexia and orthorexia nervosa may differ for men and women, making these relationships worthy of further exploration.
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Dakin C, Beaulieu K, Hopkins M, Gibbons C, Finlayson G, Stubbs RJ. Do eating behavior traits predict energy intake and body mass index? A systematic review and meta-analysis. Obes Rev 2023; 24:e13515. [PMID: 36305739 PMCID: PMC10078190 DOI: 10.1111/obr.13515] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 12/27/2022]
Abstract
At present, it is unclear whether eating behavior traits (EBT) predict objectively measured short-term energy intake (EI) and longer-term energy balance as estimated by body mass index (BMI). This systematic review examined the impact of EBT on BMI and laboratory-based measures of EI in adults ( ≥ 18 years) in any BMI category, excluding self-report measures of EI. Articles were searched up until 28th October 2021 using MEDLINE, PsycINFO, EMBASE and Web of Science. Sixteen EBT were identified and the association between 10 EBT, EI and BMI were assessed using a random-effects meta-analysis. Other EBT outcomes were synthesized qualitatively. Risk of bias was assessed with the mixed methods appraisal tool. A total of 83 studies were included (mean BMI = 25.20 kg/m2 , mean age = 27 years and mean sample size = 70). Study quality was rated moderately high overall, with some concerns in sampling strategy and statistical analyses. Susceptibility to hunger (n = 6) and binge eating (n = 7) were the strongest predictors of EI. Disinhibition (n = 8) was the strongest predictor of BMI. Overall, EBT may be useful as phenotypic markers of susceptibility to overconsume or develop obesity (PROSPERO: CRD42021288694).
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Affiliation(s)
- Clarissa Dakin
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Hopkins
- School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R James Stubbs
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Argyrides M, Anastasiades E. Intuitive eating in Greek-Cypriot adults: Influence of gender and body mass. Front Psychol 2022; 13:1033720. [PMID: 36506965 PMCID: PMC9731100 DOI: 10.3389/fpsyg.2022.1033720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction To date, research on eating behaviors has largely taken a pathological approach. Researchers are increasingly taking a positive approach to explore adaptive eating styles. One such style that has recently received much research attention is intuitive eating. Recent work examining intuitive eating and its relationships with body mass and gender has yielded mixed findings. The current study explored the differential effects of gender and body mass on intuitive eating scores in a sample of Greek-Cypriot adults. Method A total of 1,312 adult participants (women n = 655; M age = 34.49) completed the Intuitive Eating Scale-2 and provided demographic information. Results Our analyses revealed that men reported significantly higher intuitive eating scores than women. Body mass was significantly inversely associated with intuitive eating in both men and women. Additionally, a multivariate analysis of variance (MANOVA) indicated significant interaction effects between gender and body mass on intuitive eating. These interaction effects were explored for each of the four subscales of intuitive eating, identifying differential associations for intuitive eating and BMI between men and women. Discussion Both gender and body mass are important factors which influence intuitive eating levels in Greek-Cypriot adults. Discussions of how these findings can inform future research, theory and practice are presented.
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Nill T, Meule A. On the measurement and correlates of plate clearing: examining a German version of the Plate Clearing Tendency Scale. Eat Weight Disord 2022; 27:2791-2800. [PMID: 35771365 PMCID: PMC9556377 DOI: 10.1007/s40519-022-01433-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/11/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Plate clearing-eating a meal in its entirety-is common and may be a factor contributing to obesity. For the assessment of individual differences in plate clearing tendencies, Robinson et al. (Obesity 23:301-304, 2015) developed the Plate Clearing Tendency Scale (PCTS). However, little is known about the psychometric properties of this scale and its correlates. METHODS In the current study, participants (N = 207, 76% female) completed a German translation of the PCTS and other questionnaires online. RESULTS A one-factor structure had good model fit and the PCTS had acceptable internal reliability and good test-retest reliability across an average of four and a half weeks. Higher plate clearing tendencies related to more frequent parental encouragement to clear one's plate in childhood and to stronger food waste concerns but were unrelated to sex, body weight, self-control, and eating behaviors. However, higher plate clearing tendencies related to higher body weight in unsuccessful dieters. CONCLUSION The current study shows that the PCTS has sound psychometric properties and that plate clearing tendencies appear to be largely driven by food waste concerns and not by automatic eating habits or low eating-related self-control. In dieters, however, high plate clearing tendencies may contribute to low dieting success and hinder weight loss. LEVEL OF EVIDENCE No level of evidence, basic science.
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Affiliation(s)
- Tina Nill
- Institute of Psychology, University of Würzburg, Würzburg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. .,Schön Klinik Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.
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Calugi S, Morandini N, Milanese C, Dametti L, Sartirana M, Fasoli D, Dalle Grave R. Validity and reliability of the Dietary Rules Inventory (DRI). Eat Weight Disord 2022; 27:285-294. [PMID: 33782917 DOI: 10.1007/s40519-021-01177-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/23/2021] [Accepted: 02/15/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Dietary rules are common in patients with eating disorders, and according to transdiagnostic cognitive behavioural theory for eating disorders, represent a key behaviour maintaining eating-disorder psychopathology. The aim of this study was to describe the design and validation of the Dietary Rules Inventory (DRI), a new self-report questionnaire that assesses dietary rules in patients with eating disorders. METHODS A transdiagnostic sample of 320 patients with eating disorders, as well as 95 patients with obesity and 122 healthy controls were recruited. Patients with eating disorders also completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Eating Disorder Examination Questionnaire, the Brief Symptoms Inventory and the Clinical Impairment Assessment. Dietary rules were rated on a continuous Likert-type scale (0-4), rating how often (from never to always) they had been applied over the previous 28 days. RESULTS DRI scores were significantly higher in patients with eating disorders than in patients with obesity and healthy controls. Principal factor analysis identified that 55.8% of the variance was accounted for by four factors, namely 'what to eat', 'social eating', 'when and how much to eat' and 'caloric level'. Both global score and subscales demonstrated high internal and test-retest reliability. The DRI global score was significantly correlated with the DEBQ 'restrained eating' subscale, as well as eating-disorder and general psychopathology and clinical impairment scores, demonstrating good convergent validity. CONCLUSIONS These findings suggest that the DRI is a valid self-report questionnaire that may provide important clinical information regarding the dietary rules underlying dietary restraint in patients with eating disorders. LEVEL OF EVIDENCE V, descriptive study.
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy.
| | - Nicole Morandini
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Laura Dametti
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Massimiliano Sartirana
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Deborah Fasoli
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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16
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Ghani SB, Delgadillo ME, Granados K, Okuagu AC, Wills CC, Alfonso-Miller P, Buxton OM, Patel SR, Ruiz J, Parthasarathy S, Haynes PL, Molina P, Seixas A, Jean-Louis G, Grandner MA. Patterns of Eating Associated with Sleep Characteristics: A Pilot Study among Individuals of Mexican Descent at the US-Mexico Border. Behav Sleep Med 2022; 20:212-223. [PMID: 33784893 PMCID: PMC8481352 DOI: 10.1080/15402002.2021.1902814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Utilizing the revised TFEQ-R-18, this study will examine whether eating behaviors such as cognitive restraint, emotional eating and uncontrolled eating are related to self-reported sleep experiences. Specifically, we hypothesized that poor eating habits would be associated with (1) more insomnia symptoms, (2) overall worse sleep quality, (3) increased daytime sleepiness, and (4) shorter sleep duration.Methods: Data were collected from N = 100 adults (age 18-60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for "cognitive restraint," "uncontrolled eating," and "emotional eating." Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included age, sex, Body Mass Index (BMI), education and immigrant status.Results: Overall TFEQ score (problematic eating) was positively associated with greater insomnia, poorer sleep quality, more sleepiness, and less weekend (but not weekday) sleep. Mean TFEQ score in the sample was 18.7 (range 0-51). In adjusted analyses, every point on the TFEQ was associated with 0.6 ISI points, 0.8 PSQI points, 0.5 ESS points, and 1.1 minutes of less weekend sleep duration. Regarding subscale scores, relationships were generally seenbetween sleep and emotional eating and unrestricted eating, and not cognitive restraint.Conclusions: Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US-Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos.
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Affiliation(s)
- Sadia B. Ghani
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA,Sadia B Ghani Sleep Health and Research Program, Department of Psychiatry 1501 N Campbell Avenue Suite 7326 PO Box 245002 Tucson, AZ 85724-5002
| | - Marcos E. Delgadillo
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA
| | - Karla Granados
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA
| | - Ashley C. Okuagu
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA
| | - Chloe C.A. Wills
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA
| | - Pamela Alfonso-Miller
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA,Northumbria Sleep Research, Northumbria University, Newcastle-upon-Tyne, NE1 8ST, England
| | - Orfeu M. Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, USA
| | - Sanjay R. Patel
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, USA
| | - Sairam Parthasarathy
- Center for Sleep Disorders and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, and Department of Internal Medicine, University of Arizona, Tucson, USA
| | - Patricia L. Haynes
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, USA
| | - Patricia Molina
- Senior Director, Mariposa Community Health Center, Nogales, USA
| | - Azizi Seixas
- Department of Population Health, and Department of Psychiatry, NYU Langone Health, New York, USA
| | - Girardin Jean-Louis
- Department of Population Health, and Department of Psychiatry, NYU Langone Health, New York, USA
| | - Michael A. Grandner
- Sleep Health and Research Program and Department of Psychiatry, University of Arizona, Tucson, USA
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17
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Ku CW, Loo RSX, Lim CJE, Tan JJX, Ho JEW, Han WM, Ng XW, Chan JKY, Yap F, Loy SL. Development and Validation of a Lifestyle Behavior Tool in Overweight and Obese Women through Qualitative and Quantitative Approaches. Nutrients 2021; 13:4553. [PMID: 34960105 PMCID: PMC8707061 DOI: 10.3390/nu13124553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
There is a paucity of effective intervention tools for overweight/obese women to assess, guide and monitor their eating behavior. This study aimed to develop a lifestyle intervention tool, assess its acceptability and usefulness, and verify its construct validity in overweight/obese women. The 6P tool (Portion, Proportion, Pleasure, Phase, Physicality, Psychology) was developed and 15 women with a body mass index (BMI) ≥ 25 kg/m2 were interviewed to assess its perceived acceptability and usefulness. Subsequently, the revised 6P tool was tested in 46 women with a BMI ≥ 25 kg/m2. The Three-Factor Eating Questionnaire (TFEQ), International Physical Activity Questionnaire-Short (IPAQ), and weight were measured at baseline and one-month. Most participants were satisfied with the presentation of the 6P tool (86.8%), and agreed it was useful in guiding healthy eating (81.6%) and raising awareness of eating behavior (97.4%). There were significant improvements in cognitive restraint (p = 0.010) and disinhibition (p = 0.030) (TFEQ), portion size (P1), pleasure behaviors (P3), and total composite 6P score (p < 0.001). However, there was no significant reduction in weight or increase in physical activity. The 6P tool is acceptable and presents with good validity for assessing lifestyle behaviors.
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Affiliation(s)
- Chee Wai Ku
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; (J.K.Y.C.); (F.Y.)
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Rachael Si Xuan Loo
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Cheryl Jia En Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Jacinth J. X. Tan
- School of Social Sciences, Singapore Management University, Singapore 178903, Singapore;
| | - Joey Ee Wen Ho
- Department of Dietetics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (J.E.W.H.); (W.M.H.)
| | - Wee Meng Han
- Department of Dietetics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (J.E.W.H.); (W.M.H.)
| | - Xiang Wen Ng
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; (J.K.Y.C.); (F.Y.)
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; (J.K.Y.C.); (F.Y.)
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
| | - See Ling Loy
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; (J.K.Y.C.); (F.Y.)
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
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Bottera AR, Kambanis PE, De Young KP. Persistence: A key factor in understanding the circumstances under which dietary restraint predicts restriction of caloric intake. Eat Behav 2021; 43:101563. [PMID: 34517278 DOI: 10.1016/j.eatbeh.2021.101563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 07/15/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Dietary restraint refers to the intention to restrict caloric intake, whereas dietary restriction refers to the actual intentional and sustained restriction of caloric intake for weight-control purposes. Findings regarding the relation between dietary restraint and restriction to date are inconsistent. Our study sought to clarify this complex relationship using a novel laboratory task. Participants (N = 103; 56.3% female) completed a Paced Visual Serial Addition Task (PVSAT). Participants were provided a choice between ending each of eight PVSAT rounds at any time and drinking a high-calorie Kool-Aid® mixture or correctly completing 10 consecutive computations to access to a zero-calorie mixture for each round. We measured participants' dietary restraint using the Three-Factor Eating Questionnaire - Restraint Subscale and measured persistence and dietary restriction using the PVSAT. Results indicated a positive association between persistence and restriction. Female participants demonstrated higher eating disorder psychopathology, dietary restraint, and dietary restriction compared to male participants. Restraint was positively associated with restriction the more individuals persisted, indicating that persistence is a potentially important modifier of the relation between dietary restraint and restriction. Our findings highlight the complexity of the relation between dietary restraint and restriction; that is, measures of dietary restraint alone may not reliably predict short-term dietary restriction during laboratory consumption tasks; however, other factors, such as persistence, may play critical roles.
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Affiliation(s)
| | | | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, WY, USA
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19
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Hagerman CJ, Stock ML, Beekman JB, Yeung EW, Persky S. The ironic effects of dietary restraint in situations that undermine self-regulation. Eat Behav 2021; 43:101579. [PMID: 34800913 PMCID: PMC10124920 DOI: 10.1016/j.eatbeh.2021.101579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
Dietary restraint, defined as the cognitive effort to restrict eating, can paradoxically make individuals more susceptible to unhealthy eating when their ability to self-regulate is threatened. Past experiments have found that, in situations that elicit low self-control and/or unhealthy cravings, participants with higher dietary restraint eat more than those with lower restraint. However, these relationships have never been examined in a free-living environment. The current daily diary study examined if dietary restraint would exacerbate the associations between poor self-control and unhealthy cravings with overconsumption, namely, eating more than usual and binge eating. College women (N = 121, M age = 19) reported their restrained eating behavior and completed seven daily surveys. Multilevel analyses showed a significant interaction between dietary restraint and daily self-control on eating more than usual (b = -0.13, p = .001) and binge eating (b = -0.22, p < .001). Lower daily self-control was associated with eating more than usual and with more binge eating that day, but only among women with higher dietary restraint. Dietary restraint also moderated the effect of cravings on eating more than usual (b = 0.10, p = .007); this relationship was stronger for women with higher restraint. Stronger cravings were associated with more binge eating regardless of restraint. Results suggest that situations that undermine self-control are more strongly associated with overeating among those with higher dietary restraint. Findings can inform strategies to reduce overconsumption among restrained eaters.
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Affiliation(s)
- Charlotte J Hagerman
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA; Weight, Eating, and Lifestyle Science (WELL) Center, Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA.
| | - Michelle L Stock
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Janine B Beekman
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Ellen W Yeung
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, Building 31, Room B1B36, 31 Center Dr., MSC 2073, Bethesda, MD 20892, USA
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20
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Palascha A, van Kleef E, de Vet E, van Trijp HC. Self-reported sensitivity to physiological signals of satiation and hunger: Assessment of construct validity. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.111054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Middlemass KM, Cruz J, Gamboa A, Johnson C, Taylor B, Gomez F, Becker CB. Food insecurity & dietary restraint in a diverse urban population. Eat Disord 2021; 29:616-629. [PMID: 32129723 DOI: 10.1080/10640266.2020.1723343] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The primary aim of this study was to investigate self-reported reasons for engaging in dietary restraint (DR) in a food insecure urban population. It also tested whether DR was associated with increased eating disorder (ED) pathology when DR was broadly assessed. The initial sample (N = 503) consisted of adult clients visiting food pantries who completed the Eating Disorder Diagnostic Scale for DSM 5, the Radimer Cornell Food Insecurity Measure, and three items from the DR subscale of Eating Disorder Examination Questionnaire (EDE-Q); EDE-Q items were modified to allow participants to explain why they restricted. Analyses included participants (N = 259) who responded to one of the modified EDE-Q questions. Results indicated that participants engaged in DR for several reasons, including minimizing the effect of hunger for other family members (i.e., children), "stretching" food to make it last longer, and prioritizing medical expenses. Intentional efforts to limit food intake in this sample were correlated with increased ED pathology. Although it is not surprising that adults experiencing food insecurity engage in intentional DR, this study adds important information about why food insecure adults engage in DR and highlights the importance of assessing DR for reasons other than weight and shape concerns.
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Affiliation(s)
- Keesha M Middlemass
- Department of Political Science, Howard University, Washington, District of Columbia, USA
| | - Jessica Cruz
- Departments of Political Science & Psychology, Trinity University, San Antonio, Texas, USA
| | - Alexandra Gamboa
- Department of Psychology, Trinity University, San Antonio, Texas, USA
| | - Clara Johnson
- Department of Psychology, Trinity University, San Antonio, Texas, USA
| | - Brigitte Taylor
- Department of Psychology, Trinity University, San Antonio, Texas, USA
| | - Francesca Gomez
- Department of Psychology, Trinity University, San Antonio, Texas, USA
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22
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Chen JY, Singh S, Lowe MR. The food restriction wars: Proposed resolution of a primary battle. Physiol Behav 2021; 240:113530. [PMID: 34273346 DOI: 10.1016/j.physbeh.2021.113530] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/27/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022]
Abstract
Research regarding the definition and consequences of dieting has generated controversy for years. This controversy has spilled over into the public domain, especially as eating disorders and obesity have become more prevalent. One of the earliest and longest-lasting controversies involves the restrained eating framework, which was originally developed by Herman and Polivy and also strongly influenced the development of the cognitive-behavioral model of bulimia nervosa. An alternative framework for understanding the role of dieting in nonclinical and clinical groups, called the Three-Factor Model of Dieting, took a sharply different approach to defining, and understanding the impact of, dieting. This paper provides a brief historical review of the development of these divergent perspectives and updates the Three Factor Model's critical distinction between restraining eating to prevent over-consumption and dieting to lose weight. We suggest that three historical trends impacted the development of Restraint Theory in ways that unfairly impugned dieting for weight control: the emergence of the new eating disorders of bulimia nervosa and binge eating disorder, a population-based increase in loss of control eating and a population-based increase in obesity. This update is aimed in part at encouraging new research to reconcile ongoing, unresolved issues between Herman and Polivy's restrained eating model and the Three-Factor model of Dieting model. Such research might also contribute to the public's understanding of the pros and cons of dieting and to new approaches to treating eating disorders and obesity.
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Affiliation(s)
- Joanna Y Chen
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States
| | - Simar Singh
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States
| | - Michael R Lowe
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States.
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Linardon J, Tylka TL, Fuller-Tyszkiewicz M. Intuitive eating and its psychological correlates: A meta-analysis. Int J Eat Disord 2021; 54:1073-1098. [PMID: 33786858 DOI: 10.1002/eat.23509] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Intuitive eating is an adaptive style of eating that has generated significant research attention. Theoretically, intuitive eating is a core construct that features prominently in the Acceptance Model of Intuitive Eating, a framework that explains how positive environmental influences can foster intuitive eating practices via body appreciation. Empirically, intuitive eating has been connected to a broad range of adaptive mental health indices. At present, a quantitative synthesis of intuitive eating and its correlates has yet to be conducted. This was the objective of the current meta-analysis. METHOD Ninety-seven studies (89% cross-sectional) were included. Random effects meta-analyses were conducted on 23 psychological correlates, divided into three clusters: eating behavior and body image disturbances, positive body image and other adaptive factors, and general psychopathology. Meta-analytic path analyses were also computed to test the validity of the Acceptance Model. RESULTS Intuitive eating was inversely associated with multiple indices of eating pathology, body image disturbances, and psychopathology (rs = -.23 to -.58). Intuitive eating was positively associated with numerous positive psychological constructs, such as positive body image, self-esteem, and wellbeing (rs = .20 to .58). Men reported higher levels of intuitive eating than women (d = 0.39), with differences being largest in Caucasian samples. Meta-analytic path analyses strongly supported the hypothesized pathways specified in the Acceptance Model of Intuitive Eating. CONCLUSIONS There is a strong evidence base for intuitive eating's connection to numerous adaptive psychological constructs. Attention should now shift toward prospective and experimental designs so that the temporal nature of these relationships can be identified.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
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Lawless M, Shriver LH, Hubbs-Tait L, Topham GL, Swindle T, Harrist AW. Bidirectional Associations between Restrained Eating and Body Mass Index in Middle Childhood. Nutrients 2021; 13:1485. [PMID: 33924792 PMCID: PMC8146129 DOI: 10.3390/nu13051485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022] Open
Abstract
The nature of the association between dietary restraint and weight has been examined in adult samples, but much less is known about this relationship among children. The current study examined the transactional associations among restrained eating behavior and weight among boys and girls during middle childhood. Data for this study came from 263 children participating in the Families and Schools for Health Project (FiSH), a longitudinal study of the psychosocial correlates of childhood obesity. Participants were interviewed by trained researchers in their third- and fourth-grade year when they completed questionnaires and anthropometric assessments. Dietary restraint was assessed using the restrained eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ), and weight was assessed using Body Mass Index z-scores (BMIz). Bidirectional associations between variables were examined using cross-lagged models controlling for children's sex, ethnicity, and weight in first grade. Results indicated that weight in grade 3 was related to greater dietary restraint in grade 4 (B = 0.20, p = 0.001), but dietary restraint in grade 3 was not associated with weight in grade 4 (B = 0.01, p = 0.64). Neither child sex nor race/ethnicity were associated with BMIz or dietary restraint at either time point. Findings from this study advance the existing limited understanding of eating behavior development among children and show that weight predicts increases in children's dietary restraint in middle childhood.
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Affiliation(s)
- Meg Lawless
- Department of Nutrition, University of North Carolina Greensboro, 319 College Avenue, Greensboro, NC 27412, USA;
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, 319 College Avenue, Greensboro, NC 27412, USA;
| | - Laura Hubbs-Tait
- Department of Human Development & Family Science, Oklahoma State University, 341 Human Sciences, Stillwater, OK 74078, USA;
| | - Glade L. Topham
- Department of Applied Human Sciences, Kansas State University, 101 Campus Creek Complex, Manhattan, KS 66506, USA;
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Science, 4301 West Markham, Little Rock, AR 72205, USA;
| | - Amanda W. Harrist
- Department of Human Development & Family Science, Oklahoma State University, 244 Human Sciences, Stillwater, OK 74078, USA;
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Abstract
Restrained eating is a popular weight loss strategy for young women that tends to have limited effectiveness over extended periods of time. Although previous studies have explored and identified possible personality and behavior differences between successful and unsuccessful restrained eaters (REs), there has been a paucity of research on neurophysiological differences.Towards addressing this gap, we assessed brain resting state (Rs) differences in groups of unsuccessful REs (N = 39) and successful REs (N = 31). In line with hypotheses, unsuccessful REs displayed reduced regional homogeneity in brain regions involved in cognitive control (inferior parietal lobe) compared to successful REs. Regions involved in conflict monitoring (anterior cingulate cortex) were also observed to be comparatively less active in the unsuccessful RE group. Finally, based on analyses of independent components and seed-based functional connectivity, regions involved in conflict monitoring and cognitive control, especially those localized within the frontoparietal network, showed weaker connectivities among unsuccessful REs compared to their successful counterparts.These results underscore specific brain Rs differences between successful REs and unsuccessful REs in regions implicated in cognitive control and conflict monitoring.
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Enhancing dieters' perseverance in adversity: How counterfactual thinking increases use of digital health tracking tools. Appetite 2021; 164:105261. [PMID: 33894301 DOI: 10.1016/j.appet.2021.105261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Dieting is a cognitively taxing task that does not always advance well-being. A dieting lapse may result in overconsumption that undermines long-term health goals. This research explores how a process known as counterfactual thinking (CFT), reliving an event to figure out where things went wrong, may help consumers faced with a temptation to indulge. Consumers who engage in upward CFT generate an alternative set of steps or actions that could have changed the outcome in a situation. We investigate if and how CFT may be used strategically to help consumers stick to their dieting goal and advance their own well-being. METHODS A 2 (CFT vs. control) x 2 (dieter vs. non-dieter) between-subjects factorial design was used to evaluate participant interest in a digital health tracking tool after viewing an advertisement (Study 1). Study 2 was conducted as a follow-up to measure their use of the digital tracking tool, intentions to continue to use, and calories consumed (as tracked in the system) after a two-week period using the digital tracking tool advertised in Study 1. RESULTS We find that engaging in upward CFT increases a dieter's intentions to track their food, a practice emerging as a strategy to help maintain goal consistency. Among dieters, perceived feasibility mediated the impact of CFT on both ad evaluations (Study 1) as well as intentions to continue to use the digital health tracking tool (Study 2). In the follow-up study we also find that dieters in the CFT condition used more of the online features offered and that all consumers in the CFT condition ate marginally fewer calories across two weeks of tracking using the digital health tool. DISCUSSION Encouraging consumers to generate upward counterfactual thoughts in the face of a dieting lapse increases their propensity to use an online tracking tool and reduces calories consumed. In the age of digital tracking tools, personalized prompts could be set to encourage CFT to help get a consumer back on track to pursue their healthy eating goals.
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Call CC, D'Adamo L, Butryn ML, Stice E. Examining weight suppression as a predictor and moderator of intervention outcomes in an eating disorder and obesity prevention trial: A replication and extension study. Behav Res Ther 2021; 141:103850. [PMID: 33839586 DOI: 10.1016/j.brat.2021.103850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/16/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Weight suppression (WS) predicts future weight gain and increases in eating disorder symptoms in community and clinical samples but has received minimal attention in obesity and eating disorder prevention programs. In a sample of emerging adults (N = 364) in a randomized controlled trial evaluating two obesity and eating disorder prevention interventions versus a control condition, this study aimed to replicate the findings that WS and its interaction with baseline BMI predict increases in weight and eating disorder symptoms and test a novel hypothesis that WS would moderate the effects of the interventions on change in weight and eating disorder symptoms. Participants completed assessments at baseline, post-intervention, 6-, 12-, and 24-months. WS was calculated as the difference between highest lifetime weight and baseline weight. WS interacted with baseline BMI to predict greater weight gain over 24-months, such that those with high WS and lower baseline BMI gained weight most rapidly. WS did not predict eating disorder symptom change and did not moderate the effects of the prevention programs. Given that individuals with WS are at increased risk for weight gain, expressly targeting this high-risk population with evidence-based obesity prevention programs may be useful. CLINICALTRIALS.GOV REGISTRATION: NCT01680224.
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Affiliation(s)
- Christine C Call
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Laura D'Adamo
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5101, USA.
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Jurov I, Keay N, Hadžić V, Spudić D, Rauter S. Relationship between energy availability, energy conservation and cognitive restraint with performance measures in male endurance athletes. J Int Soc Sports Nutr 2021; 18:24. [PMID: 33736663 PMCID: PMC7977281 DOI: 10.1186/s12970-021-00419-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/03/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Low energy availability in male athletes has gained a lot of attention in recent years, but direct evidence of its effects on health and performance is lacking. The aim of this research was to objectively measure energy availability (EA) in healthy male endurance athletes without pre-existing relative energy deficiency signs during pre-race season. METHODS Twelve trained endurance athletes (performance level 3, 4, and 5) participated in the cross-sectional controlled laboratory study. Fat-free mass, exercise energy expenditure, and energy intake were measured to calculate EA. Resting energy expenditure was measured and estimated to assess energy conservation. Three specific performance tests were used to assess endurance, agility, and explosive strength performance. For psychological evaluation, the Three Factor Eating Questionnaire and a short Well-being questionnaire were completed. RESULTS Mean EA was 29.5 kcal/kg FFM/day. The majority (66.6%) had EA under the threshold for low EA in females. Critical cognitive restraint (≥13) was reported by 75% of participants. There were no differences in performance, blood values, or psychological evaluation when subjects were divided into two groups divided by EA = 30 kcal/kg FFM/day. Cognitive restraint was negatively associated with measured resting energy expenditure and energy conservation (r = -.578, p = .025 and r = -.549, p = .032, respectively). CONCLUSIONS The mean EA measured in this study supports the theory that the threshold for low EA in endurance male athletes might be under the threshold for females. In addition, we confirmed cognitive restraint could be useful for early detection of energy conservation. The high cognitive restraint as measured in our sample stressed the need of eating behavior screening in endurance athletes in order to reduce risk of any disordered eating patterns.
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Affiliation(s)
- Iva Jurov
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia.
| | - Nicola Keay
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia
| | - Darjan Spudić
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia
| | - Samo Rauter
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia
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Individual differences in within-subject weight variability: There's a signal in the noise. Physiol Behav 2020; 226:113112. [DOI: 10.1016/j.physbeh.2020.113112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/06/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022]
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Stice E, Rohde P, Shaw H, Desjardins C. Weight suppression increases odds for future onset of anorexia nervosa, bulimia nervosa, and purging disorder, but not binge eating disorder. Am J Clin Nutr 2020; 112:941-947. [PMID: 32534455 PMCID: PMC7528557 DOI: 10.1093/ajcn/nqaa146] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/18/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Eating disorders affect 13% of females and contribute to functional impairment and mortality, but few studies have identified risk factors that prospectively correlate with future onset of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Identifying risk factors specific to each eating disorder is critical for advancing etiologic knowledge and designing effective prevention programs. OBJECTIVES This study examined whether weight suppression (the difference between a person's highest past weight at their adult height and their current weight) correlates with future onset of AN, BN, BED, and PD. METHODS Data from 1165 young women with body image concerns (mean ± SD age: 21.9 ± 6.4 y) who completed annual diagnostic interviews over a 3-y follow-up period were examined. Logistic regression models evaluated the relation of baseline weight suppression to onset risk of each eating disorder controlling for age, dietary restraint, and intervention condition. RESULTS Elevated weight suppression predicted future onset of AN (OR: 1.36; 95% CI: 1.03, 1.80), BN (OR: 1.34; 95% CI: 1.11, 1.62), PD (OR: 1.46; 95% CI: 1.23, 1.74), and any eating disorder (OR: 1.32; 95% CI: 1.12, 1.56), but not BED (OR: 1.10; 95% CI: 0.89, 1.37). Highest past weight correlated with future onset of BN and PD but not onset of AN, BED, or any eating disorder, and baseline current weight was inversely related to future AN onset only, implying that women with the largest difference between their highest past weight and current weight are at greatest risk of eating disorders. CONCLUSIONS The results provide novel evidence that weight suppression correlates with future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviors and suggest weight-suppressed women constitute an important risk group to target with selective prevention programs.These trials were registered at clinicaltrials.gov as NCT01126918 and NCT01949649.
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Affiliation(s)
- Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Paul Rohde
- Oregon Research Institute, Eugene, OR, USA
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Georgii C, Schulte-Mecklenbeck M, Richard A, Van Dyck Z, Blechert J. The dynamics of self-control: within-participant modeling of binary food choices and underlying decision processes as a function of restrained eating. PSYCHOLOGICAL RESEARCH 2020; 84:1777-1788. [PMID: 31004194 PMCID: PMC7478946 DOI: 10.1007/s00426-019-01185-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/11/2019] [Indexed: 12/19/2022]
Abstract
Successful self-control during food choice might require inhibition of impulses to avoid indulging in tempting but calorie-dense foods, and this might particularly apply to individuals restraining their food intake. Adopting a novel within-participant modeling approach, we tested 62 females during a mouse-tracking based binary food choice task. Subsequent ratings of foods on palatability, healthiness, and calorie density were modeled as predictors for both decision outcome (choice) and decision process (measures of self-control conflict) while considering the moderating role of restrained eating. Results revealed that individuals higher on restrained eating were less likely to choose more high-calorie foods and showed less self-control conflict when choosing healthier foods. The latter finding is in contrast with the common assumption of self-control as requiring effortful and conscious inhibition of temptation impulses. Interestingly, restrained eaters rated healthy and low-calorie foods as more palatable than individuals with lower restrained eating scores, both in the main experiment and an independent replication study, hinting at an automatic and rather effortless mechanism of self-control (palatability shift) that obviates effortful inhibition of temptation impulses.
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Affiliation(s)
- Claudio Georgii
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria.
| | - Michael Schulte-Mecklenbeck
- Institute of Marketing and Management, University of Bern, Bern, Switzerland
- Max Planck Institute for Human Development, Berlin, Germany
| | - Anna Richard
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria
- Schoen Clinic Roseneck, Prien, Germany
| | - Zoé Van Dyck
- Faculty of Language and Literature, Humanities, Arts and Education, University of Luxembourg, Luxembourg City, Luxembourg
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria
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Abstract
PURPOSE OF REVIEW Dieting is often blamed for causing food cravings. Such diet-induced cravings may be mediated by physiological (e.g., nutritional deprivation) or psychological (e.g., ironic effects of food thought suppression) mechanisms. However, this notion is often based on cross-sectional findings and, thus, the causal role of food deprivation on food cravings is unclear. RECENT FINDINGS Experimental studies suggest that a short-term, selective food deprivation seems to indeed increase cravings for the avoided foods. However, experimental studies also show that food craving can be understood as a conditioned response that, therefore, can also be unlearned. This is supported by intervention studies which indicate that long-term energy restriction results in a reduction of food cravings in overweight adults. Dieting's bad reputation for increasing food cravings is only partially true as the relationship between food restriction and craving is more complex. While short-term, selective food deprivation may indeed increase food cravings, long-term energy restriction seems to decrease food cravings, suggesting that food deprivation can also facilitate extinction of conditioned food craving responses.
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Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
- Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.
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Block M, Kattelmann KK, Meendering J, McCormack L. Relationship of Weight-Related Eating Behaviors and Weight Loss of Participants Enrolled in a Proprietary Weight Loss Program. Nutr Metab Insights 2020; 13:1178638820928413. [PMID: 32595281 PMCID: PMC7297474 DOI: 10.1177/1178638820928413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 04/30/2020] [Indexed: 11/15/2022] Open
Abstract
Background: There is a need for improving long-term success in meal replacement programs and identifying the variables that affect weight loss and maintenance in a proprietary weight loss program that includes health coaching. Objective: The aim of this study is to evaluate weight-related eating behaviors of participants with clinically significant weight loss (CSWL) in a proprietary weight loss program. Study Design, Setting, and Participants: A cross-sectional sample of participants (n=1,454) enrolled in a proprietary weight-loss program that includes meal replacements and health coaching were queried via an on-line survey for weight-related eating behaviors and weight history. Main Outcome Measures and Analysis: Weight-related eating behaviors of routine restraint (RR), compensatory restraint (CR), susceptibility to external cues (SEC), and emotional eating (EE) were assessed using the Weight Related Eating Questionnaire. CSWL was defined as having achieved a weight loss greater than 10% of starting weight. Participants were dichotomized into those with CSWL (n=973) and with no CSWL (n=481). The relationship between CSWL (controlling for age and sex) as the dependent variable and weight-related eating behaviors (RR, CR, SEC, and EE) as the independent variables was assessed using logistic regression (Stata/SE 14). Results: Those with CSWL have higher odds of having RR (OR: 1.3, p<0.05) and CR (OR: 1.1, p<0.05) and lower odds of SEC (OR: 0.7, p<0.05) and EE (OR: 0.8, p<0.05) eating behaviors than those without CSWL. Conclusions: Weight-related eating behaviors of participants in proprietary meal replacement weight-loss programs who have successfully lost weight differ compared to those who have not. Knowledge of the relationship between CSWL and weight-related eating behaviors can be used by coaches to assist participants in reinforcing those behaviors that support weight-loss. These results are limited to participants who self-select for proprietary meal-replacement weight-loss programs and cannot be generalized to other weight-loss or maintenance programs.
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Affiliation(s)
- Megan Block
- Division of Health and Consumer Sciences, South Dakota State University, Brookings, SD, USA
| | - Kendra K Kattelmann
- Division of Health and Consumer Sciences, South Dakota State University, Brookings, SD, USA
| | - Jessica Meendering
- Division of Health and Consumer Sciences, South Dakota State University, Brookings, SD, USA
| | - Lacey McCormack
- Division of Health and Consumer Sciences, South Dakota State University, Brookings, SD, USA
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Vlahoyiannis A, Nifli AP. Dietary restraint is associated with adiposity and repeated attempts of food avoidance since early adolescence. Physiol Behav 2020; 218:112826. [DOI: 10.1016/j.physbeh.2020.112826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/18/2020] [Accepted: 01/30/2020] [Indexed: 01/10/2023]
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“I will fast … tomorrow”: Intentions to restrict eating and actual restriction in daily life and their person-level predictors. Appetite 2019; 140:10-18. [DOI: 10.1016/j.appet.2019.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/01/2019] [Accepted: 04/26/2019] [Indexed: 12/25/2022]
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Meadows A, Higgs S. Internalised Weight Stigma Moderates the Impact of a Stigmatising Prime on Eating in the Absence of Hunger in Higher- but Not Lower-Weight Individuals. Front Psychol 2019; 10:1022. [PMID: 31139111 PMCID: PMC6519002 DOI: 10.3389/fpsyg.2019.01022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/17/2019] [Indexed: 11/23/2022] Open
Abstract
A considerable body of evidence links internalised weight stigma with higher levels of disordered eating behaviour and cognitions in both normative- and higher-weight populations. However, to date, the impact of internalised weight stigma on objectively measured food intake has not been explored. In the present study, a weight-diverse sample of 158 non-smoking adults (BMI ≥ 25 kg/m2 n = 72, BMI < 25 kg/m2 n = 86) were recruited to a study on "The effects of hunger and satiety on information processing." Participants first completed a series of online questionnaires, then attended a lab visit in a fed state. Participants were randomised to read a sham news article on the negative consequences of either weight (stigma condition) or smoking (control condition) and answer some questions about the article. Then, under the pretence of a non-study-relevant break, participants were exposed to a pre-weighed selection of sweet and savoury snacks for 15 min. Mood and hunger levels were assessed prior to and after reading the vignette, and after the break. In contrast to the relationship with self-report eating behaviour, internalised weight stigma was not a significant independent predictor of total energy intake and did not moderate the relationship between exposure to the stigma prime and calories consumed. However, differences emerged on the basis of participants' weight status. Higher-weight participants with high levels of internalised weight stigma consumed fewer snack calories following exposure to a weight-stigma prime compared with a neutral prime (B = -137, SE = 58, t = -2.35, p = 0.020, 95% CI -252, -22) whereas those with low levels of internalised weight stigma tended to eat more in the weight stigma condition (B = 118, SE = 62, t = 1.91, p = 0.059, 95% CI -4, 241). In normative-weight participants, no differences in energy intake by levels of internalised weight stigma were observed. These findings suggest differences in the relationships between internalised weight stigma and self-reported disordered eating behaviour versus eating in the absence of hunger (EAH) measured under laboratory conditions. Additionally, internalised weight stigma appears to have differential effects on response to stigma in higher-weight and normative-weight individuals.
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Affiliation(s)
- Angela Meadows
- School of Psychology, University of Exeter, Exeter, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Zambrowicz R, Schebendach J, Sysko R, Mayer LES, Walsh BT, Steinglass JE. Relationship between three factor eating questionnaire-restraint subscale and food intake. Int J Eat Disord 2019; 52:255-260. [PMID: 30638263 PMCID: PMC6601332 DOI: 10.1002/eat.23014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Dietary restraint refers to an individual's intention to restrict food intake, measured via self-report questionnaires, whereas dietary restriction refers to actual reduction in caloric intake. The aim of this research was to investigate the association between dietary restraint scales and actual caloric restriction. METHOD Data were collected from six previously published or two ongoing eating behavior studies in which participants (n = 183) completed the Three Factor Eating Questionnaire (TFEQ) and Eating Disorders Examination Questionnaire (EDE-Q) and participated in a laboratory-based research lunch meal. Participants were individuals with anorexia nervosa (AN), bulimia nervosa (BN), and healthy controls (HC). The primary analysis was the association between TFEQ Restraint subscale and caloric intake in the meal. RESULTS There was a significant negative correlation between total caloric intake and TFEQ Restraint scores (r = -.60, p < .001) and EDE-Q Restraint scores (r = -.54, p < .001). For TFEQ Restraint score, this relationship was significant within each diagnostic group (HC: r = -.32, p = .007; AN: r = -.38, p < .001; BN: r = -.43, p = .02). DISCUSSION These results suggest that the TFEQ Restraint scale is a useful measure of dietary restriction, especially among individuals with eating disorders.
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Affiliation(s)
- Rachel Zambrowicz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Janet Schebendach
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Robyn Sysko
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laurel E S Mayer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
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The Relation of Dietary Restraint and Affect with Food Choice and the Experience of Guilt after Eating. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-017-9592-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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De Giuseppe R, Di Napoli I, Porri D, Cena H. Pediatric Obesity and Eating Disorders Symptoms: The Role of the Multidisciplinary Treatment. A Systematic Review. Front Pediatr 2019; 7:123. [PMID: 31024868 PMCID: PMC6463004 DOI: 10.3389/fped.2019.00123] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/12/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of obesity in children/adolescents has increased worldwide during the past 30 years, becoming a significant public health concern; prevention, and management of pediatric obesity onset is one of the most critical public health goals for both industrialized and developing countries. Pediatric obesity has been identified as a risk factor for various psychopathologies, including eating disorders (ED). Although it has been demonstrated that a comprehensive multidisciplinary treatment (MT), with small steps and practical approaches to lifestyle change, can be an effective treatment for children and adolescents with obesity, to the best of our knowledge, this is the first systematic review investigating the effect of MT on the development, progression or decrease of ED symptoms (EDS) in this target population. PubMed and Web of Science databases were searched (last search on 18 February 2019) according to a predetermined search strategy, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines and Statement. Original studies published in English examining the effect of MT on pediatric overweight/obesity, paying particularly attention at the development of EDS, were eligible for inclusion. Seven hundred and forty-four records have been identified; nine articles with study quality ranging from weak to moderate have been included. MTs were heterogeneous in nature including length, number, frequency and type of sessions, parent-involvement and use of technology, besides several psychometric questionnaires were used to screen for EDS, since there are no standardized criteria. In 3 studies there was a significant decrease in external and emotional eating and in four studies a significant increase in restraint eating post MT. Two studies found a significant decrease of binge eating symptoms and other two studies showed an improvement of self-perception, weight, and shape concern. A statistical significant decrease in BMI, BMIz, BMISDS, and adjusted BMI was observed after all MTs, except one. A narrative summary of the evidences reported highlighted the positive impact of MT on the EDS. Moreover, since weight loss post MTs was not necessarily related to EDS, clinicians should also look for the presence of EDS and treat them accordingly.
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Affiliation(s)
- Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ilaria Di Napoli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Debora Porri
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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Albayrak Ö, Pott W, Hebebrand J, de Zwaan M, Pauli-Pott U. Baseline Dietary Restraint Predicts Negative Treatment Outcomes after 12 Months in Children and Adolescents with Obesity Participating in a Lifestyle Intervention. Obes Facts 2019; 12:179-189. [PMID: 30893684 PMCID: PMC6547296 DOI: 10.1159/000496940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/14/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Current lifestyle interventions for children and adolescents with obesity often exclude patients with an eating pathology, leaving the impact of eating pathologies on treatment outcomes largely unconsidered. We investigated the predictive value of disordered eating symptoms on BMI z-score reduction in a sample of 111 German children and adolescents with overweight (90th percentile ≤ BMI < 97th percentile) and obesity (BMI > 97th percentile) aged 7-15 years in an outpatient lifestyle intervention program. METHODS We defined a BMI z-score reduction of more than 5% after 12 months as a successful outcome. Disordered eating symptoms (i.e., dietary restraint, emotional eating, external eating, and binge eating) were assessed at baseline with the Eating Pattern Inventory (EPI-C) and the "bulimia" scale of the Eating Disorder Inventory (EDI-2). Covariates were: baseline z-BMI, age, gender, and maternal education level. RESULTS Multiple regression analysis revealed that dietary restraint significantly predicted change in BMI z-scores between baseline and T1. Higher levels of dietary restraint were associated with a lower BMI z-score reduction between T0 and T1. To compare non-completers with completers on the 4 eating behavior scales, we used MANCOVA. At baseline, children who subsequently dropped out of the program prematurely showed significantly higher dietary restraint scores than children who completed the intervention, irrespectively of their gender, age, and BMI z-score at baseline and their mother's education level. DISCUSSION Our results provide further evidence that the analysis of treatment processes in lifestyle intervention programs for children and adolescents with overweight and obesity should take into account a broader multidimensional approach including eating and dietary habits.
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Affiliation(s)
- Özgür Albayrak
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Wilfried Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps University Marburg, Marburg, Germany
- Department of Psychosomatic and Psychiatry, Red Cross Children's Hospital Siegen, Siegen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany,
| | - Ursula Pauli-Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps University Marburg, Marburg, Germany
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41
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Cheng ZH, Perko VL, Fuller- Marashi L, Gau JM, Stice E. Ethnic differences in eating disorder prevalence, risk factors, and predictive effects of risk factors among young women. Eat Behav 2019; 32:23-30. [PMID: 30529736 PMCID: PMC6382562 DOI: 10.1016/j.eatbeh.2018.11.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 10/05/2018] [Accepted: 11/20/2018] [Indexed: 01/22/2023]
Abstract
Findings regarding ethnic differences in eating disorder diagnoses and risk factors have been mixed. This study evaluated whether there are ethnic differences in eating disorder prevalence, risk factors, and the predictive relations of the risk factors to future eating disorder onset. We used a large sample of young women followed longitudinally over three years to increase sensitivity to detect differences and to provide the first test of ethnic differences in the relation of risk factors to future onset of eating disorders. Females with body image concerns (N = 1177) were recruited from high schools and colleges for trials of a body acceptance eating disorder prevention program. They completed surveys and interviews at baseline and at 1-, 6-, 12-, 24-, and 36-month follow-up. Significant differences between ethnic groups were found for two of the 13 baseline risk factors: thin-ideal internalization and body mass index. No significant differences in later onset rates among ethnic groups were found. There were also no reliable ethnic differences in the relation of risk factors for future eating disorder onset. These findings suggest that eating disorders affect ethnic minorities as much as Whites and that there are more overlapping risk factors shared among various ethnic groups than differences.
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Affiliation(s)
- Zhen Hadassah Cheng
- Veterans Affairs Portland Health Care System, Portland, OR 97239, United States of America.
| | | | | | | | - Eric Stice
- Oregon Research Institute, Eugene, OR 97403
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Schulte EM, Smeal JK, Lewis J, Gearhardt AN. Development of the Highly Processed Food Withdrawal Scale. Appetite 2018; 131:148-154. [DOI: 10.1016/j.appet.2018.09.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/10/2018] [Accepted: 09/14/2018] [Indexed: 11/29/2022]
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43
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Core TJ, Price MM, Alquist JL, Baumeister RF, Tice DM. Life is uncertain, eat dessert first: Uncertainty causes controlled and unemotional eaters to consume more sweets. Appetite 2018; 131:68-72. [PMID: 30195822 DOI: 10.1016/j.appet.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/17/2018] [Accepted: 09/04/2018] [Indexed: 11/26/2022]
Abstract
Sometimes even dieters with the best self-control overindulge. Uncertain situations may undermine the self-control of even well-controlled eaters. This study was designed to test the hypothesis that uncertainty increases unhealthy snacking. Participants were either told that they would be giving a speech, that they would be listening to a speech, or that they would find out later whether they were to give a speech or not. Among participants who typically reported good control over their eating or scored low on emotional eating, participants who were uncertain about whether they would be giving a speech ate more candy than participants who expected to not have to give a speech and even those who expected to have to give a speech. Participants who reported poor control over their eating or scored high on emotional eating did not eat significantly more when uncertain. These findings suggest that, for people who are typically able to control their eating, uncertainty increases snacking more than certainty of a negative outcome.
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Affiliation(s)
- Tammy J Core
- Texas Tech University, Department of Psychological Sciences, 1800 18th St, Lubbock, TX, 79409, United States
| | - Mindi M Price
- Texas Tech University, Department of Psychological Sciences, 1800 18th St, Lubbock, TX, 79409, United States.
| | - Jessica L Alquist
- Texas Tech University, Department of Psychological Sciences, 1800 18th St, Lubbock, TX, 79409, United States
| | - Roy F Baumeister
- University of Queensland, School of Psychology, St Lucia, QLD, 4072, Australia
| | - Dianne M Tice
- Brigham Young University, Department of Psychology, 1001 SWKT, Provo, UT, 84602, United States
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44
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Bodell LP, Forney KJ, Chavarria J, Keel PK, Wildes JE. Self-report measures of loss of control over eating: Psychometric properties in clinical and non-clinical samples. Int J Eat Disord 2018; 51:1252-1260. [PMID: 30265751 PMCID: PMC11037076 DOI: 10.1002/eat.22957] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/17/2018] [Accepted: 08/25/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Research evidence supports the clinical significance of subjective feelings of loss of control over eating; however, limited attention has been given to how this construct is assessed. Two measures have been developed in recent years (i.e., Eating Loss of Control Scale [ELOC] and Loss of Control over Eating Scale [LOCES]), but further validation in clinical and non-clinical samples is needed. METHOD The current study evaluated the psychometric properties, including factor structure, criterion validity, and measurement invariance of the ELOC and LOCES across two groups: (a) a clinical sample of individuals with eating disorders (n = 106) and (b) a non-clinical sample of college students (n = 321). RESULTS Confirmatory factor analyses indicated that the 16-item version of the ELOC and 7-item brief version of the LOCES provided good fit to the data in both samples. These measures were highly correlated (r = .83-.87) and associated with binge-eating and related psychopathology. The ELOC demonstrated partial invariance between men and women and between the clinical and non-clinical samples. The LOCES-brief demonstrated full invariance between men and women and partial invariance between the clinical and non-clinical samples. DISCUSSION Findings suggest that the 16-item ELOC and 7-item LOCES are reliable measures of severity of loss of control eating in clinical and non-clinical samples. Given the brevity of the LOCES-brief and evidence for measurement invariance across sex, it is recommended over the ELOC in heterogeneous samples. Future research is needed to confirm the validity of these measures across individuals with and without eating disorders.
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Affiliation(s)
- Lindsay P. Bodell
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Katherine Jean Forney
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jesus Chavarria
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jennifer E. Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
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45
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Kwan MY, Haynos AF, Blomquist KK, Roberto CA. Warning labels on fashion images: Short- and longer-term effects on body dissatisfaction, eating disorder symptoms, and eating behavior. Int J Eat Disord 2018; 51:1153-1161. [PMID: 30480830 PMCID: PMC6289689 DOI: 10.1002/eat.22951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Fashion warning labels that caution readers about digitally altered images have been recommended and adopted by several countries to prevent body dissatisfaction and eating disorders. This study investigated the short- and longer-term influence of fashion warning labels on affect, body dissatisfaction, eating disorder symptoms, and snack consumption using a randomized-controlled experiment. METHOD Female undergraduates (n = 118) were randomized to view and rate responses to fashion images either with or without a warning label. They then consumed snacks and completed questionnaires. Sixty-four participants (54%) completed follow-up online surveys asking them to view and rate new fashion images with or without warning labels once per week for 4 weeks. Primary outcomes were affect, body dissatisfaction, eating disorder symptoms, and kilocalories consumed. RESULTS Overall, fashion warning labels had no short-term effects on affect, body dissatisfaction, or kilocalories consumed in the lab. However, individuals who reported engaging in restrictive eating consumed fewer kilocalories when exposed to advertisements with warning labels (M = 170.33, SD = 120.78) versus no labels (M = 286.46, SD = 166.30), p = .008. Warning labels also had no protective effects after repeated exposure over 4 weeks on affect or eating disorder symptoms, and significantly increased appearance orientation (p = .001). DISCUSSION Warning labels on media images are unlikely to be an effective policy tool to prevent negative affect, body dissatisfaction, and eating disorder symptoms, and, in some cases, may exacerbate these concerns.
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Affiliation(s)
- Mun Yee Kwan
- Department of Psychology, Sociology, and Social Work, West Texas A&M University, Canyon, Texas
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota
| | | | - Christina A. Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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46
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Neumann M, Holzapfel C, Müller A, Hilbert A, Crosby RD, de Zwaan M. Features and Trajectories of Eating Behavior in Weight-Loss Maintenance: Results from the German Weight Control Registry. Obesity (Silver Spring) 2018; 26:1501-1508. [PMID: 30230246 DOI: 10.1002/oby.22270] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Eating behaviors such as dietary restraint and disinhibition caused by emotional and external cues play a relevant role in weight-loss maintenance. METHODS Four hundred forty individuals with successful weight-loss maintenance included in the prospective German Weight Control Registry completed the Dutch Eating Behavior Questionnaire. Participants were categorized into the following two weight groups: stable weight trajectory (WS) (n = 280) and unstable weight trajectory (WUS) (n = 160) over the 2-year assessment period. RESULTS Those with successful weight-loss maintenance had significantly higher scores on the restrained and emotional eating subscales compared with a general population (GP) sample. At baseline, the WS individuals had lower restrained, emotional, and external eating scores compared with the WUS individuals. Over the 2-year follow-up period, the trajectories of the restraint scores decreased in both groups but stayed elevated compared with the GP sample. Scores of the emotional and external eating subscales remained stable in the WS group but increased in the WUS group. CONCLUSIONS A certain degree of restraint seems to be necessary for successful weight-loss maintenance; however, high emotional and external eating may counteract this effect, resulting in weight regain in the long run.
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Affiliation(s)
- Maria Neumann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Technical University of Munich, University Hospital "Klinikum rechts der Isar,", Munich, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, Leipzig, Germany
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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47
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Sysko R, Steinglass J, Schebendach J, Mayer LES, Walsh BT. Rigor and reproducibility via laboratory studies of eating behavior: A focused update and conceptual review. Int J Eat Disord 2018; 51:608-616. [PMID: 30132949 DOI: 10.1002/eat.22900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The eating behavior of individuals with eating disorders has been examined in laboratory settings over the last 30 years. In this focused review, we build on prior research and highlight several feeding laboratory paradigms that have successfully demonstrated quantifiable and observable behavioral disturbances, and thereby add rigor and reproducibility to the examination of disturbances of eating behavior. This review describes the measures commonly obtained via these laboratory techniques. Supporting Information Appendices with detailed information about implementation are provided to allow for the reproducible execution of these techniques across labs. METHODS/RESULTS Literature documenting the existence of objective abnormalities in eating behavior among individuals with eating disorders or in comparison to healthy controls (n > 40) is briefly summarized. These protocols, conducted across at least 17 independent labs, are sensitive and reproducible, can be used to assess subjective and physiological parameters associated with eating, and elucidate the impact of treatment. Laboratory studies from patients with eating disorders compared with healthy controls reproducibly demonstrate both that patients with Anorexia Nervosa ingest fewer calories and that individuals with Bulimia Nervosa and Binge-Eating Disorder ingest more calories when asked to binge-eat. DISCUSSION Feeding laboratory studies have the potential for quantifying the characteristic behavioral psychopathology of patients with eating disorders, and may provide a useful tool to explore the potential utility of new treatments for individuals with Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder.
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Affiliation(s)
- Robyn Sysko
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanna Steinglass
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - Janet Schebendach
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - Laurel E S Mayer
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - B Timothy Walsh
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
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48
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Wang SB, Pisetsky EM, Skutch JM, Fruzzetti AE, Haynos AF. Restrictive eating and nonsuicidal self-injury in a nonclinical sample: Co-occurrence and associations with emotion dysregulation and interpersonal problems. Compr Psychiatry 2018; 82:128-132. [PMID: 29477705 PMCID: PMC6167742 DOI: 10.1016/j.comppsych.2018.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 01/11/2023] Open
Abstract
Disordered eating frequently co-occurs with nonsuicidal self-injury (NSSI), and evidence suggests that the co-occurrence of these behaviors is associated with heightened emotion dysregulation. However, little is known about the relationship between restrictive eating and NSSI, and the significance of their co-occurrence. This study examined cross-sectional associations between self-reported restrictive eating, NSSI, and putative mechanisms of emotion regulation and interpersonal problems in a non-clinical sample of undergraduate students (N = 98, 80.6% female), using the Dietary Restriction Screener (Haynos & Fruzzetti, 2015), Deliberate Self-Harm Inventory (Gratz, 2001), Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2006), and Inventory of Interpersonal Problems-Personality Disorders-25 (Kim & Pilkonis, 1999). Hierarchical logistic regression analyses indicated that restrictive eating was associated with NSSI above and beyond the influence of binge eating, purging, and relevant covariates (B = 2.04, p < 0.001). In addition, multivariate analyses of variance revealed that the co-occurrence of restrictive eating and NSSI was associated with greater difficulties accessing and implementing effective, rather than impulsive, emotion regulation strategies when distressed than either behavior alone (p < 0.001). Findings highlight the seriousness of restrictive eating even within a nonclinical sample, as it is associated with heightened probability of NSSI and clinical severity among those who engage in co-morbid NSSI. Healthcare providers are encouraged to screen for NSSI among individuals with restrictive eating. In addition, a focus on improving emotion regulation and interpersonal skills may enhance prevention and intervention efforts for individuals with co-occurring restrictive eating and NSSI behaviors.
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Affiliation(s)
- Shirley B Wang
- Department of Psychology, Harvard University, Cambridge, MA, United States.
| | - Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Julie M Skutch
- Department of Psychology, University of Nevada, Reno, NV, United States
| | - Alan E Fruzzetti
- Department of Psychology, University of Nevada, Reno, NV, United States; Department of Psychiatry, Harvard University, Cambridge, MA, United States
| | - Ann F Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
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49
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Racine SE. Emotional ratings of high- and low-calorie food are differentially associated with cognitive restraint and dietary restriction. Appetite 2018; 121:302-308. [DOI: 10.1016/j.appet.2017.11.104] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/25/2017] [Accepted: 11/23/2017] [Indexed: 11/30/2022]
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50
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Mengotti P, Aiello M, Terenzi D, Miniussi C, Rumiati RI. How brain response and eating habits modulate food energy estimation. Physiol Behav 2018; 188:18-24. [PMID: 29378188 DOI: 10.1016/j.physbeh.2018.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 01/09/2018] [Accepted: 01/19/2018] [Indexed: 11/26/2022]
Abstract
The estimates we do of the energy content of different foods tend to be inaccurate, depending on several factors. The elements influencing such evaluation are related to the differences in the portion size of the foods shown, their energy density (kcal/g), but also to individual differences of the estimators, such as their body-mass index (BMI) or eating habits. Within this context the contribution of brain regions involved in food-related decisions to the energy estimation process is still poorly understood. Here, normal-weight and overweight/obese women with restrained or non-restrained eating habits, received anodal transcranial direct current stimulation (AtDCS) to modulate the activity of the left dorsolateral prefrontal cortex (dlPFC) while they performed a food energy estimation task. Participants were asked to judge the energy content of food images, unaware that all foods, for the quantity presented, shared the same energy content. Results showed that food energy density was a reliable predictor of their energy content estimates, suggesting that participants relied on their knowledge about the food energy density as a proxy for estimating food energy content. The neuromodulation of the dlPFC interacted with individual differences in restrained eating, increasing the precision of the energy content estimates in participants with higher scores in the restrained eating scale. Our study highlights the importance of eating habits, such as restrained eating, in modulating the activity of the left dlPFC during food appraisal.
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Affiliation(s)
- P Mengotti
- Area of Neuroscience, SISSA, Via Bonomea 265, 34136 Trieste, Italy; Cognitive Neuroscience, Institute of Neuroscience & Medicine (INM-3), Research Centre Juelich, Leo-Brandt-Str. 5, 52425 Juelich, Germany.
| | - M Aiello
- Area of Neuroscience, SISSA, Via Bonomea 265, 34136 Trieste, Italy
| | - D Terenzi
- Area of Neuroscience, SISSA, Via Bonomea 265, 34136 Trieste, Italy
| | - C Miniussi
- Center for Mind/Brain Sciences CIMeC, University of Trento, Corso Bettini 31, 38068 Rovereto, TN, Italy; Cognitive Neuroscience Section, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125 Brescia, Italy
| | - R I Rumiati
- Area of Neuroscience, SISSA, Via Bonomea 265, 34136 Trieste, Italy; ANVUR, Via Ippolito Nievo 35, 00153 Rome, Italy
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