Weight perception, weight change intentions, and alcohol use among young adults

Examining the role of body esteem and sensation seeking in drunkorexia behaviors

PURPOSE

The purpose of the present study was to examine the role of body esteem (BE), sensation seeking (SS), and their interaction in drunkorexia, a behavior pattern marked by calorie restriction/compensation in the context of alcohol consumption. While previous research on drunkorexia has focused on a range of variables, the present study examined two novel variables and their potential interaction: body esteem (weight, appearance) and sensation seeking.

METHODS

A sample of college students (n =488) completed the Body Esteem Scale for Adolescents and Adults, the Brief Sensation Seeking Scale, and the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale, which measures overall drunkorexia engagement as well as four dimensions: alcohol effects, bulimia, dietary restraint and exercise, and restriction.

RESULTS

Moderated linear regression analyses indicated that SS and BE (weight, appearance) did not interact in predicting drunkorexia. Rather, only main effects were observed; SS, weight esteem (WE), and appearance esteem (AE) were significant in predicting overall drunkorexia engagement. In terms of the drunkorexia dimensions, AE was a significant predictor in the alcohol effects, dietary restraint and exercise, and restriction models. WE was significant in the dietary restraint and exercise model as well as the restriction model. SS was a significant predictor across all drunkorexia dimensions.

CONCLUSIONS

Our findings suggest that both elevated SS and lowered BE are associated with drunkorexia engagement. Implications for practice are discussed. Drunkorexia is a complex and multifaceted behavior pattern; therefore, further research is needed in this area of study.

LEVEL OF EVIDENCE

Level V (descriptive study).

Influences on Body Size Perceptions Among Black Women in the Mississippi Delta

PURPOSE

To identify factors that influence Black women's body size perceptions.

DESIGN

Interviews (cognitive mapping exercise) with 25 women; focus group with 7 additional women.

SETTING

Mississippi Delta.

PARTICIPANTS

Thirty-two black women.

MEASURES

Influences on body size perceptions, body mass index, and body satisfaction.

ANALYSIS

Interviewee maps were combined and condensed, using matrix addition and qualitative aggregation, to create a social map. The social map was presented to a focus group. A paired sample t test and descriptive statistics were run to assess weight perception accuracy and body satisfaction.

RESULTS

The initial social map contained 27 variables. Male preferences (87.5%) and appearance (64%) were believed by most participants to influence perceptions of body size. The focus group identified lack of encouragement, stress, and substance use as factors worth adding to the map. A statistically significant proportion of interviewees possessed an inaccurate weight perception, t(24) = 2.741, P < .05. Furthermore, 76% were dissatisfied with their current weight status and 80% desired a healthy body size.

CONCLUSION

These findings provide practitioners with leverage points, beyond diet and physical activity, that may improve the efficacy of weight reduction interventions among black women. Considering the paucity of research regarding influences on body size perceptions, this study also provides researchers with participant-defined variables worthy of further examination.

Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity

OBJECTIVE

Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored.

METHODS

Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression.

RESULTS

YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours.

CONCLUSION

Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.

Reversibility of psychotropic medication induced weight gain among children and adolescents with bipolar disorders

OBJECTIVE

To assess the reversibility of weight gain associated with psychotropic medications in children.

METHODS

A retrospective cohort study was conducted using an ambulatory electronic medical records database. Individuals under 18 years of age were identified if they were initiating a new course of second generation/atypical antipsychotics (SGA) or mood stabilizers (MS) following a bipolar disorder diagnosis and subsequently discontinued treatment within 24 months of treatment initiation.

RESULTS

Of the 297 children who had experienced positive BMI percentile increase (mean±SD: 8.71±11.94) during the treatment of SGA and/or MS, treatment discontinuation led to an average of 1.88 (±13.41) unit decrease in BMI percentile during a 12-month period since the treatment discontinuation. Repeated measure mixed model analysis showed that the reduction of BMI percentile after treatment discontinuation was neither associated with the treatment regimens patients previously received, nor associated with time since the treatment discontinuation. The three statistically significant predictors were baseline BMI percentile, BMI percentile gained during the treatment, and comorbid substance abuse disorder.

CONCLUSION

Children with bipolar disorder were able to lose a fraction of weight gained during pharmacotherapy after the treatment discontinuation, however, their BMI percentile may not return to the prior treatment level within a year post-medication discontinuation.

Physical and psychosocial factors associated with psychostimulant use in a nationally representative sample of French adolescents: Specificities of cocaine, amphetamine, and ecstasy use

PURPOSE

Patterns of psychostimulant (PST) use, psychological and physical factors, and family relationships were investigated in a nationally representative sample of adolescents. The differences between users of cocaine (Cc), ecstasy/MDMA, and amphetamine (EA) were analyzed, taking into account gender differences.

METHODS

Substance use, psychological factors (lifetime suicide attempts, suicidal thoughts in the previous year, visits to a mental health professional), physical factors (health and body shape perceptions (BSP), body mass index (BMI)), and family relationships (existence of disagreements with parents, relationships with mother and father) were investigated in 26,351 17-year-old French adolescents.

RESULTS

Lifetime suicidal behavior was strongly associated with EA use only. Suicidal ideation in the previous year was associated with Cc use among both boys and girls and associated with EA use among girls. Compared to Cc users, more EA users were overweight, while more Cc users were underweight compared to EA users. BSP, BMI, and EA use were related in girls only. Having a good or very good relationship with both mother and father was negatively associated with Cc use in boys and girls. Girls who had a good or very good relationship with their fathers seemed to be less prone to use EA. Boys with a good or very good relationship with their mothers seemed to be less prone to use EA.

CONCLUSION

The results of the present study could serve as a basis for prevention and harm reduction strategies/programs targeting youth use and for the adaptation of these strategies/programs according to substance and gender.

A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

Objectives: To compare the impact of appearance versus health-framed messages on engagement in a brief web-based risk screening and alcohol reduction intervention. Design: Randomised trial delivered via Drinkaware's website. Visitors were exposed to appearance (n = 51,588) or health-framed messages (n = 52,639) directing them towards an AUDIT-C risk screening questionnaire. Users completing this questionnaire were given feedback on their risk level and extended frame-congruent information. Outcomes: The primary outcome is completion of the AUDIT-C questionnaire. The secondary outcome is whether the participant accessed any of four further resources. Results: The appearance-framed message led to a small but significant increase in the number of users completing the AUDIT-C compared to the health-framed message (n = 3,537, 6.86% versus n = 3,355, 6.37%, p < 0.01). Conversely, following subsequent risk feedback, users exposed to extended health-framed information were more likely to access further resources (n = 1,146, 2.17% versus n = 942, 1.83%, p < 0.01). Conclusions: Physical appearance-framed messages increased the likelihood of engagement with an online alcohol screening and brief intervention tool, whereas health-framed messages increased the likelihood of accessing further resources. This highlights the potential for the use of multi-level approaches in alcohol reduction interventions.

Body weight perception, disordered weight control behaviors, and depressive symptoms among Korean adults: The Korea National Health and Nutrition Examination Survey 2014

BACKGROUND/ PURPOSE

Despite emerging evidence suggesting harmful influences of accurate weight perception on psychological health among individuals with obesity, little is known about the association in Asian populations. The aim of this study was investigate the association between body weight perception and depressive symptoms among Korean adults, and potential differential associations across gender.

METHODS

We used data from the sixth Korea National Health and Nutrition Examination Survey in 2014, comprising 3,318 female (n = 1,876) and male (n = 1,442) participants, aged 19-65 years, with no history of depression and a body-mass index (BMI)> = 18.5kg/m2. Depressive symptoms were measured by the Patient Health Questionnaire-9 Korean version. Weight perception patterns were categorized by comparing self-perceived and objectively measured weight status. Gender-stratified four-level multilevel linear models adjusted for age, BMI, menopause, education, income, marital status, urbanicity, chronic conditions, exercise, smoking, and alcohol use. Subgroup analyses were performed across BMI category.

RESULTS

Among women with obesity, those who underperceived their weight status reported fewer depressive symptoms compared to those who accurately perceived their weight status (β = -1.25, p<0.05). Among women with normal weight, those who overperceived their weight status reported more depressive symptoms compared to those who accurately perceived their weight status (β = 1.00, p<0.05). The same associations were not found in men.

CONCLUSION

Awareness-oriented strategies for obesity prevention and weight management focused on providing information on weight status may need to consider unintended consequences of accurate weight perception on mental health among individuals with obesity, particularly among women.

Behavioral Correlates of Empirically-Derived Dietary Patterns among University Students

Given the importance of young adulthood in establishing lifelong dietary habits, it is imperative to better understand potential underlying drivers of dietary behavior in the university-age population. Dietary patterns have been associated with disease risk, but behavioral predictors of dietary pattern adherence are poorly understood, especially among emerging adults. This study aims to evaluate health-related behaviors associated with dietary pattern scores among freshmen participating in the Tufts Longitudinal Health Study (TLHS; n = 630). We previously derived dietary patterns using principal components analysis and orthogonal rotation from dietary intake data. Health-related behavior data were collected via survey. All data were collected during the Spring semesters of 1998⁻2007. Unadjusted linear models were used to determine associations between dietary pattern scores and health-related behaviors. Significant correlates were retained in multivariable regression models, which were adjusted for demographic characteristics. We found that never eating meals away from home was associated with higher adherence to the Prudent and lower adherence to the Western and Alcohol patterns. Intention to lose weight was negatively associated with the Western pattern, while intention to gain weight was positively associated with all dietary patterns. These findings suggest that intervention efforts aimed at improving eating out behaviors and engaging in healthy weight management strategies may promote healthier dietary patterns among university students.

Relationship Between Current Substance Use and Unhealthy Weight Loss Practices Among Adolescents

OBJECTIVES

To determine the relationship between current substance use and unhealthy weight loss practices (UWLP) among 12-to-18 year olds.

METHODS

Participants were 12-to-18 year olds who completed the 2013 Youth Risk Behavior Survey in Florida (N = 5620). Current alcohol, tobacco, and marijuana use was self-reported based on last 30-day use. UWLP was defined based on self-report of at least one of three methods to lose weight in last 30-days: (1) ≥24 h of fasting, (2) diet pill use, and (3) laxative use/purging. The reference group included those with no reported UWLP. Logistic regression models adjusted for age, gender, race/ethnicity, academic performance, age-sex-specific body mass index percentiles, and perceived weight status were fitted to assess relationships between UWLP and current substance use.

RESULTS

About 15 and 41 % of adolescents reported ≥1 UWLP and use of ≥1 substance in the last 30-days, respectively. Over half (60.1 %) of adolescents who reported substance use engaged in UWLP (p < 0.0001). The prevalence of current alcohol use (50.6 %) was the highest among those who reported UWLP, followed by marijuana (31.9 %), tobacco (19.7 %), and cocaine (10.5 %) use. Adolescents who reported current tobacco [adjusted odds ratio (AOR) 2.7, 95 % confidence interval (CI) 2.1-3.6], alcohol (AOR 2.2, 95 % CI 1.9-2.6), or marijuana (AOR 2.1, 95 % CI 1.7-2.5) use had significantly higher odds of UWLP compared to their non-user counterparts.

CONCLUSIONS

This cross-sectional study shows that substance use and UWLP behaviors are likely to co-exist in adolescents. Further studies are necessary to determine the temporal relationship between substance use and UWLP. It is recommended that intervention programs for youth consider targeting these multiple health risk behaviors.

The association between discrepant weight perceptions and objectively measured physical activity

BACKGROUND

Some individuals perceive themselves as being normal weight, despite having an excess body fat percentage (e.g., underestimate weight). Conversely, other individuals perceive themselves as being overweight, despite having a normal body fat percentage (e.g., overestimate weight). When perceived and actual weight statuses are incongruent, individuals possess a discrepant weight perception. The association between discrepant weight perceptions and engagement in moderate-to-vigorous physical activity (MVPA) has not been thoroughly investigated, which was this study's purpose.

METHODS

For this cross-sectional study, data from the 2003-2006 National Health and Nutrition Examination Survey were utilized (N=5462 adults). MVPA was assessed via accelerometry. Based on measured body mass index and whether participants considered themselves as overweight, underweight, or about the right weight, we classified individuals as accurate perception, overestimate weight (discrepant), or underestimate weight (discrepant). A negative binomial logistical regression was used to assess the association between discrepant weight perception (independent variable) and engagement in MVPA (outcome variable).

RESULTS

Females who said that they are normal weight, but were in fact overweight based on body mass index, engaged in 13% less MVPA (rate ratio=.87, 95% confidence interval: .769-.999, P=.05). Also, older adults (>60yrs) who said that they are normal weight, but were overweight based on body mass index, engaged in 23% less MVPA (rate ratio=.77, 95% confidence interval: .616-.965, P=.025).

CONCLUSION

Discrepant weight perceptions were associated with less objectively measured MVPA. Interventions should take weight perceptions into consideration when designing and evaluating intervention impact.

Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.

Cross-Sectional Associations between Empirically-Derived Dietary Patterns and Indicators of Disease Risk among University Students

The transition from adolescence to adulthood is a unique period during which lifelong dietary habits are shaped. Dietary patterns (DPs) among young adults attending college have not been adequately described, and associations between DPs and indicators of disease risk are not well understood in this age group. Dietary data were collected from undergraduates participating in the Tufts Longitudinal Health Study (TLHS; 1998-2007) by Food Frequency Questionnaire (FFQ; n = 1323). DPs were derived using principal components analysis with varimax rotation. Scree plots; eigenvalues; factor loadings; and previous studies were used to determine and label the DPs retained. Cross-sectional relationships between DP scores and anthropometric measures (percent body fat (PBF) and (BMI) and lipid biomarkers (total; HDL and LDL cholesterol; and triglycerides) were assessed with multivariable regression models; adjusted for demographics; physical activity; smoking; intention to gain/lose weight; and total energy intake. Effect modification by sex was tested. Three DPs were identified: Prudent; Western; and Alcohol. Greater adherence to the Prudent DP was associated with favorable anthropometric outcomes. The Alcohol DP was associated with a favorable lipid profile. Associations between the Western DP and blood lipids differed by sex; with unfavorable impact observed only among males. Our findings add to the literature linking DPs in young adults with measurable adiposity and cardiometabolic outcomes; suggesting that improving nutrition among college students could reduce chronic disease risk.

A qualitative exploration of experiences of overweight young and older adults. An application of the integrated behaviour model

While rates of obesity continue to increase, weight-loss interventions to date have not been hugely successful. The purpose of this study was to explore the specific factors that are relevant to weight control in overweight and obese young adults compared to older adults, within the context of the theory of planned behaviour (TPB). A qualitative methodology with purposive sampling was used. Semi-structured interviews were conducted with 23 young adults and older adults who were currently overweight or obese. The research was informed by thematic analysis. A mixed deductive-inductive approach that was structured around but not limited to TPB constructs was applied. Themes mapped onto the TPB behaviour well, with additional themes of motivation, and knowledge and experience emerging. Differences across groups included motivators to weight loss (e.g. appearance and confidence for young adults, health for older adults), importance of social influences, and perceptions of control (e.g. availability and cost for young adults, age and energy for older adults). Similarities across groups included attitudes towards being overweight and losing weight, and the value of preparation and establishment of a healthy routine. Finally, across both groups, knowledge and confidence in ability to lose weight appeared adequate, despite failed attempts to do so. The different experiences identified for younger and older adults can be used to inform future tailored weight-loss interventions that are relevant to these age groups, and the TPB could provide a useful framework. Additional intervention strategies, such as improving behavioural routine and improving self-regulation also warrant further investigation.