1
|
Prince T, Mulgrew KE, Driver C, Mills L, Loza J, Hermens DF. Appearance-related cyberbullying and its association with the desire to alter physical appearance among adolescent females. J Eat Disord 2024; 12:125. [PMID: 39215341 PMCID: PMC11365200 DOI: 10.1186/s40337-024-01083-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Cyberbullying is associated with various mental health concerns in adolescents, including body dissatisfaction and disordered eating behaviours. However, there is a significant research gap concerning the unique effects of appearance-related cyberbullying (ARC) on adolescent mental health. This study examined the prevalence and psychological consequences of ARC among middle to late adolescent females (aged 14-19 years, Mage = 15.98, N = 336). Participants completed an online survey regarding their experiences of ARC, body image variables, and eating disorder symptomology. Findings indicate the widespread occurrence of ARC among adolescent females, with body shape and size emerging as predominant targets. Experiences of ARC-victimisation positively correlated with increased concerns about body shape, body shame, and eating disorder symptomology. Conversely, experiences of ARC-victimisation were negatively correlated with body esteem and body appreciation. Finally, appearance-related cybervictimisation was significantly associated with adolescent females' desire to pursue appearance alterations through methods such as dieting and exercising, altering self-presentation, and undergoing cosmetic procedures due to perceived experiences of ARC. These findings highlight the urgent need for preventative measures, such as age-appropriate social media policies and health promotion programs that encourage positive online behaviour, and strategies to address the impacts of ARC to protect the mental well-being of adolescent females.
Collapse
Affiliation(s)
- Taliah Prince
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia.
| | - Kate E Mulgrew
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Christina Driver
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Lia Mills
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | | | - Daniel F Hermens
- Thompson Institute, UniSC, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| |
Collapse
|
2
|
Modica CA, Markley AE. Reciprocal longitudinal associations between positive body image and wellbeing among early-adult women. Body Image 2024; 51:101770. [PMID: 39116579 DOI: 10.1016/j.bodyim.2024.101770] [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: 04/29/2024] [Revised: 06/18/2024] [Accepted: 07/14/2024] [Indexed: 08/10/2024]
Abstract
This longitudinal study examined the prospective associations between body appreciation and wellbeing (i.e., self-esteem, depression, and emotional wellbeing) as well as body image flexibility and wellbeing among 490 women between 18-35 years of age (M = 28.63; SD = 4.27) residing in the United States. Women were contacted in three waves, each two months apart, and completed measures relating to each construct online. As a prerequisite of longitudinal analyses, this study found evidence of configural, metric, scalar, and strict invariance over time for each relevant measure. Cross-lagged panel modeling evidenced bidirectional associations between body appreciation and self-esteem between all waves and unidirectional associations between body appreciation and subsequent depression (negative) and body appreciation and subsequent emotional wellbeing (positive). Results showed bidirectional associations between body image flexibility, self-esteem, depression, and emotional wellbeing, although these bidirectional associations never occurred during the same interval between waves. This study evidences that higher body appreciation and body image flexibility are prospectively associated with increases in self-esteem, emotional wellbeing and decreases in depression, and also shows scenarios where the inverse associations also hold true. We also describe how this study complements existing cross-sectional research and the need to examine associations among more diverse participant groups.
Collapse
Affiliation(s)
| | - Abigail E Markley
- Department of Psychology, Ohio Wesleyan University, Delaware, OH United States
| |
Collapse
|
3
|
Eaton M, Probst Y, Foster T, Messore J, Robinson L. A systematic review of observational studies exploring the relationship between health and non-weight-centric eating behaviours. Appetite 2024; 199:107361. [PMID: 38643903 DOI: 10.1016/j.appet.2024.107361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/23/2024]
Abstract
Eating behaviour that does not centralise weight, otherwise known as weight-neutral, is associated with improved physical and psychological health, and greater health promoting behaviours. However, consolidated evidence is lacking. This study aimed to systematically evaluate 'health-centric' eating behaviour reflective of weight-neutral approaches, and their relationship with health (physical and mental) and health promoting behaviours. A systematic search was performed, identifying observational studies with adult populations, ≥1 physical/mental health outcome(s), and ≥1 validated measure(s) of health-centric eating behaviour. Study design, sample characteristics and outcomes were extracted and characterised into four domains. Our search identified 8281 records, with 86 studies, 75 unique datasets, and 78 unique exposures including 94,710 individuals. Eating behaviours included intuitive eating (n = 48), mindful eating (n = 19), and eating competence (n = 11). There were 298 outcomes identified for body composition, size, and physical health (n = 116), mental health and wellbeing (n = 123), health promoting behaviours (n = 51) and other eating behaviour (n = 8). Higher levels of intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, better diet quality and greater physical activity. Higher intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, and greater body image, self-compassion, and mindfulness. Greater eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and greater eating competence to higher fibre intake and better sleep quality. Our results demonstrate that 'health-centric' eating behaviours are related to a range of favourable health outcomes and engagement in health promoting behaviours. These findings help to enhance our understanding of eating behaviours that do not centre around body weight, providing support for health-centric eating behaviour in healthcare. Future research should focus on intervention studies and more diverse population groups.
Collapse
Affiliation(s)
- Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | - Julia Messore
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
| |
Collapse
|
4
|
Behrend N, Webb JB, Warschburger P. Explaining the prospective paths from body appreciation to intuitive eating facets: Does body image flexibility serve as a mediator? Body Image 2024; 49:101710. [PMID: 38569448 DOI: 10.1016/j.bodyim.2024.101710] [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: 10/30/2023] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
Initial evidence suggests that body appreciation prospectively predicts intuitive eating. However, the limited number of longitudinal studies focused solely on girls and women, with a lack of evaluation among men. Furthermore, the underlying mechanisms explaining this relationship remain poorly understood. The present study examined whether body appreciation prospectively predicted intuitive eating facets among women and men in Germany. We also tested whether adaptive affect regulation skills (i.e., body image flexibility) mediated these relationships. We analyzed data from 1436 women and 704 men across three time points: Baseline (T1), 6-month (T2), and 12-month (T3) follow-up, using latent variable path models to assess direct and indirect effects. Among women, T1 body appreciation directly predicted T3 body-food choice congruence. Additionally, body appreciation indirectly predicted unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on hunger and satiety cues at T3 via its effect on T2 body image flexibility. Among men, T1 body appreciation indirectly predicted T3 eating for physical rather than emotional reasons via T2 body image flexibility. Our findings suggest that body image flexibility plays a pivotal role in explaining why individuals who appreciate their bodies are more likely to eat intuitively.
Collapse
Affiliation(s)
- Nicole Behrend
- University of Potsdam, Department of Psychology, Counseling Psychology, Potsdam, Germany
| | - Jennifer B Webb
- University of North Carolina at Charlotte, Department of Psychological Science, Health Psychology Ph.D. Program, Charlotte, NC, United States
| | - Petra Warschburger
- University of Potsdam, Department of Psychology, Counseling Psychology, Potsdam, Germany.
| |
Collapse
|
5
|
Rezende F, Oliveira BMPM, Poínhos R. Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review. Healthcare (Basel) 2024; 12:572. [PMID: 38470683 PMCID: PMC10931607 DOI: 10.3390/healthcare12050572] [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: 01/24/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.
Collapse
Affiliation(s)
- Fabiane Rezende
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
| | - Bruno M. P. M. Oliveira
- Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIIAD, INESC-TEC), 4200-465 Porto, Portugal;
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Rua do Campo Alegre 823, 4150-180 Porto, Portugal;
| |
Collapse
|
6
|
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.
Collapse
|
7
|
Burnette CB, Hazzard VM, Hahn SL, Larson N, Neumark-Sztainer D. Like parent, like child? Intuitive eating among emerging adults and their parents. Appetite 2022; 176:106132. [PMID: 35700840 PMCID: PMC9667887 DOI: 10.1016/j.appet.2022.106132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/11/2022] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
Intuitive eating (IE) emphasizes relying on hunger and satiety cues to guide eating, and is associated with positive mental health and health-promoting behaviors. Although parents' own eating patterns often shape those of their children, no known research has explored familial associations of IE. The purpose of this cross-sectional, population-based study was to examine IE concordance between emerging adults and their parents, and whether concordance differed across sociodemographic characteristics and weight perceptions. The analytic sample included 891 emerging adults (M age = 22.0) and their primary parent (M age = 50.4) who participated in the population-based, longitudinal EAT and F-EAT 2010-2018 studies. Parents and emerging adults were grouped into dyads based on IE concordance: (1) neither are intuitive eaters; (2) only the emerging adult is an intuitive eater; (3) only the parent is an intuitive eater; (4) both are intuitive eaters. Dyads differed across socioeconomic status (SES), race/ethnicity, and weight perceptions. Concordant dyads who ate intuitively were more likely to be at higher SES and perceive their weight as "about right" than concordant dyads who did not eat intuitively. Asian emerging adults were most likely to belong to concordant non-intuitive eater dyads. Emerging adults who shared their parent's perception their weight was "overweight" were less likely to be intuitive eaters (even if their parents were). In this sample, sociodemographic characteristics and weight perceptions were related to IE concordance among emerging adults and their parents. Lower SES might be an intergenerational barrier to IE disproportionately impacting communities of color, though longitudinal data are needed. Results also suggest rather than motivating healthful eating, perceiving one's weight as "overweight" could hinder IE. Differences across sociodemographic variables likely intersect in meaningful ways, which is an important future research direction.
Collapse
Affiliation(s)
- C Blair Burnette
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Samantha L Hahn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
8
|
Jiwanmall SA, Kattula D, Nandyal MB, Parvathareddy S, Kirubakaran R, Jebasingh F, Paul TV, Thomas NJ, Kapoor N. Weight Stigma in Patients With Obesity and Its Clinical Correlates: A Perspective From an Indian Bariatric Clinic. Cureus 2022; 14:e26837. [PMID: 35974866 PMCID: PMC9375229 DOI: 10.7759/cureus.26837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Obesity being a global epidemic, currently has several adverse health outcomes. Weight stigma is a significant barrier to delivering quality services and also impairs clinical progress. We intended to study the association of stigma with demographic and clinical variables in obese patients to identify the obstacles in treatment-seeking, so stigma could be adequately addressed to improve clinical outcomes. Methods This study was a retrospective chart review in a Bariatric clinic in a tertiary care hospital. The weight self-stigma questionnaire (WSSQ) was routinely used in the clinic. Demographic and clinical data were collected for 146 obese patients. Results Female patients (73%) had higher stigma scores. The mean total stigma score was 41.6(SD 3.83), the total self-devaluation score was 21.88(SD 2.10), total fear of enacted stigma was 21.26(SD 2.33). Multivariate analysis revealed an association between stigma with multiple dysfunctional eating patterns like bingeing, overeating, and grazing (Adjusted aOR 3.86, 95% CI- 1.66-8.96) and psychiatric diagnosis (adjusted aOR 3.00, CI- 1.25-7.17). Conclusion This study found an association between stigma and certain clinical variables that maintain and worsen obesity and comorbid psychiatric diagnoses. This highlights the importance of an assessment of mental health and stigma in general practice when dealing with patients with obesity. Treating the underlying psychiatric comorbidities and addressing unhealthy eating behaviors can help reduce self-stigma. Stigma is a barrier to treatment-seeking that needs to be addressed in the community.
Collapse
|
9
|
Linardon J. Reciprocal associations between intuitive eating and positive body image components: A multi-wave, cross-lagged study. Appetite 2022; 178:106184. [DOI: 10.1016/j.appet.2022.106184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 01/18/2023]
|
10
|
Body image and eating behaviors: A latent profile analysis. Body Image 2022; 41:396-405. [PMID: 35533520 DOI: 10.1016/j.bodyim.2022.04.013] [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] [Received: 09/08/2021] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022]
Abstract
Body image is multidimensional and less is known about how the combination of positive and negative body image relates to eating behaviors. We used a person-centered approach to identify profiles of body image and explore the relationship between profile membership, sex, age, race, and current marital status, and eating behaviors in a community sample of adults. We recruited 288 adults 18 and older living in the United States using Prolific Academic. Participants completed an online survey assessing body appreciation, functionality appreciation, body dissatisfaction, weight bias internalization, and adaptive and maladaptive eating behaviors. We used latent profile analysis to identify four distinct body image profiles: appreciation & mild dissatisfaction, functional appreciation & moderate dissatisfaction, strong dissatisfaction, and strong appreciation. Profile membership differed by sex with more women and younger adults in profiles higher in negative body image. The relationships between profiles and eating behaviors differed; the three profiles including negative body image had the lowest adaptive and highest maladaptive eating behaviors. The identification of clinically relevant profiles: (1) confirm positive and negative body image coexist, (2) identify high- and low-risk profiles of body image and eating behavior, and (3) offer preliminary suggestions for screening and tailoring preventive interventions.
Collapse
|
11
|
Webb JB, Padro MP, Thomas EV, Davies AE, Etzel L, Rogers CB, Heredia NI. Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women. Front Glob Womens Health 2022; 3:852854. [PMID: 35720811 PMCID: PMC9199427 DOI: 10.3389/fgwh.2022.852854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3–4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1–2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.
Collapse
Affiliation(s)
- Jennifer B. Webb
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
- *Correspondence: Jennifer B. Webb
| | - Meagan P. Padro
- Department of Education, UNC Chapel Hill, Chapel Hill, NC, United States
| | - Erin Vinoski Thomas
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Alexandria E. Davies
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Lena Etzel
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, United States
| | | | - Natalia I. Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
12
|
Resende TRO, Almeida M, Dos Santos Alvarenga M, Brown TA, de Carvalho PHB. Dissonance-based eating disorder prevention improves intuitive eating: a randomized controlled trial for Brazilian women with body dissatisfaction. Eat Weight Disord 2022; 27:1099-1112. [PMID: 34143404 DOI: 10.1007/s40519-021-01245-x] [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: 03/25/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Investigate the efficacy of a dissonance-based (DB) intervention (i.e., the Body Project), during which some examples of intuitive eating were provided by peer leaders, in improving intuitive eating and targeting risk and protective factors for eating disorders (ED) among Brazilian women with body dissatisfaction. METHODS Participants were randomized to a four-session DB intervention (n = 38) or assessment-only control (AOC) (n = 36), and completed validated measures assessing intuitive eating, body appreciation, self-esteem, body-ideal internalization, body dissatisfaction, negative affect, and disordered eating pre-intervention, post-intervention, and at 4- and 24-week follow-ups. RESULTS The DB condition demonstrated significantly greater increases in intuitive eating, body appreciation and self-esteem scores compared to AOC from pre-intervention to post-intervention (between-condition Cohen's d = 0.73-0.98), 4-week (between-condition Cohen's d = 1.25-1.87) and 24-week follow-up (between-condition Cohen's d = 0.82-1.38). Also, the DB condition showed significantly greater decreases in body-ideal internalization, body dissatisfaction and disordered eating scores from pre-intervention to post-intervention (between-condition Cohen's d = 0.76-1.04), 4-week (between-condition Cohen's d = 1.27-1.71) and 24-week follow-up (between-condition Cohen's d = 1.04-1.19). Regarding negative affect, DB condition showed significantly greater reduction only at 24-week follow-up (between-condition Cohen's d = 0.60). CONCLUSION Results reinforce the efficacy of DB interventions in reducing ED risk factors for young women and support the preliminary efficacy of these programs in improving intuitive eating, body appreciation, and self-esteem. LEVEL OF EVIDENCE Level I, randomized controlled trial. ReBEC (Brazilian Registry of Clinical Trials; available at http://www.ensaiosclinicos.gov.br/ ) number of registration: RBR-2f57cs. Date of registration: June 1, 2020.
Collapse
Affiliation(s)
- Thainá Richelli Oliveira Resende
- NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, 745, São Paulo Street, City Center, Governador Valadares, Brazil
| | - Maurício Almeida
- NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, 745, São Paulo Street, City Center, Governador Valadares, Brazil
| | - Marle Dos Santos Alvarenga
- School of Public Health, Nutrition in Public Health Post Graduation Program, University of São Paulo, São Paulo, Brazil
| | - Tiffany A Brown
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,San Diego State University Research Foundation, San Diego, CA, USA
| | - Pedro Henrique Berbert de Carvalho
- NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, 745, São Paulo Street, City Center, Governador Valadares, Brazil. .,AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
13
|
Koçyiğit E, Uzunlar EA, Özer ŞD, Zakkour HK, Akbulut G. The relationship between intuitive eating, eating disorders, and body image perceptions in young adult women. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-211583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The term intuitive eating is a new concept that has emerged in recent years. It is a way of eating that is based on responding to the body’s natural signals of hunger and satiety. OBJECTIVE: The study was conducted to evaluate the relationship between intuitive eating and eating disorders and body image perception in young adult women. METHODS: The study was conducted with 400 women aged 19–35 years. The data were collected with the Figure Rating Scale, the Intuitive Eating Scale-2 (IES-2), and the Eating Attitude Test-26. RESULTS: The mean body mass index was significantly higher in individuals who misperceived their body image. While 51.4% of the participants with normal eating behavior had appropriate body image perception, 38.8% of the participants with abnormal eating behavior had appropriate body image perception. The IES-2 total score was significantly lower in women with abnormal eating behavior and overweight/obese women. CONCLUSIONS: Our findings showed that intuitive eating is negatively associated with abnormal eating behavior and obesity in young adult women and that women with low intuitive eating inclinations misperceived their body image.
Collapse
Affiliation(s)
- Emine Koçyiğit
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara/Turkey
| | - Elif Adanur Uzunlar
- Karadeniz Technical University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Trabzon/Turkey
| | - Şehriban Duyar Özer
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara/Turkey
| | - Hazal Küçükkaraca Zakkour
- Ondokuz Mayıs University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Samsun/Turkey
| | - Gamze Akbulut
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara/Turkey
| |
Collapse
|
14
|
Braun TD, Unick JL, Abrantes AM, Dalrymple K, Conboy LA, Schifano E, Park CL, Lazar SW. Intuitive eating buffers the link between internalized weight stigma and body mass index in stressed adults. Appetite 2022; 169:105810. [PMID: 34813916 PMCID: PMC9434977 DOI: 10.1016/j.appet.2021.105810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 11/05/2021] [Accepted: 11/14/2021] [Indexed: 02/03/2023]
Abstract
Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive eating, and BMI has yet to be examined, and it is unclear whether the link between IWS and BMI is buffered by high intuitive eating. This secondary preliminary analysis examined baseline data of stressed adults with poor diet (N = 75, 70% female, 64.1% White, 42.7% with overweight/obesity) in a parent clinical trial that tested the effects of yoga on diet and stress. Validated self-report surveys of IWS and intuitive eating were analyzed with objectively-assessed BMI. Moderated regression analyses using the SPSS PROCESS macro tested whether intuitive eating moderated the IWS-BMI link. The analysis revealed IWS was positively associated with BMI except among people with high intuitive eating. Results extend observational findings linking intuitive eating to lower BMI, and offer preliminary support for the hypothesis that this link may hold even among those with greater IWS. It's possible that individuals with lower BMI and greater IWS may gravitate more towards intuitive eating than those with greater BMI, and/or intuitive eating may be an important target for ameliorating the adverse association of IWS with behavioral and physical health indicators linked to BMI. Continued work is warranted in larger, more generalizable samples using causal and prospective designs.
Collapse
Affiliation(s)
- Tosca D Braun
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269-1020, UK; Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA.
| | - Jessica L Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University, USA; Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA.
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University, USA; Behavioral Medicine and Addictions Research, Butler Hospital, USA.
| | - Kristy Dalrymple
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University, USA; Lifespan Physician's Group, 146 West River Street, Suite 11B, Providence, RI, 02904, USA.
| | - Lisa A Conboy
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA; New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences, USA.
| | - Elizabeth Schifano
- Department of Statistics, University of Connecticut, 215 Glenbrook Road U4120, Storrs, CT, 06269, UK.
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269-1020, UK.
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, USA; Department of Psychology, Harvard Medical School, USA.
| |
Collapse
|
15
|
Braun TD, Riley KE, Kunicki ZJ, Finkelstein-Fox L, Conboy LA, Park CL, Schifano E, Abrantes AM, Lazar SW. Internalized weight stigma and intuitive eating among stressed adults during a mindful yoga intervention: associations with changes in mindfulness and self-compassion. Health Psychol Behav Med 2021; 9:933-950. [PMID: 34868736 PMCID: PMC8635578 DOI: 10.1080/21642850.2021.1992282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose Internalized weight stigma (IWS) is common in the United States of America across body weight categories, and is implicated in the development of distress and unhealthy eating behaviors (e.g. overeating, disordered eating) that can foster poor cardiometabolic health. While emerging intervention research shows early promise in reducing IWS, long-term efficacy is unclear and novel strategies remain needed. This analysis examined whether participation in a mindful yoga intervention was associated with reduced IWS and increased intuitive eating, an adaptive eating behavior, and whether these changes correlated with each other or with changes in mindfulness and self-compassion. Methods Participants were stressed adults with low fruit and vegetable intake (N = 78, 64.1% White, M. Body Mass Index 25.59 ± 4.45) enrolled in a parent clinical trial of a 12-week mindful yoga intervention. Validated self-report measures of IWS, intuitive eating, mindfulness, and self-compassion were administered at pre-treatment, mid-treatment (8 weeks), post-treatment (12 weeks), and 4-month follow-up (24 weeks). Results Linear mixed modeling revealed significant improvements in IWS and intuitive eating across the four timepoints (p < .001). Reduced IWS correlated with increased intuitive eating pre- to post-treatment (p = .01). Improved self-compassion and mindfulness correlated with intuitive eating (both p = . 04), but not IWS (p = .74 and p = .56, respectively). Conclusion This study offers preliminary support for the hypothesis that mindful yoga may promote intuitive eating and reduce IWS among stressed adults with poor diet, and suggests that changes in these factors may co-occur over time. Further investigation with controlled designs is necessary to better understand the temporality and causality of these relationships.Trial registration: ClinicalTrials.gov identifier: NCT02098018.
Collapse
Affiliation(s)
- Tosca D Braun
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine, Brown University, Providence, RI, USA.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Kristen E Riley
- Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Zachary J Kunicki
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Lucy Finkelstein-Fox
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, USA
| | - Lisa A Conboy
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Crystal L Park
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, USA
| | | | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine, Brown University, Providence, RI, USA.,Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
16
|
Carels RA, Miller JC, Shonrock AT, Byrd R, Haley E. Exploring the addition of self-compassion skills training to a behavioral weight loss program delivered using video conferencing software. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
17
|
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: 97] [Impact Index Per Article: 32.3] [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.
Collapse
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
| |
Collapse
|
18
|
Lucibello KM, Nesbitt AE, Solomon-Krakus S, Sabiston CM. Internalized weight stigma and the relationship between weight perception and negative body-related self-conscious emotions. Body Image 2021; 37:84-88. [PMID: 33596497 DOI: 10.1016/j.bodyim.2021.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 01/27/2023]
Abstract
Individuals who perceive themselves as "overweight" experience higher negative body-related self-conscious emotions than those who do not. Theoretical and empirical evidence suggests internalized weight stigma may be an important mediator of the relationship between weight perception and self-conscious emotions. Overcoming common measurement limitations and sampling limitations, the present study investigated whether gender moderates the associations among weight perceptions, internalized weight stigma, and negative body-related self-conscious emotions in 104 young adults (64 % women). Individuals who perceived themselves as too heavy (52 %) experienced higher body-related shame and guilt compared to those who perceived themselves as about right. Internalized weight stigma mediated these associations in women but not men, such that perceiving oneself as too heavy was associated with higher internalized weight stigma, which was associated with higher body-related shame and guilt in women. Results underscore the importance of internalized weight stigma as a potential target for intervention among women of diverse weight statuses who are prone to experiencing body-related shame and guilt.
Collapse
Affiliation(s)
- Kristen M Lucibello
- Department of Kinesiology, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Amy E Nesbitt
- Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Shauna Solomon-Krakus
- Department of Psychological Clinical Science, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada
| | - Catherine M Sabiston
- Department of Kinesiology, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada.
| |
Collapse
|
19
|
Linardon J, Anderson C, Messer M, Rodgers RF, Fuller-Tyszkiewicz M. Body image flexibility and its correlates: A meta-analysis. Body Image 2021; 37:188-203. [PMID: 33684721 DOI: 10.1016/j.bodyim.2021.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 12/16/2022]
Abstract
Body image flexibility refers to the ability to openly experience thoughts or feelings about the body without acting on them or trying to change them. Accumulating evidence has demonstrated that body image flexibility is connected to numerous adaptive processes, and that it is sensitive to change during psychological interventions. However, a quantitative synthesis of empirical research on body image flexibility is lacking. We conducted the first meta-analysis on body image flexibility and its correlates. Sixty-two studies were included. Random effects meta-analyses were conducted on 19 psychological correlates, divided into three clusters: eating and body image disturbances, positive body-related and general psychological constructs, and general psychopathology. Meta-analyses showed inverse correlations between body image flexibility and each construct within the eating and body image disturbances cluster (rs= -.45 to -.67), and the general psychopathology cluster (rs= -.37 to -.58). Body image flexibility was positively associated with each positive psychology construct (rs = .23 - .58). Men reported higher levels of body image flexibility than women (d = 0.32). Psychological interventions were more effective than control groups at enhancing body image flexibility in randomized controlled trials (d = 0.42). Findings confirm that body image flexibility is consistently connected to indices of mental health, and that it can be enhanced during psychological interventions.
Collapse
Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Cleo Anderson
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Rachel F Rodgers
- Department of Applied Psychology, North Eastern University, 360 Huntington Ave, Boston, MA, 02115, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia; Center for Social and Early Emotional Development, Deakin University, Burwood, VIC, 3125, Australia
| |
Collapse
|
20
|
Internalized transphobia, nondisclosure of gender identity, and life satisfaction among transgender and non-binary adults: The moderating roles of psychological flexibility and inflexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
21
|
Perey I, Koenigstorfer J. Appearance Comparisons and Eating Pathology: A Moderated Serial Mediation Analysis Exploring Body Image Flexibility and Body Appreciation as Mediators and Self-Compassion as Moderator. Body Image 2020; 35:255-264. [PMID: 33157399 DOI: 10.1016/j.bodyim.2020.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 01/26/2023]
Abstract
Comparing one's body against the bodies of others is related to lower positive body image and higher eating pathology. Underlying mechanisms as well as protective factors of these relationships are yet to be discovered. The present study examined body image flexibility and body appreciation as potential mediators of the association between appearance comparisons and eating disorder psychopathology. Additionally, it was tested whether self-compassion moderates the mediation effects. In an online sample comprising 250 women (Mage = 42.66, SD = 12.24), the inverse relationship between appearance comparisons and body appreciation was mediated by body image flexibility and the positive relationship between appearance comparisons and eating disorder psychopathology was mediated by body image flexibility and serially mediated by body image flexibility and body appreciation, when controlling for body mass index and age. Simple mediations were further moderated by self-compassion, such that indirect effects were attenuated at high levels of self-compassion. Promoting body image flexibility may be one potential target for helping women to engage in less maladaptive and more adaptive ways of treating the body when comparing one's appearance. Building self-compassion may be another potential target that may protect body image flexibility and its correlates in the face of appearance comparisons.
Collapse
Affiliation(s)
- Iris Perey
- Chair of Sport and Health Management, Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Joerg Koenigstorfer
- Chair of Sport and Health Management, Department of Sport and Health Sciences, Technical University of Munich, Germany.
| |
Collapse
|
22
|
Confirmatory factor analyses of the Body Image-Acceptance and Action Questionnaire and Functionality Appreciation Scale among LGBQ adults. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01199-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
23
|
Puhl RM, Telke S, Larson N, Eisenberg ME, Neumark-Stzainer D. Experiences of weight stigma and links with self-compassion among a population-based sample of young adults from diverse ethnic/racial and socio-economic backgrounds. J Psychosom Res 2020; 134:110134. [PMID: 32413612 PMCID: PMC7384387 DOI: 10.1016/j.jpsychores.2020.110134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study examines weight stigma experiences in a population-based sample of young adults from diverse ethnic/racial and socio-economic backgrounds, and explores cross-sectional associations between weight stigma and self-compassion, including gender differences in this relationship. METHODS Data come from EAT 2018, a population-based study of weight and related behaviors in young adults (N = 1523, mean age = 22 years, 53.5% females). Adjusted models tested associations between different experiences of weight stigma and the Self-Kindness Subscale of the Self-Compassion Scale, controlling for age, body mass index (BMI), ethnicity/race, and SES. RESULTS Over a third (32.3-52.2%) of participants reported experiences of weight teasing, and almost half (39.2-54.8%) indicated that people in their work or school settings are treated differently based on weight. There were few differences across ethnic/racial groups in reports of weight stigma. The prevalence of weight stigma experiences reported by participants in their current school or work environment was similar across gender, and those who had experienced weight stigma had lower levels of self-kindness. Among both females and males, lower self-kindness scores were associated with the experience of weight teasing (females: χ2 = 22.6, df = 1, p < .001, d = 0.32; males χ2 = 7.6, df = 1, p < .001, d = 0.22). For females only, lower self-kindness scores were associated with being treated unfairly due to weight (χ2 = 11.1, df = 1, p < .001, d = 0.23), and having others make comments about your weight (χ2 = 14.6, df = 1, p < .001, d = 0.28). Findings remained after adjusting for race/ethnicity, BMI, and SES. CONCLUSION Associations between self-compassion and experiences of weight stigma found in our diverse sample of young adults offers insights on this understudied relationship.
Collapse
Affiliation(s)
- Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, United States of America; Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, United States of America.
| | - Susan Telke
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States of America
| | - Dianne Neumark-Stzainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
| |
Collapse
|
24
|
Meadows A, Higgs S. A bifactor analysis of the Weight Bias Internalization Scale: What are we really measuring? Body Image 2020; 33:137-151. [PMID: 32155463 DOI: 10.1016/j.bodyim.2020.02.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 02/23/2020] [Accepted: 02/23/2020] [Indexed: 12/13/2022]
Abstract
Internalized weight stigma (IWS) has been linked with disordered eating behavior, both directly, and as a mediator of the relationship between experienced weight stigma and maladaptive coping. However, the construct of IWS is highly correlated with the related constructs of body image and global self-esteem, and the three constructs may better be represented by underlying trait self-judgment. This overlap is not generally accounted for in existing studies. The present study investigated the shared variance between self-esteem, body image, and IWS in an international sample of higher-weight individuals. Bifactor analysis confirmed that the intermediary role of IWS in the relationship between experienced stigma and self-reported eating behavior was largely accounted for by aspects of body image and global self-esteem. Greater conceptual clarity in the study of IWS is needed to understand the mechanisms via which societal weight stigma impacts on individuals' self-directed judgments and downstream health-related behaviors.
Collapse
Affiliation(s)
- Angela Meadows
- School of Psychology, Western University, London, Ontario, N6A 5C2, Canada.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| |
Collapse
|
25
|
Turk F, Waller G. Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clin Psychol Rev 2020; 79:101856. [PMID: 32438284 DOI: 10.1016/j.cpr.2020.101856] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
Eating disorders are severe mental health conditions, with substantial consequences for health and quality of life. Such disorders are strongly associated with body image concerns. It is important to consider treatments that might enhance our ability to treat such cases. Recently, there has been a growing body of research on self-compassion in relation to such problems. However, we are not yet clear about the extent of such effects, given the range of studies and methodologies used. Therefore, a systematic literature review was carried out using four key databases. Meta-analysis was used to reach conclusions about the size of the effects and moderators. Random-effects meta-analyses were conducted with 59 studies. Higher self-compassion was associated with lower eating pathology, reduced body image concerns, and greater positive body image, with medium to strong effect sizes (respectively, r = -0.34, r = -0.45, r = 0.52). Furthermore, self-compassion interventions for eating pathology and body image were effective, and superior to control groups (respectively, g = 0.58, g = 0.39). These findings support the role of self-compassion in understanding and addressing eating and body image concerns. Self-compassion appears to be an adaptive emotion regulation strategy in eating disorders and body image.
Collapse
Affiliation(s)
- Fidan Turk
- Department of Psychology, University of Sheffield, Sheffield, UK.
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
| |
Collapse
|
26
|
Ralph-Nearman C, Stewart JL, Jones KA. The role of negative urgency in risky alcohol drinking and binge-eating in United Kingdom male and female students. Addict Behav Rep 2020; 11:100274. [PMID: 32322660 PMCID: PMC7171258 DOI: 10.1016/j.abrep.2020.100274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 10/26/2022] Open
Abstract
Identifying students at risk of developing binge-eating and alcohol use disorders is a priority in the United Kingdom (UK). Although relationships between negative urgency (impulsive behavior during times of negative emotion), risky drinking, and binge-eating have been established in students from other countries, these links have yet to be replicated in male and female UK students. UK students aged 18-30 (n = 155) completed the: (1) the Urgency, Pre-meditation, Perseverance, Sensation Seeking (UPPS-P) negative urgency subscale; (2) Alcohol Use Disorders Identification Test (AUDIT); and (3) Binge-Eating Scale (BES). For categorical analysis, participants were assigned to one of four groups as a function of AUDIT and BES clinical cut-off scores: (1) no risk (28%); (2) risky drinkers (47%); (3) binge-eaters (6%); and (4) risky drinkers + binge-eaters (19%). For dimensional analysis, across students with non-zero AUDIT and BES scores (n = 141), BES, AUDIT, gender, and their interactions were entered as predictors in the same block of a regression. UPPS-P negative urgency was the dependent variable. Categorical results indicated that binge-eaters with and without risky drinking endorsed significantly higher negative urgency than students with no risk. Dimensional results showed that although higher BES and AUDIT scores were positively linked to higher negative urgency, but only the BES was significantly associated. Furthermore, BES shared substantially more variance with negative urgency than the AUDIT, and the BES-negative urgency relationship was stronger in male students than female students. High risk students may benefit the most from interventions that help regulate negative emotion.
Collapse
Affiliation(s)
- Christina Ralph-Nearman
- School of Psychology, University of Nottingham, United Kingdom.,Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Department of Community Medicine, University of Tulsa, United States
| | - Katy A Jones
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, United Kingdom
| |
Collapse
|
27
|
Factor structure of the Intuitive Eating Scale-2 among a low-income and racial minority population. Appetite 2019; 142:104390. [DOI: 10.1016/j.appet.2019.104390] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/05/2019] [Accepted: 07/30/2019] [Indexed: 11/18/2022]
|
28
|
"No seconds for you!": Exploring a sociocultural model of fat-talking in the presence of family involving restrictive/critical caregiver eating messages, relational body image, and anti-fat attitudes in college women. Body Image 2019; 30:56-63. [PMID: 31129472 DOI: 10.1016/j.bodyim.2019.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/07/2019] [Accepted: 05/07/2019] [Indexed: 11/22/2022]
Abstract
In line with sociocultural models of parental influence on body image, we examined the relationship between recall of restrictive/critical caregiver eating messages (RCEM) and current frequency of disclosing self-disparaging fat talk among family in 335 undergraduate women (Mage = 19.4; SD = 1.53; range = 18-27). Additionally, two forms of relational body image (i.e., perceived body acceptance by others, external body image shame) and anti-fat attitudes were tested as potential explanatory pathways. RCEM were positively related to current frequency of self-directed fat talk in the family context. All three proposed mediators helped explain this relationship, with external body image shame demonstrating the largest observed effect. Findings suggest frequent recollections of caregivers' implied weight-stigmatizing comments surrounding eating may contribute to more frequent self-denigrating body talk with family members at present via both positive and negative dimensions of relational body image and endorsed explicit weight bias. Theoretical and practical implications are discussed.
Collapse
|
29
|
Internalized weight bias and psychological wellbeing: An exploratory investigation of a preliminary model. PLoS One 2019; 14:e0216324. [PMID: 31071115 PMCID: PMC6508719 DOI: 10.1371/journal.pone.0216324] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 04/18/2019] [Indexed: 12/12/2022] Open
Abstract
Although a growing body of literature demonstrates negative effects of internalized weight bias (IWB), the relationships between IWB and relevant social, psychological, and behavioral variables have not yet been evaluated systematically. The purpose of the present study was to create and assess a model of hypothesized risks and outcomes of IWB. In an online survey, 650 adult males and females completed self-report measures of IWB, self-esteem, weight-related stigma experiences, body-related shame, body satisfaction, societal influence on body image, appearance comparisons, binge eating, distress, and weight-related quality of life. The originally hypothesized model did not provide an adequate fit to the data. Iterative modifications were undertaken, and the resulting model, in which social factors were associated with IWB and body image-related constructs which were in turn associated with psychological and behavioral outcomes, provided excellent fit to the data (CFI > .99, SRMR = .02, and RMSEA = .03). Most model paths were similar for underweight or normal weight participants versus participants with overweight or obesity. This study represents an initial effort at constructing a comprehensive model of IWB that can be further refined in future research and used to help guide the development of related interventions.
Collapse
|
30
|
Craven MP, Fekete EM. Weight-related shame and guilt, intuitive eating, and binge eating in female college students. Eat Behav 2019; 33:44-48. [PMID: 30903861 DOI: 10.1016/j.eatbeh.2019.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/13/2022]
Abstract
Shame and guilt are associated with greater eating disorder symptomatology, including binge eating. These emotional states may be related to binge eating as a result of one's attempt to use food as a means of coping. Little research has examined associations between weight-specific negative emotions and eating behaviors. Even less research has examined the role of intuitive eating as a mitigating factor of these associations. This study examined the relationships among weight-related shame and guilt and binge eating symptomatology in a sample of 196 undergraduate women. Further, we assessed the role of intuitive eating as a moderator of these relationships. Female college students completed an online questionnaire assessing demographics, weight-related shame and guilt, intuitive eating, and binge eating. After accounting for covariates, including body mass index, multiple regression analyses revealed that weight-related shame and guilt were related to increased binge eating symptomatology. Further, intuitive eating attenuated the relationship between weight-related shame and binge eating, but not between weight-related guilt and binge eating. Intuitive eating may be a protective factor for women experiencing weight-related shame.
Collapse
Affiliation(s)
- Michael P Craven
- School of Psychological Sciences, University of Indianapolis, United States of America
| | - Erin M Fekete
- School of Psychological Sciences, University of Indianapolis, United States of America.
| |
Collapse
|
31
|
Rogers CB, Webb JB, Jafari N. A systematic review of the roles of body image flexibility as correlate, moderator, mediator, and in intervention science (2011-2018). Body Image 2018; 27:43-60. [PMID: 30144730 DOI: 10.1016/j.bodyim.2018.08.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 01/25/2023]
Abstract
The emergence of body image flexibility into the positive body image nomenclature has innovatively expanded the conceptualization of how individuals may adaptively respond to body image threats. Given the notable growth of interest in researching this construct over nearly the past decade, the present analysis provides a systematic and critical review of evidence examining the roles of body image flexibility as correlate, mediator, moderator, and in intervention research. Results indicated that body image flexibility tended to demonstrate a pattern of relationships with correlates in directions predicted by its conceptualization and showed promise in functioning as both effect modifier and as an explanatory variable in the associations evaluated. Multiple studies demonstrated susceptibility to change following intervention. Although the current state of the literature is bound by notable limitations, the results of this review point to pertinent future steps in advancing the theory and application of body image flexibility scholarship.
Collapse
Affiliation(s)
| | - Jennifer B Webb
- UNC Charlotte, Health Psychology, United States; UNC Charlotte, Department of Psychological Science, United States
| | | |
Collapse
|
32
|
Palmeira L, Cunha M, Pinto-Gouveia J. The weight of weight self-stigma in unhealthy eating behaviours: the mediator role of weight-related experiential avoidance. Eat Weight Disord 2018; 23:785-796. [PMID: 30019257 DOI: 10.1007/s40519-018-0540-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 07/06/2018] [Indexed: 11/29/2022] Open
Abstract
Weight stigma plays a damaging role in the life of the individuals with overweight and obesity who may internalise the widespread stigmatisation messages. Weight self-stigma is defined as personal experiences of shame, negative self-evaluations as well as perceived discrimination. It has been found to be related to experiential avoidance patterns and poorer outcomes. The current study aims to conduct a confirmatory factor analysis (CFA) on the Weight Self-Stigma Questionnaire (WSSQ) and explore its psychometric properties. Furthermore, the mediator role of weight-related experiential avoidance on the relationship between weight self-stigma and unhealthy eating behaviour was analysed. Concerning the CFA, the sample comprised 331 women with overweight and obesity seeking nutritional treatment. A second independent sample of 58 overweight and obese women was used to assess WSSQ's temporal validity and internal responsiveness. Results supported the WSSQ two-factor structure and good psychometric properties and responsiveness to change. Also, evidence was found for the mediator role of weight-related experiential avoidance on the relationship between BMI, weight self-stigma and unhealthy eating patterns in women with overweight and obesity. Overall, the current study showed that WSSQ is a reliable measure and highlights the important role of weight self-stigma and weight-related experiential avoidance in women with overweight and obesity. Level of evidence: Level V, descriptive studies.
Collapse
Affiliation(s)
- Lara Palmeira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
| | - Marina Cunha
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.,Miguel Torga Superior Institute (ISMT), Coimbra, Portugal
| | - José Pinto-Gouveia
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| |
Collapse
|
33
|
Pearl RL, Puhl RM. Weight bias internalization and health: a systematic review. Obes Rev 2018; 19:1141-1163. [PMID: 29788533 PMCID: PMC6103811 DOI: 10.1111/obr.12701] [Citation(s) in RCA: 299] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 01/31/2023]
Abstract
A robust literature has documented the negative health effects of being the target of weight bias. Weight bias internalization (WBI) occurs when individuals apply negative weight stereotypes to themselves and self-derogate because of their body weight. Compared with experiences of weight bias, less is known about the relationship between WBI and mental and physical health, although more literature on this topic has emerged in recent years. The current systematic review identified 74 studies assessing the relationship between WBI and health and interventions designed to reduce WBI and improve health. Over half of identified studies were published from 2016 to 2017. Results showed strong, negative relationships between WBI and mental health outcomes. Fewer studies have examined the relationship between WBI and physical health, and results were less consistent. Key directions for future research are highlighted, including the need for prospective and experimental studies with greater sample diversity.
Collapse
Affiliation(s)
- R L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - R M Puhl
- Rudd Center for Food Policy and Obesity, Department of Human Development & Family Studies, University of Connecticut, Hartford, CT, USA
| |
Collapse
|
34
|
“Mom, quit fat talking—I'm trying to eat (mindfully) here!”: Evaluating a sociocultural model of family fat talk, positive body image, and mindful eating in college women. Appetite 2018; 126:169-175. [DOI: 10.1016/j.appet.2018.04.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 03/08/2018] [Accepted: 04/05/2018] [Indexed: 01/25/2023]
|
35
|
Mechanisms underlying weight status and healthcare avoidance in women: A study of weight stigma, body-related shame and guilt, and healthcare stress. Body Image 2018; 25:139-147. [PMID: 29574257 DOI: 10.1016/j.bodyim.2018.03.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 11/22/2022]
Abstract
Studies show that women with high BMI are less likely than thinner women to seek healthcare. We aimed to determine the mechanisms linking women's weight status to their healthcare avoidance. Women (N = 313) were surveyed from a U.S. health-panel database. We tested a theory-driven model containing multiple stigma and body-related constructs linking BMI to healthcare avoidance. The model had a good fit to the data. Higher BMI was related to greater experienced and internalized weight stigma, which were linked to greater body-related shame. Internalized weight stigma was also related to greater body-related guilt, which was associated with higher body-related shame. Body-related shame was associated with healthcare stress which ultimately contributed to healthcare avoidance. We discuss recommendations for a Weight Inclusive Approach to healthcare and the importance of enhancing education for health professionals in weight bias in order to increase appropriate use of preventive healthcare in higher weight women.
Collapse
|
36
|
|
37
|
Psychometric evaluation of the German version of the Intuitive Eating Scale-2 in a community sample. Appetite 2017. [DOI: 10.1016/j.appet.2017.06.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
38
|
Beekman JB, Stock ML, Howe GW. Stomaching rejection: Self-compassion and self-esteem moderate the impact of daily social rejection on restrictive eating behaviours among college women. Psychol Health 2017; 32:1348-1370. [PMID: 28475370 DOI: 10.1080/08870446.2017.1324972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study examined whether having high self-esteem or a self-compassionate perspective help mitigate the impact of daily social rejection on negative affect and restrictive eating behaviours. DESIGN Following a baseline survey assessing self-esteem and self-compassion, 121 college women completed online daily diaries for one week. MAIN OUTCOME MEASURES Negative affect and restrictive eating behaviours. RESULTS On days when women reported more rejection, they also reported higher restrictive eating behaviours and greater negative affect. Effects were moderated by self-esteem and self-compassion, such that the lower participants were in self-esteem or self-compassion, the stronger the positive relation between rejection and negative affect and restrictive eating. However, only the common humanity/isolation dimension of self-compassion significantly moderated daily effects of rejection when controlling for self-esteem. Mediated moderation results reveal different mechanisms by which self-esteem and self-compassion buffer against rejections' effects on affect and restrictive eating. CONCLUSION Self-compassion and self-esteem influence the complex impact that social rejection has on affect and restrictive eating. More than other dimensions of self-compassion or self-esteem, remembering one's common humanity can result in a healthier response to social rejection.
Collapse
Affiliation(s)
- Janine B Beekman
- a Department of Psychology , The George Washington University , Washington , DC , USA
| | - Michelle L Stock
- a Department of Psychology , The George Washington University , Washington , DC , USA
| | - George W Howe
- a Department of Psychology , The George Washington University , Washington , DC , USA
| |
Collapse
|
39
|
Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions. Public Health Nutr 2017; 20:1681-1691. [PMID: 28414018 DOI: 10.1017/s1368980017000441] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions' effect on intuitive eating and weight. DESIGN Secondary analysis of a randomized control trial. Mediation analysis compared two ACT interventions - face-to-face (in a group) and mobile (individually) - with a control group using a latent difference score model. Settings Data were collected in three Finnish towns. SUBJECTS The participants were overweight or obese (n 219), reporting symptoms of perceived stress. RESULTS The effect of the interventions on participants' (i) BMI, (ii) intuitive eating and its subscales, (iii) eating for physical rather than emotional reasons and (iv) reliance on internal hunger and satiety cues was mediated by changes in weight-related psychological flexibility in both ACT groups. CONCLUSIONS These findings suggest that ACT interventions aiming for lifestyle changes mediate the intervention effects through the enhanced ability to continue with valued activities even when confronted with negative emotions and thoughts related to weight.
Collapse
|
40
|
Carels RA, Latner J. Weight stigma and eating behaviors. An introduction to the special issue. Appetite 2016; 102:1-2. [PMID: 26946278 DOI: 10.1016/j.appet.2016.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|