Weight perceptions, disordered eating behaviors, and emotional self-efficacy among high school adolescents

Variation of psychological and anthropometrics measures before and after dieting and factors associated with body dissatisfaction and quality of life in a Lebanese clinical sample

Objective

The primary objective of this study was to assess a change in the psychological states (stress, self-esteem, anxiety and depression), anthropometric measurements and physical/mental quality of life before and after diet in a sample of Lebanese subjects visiting a diet clinic. The secondary objectives included the evaluation of factors associated with body dissatisfaction, mental and physical quality of life (QOL) before the intervention of the diet program and the change in quality of life after this intervention among those participants.

Methods

This cross-sectional study, conducted between May and August 2018, enrolled 62 participants recruited from three diet clinics. The QOL was measured using the 12-item Short Form Health Survey (SF-12) and the psychological states was measured using the following scales: The Rosenberg Self-esteem Scale, Perceived Stress Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale.

Results

A significant reduction in body dissatisfaction, anxiety, waist, weight and body fat and a significant increase in the physical and mental quality of life was seen after diet compared to before it (p < 0.001 for all). No significant variation in perceived stress (p = 0.072), self-esteem (p = 0.885), and depression (p = 0.353) after diet were found. Higher BMI (β = 0.440) and higher anxiety (β = 0.132) were associated with higher body dissatisfaction scores, whereas higher self-esteem (β = − 0.818) was significantly associated with lower body dissatisfaction. Higher perceived stress (β = − 0.711), higher body dissatisfaction (β = − 0.480) and being a female (β = − 4.094) were associated with lower mental QOL. Higher Physical Activity Index was significantly associated with higher mental and physical QOL (β = 0.086 and β = 0.123 respectively).

Conclusion

The results indicate the effectiveness of diet programs in enhancing the quality of life, psychological and anthropometric measures.

Disordered Eating Behaviors Are Associated with Gestational Weight Gain in Adolescents

Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents’ offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge–purge behaviors. The main events were GWG and offspring’s birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg; adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (β = 0.67, p = 0.039), compensatory (β = 0.65, p = 0.044), and binge–purge behaviors (β = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.

Validation of the Arabic version of the Eating Attitude Test in Lebanon: a population study

OBJECTIVES

To validate an Arabic version of the Eating Attitude Test (EAT-26) and identify factors (such as depression, stress, anxiety and body dissatisfaction) that might be associated with disordered eating among a sample of the Lebanese population.

DESIGN

Cross-sectional study.

SETTING

All Lebanese governorates.

PARTICIPANTS

A total of 811 participants randomly selected participated in this 5-month study (January-May 2018).

RESULTS

The EAT-26 scale items converged over a solution of six factors that had an eigenvalue over 1, explaining a total of 60·07 % of the variance (Cronbach's α = 0·895). The prevalence of disordered eating attitudes was 23·8 %. Higher EAT-26 scores (disordered eating attitudes) were significantly associated with higher depression (β = 0·325), higher emotional eating (β = 0·083), daily weighing (β = 3·430), higher physical activity (β = 0·05), starving to reduce weight (β = 4·94) and feeling pressure from TV/magazine to lose weight (β = 3·95).

CONCLUSIONS

The Arabic version of EAT-26 can be a useful instrument for screening and assessing disordered eating attitudes in clinical practice and research. Some factors seem to be associated with more disordered eating attitudes among participants for whom psychological counseling may be needed. Yet, our findings are considered preliminary, and further studies are warranted to confirm them.

School self-efficacy is affected by gender and motor skills: findings from an Italian study

Background

Perceived school self-efficacy (SE) is an important variable in students’ activities as it affects their motivation and learning. Further, self-efficacy might represent a good predictor of performance, persistence and perseverance. Motor skills and other physical health determinants are extensively debated and linked to cognitive function in children of developmental age. However, inconclusive evidence supports a definitive relationship between perceived school SE and motor skills among schoolchildren. We conducted a cross-sectional study on 6–11-year-old schoolchildren to evaluate the extent by which perceived school SE and physical health determinants were related.

Methods

A SE questionnaire and motor performance battery tests were administered to primary school pupils recruited from 154 sampled schools of northwest Italy. Perceived SE at school was assessed via 12 items from the Caprara’s questionnaire. Motor performance scores were obtained from motor skill tests: 4 × 10 m shuttle run test, SRT; standing broad jump, SBJ; six-minute walking test, 6MWT.

Results

A total of 3,962 children (M = 2,019; F = 1943) were studied and 68% were normal weight. Overall, a 58% of the sample perceived a high SE, while, as to gender differences, a greater percentage of females perceived high levels of school SE with respect to any other level (χ² = 38.93, p < 0.0001). Results from multinomial logistic regression analysis revealed that: (i) females perceived higher SE compared to males; (ii) children who performed better in SRT and 6MWT showed higher levels of perceived school SE; (iii) no significant effect was registered for the body weight. Alternative strategies are encouraged to enhance SE through physical education: structured interventions might enhance both complex motor skills and high-order cognitive skills, like SE, in young children.

Factors associated with body dissatisfaction among the Lebanese population

OBJECTIVE

To evaluate the factors associated with body dissatisfaction among the Lebanese population, including sociodemographic characteristics, self-esteem, stress, anxiety, depression, emotional regulation, emotional eating and the adult attachment style.

METHODS

This cross-sectional study, conducted between January and May 2018, enrolled 811 adult participants from all districts of Lebanon. The body dissatisfaction subscale of the eating disorder inventory version 2 (EDI-2) was used to measure body disturbance.

RESULTS

The mean age of the participants was 27.59 ± 11.76 years, with 66.5% females. The final model of the regression analysis showed that a higher binge eating score (Beta = 0.202), being married (Beta = 1.233), having a family history of eating disorders (Beta = 1.933), higher BMI (Beta = 0.076), dieting to lose weight (past 30 days) (Beta = 2.345), receiving comments from the family (Beta = 2.234) and pressure from TV/magazines to lose weight (Beta = 1.320), vomiting or taking laxatives to lose weight (past 30 days) (Beta = 1.861), higher depression (Beta = 0.103) and higher perceived stress (Beta = 0.107) were associated with a higher body dissatisfaction score. However, higher self-esteem (Beta = - 0.246), increased physical activity (Beta = - 0.022) and being divorced (Beta = - 4.226) were significantly associated with a lower body dissatisfaction score.

CONCLUSION

A significant association was found in this current study between the main variables: depression, self-esteem, social anxiety, eating disorders, family and television pressure and body image dissatisfaction.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Correlates of orthorexia nervosa among a representative sample of the Lebanese population

INTRODUCTION

Orthorexia nervosa (ON), or the pathological preoccupation and "fixation on healthy food" has been emerging as a new eating disorder. A limited amount of literature exists today on the prevalence of ON. The objective of the current study was to assess factors associated with ON tendencies and behaviors among a representative sample of the Lebanese population.

METHODS

This was a cross-sectional study, conducted between January and May 2018, which enrolled 811 participants from all Lebanese governorates. The ORTHO-15 scale was used to evaluate ON tendencies and behaviors among participants. Scores below 40 indicate the presence of ON.

RESULTS

The results showed that 589 (75.2%) participants had ON tendencies and behaviors. The results of the multivariable analysis taking the ORTHO-15 score as the dependent variable, showed that female gender (Beta = - 0.739), starving to lose weight (Beta = - 0.859), convincing others to follow a diet (Beta = - 0.971), thinking that eating out is unhealthy (Beta = - 0.931) and increased EAT (eating attitudes test) scores (Beta = - 0.087) were associated with higher level of orthorexia tendencies and behaviors (lower ORTHO-15 scores).

CONCLUSION

A highly unexpected prevalence of ON tendencies and behaviors was found in our sample. The Lebanese population might have high preoccupation behavior towards healthy and proper nutrition. Social awareness and behavioral intervention programs are warranted to follow a healthy diet and lifestyle behaviors, and consequently overcome ON.

LEVEL OF EVIDENCE

Level 5, cross-sectional descriptive study.

Assessment of Knowledge, Attitudes, and Behaviors toward Eating Disorders among Adolescents in Italy

The objectives of this survey were to assess the knowledge, attitudes, and behaviors toward eating disorders among adolescents in Italy. The survey was undertaken between May and June 2017 among a random sample of 420 adolescents aged 14-20 years. Data were collected through a self-administered questionnaire. Only 22.8% correctly knew both the definition of anorexia and bulimia nervosa. Female, overweight or obese individuals, and who had at least one parent with a college degree or higher level of education were more likely to have this knowledge. More than one third (38.8%) had a fear of getting fat. Female, overweight or obese individuals, who did not know the definition of anorexia and bulimia nervosa, who avoided eating when they were hungry, and who always and usually were engaged in dieting behavior were more likely to have a fear of getting fat. Only 10.1% and 11.9% always and usually were engaged in dieting behavior, and 40.8% never did so. Respondents who usually/always had a strong desire to be thinner and who had a fear of getting fat were more likely to be engaged in dieting behavior. There is an urgent need to inform Italian adolescents about eating disorders, and healthcare workers may play a crucial role in distributing eating disorder-related knowledge.

Eating Breakfast and Family Meals in Adolescence: The Role of Body Image

Regularly eating breakfast and meals with family has important health implications for youth. However, the association between eating breakfast and family meals regularly with body image has not been explored. Utilizing the 2009-2010 World Health Organization's Health Behavior in School-Aged Children U.S. survey (N = 12,642), we sought to begin this conversation. Our findings suggest that eating breakfast and meals with parents more regularly may be related to more positive body image. This cross-sectional glance suggests that policies and programs that encourage youth and families to regularly eat breakfast and family meals may also encourage better body image among youth.

Adolescent Body Weight Perception: Association With Diet and Physical Activity Behaviors

To assess the prevalence of weight misperception in American adolescents and its association with diet and physical activity behaviors, Youth Risk Behavior Survey data were utilized for this study. Based on reported and perceived weight, adolescents in the study were grouped into four categories (true negative [52.4%] = normal body mass index [BMI]/accurate weight perception; false negative [11.3%] = high BMI/weight misperception; false positive [11.6%] = normal BMI/weight misperception; and true positive [24.8%] = high BMI/accurate weight perception). Diet and physical activity of adolescents were compared in these categories. A total of 12,016 participants were included in our analysis (74.9% aged 15–17 years, 54.5% Whites, 52% females). Almost a third (31.8%) were overweight and obese, and more than a fifth (22.9%) misperceived their weight (11.6% overestimated and 11.3% underestimated their weight). In a gender-stratified analysis, the odds of avoiding a healthy diet and physical inactivity were higher among those with body weight misperception.

Self-efficacy and emotionally dysregulated behaviour: An exploratory test of the role of emotion regulatory and behaviour-specific beliefs

We examined the relationship between self-efficacy and three behaviours that can serve similar affect-regulatory functions (self-injury, risky alcohol use, disordered eating). We proposed that general self-efficacy would be indirectly related to each outcome, operating via emotion regulatory self-efficacy and behaviour-specific self-efficacy. A path analysis confirmed this proposal in a sample of 490 university students, who completed questionnaires assessing the constructs of interest. Emotion regulatory self-efficacy was a salient predictor of self-injury and disordered eating, evidencing both direct and indirect relationships. Self-efficacy to resist each of the behaviours was uniquely related to its target behaviour. We discuss these findings, outlining the implications for a theoretical understanding of emotion-regulatory behaviours, and offer suggestions for prevention and early intervention initiatives.

Physical self-efficacy is associated to body mass index in schoolchildren

OBJECTIVE

The present study aimed to investigate the relationship between physical self-efficacy and body mass index in a large sample of schoolchildren.

METHODS

The Perceived Physical Ability Scale for Children was administered to 1560 children (50.4% boys; 8-12 years) from three different countries. Weight and height were also recorded to obtain the body mass index.

RESULTS

In agreement with the literature, the boys reported greater perceived physical self-efficacy than girls. Moreover, the number of boys who are obese is double that of girls, while the number of boys who are underweight is half that found in girls. In the linear regression model, the increase in body mass index was negatively related to the physical self-efficacy score, differently for boys and girls. Furthermore, age and nationality also were predictors of low physical self-efficacy only for girls.

CONCLUSION

The results of this study reinforce the importance of psychological aspect of obesity, as the perceived physical self-efficacy and body mass index were negatively associated in a sample of schoolchildren for boys and girls.