1
|
Van Buuren L, Fleming CAK, Hay P, Bussey K, Trompeter N, Lonergan A, Mitchison D. The prevalence and burden of avoidant/restrictive food intake disorder (ARFID) in a general adolescent population. J Eat Disord 2023; 11:104. [PMID: 37386518 PMCID: PMC10311698 DOI: 10.1186/s40337-023-00831-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/17/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Little is known about the prevalence and impairment associated with possible Avoidant/restrictive food intake disorder (ARFID) in community adolescent populations. We aimed to investigate the prevalence, health-related quality of life (HRQoL), and psychological distress associated with possible ARFID in a sample of adolescents from the general population in New South Wales, Australia. METHODS A representative sample of 5072 secondary school students aged between 11 and 19 years completed the online EveryBODY survey in 2017. The survey included demographic data, eating behaviours, psychological distress and both physical and psychosocial health-related quality of life. RESULTS The prevalence of possible ARFID was 1.98% (95% CI 1.63-2.41) and did not differ significantly across school years 7-12. The weight status of participants with possible ARFID did not differ significantly from those without possible ARFID. When measuring gender identity, the ratio of males to females with possible ARFID was 1:1.7. This was statistically significant, however, the effect size was very small. Psychological distress and HRQoL did not differ significantly between the possible ARFID and non-ARFID group. CONCLUSIONS The prevalence of possible ARFID was found to be similar to that of anorexia nervosa and binge eating disorder in the general adolescent population. Adolescents who identify as girls rather than boys may be more likely to develop ARFID, replication with new samples is required to confirm these findings. The impact of ARFID on HRQoL may be minimal in adolescence and become more significant in adulthood, further research using longitudinal design, healthy control groups and/or diagnostic interviews is required.
Collapse
Affiliation(s)
- Lara Van Buuren
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Catharine Anne Kerle Fleming
- School of Health Sciences, Western Sydney University, Sydney, Australia.
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Kay Bussey
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| |
Collapse
|
2
|
Brandt G, Halbeisen G, Braks K, Huber TJ, Paslakis G. Gender differences in individuals with obesity and binge eating disorder: A retrospective comparison of phenotypical features and treatment outcomes. EUROPEAN EATING DISORDERS REVIEW 2023; 31:413-424. [PMID: 36802088 DOI: 10.1002/erv.2972] [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: 09/18/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE Phenotypical comparisons between individuals with obesity without binge eating disorder (OB) and individuals with obesity and comorbid binge eating disorder (OB + BED) are subject to ongoing investigations. At the same time, gender-related differences have rarely been explored, raising the question whether men and women with OB and OB + BED may require differently tailored treatments. METHOD We retrospectively compared pre- versus post-treatment data in a matched sample of n = 180 men and n = 180 women with OB or OB + BED who received inpatient treatment. RESULTS We found that men displayed higher weight loss than women independent of diagnostic group. In addition, men with OB + BED showed higher weight loss than men with OB after 7 weeks of treatment. CONCLUSIONS The present findings add to an emerging yet overall still sparse body of studies comparing phenotypical features and treatment outcomes in men and women with OB and OB + BED; implications for further research are discussed. CLINICAL TRIAL REGISTRATION The study was prospectively registered with the German Clinical Trial Register as part of application DRKS00028441.
Collapse
Affiliation(s)
- Gerrit Brandt
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Karsten Braks
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Thomas J Huber
- Centre for Eating Disorders, Klinik am Korso, Bad Oeynhausen, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| |
Collapse
|
3
|
Habashy J, Benning SD, Renn BN, Borgogna NC, Lawrence EM, Kraus SW. Psychometric properties of the eating disorder examination questionnaire: Factor analysis and measurement invariance by race/ethnicity and gender. Eat Behav 2023; 48:101696. [PMID: 36516727 DOI: 10.1016/j.eatbeh.2022.101696] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The Eating Disorder Examination Questionnaire (EDE-Q) was originally validated in non-Hispanic White women and has become widely used as an assessment tool for research on eating pathology in college students. However, the original factor structure has generally failed to replicate across various samples, especially among diverse populations. The current study examined the factor structure and measurement invariance of the EDE-Q in a large sample of racially/ethnically diverse college men and women. METHOD Participants included a diverse sample of men and women from two universities (N = 1981). Exploratory factory analysis (EFA) was conducted to examine the factor structure of the EDE-Q, followed by confirmatory factor analysis (CFA) to verify the factor structure, and establish the configural model. Furthermore, we explored the measurement invariance of the configural model by gender (i.e., men, women) and race/ethnicity (i.e., White, Black, Asian, Hispanic, and multiracial). RESULTS EFA and CFA results suggested a three-factor, 10-item measure best fit the data, reflecting Dietary Restraint, Preoccupation and Eating Concern, and Shape/Weight Overvaluation. This measure achieved strict invariance by gender and race/ethnicity, indicating that mean comparisons across groups are meaningful. Women, relative to men, reported higher scores for all subscales. Significant differences across race/ethnicity emerged for Dietary Restraint and Shape/Weight Overvaluation in which Hispanic individuals endorsed the highest means compared to other racial/ethnic groups. DISCUSSION The three-factor, 10-item measure is a brief, valid, and reliable measure of eating disorder psychopathology for U.S. college students.
Collapse
Affiliation(s)
- Jessica Habashy
- Department of Psychology, University of Nevada, Las Vegas, United States of America
| | - Stephen D Benning
- Department of Psychology, University of Nevada, Las Vegas, United States of America
| | - Brenna N Renn
- Department of Psychology, University of Nevada, Las Vegas, United States of America
| | - Nicholas C Borgogna
- Department of Psychological Sciences, Texas Tech University, United States of America
| | - Elizabeth M Lawrence
- Department of Sociology, University of Nevada, Las Vegas, United States of America
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, United States of America.
| |
Collapse
|
4
|
Conradson HE, Hayden KA, Russell‐Mayhew S, Raffin Bouchal S, King‐Shier K. Positive psychological well-being in women with obesity: A scoping review of qualitative and quantitative primary research. Obes Sci Pract 2022; 8:691-714. [PMID: 36483121 PMCID: PMC9722462 DOI: 10.1002/osp4.605] [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: 09/13/2021] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Positive psychological well-being (PPWB) is generally associated with improved physical health, mental well-being, and healthy behaviors. However, it is not clear how PPWB differs in women with obesity or if improving PPWB will improve their health. The objective of this study was to summarize the evidence on PPWB in women with obesity. Method A scoping review was conducted in APA PsycINFO, EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, SocINDEX, Family & Society Studies Worldwide, ProQuest Dissertations and Theses Global databases. Primary research studies, with an analysis of adult women with a BMI ≥30 kg/m2 with measures of PPWB are included. Results Thirty-two studies encompassing >57,000 women with obesity, measured constructs of PPWB included: self-esteem, life satisfaction, positive affect, social support, vitality, happiness, self-acceptance, and optimism. Most studies showed that PPWB was lower in women with obesity although this association dissipated in studies when health and negative social factors were considered. Improvements in PPWB were associated with weight loss and with successful lifestyle changes with and without weight loss. Positive psychological interventions (PPIs) were used to bolster psychological well-being. PPIs were associated with improved measures of self-esteem and well-being. Conclusions Prospective longitudinal and intervention studies are required to understand how evaluating and fostering PPWB might support gender-informed obesity care.
Collapse
Affiliation(s)
| | - K. Alix Hayden
- Libraries & Cultural ResourcesUniversity of CalgaryCalgaryAlbertaCanada
| | - Shelly Russell‐Mayhew
- Counselling PsychologyWerklund School of EducationUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Kathryn King‐Shier
- Faculty of NursingDepartment of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| |
Collapse
|
5
|
Barberis N, Calaresi D, Cannavò M, Verrastro V. Body mass index and quality of life in individuals with polycystic ovary syndrome: Dysmorphic concerns and eating disorders as mediators. Front Public Health 2022; 10:962083. [PMID: 36276397 PMCID: PMC9581187 DOI: 10.3389/fpubh.2022.962083] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/06/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Weight issues, dysmorphic concerns and eating disorders are common among individuals with polycystic ovary syndrome (PCOS) and are linked to poor quality of life (QoL). The goal of the current study was to examine whether the association between body mass index (BMI) and QoL was mediated by dysmorphic concerns, examining also the relations with eating disorder symptomatology. Methods Questionnaires were administered to 435 individuals with PCOS aged between 18 and 40 years (M = 27.62; SD = 4.83) to measure dysmorphic concerns, eating disorder symptoms and QoL. Participants were also asked to report their height and weight to compute their BMI. Results Structural equation modeling was used to observe the relationship between the variables. The results revealed a direct relationship between QoL, BMI, dysmorphic concerns and eating disorder symptomatology. In addition, dysmorphic concerns were related to BMI and eating disorder symptomatology. Furthermore, the results showed the mediating role of dysmorphic concerns and eating disorder symptoms in the relationship between BMI and QoL. Conclusion The current results highlight the potential importance of harmful relationships with one's own body and food, explaining why weight issues may be linked to different levels of QoL in PCOS individuals. The implications of these findings are discussed.
Collapse
Affiliation(s)
- Nadia Barberis
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy
| | - Danilo Calaresi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marco Cannavò
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy,*Correspondence: Marco Cannavò
| | - Valeria Verrastro
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy
| |
Collapse
|
6
|
Van Dyke N, Drinkwater EJ. Intuitive eating is positively associated with indicators of physical and mental health among rural Australian adults. Aust J Rural Health 2022; 30:468-477. [PMID: 35239235 PMCID: PMC9544126 DOI: 10.1111/ajr.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/30/2021] [Accepted: 02/06/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Rural Australians have comparatively higher rates of overweight and obesity, as well as some mental health issues. Intuitive eating has been shown to be positively associated with an array of physical and mental health indicators. Few studies, however, have been conducted with general populations, and none has explicitly examined intuitive eating among rural residents. Objective To investigate the prevalence of intuitive eating, and associations between intuitive eating and indicators of physical and mental health, among a general population of rural adults. Design Cross‐sectional telephone survey of 200 randomly selected, non‐metropolitan, English‐speaking Australian residents aged 18 or older. Findings The prevalence of intuitive eating in the sample was 17.6%, with a higher level of intuitive eating among men than women (26.1% vs 9.1%). Bivariate associations between intuitive eating and each of the six health indicators were all positive and mostly statistically significant. Particularly strong was the correlation between intuitive eating and self‐esteem for women (r = 0.53). After controlling for indication of an eating disorder and demographics, the associations between intuitive eating and the outcome variables held for body mass index (BMI), psychological distress and body esteem for men, and for BMI and self‐esteem for women. Post hoc analyses found that BMI did not moderate the relationship for women between intuitive eating and self‐esteem and that body esteem mediates the relationships between intuitive eating and BMI and psychological distress for men, and between intuitive eating and self‐esteem for women. Discussion Consistent with most prior research, this study finds that intuitive eating is positively associated with several indicators of both physical and mental health among non‐metropolitan residents in Australia. Practice of intuitive eating in this population, however, is low. These findings may help allied health professionals guide rural populations to better health, and may be a particularly effective approach for people for whom the barriers to seeking out health services are high. Conclusion Intuitive eating appears to have substantial correlations with mental health indicators, and to some extent, physical health indicators, among rural Australians and therefore should be further investigated for its potential to inform public health policy targeted to similar populations.
Collapse
Affiliation(s)
- Nina Van Dyke
- Social Research Centre, Melbourne, Victoria, Australia
| | - Eric J Drinkwater
- School of Exercise and Sport Science, Charles Sturt University, Bathurst, New South Wales, Australia
| |
Collapse
|
7
|
Predictors of binge eating disorder and the impact on the quality of life in patients with severe obesity before bariatric surgery. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1011364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
8
|
McAulay C, Dawson L, Mond J, Outhred T, Touyz S. "The Food Matches the Mood": Experiences of Eating Disorders in Bipolar Disorder. QUALITATIVE HEALTH RESEARCH 2021; 31:100-112. [PMID: 32940133 DOI: 10.1177/1049732320956267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Approximately 33% of those with bipolar disorder (BD) have a comorbid eating disorder (ED). However, the trajectory of these conditions has received little research attention. Nine participants who met criteria for BD and an ED participated in qualitative interviews exploring experiences of illness onset, the interaction of these conditions, and service provision. Almost all participants in the sample reported minimal to no screening of ED problems, despite their health professionals' frequent discussion of obesity. Findings suggested that ED features were diverse and evolved over time. Mania and depression were connected to ED features such as overeating and restricting, but this differed between and within participants. Most participants disclosed historic trauma which they considered central to their mental health concerns. This clinical group appears to be underserviced. Clinicians and researchers should routinely screen for ED features when treating and diagnosing BD to inform their physical and mental health interventions.
Collapse
Affiliation(s)
- Claire McAulay
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Lisa Dawson
- St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Jonathan Mond
- University of Tasmania, Launceston, Tasmania, Australia
| | - Tim Outhred
- The University of Sydney, Camperdown, New South Wales, Australia
- Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Touyz
- The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
9
|
Bullivant B, Mitchison D, Skromanis S, Mond J. Elucidating individuals' beliefs about the severity of eating disorders and obesity: implications for public health programs. Eat Weight Disord 2020; 25:929-938. [PMID: 31098985 DOI: 10.1007/s40519-019-00708-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine perceptions of the severity of eating disorders and obesity and the effects on these of an information manipulation while also considering the influence of potential covariates such as age, gender, physical and mental health and beliefs about the prevalence and causes of the respective conditions. METHODS Australian women and men (n = 488) aged 18-73 years were randomly assigned to one of four conditions: no information, neutral information, eating disorders emphasis and obesity emphasis. Mixed-model analysis of variance (ANOVA) was used to compare the perceived severity of eating disorders and obesity (within-subjects factor), while also testing the effect of manipulating information, i.e., selectively emphasising the occurrence and adverse effects of one condition or the other (between-subjects factor), on perceptions of severity. Correlational analysis was used to examine associations between perceptions of severity and potential covariates, those covariates for which significant associations were observed being included as covariates in the ANOVA. RESULTS Eating disorders were perceived to be a more severe condition than obesity and the information manipulation was largely ineffective. Perceptions of the severity of both eating disorders and obesity were found to be associated with several covariates, including gender, body dissatisfaction, familiarity with and beliefs about the prevalence of eating disorders and beliefs about the causes of both eating disorders and obesity. CONCLUSIONS The findings support the need for-and provide a platform for-greater collaboration between obesity and eating disorder researchers in the development of integrated prevention and health promotion programs. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Skromanis
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia
| | - Jonathan Mond
- School of Medicine, Western Sydney University, Sydney, Australia.
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia.
| |
Collapse
|
10
|
Elia C, Karamanos A, Silva MJ, O’Connor M, Lu Y, Dregan A, Huang P, O’Keeffe M, Cruickshank JK, Enayat EZ, Cassidy A, Molaodi OR, Maynard M, Harding S. Weight misperception and psychological symptoms from adolescence to young adulthood: longitudinal study of an ethnically diverse UK cohort. BMC Public Health 2020; 20:712. [PMID: 32423390 PMCID: PMC7236343 DOI: 10.1186/s12889-020-08823-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To evaluate the association between weight misperception and psychological symptoms in the Determinants of young Adults Social well-being and Health (DASH) longitudinal study. METHODS A longitudinal sample of 3227 adolescents, in 49 secondary schools in London, aged 11-16 years participated in 2002/2003 and were followed up in 2005/2006. A sub-sample (N = 595) was followed up again at ages 21-23 years in 2012/2013. An index of weight misperception was derived from weight perception and measured weight. Psychological well- being was measured using the Strengths and Difficulties Questionnaire at 11-16 years and the General Health Questionnaire at 21-23 years. Associations with weight misperception was assessed using regression models, adjusted for socio-economic and lifestyle factors. RESULTS White British males and females were more likely than ethnic minority peers to report accurate perceptions of measured weight. At 11-13y, 46% females and 38% males did not have an accurate perception of their measured weight. The comparable figures at 14-16y were 42 and 40%. Compared with male adolescents, more females perceived themselves as overweight or were unsure of their weight but measured normal weight, and this was more pronounced among Indians, Pakistanis and Bangladeshis. At 14-16y, more males perceived themselves as underweight but measured normal weight, and this was more pronounced among Indians. Compared with those who had an accurate perception of their normal weight, a higher likelihood of probable clinically-relevant psychological symptoms was observed among those who measured normal weight but perceived themselves to be underweight (females Odds Ratio (OR) = 1.87 95% CI 1.03-3.40; males OR = 2.34 95% CI 1.47-3.71), overweight (females only OR = 2.06 95% CI 1.10-3.87), or unsure of their weight (males only OR = 1.61 95% CI 1.04-2.49). Among females, the association was driven by internalising rather than externalising symptoms. An accurate perception of overweight was associated with higher psychological symptoms in adolescence and early 20s. Ethnic specific effects were not evident. CONCLUSION Weight misperception may be an important determinant of psychological symptoms in young people, with an accurate perception of normal weight status being protective. Culturally targeted interventions should be considered to promote healthy perceptions of body image.
Collapse
Affiliation(s)
- Christelle Elia
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Alexis Karamanos
- grid.83440.3b0000000121901201ESRC International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Health, University College London, London, WC1 6BT UK
| | - Maria João Silva
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Maeve O’Connor
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Faculty of Life Sciences & Medicine, King’s College London, Denmark Hill Campus, London, SE5 9RJ UK
| | - Yao Lu
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, Faculty of Life Sciences & Medicine, King’s College London, Denmark Hill Campus, London, SE5 9RJ UK
| | - Alexandru Dregan
- grid.13097.3c0000 0001 2322 6764Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, Addison House, Guy’s Campus, London, SE11UL UK
| | - Peiyuan Huang
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Majella O’Keeffe
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - J. Kennedy Cruickshank
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Elli Z. Enayat
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Aidan Cassidy
- grid.13097.3c0000 0001 2322 6764Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King’s College London, Franklin Wilkins Building, London, SE1 9NH UK
| | - Oarabile R. Molaodi
- grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Maria Maynard
- grid.10346.300000 0001 0745 8880School of Clinical & Applied Sciences, Leeds Beckett University, CL 413 Calverley Building, City Campus, Leeds, LS1 3HE UK
| | - Seeromanie Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, Franklin Wilkins Building, London, SE1 9NH, UK. .,Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, Addison House, Guy's Campus, London, SE11UL, UK.
| |
Collapse
|
11
|
O’Connor SM, Culbert KM, Mayhall LA, Burt SA, Klump KL. Differences in genetic and environmental influences on body weight and shape concerns across pubertal development in females. J Psychiatr Res 2020; 121:39-46. [PMID: 31759219 PMCID: PMC7099836 DOI: 10.1016/j.jpsychires.2019.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/12/2019] [Accepted: 11/07/2019] [Indexed: 02/08/2023]
Abstract
The heritability of disordered eating increases during puberty; however, prior studies have largely examined a composite score of disordered eating, rather than specific symptoms. Body weight and shape concerns cut across all eating disorder diagnoses and are some of the strongest prospective risk factors for the development of eating disorders. Yet, little is known about potential developmental increases or decreases in genetic and environmental influences for these key symptoms. This study examined differences in genetic and environmental effects on a range of body weight and shape concerns during puberty and compared results to findings for overall levels of disordered eating symptoms. Participants were 926 same-sex female twins (ages 8-16) from the Michigan State University Twin Registry. Well-validated questionnaires were used to examine pubertal maturation, overall levels of disordered eating, and a range of cognitive body weight/shape constructs: body dissatisfaction, weight/shape concerns, and weight preoccupation. Findings for overall levels of disordered eating were very similar to those obtained in previous work, with significantly increased genetic effects in girls at more advanced pubertal development. Importantly, these same pubertal increases in genetic influences were observed for body dissatisfaction and weight/shape concerns. However, no pubertal moderation of genetic effects was observed for weight preoccupation; instead, pubertal moderation of nonshared and shared environmental effects was observed. Our findings point to differences in the extent to which genetic and environmental factors contribute to various cognitive body weight and shape symptoms during puberty.
Collapse
Affiliation(s)
- Shannon M. O’Connor
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Kristen M. Culbert
- Department of Family Medicine and Public Health, Wayne State University School of Medicine, Detroit, MI, USA
| | - Laura A. Mayhall
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - S. Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
12
|
Bullivant B, Denham AR, Stephens C, Olson RE, Mitchison D, Gill T, Maguire S, Latner JD, Hay P, Rodgers B, Stevenson RJ, Touyz S, Mond JM. Elucidating knowledge and beliefs about obesity and eating disorders among key stakeholders: paving the way for an integrated approach to health promotion. BMC Public Health 2019; 19:1681. [PMID: 31842820 PMCID: PMC6916014 DOI: 10.1186/s12889-019-7971-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 11/19/2019] [Indexed: 12/22/2022] Open
Abstract
Background Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia. Methods Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis. Results The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents. Conclusions The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.
Collapse
Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia. .,Macquarie University, Sydney, New South Wales, Australia.
| | - Aaron R Denham
- Macquarie University, Sydney, New South Wales, Australia
| | - Clare Stephens
- Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca E Olson
- The University of Queensland, St. Lucia, Queensland, Australia
| | - Deborah Mitchison
- Macquarie University, Sydney, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia
| | - Timothy Gill
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarah Maguire
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Phillipa Hay
- Western Sydney University, Penrith, New South Wales, Australia
| | - Bryan Rodgers
- Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Stephen Touyz
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan M Mond
- Western Sydney University, Penrith, New South Wales, Australia.,University of Tasmania, Launceston, Tasmania, Australia
| |
Collapse
|
13
|
Kilpela LS, Verzijl CL, Becker CB. Body image in older women: a mediator of BMI and wellness behaviors. J Women Aging 2019; 33:298-311. [PMID: 31751189 DOI: 10.1080/08952841.2019.1692629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Negative body image is prevalent among mid- and late-life women. In younger women, negative body image is associated with reduced quality of life (QOL) when controlling for body mass index (BMI), and mediates the relationship between obesity and emotional wellbeing. Yet, much remains unknown about body image in older populations. In our sample of women aged 50-86 (N = 181), negative body image mediated the relationship between BMI and sleep, all four domains of QOL, negative affect, nutritious food consumption, and psychosocial impairment, but not enjoyment of physical activity. Findings suggest negative body image impacts the wellbeing of older women.
Collapse
Affiliation(s)
- Lisa Smith Kilpela
- Department of Psychiatry, Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | | | | |
Collapse
|
14
|
Rodriguez-Lozada C, Cuervo M, Cuevas-Sierra A, Goni L, Riezu-Boj JI, Navas-Carretero S, Milagro FI, Martinez JA. Changes in Anxiety and Depression Traits Induced by Energy Restriction: Predictive Value of the Baseline Status. Nutrients 2019; 11:nu11061206. [PMID: 31141954 PMCID: PMC6627283 DOI: 10.3390/nu11061206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/22/2022] Open
Abstract
Current evidence proposes diet quality as a modifiable risk factor for mental or emotional impairments. However, additional studies are required to investigate the effect of dietary patterns and weight loss on improving psychological symptoms. The aim of this investigation was to evaluate the effect of energy-restriction, prescribed to overweight and obese participants, on anxiety and depression symptoms, as well as the potential predictive value of some baseline psychological features on weight loss. Overweight and obese participants (n = 305) were randomly assigned for 16 weeks to two hypocaloric diets with different macronutrient distribution: a moderately high-protein (MHP) diet and a low-fat (LF) diet. Anthropometrical, clinical, psychological, and lifestyle characteristics were assessed at baseline and at the end of the intervention. The nutritional intervention evidenced that weight loss has a beneficial effect on trait anxiety score in women (β = 0.24, p = 0.03), depression score in all population (β = 0.15, p = 0.02), particularly in women (β = 0.22, p = 0.03) and in subjects who followed the LF diet (β = 0.22, p = 0.04). Moreover, weight loss could be predicted by anxiety status at baseline, mainly in women and in those who were prescribed a LF diet. This trial suggests that weight loss triggers an improvement in psychological traits, and that anxiety symptoms could predict those volunteers that benefit most from a balanced calorie-restricted intervention, which will contribute to individualized precision nutrition.
Collapse
Affiliation(s)
- Claudia Rodriguez-Lozada
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
| | - Marta Cuervo
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, 28029 Madrid, Spain.
| | - Amanda Cuevas-Sierra
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
| | - Leticia Goni
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
| | - Jose Ignacio Riezu-Boj
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, 28029 Madrid, Spain.
| | - Fermin Ignacio Milagro
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, 28029 Madrid, Spain.
| | - Jose Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, 28029 Madrid, Spain.
| |
Collapse
|
15
|
Liu W, Lin R, Guo C, Xiong L, Chen S, Liu W. Prevalence of body dissatisfaction and its effects on health-related quality of life among primary school students in Guangzhou, China. BMC Public Health 2019; 19:213. [PMID: 30786874 PMCID: PMC6381611 DOI: 10.1186/s12889-019-6519-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/07/2019] [Indexed: 02/06/2023] Open
Abstract
Background The relationship between body dissatisfaction (BD) and health-related quality of life (HRQoL) has been well documented in adolescents and adults but is less clear in children, particularly in China. The aims of this study were to describe body image perception and dissatisfaction and to examine their effects on HRQoL among primary school students in Guangzhou, China. Methods A total of 5734 children aged 8–12 years from 29 schools completed self-report questionnaires, which included the Paediatric Quality of Life Inventory 4.0 for measuring HRQoL and Ma figural stimuli for measuring BD. Based on their level of BD, the children were divided into three groups: no dissatisfaction, mild dissatisfaction and moderate or high dissatisfaction. Based on the children’s perceptions of their own body image, the groups were also categorized into just right, too fat and too thin groups. Height and weight were objectively measured using standardized methods, and a BMI z-score was derived using the age- and sex-specific WHO references from 2007 for children aged 5–19 years. Weight status was classified as underweight, healthy weight, overweight or obese. Results A total of 78.10% of children aged 8–12 years in Guangzhou had different levels of BD; boys had slightly higher levels BD than girls (p < 0.01), and obese children demonstrated the highest degree of BD (p < 0.01). However, BD levels did not differ significantly according to age (p = 0.194). Gender differences in body image perceptions were only found in children with a healthy weight (p < 0.01), but age differences in body image perception were present in both children with a healthy weight (p < 0.05) and underweight children (p < 0.05). Of the children with a healthy weight who were dissatisfied with their body image, 65.54% of the boys wanted to be heavier, whereas 52.95% of the girls wanted to be thinner (p < 0.01), and older children were more inclined to perceive themselves as too fat (p < 0.01). After controlling for the influence of confounding factors, significant trends for lower HRQoL scores with increasing BD levels persisted in all domains (p < 0.01). Conclusions BD is as common in children as in adolescents and adults and might be independently associated with HRQoL impairment. The present findings suggest that the current epidemic of BD is a threat to the health of primary school children in China, and prevention programmes for this population should be implemented in the future.
Collapse
Affiliation(s)
- Wei Liu
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China
| | - Rong Lin
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China
| | - Chongshan Guo
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China
| | - Lihua Xiong
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China
| | - Siyu Chen
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China
| | - Weijia Liu
- Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, No. 1, Qide road, Jiahe, Baiyun District, Guangzhou, 510440, China.
| |
Collapse
|
16
|
Purton T, Mond J, Cicero D, Wagner A, Stefano E, Rand-Giovannetti D, Latner J. Body dissatisfaction, internalized weight bias and quality of life in young men and women. Qual Life Res 2019; 28:1825-1833. [DOI: 10.1007/s11136-019-02140-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
|
17
|
Rand-Giovannetti D, Cicero DC, Mond JM, Latner JD. Psychometric Properties of the Eating Disorder Examination–Questionnaire (EDE-Q): A Confirmatory Factor Analysis and Assessment of Measurement Invariance by Sex. Assessment 2017; 27:164-177. [DOI: 10.1177/1073191117738046] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The original, theoretically derived factor structure of the Eating Disorder Examination–Questionnaire (EDE-Q) has received limited empirical support and there is no consensus on an appropriate alternative. Moreover, there is a paucity of data on the factor structure of the EDE-Q across sexes. The goals of the current study were to evaluate models of the EDE-Q factor structure and to assess the best-fitting model for differences by sex. Twelve models were compared using confirmatory factor analysis in a sample of 940 undergraduates. Confirmatory factor analysis did not support the original factor structure. A four-factor model fit the data reasonably well with factors corresponding to themes of (a) dietary restraint, (b) preoccupation and restriction, (c) weight and shape concern, and (d) eating shame. The EDE-Q was found to be invariant by sex across all factors except Factor 3. The implications of these findings are discussed.
Collapse
Affiliation(s)
| | | | - Jonathan M. Mond
- University of Tasmania, Launceston, Tasmania, Australia
- Western Sydney University, Campbelltown, New South Wales Australia
| | | |
Collapse
|
18
|
Becker CB, Verzijl CL, Kilpela LS, Wilfred SA, Stewart T. Body image in adult women: Associations with health behaviors, quality of life, and functional impairment. J Health Psychol 2017. [PMID: 28810463 DOI: 10.1177/1359105317710815.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined body image in adult women along with probable correlates including health behaviors, negative affect, quality of life, and functional impairment. Adult women (N = 738, age = 25-86 years) completed an online survey assessing these domains. Women across all ages reported similar body image concerns. Negative body image significantly correlated with poorer wellness behaviors, negative affect, quality of life, and functional impairment. The inverse held for positive body image. The majority of correlations remained even when controlling for negative affect. Further research is warranted to investigate nature of the correlational relationships identified in this study.
Collapse
Affiliation(s)
| | | | - Lisa S Kilpela
- 2 The University of Texas Health Science Center at San Antonio, USA
| | | | | |
Collapse
|
19
|
Griffiths S, Murray SB, Bentley C, Gratwick-Sarll K, Harrison C, Mond JM. Sex Differences in Quality of Life Impairment Associated With Body Dissatisfaction in Adolescents. J Adolesc Health 2017; 61:77-82. [PMID: 28389062 DOI: 10.1016/j.jadohealth.2017.01.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/26/2016] [Accepted: 01/29/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Body dissatisfaction is strongly associated with quality of life impairment among both male and female adults, and the strength of this relationship is comparable between the sexes. Whether this is the case among adolescents, however, is unclear. METHODS Adolescent girls (n = 1,135) and boys (n = 531) aged 12-18 years were recruited from secondary schools located in the Australian Capital Territory, Australia. Students completed a survey that included measures of body dissatisfaction, eating disorder symptoms, and psychosocial health- and physical health-related quality of life. RESULTS Girls reported higher levels of dissatisfaction than boys for each of the 12 body features assessed. The strength of the adverse associations between body dissatisfaction and quality of life impairment did not, however, differ by sex, and this was the case for both physical health-related and psychosocial quality of life domains. For both girls and boys, associations between body dissatisfaction and both quality of life impairment persisted after controlling for eating disorder symptoms, body mass index, and other covariates. CONCLUSIONS While levels of body dissatisfaction remain higher in girls than in boys, the adverse impact of body dissatisfaction on adolescents' quality of life does not appear to differ by sex. This impact entails impairment in both physical health and psychosocial quality of life domains and does not appear to be accounted for by an association between body dissatisfaction and eating disorder pathology. The findings support the need to conceive of body dissatisfaction as a public health concern in its own right.
Collapse
Affiliation(s)
- Scott Griffiths
- Centre for Applied Psychology, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia; Research School of Psychology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia.
| | - Stuart B Murray
- School of Medicine, Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Caroline Bentley
- Research School of Psychology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kassandra Gratwick-Sarll
- Research School of Psychology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carmel Harrison
- Research School of Psychology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jonathan M Mond
- Department of Psychology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW The purposes of this study were to examine the relationships between obesity and a wide range of mental health issues and to identify where sex differences exist and may vary across disorders. RECENT FINDINGS Research on sex differences in the relationship between obesity and psychiatric disorders is more abundant in some areas, such as depression and eating disorders, than others, such as anxiety, trauma, and substance use. However, for most of the disorders, their relationships with obesity and sex are complex and are usually moderated by additional variables. Thus, studies that find stronger relationships for women between depression and obesity cross-sectionally do not tell the whole story, as longitudinal studies suggest that this relationship may also be present among men, particularly when confounders are considered. For those with eating disorders, men and women with obesity are fairly equally affected, and weight and shape concerns may play a role in maintaining these behaviors for both sexes. Weight stigma, though, seems to have worse consequences for women than men with obesity. Sex differences exist in relation to the associations between mental health and obesity. However, these differences vary by disorder, with disorder-specific moderators playing a role, such as age for depressive disorders, comorbid depression for anxiety disorders, and weight and shape concerns for eating disorders. More work is needed to understand if sex differences play a role in the relationship between obesity and anxiety, trauma, and substance use disorders.
Collapse
Affiliation(s)
- Jena Shaw Tronieri
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Courtney McCuen Wurst
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Rebecca L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA.
| |
Collapse
|
21
|
Becker CB, Verzijl CL, Kilpela LS, Wilfred SA, Stewart T. Body image in adult women: Associations with health behaviors, quality of life, and functional impairment. J Health Psychol 2017; 24:1536-1547. [PMID: 28810463 DOI: 10.1177/1359105317710815] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined body image in adult women along with probable correlates including health behaviors, negative affect, quality of life, and functional impairment. Adult women (N = 738, age = 25-86 years) completed an online survey assessing these domains. Women across all ages reported similar body image concerns. Negative body image significantly correlated with poorer wellness behaviors, negative affect, quality of life, and functional impairment. The inverse held for positive body image. The majority of correlations remained even when controlling for negative affect. Further research is warranted to investigate nature of the correlational relationships identified in this study.
Collapse
Affiliation(s)
| | | | - Lisa S Kilpela
- 2 The University of Texas Health Science Center at San Antonio, USA
| | | | | |
Collapse
|
22
|
Mitchison D, Hay P, Griffiths S, Murray SB, Bentley C, Gratwick‐Sarll K, Harrison C, Mond J. Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents. Int J Eat Disord 2017; 50:118-126. [PMID: 27539911 PMCID: PMC6585604 DOI: 10.1002/eat.22592] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. METHOD Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. RESULTS Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. DISCUSSION Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126).
Collapse
Affiliation(s)
- Deborah Mitchison
- Department of PsychologyMacquarie UniversitySydneyNew South WalesAustralia,School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Phillipa Hay
- Centre for Health Research, Sydney, Western Sydney UniversityNew South WalesAustralia
| | - Scott Griffiths
- Department of PsychologyUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
| | - Stuart B. Murray
- Department of PsychiatryUniversity of CaliforniaSan FranciscoCalifornia
| | - Caroline Bentley
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Kassandra Gratwick‐Sarll
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Carmel Harrison
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Jonathan Mond
- School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| |
Collapse
|
23
|
de Montigny F, Cloutier L, Meunier S, Cyr C, Coulombe S, Tremblay G, Auger N, Roy B, Gaboury I, Lavoie B, Dion H, Houle J. Association between weight status and men's positive mental health: The influence of marital status. Obes Res Clin Pract 2016; 11:389-397. [PMID: 28007535 DOI: 10.1016/j.orcp.2016.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to (1) examine the association between weight status and men's positive mental health, defined as the presence of symptoms of emotional, psychological, and social well-being, and (2) evaluate the moderating effect of marital status. A total of 645 men aged between 19 and 71 years self-reported their height and weight and answered a questionnaire measuring their emotional, psychological, and social well-being. Analysis of variance revealed that mean levels of emotional, psychological, and social well-being did not significantly differ according to men's weight status. Moderation analyses indicated that, for men in a relationship (married or living common-law), there were no significant associations between overweight, obesity, and the three components of positive mental health. However, for single men, overweight was marginally associated with higher emotional well-being, while obesity was associated with lower psychological well-being and marginally associated with lower social well-being. Results of the present study suggest that health professionals and researchers should take the characteristics (such as marital status) of men with obesity and overweight into account when working with them. Mental health researchers may need to examine men in each weight category separately (e.g. obesity vs. overweight), since the association with positive mental health can differ from one category to another.
Collapse
Affiliation(s)
| | - Lyne Cloutier
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
| | - Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Caroline Cyr
- Department of Psychology and Psychoeducation, Université du Québec en Outaouais, Gatineau, Canada.
| | - Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| | - Gilles Tremblay
- School of Social Work, Université Laval, Québec City, Canada.
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montréal, Canada.
| | - Bernard Roy
- Faculty of Nursing, Université Laval, Québec City, Canada.
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Canada.
| | | | - Harold Dion
- Clinique médicale l'Actuel, Montréal, Canada.
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada.
| |
Collapse
|
24
|
Han SY, Brewis AA, Wutich A. Body image mediates the depressive effects of weight gain in new mothers, particularly for women already obese: evidence from the Norwegian Mother and Child Cohort Study. BMC Public Health 2016; 16:664. [PMID: 27473373 PMCID: PMC4966799 DOI: 10.1186/s12889-016-3363-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/23/2016] [Indexed: 11/10/2022] Open
Abstract
Background Multiple studies show that obesity and depression tend to cluster in women. An “appearance concern” pathway has been proposed as one basic explanation of why higher weights might lead to depression. The transition to motherhood is a life phase in which women’s body image, weight, and depressive risk are in flux, with average weight increasing overall during this period. Examination of how these factors interact from pre- to post-pregnancy provides a means to test how body image plays a key role, as proposed, in causally shaping women’s depressive risk. Methods Tracking 39,915 pregnant women in the Norwegian Mother and Child (MoBA) Cohort Study forward 36 months after their deliveries, we test the moderating and mediating effects of body image concerns on the emergence of new mothers’ depressive symptoms by using a binary logistic regression model with a discrete-time event history approach and mediation analysis with bootstrapping. Results For women with high pre-pregnancy body mass index (BMI), weight gain heightens their depressive symptoms over time. Body image concerns mediate the association between weight gain and the development of depressive symptoms regardless of weight status. However, the mediation effect is more evident for women with higher pre-pregnancy BMI. Conversely, better body image is highly protective against the transition to mild or more severe depressive symptoms among new mothers, but only for women who were not classified as obese prior to their pregnancies. Conclusions These findings support a role for body image concerns in the etiology of depressive symptoms during the transition to motherhood. The findings suggest body image interventions before or during pregnancy could help reduce risks of depression in the early postpartum period and well beyond.
Collapse
Affiliation(s)
- Seung-Yong Han
- Mayo Clinic/Arizona State University Obesity Solutions initiative, Arizona State University, Tempe, AZ, 85287-2402, USA.
| | - Alexandra A Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287, USA
| |
Collapse
|
25
|
Gall K, van Zutven K, Lindstrom J, Bentley C, Gratwick-Sarll K, Harrison C, Lewis V, Mond J. Obesity and emotional well-being in adolescents: Roles of body dissatisfaction, loss of control eating, and self-rated health. Obesity (Silver Spring) 2016; 24:837-42. [PMID: 26880693 DOI: 10.1002/oby.21428] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 11/16/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Weak or inconsistent association between obesity and impairment in emotional well-being in population-based samples has led to efforts to identify mediating variables. This study examined the relative importance of body dissatisfaction (BD), loss of control (LOC) eating, and self-rated health (SRH) in mediating the association between obesity and impairment in emotional well-being in a school-based sample of adolescents (boys, n = 437; girls, n = 950). METHODS Moderated mediation analysis was employed to assess the relative importance of the putative mediating variables and moderation of mediation effects by sex following the methods suggested by Hayes and coworkers. RESULTS BD and SRH, but not LOC eating, were found to mediate the association between obesity and impairment in emotional well-being. Stronger mediation effects were observed for BD than for SRH. None of these results was moderated by sex. CONCLUSIONS The findings suggest that it may be important to target BD in obesity prevention and treatment programs in order to reduce the adverse impact of excess body weight on young people's emotional well-being.
Collapse
Affiliation(s)
- Kelly Gall
- Department of Psychology, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Kim van Zutven
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Joanna Lindstrom
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Caroline Bentley
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kassandra Gratwick-Sarll
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carmel Harrison
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Vivienne Lewis
- Department of Psychology, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Jonathan Mond
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
26
|
Abstract
Obese individuals face weight-based stigmatization and discrimination in virtually all areas of life. These stigmatizing experiences can lead to detrimental psychological, physical, and societal consequences and may further perpetuate the increasing prevalence of obesity. A. J. Stunkard was one of the first medical professionals to identify and address the serious ramifications of obesity stigmatization on both individual and societal levels. Throughout the last half-century, Stunkard contributed numerous findings and publications to the field of obesity stigmatization. His work laid the foundation and direction for important areas of current research, such as the cultural influences on weight bias, stigmatization among healthcare professionals, weight stigma among children, and the internalization of weight bias by obese individuals. His contributions have had an important influence on the current directions of these fields.
Collapse
Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA.
| | - Emily C Stefano
- Department of Psychology, University of Hawaii at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| |
Collapse
|
27
|
The Combined Effects of Obesity, Abdominal Obesity and Major Depression/Anxiety on Health-Related Quality of Life: the LifeLines Cohort Study. PLoS One 2016; 11:e0148871. [PMID: 26866920 PMCID: PMC4750966 DOI: 10.1371/journal.pone.0148871] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 01/24/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and major depressive disorder (MDD)/anxiety disorders often co-occur and aggravate each other resulting in adverse health-related outcomes. As little is known about the potential effects of interaction between obesity and MDD and/or anxiety disorders on health-related quality of life (HR-QoL), this study was aimed at examining these combined effects. METHODS We collected data among N = 89,332 participants from the LifeLines cohort study. We categorized body weight using body mass index (kg/m2) as normal weight (18.5-24.99), overweight (25-29.9), mild obesity (30-34.9) and moderate/severe obesity (≥ 35); we measured abdominal obesity using a waist circumference of ≥102 and ≥ 88 cm for males and females, respectively. MDD and anxiety disorders were diagnosed with the Mini-International Neuropsychiatric Interview. HR-QoL was assessed using the RAND-36 questionnaire to compute physical and mental quality of life scores. We used binary logistic and linear regression analyses. RESULTS The combined effect of obesity and MDD and/or anxiety disorders on physical QoL was larger than the sum of their separate effects; regression coefficients, B (95%-confidence interval, 95%-CI) were: - 1.32 (-1.75; -0.90). However, the combined effect of obesity and major depression alone on mental QoL was less than the additive effect. With increasing body weight participants report poorer physical QoL; when they also have MDD and/or anxiety disorders participants report even poorer physical QoL. In persons without MDD and/or anxiety disorders, obesity was associated with a better mental QoL. CONCLUSIONS Obesity and MDD and/or anxiety disorders act synergistically on physical and mental QoL. The management of MDD and/or anxiety disorders and weight loss may be important routes to improve HR-QoL.
Collapse
|
28
|
Shin A, Nam CM. Weight perception and its association with socio-demographic and health-related factors among Korean adolescents. BMC Public Health 2015; 15:1292. [PMID: 26703247 PMCID: PMC4690271 DOI: 10.1186/s12889-015-2624-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a time of rapid growth with dramatic changes in physical appearance. The body image established at this time could affect their physical and mental health throughout their entire life. However, adolescents sometimes perceive themselves as underweight or overweight irrespective of actual weight status. The purpose of the present study was to examine the extent of weight misperception for Korean adolescents, to explore socio-demographic factors associated with weight misperception, and to examine gender-specific differences in the relationships between weight misperception and health-related factors. METHODS We selected data on 3321 adolescents aged 12-18 years from the five-year Korea Health and Nutrition Examination Survey (KNHANES) datasets (2007-2011). Self-perceived weight status was compared with measured weight status by cross-tabulation. The generalized logit model was used to explore the socio-demographic factors associated with weight misperception, and separate logistic regression models were fitted to examine gender-specific differences in the relationships between weight misperception and health-related factors. RESULTS Overall, 25.8 % of boys (overestimation 17.1 %; underestimation 8.6 %) and 29.3 % of girls (overestimation 24.0 %; underestimation 5.3 %) misclassified their weight status according to the objective standards. Weight overestimation was particularly prominent among underweight girls. Weight misperception was associated with socio-demographic factors such as gender, age, BMI, place of residence, and maternal education level. Weight overestimation and underestimation in boys and weight overestimation in girls were significantly related to inappropriate weight control practice. However, weight underestimation in girls seems to be negatively linked to inappropriate weight control practice. CONCLUSIONS Based on the results of the present study, comprehensive intervention programs for adolescents and their parents could be devised to raise self-awareness of their weight status, to overcome weight misperception, and to prevent obesity and its related health risks.
Collapse
Affiliation(s)
- Anna Shin
- Department of Public Health, College of Medicine, Yonsei University, Seoul, South Korea.
| | - Chung Mo Nam
- Department of Preventive Medicine/Department of Biostatistics, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, 120-752, South Korea.
| |
Collapse
|
29
|
Mäkinen M, Marttunen M, Komulainen E, Terevnikov V, Puukko-Viertomies LR, Aalberg V, Lindberg N. Development of self-image and its components during a one-year follow-up in non-referred adolescents with excess and normal weight. Child Adolesc Psychiatry Ment Health 2015; 9:5. [PMID: 25737741 PMCID: PMC4347918 DOI: 10.1186/s13034-015-0038-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 02/16/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The proportion of overweight and obese youths is high. The present study aimed to investigate the development of self-image and its components during a one-year follow-up among non-referred adolescents with excess and normal weight. Furthermore, we separately analyzed the data for girls and boys. METHODS Altogether 86 8(th) grades (41 girls and 45 boys) with a relative weight of 26% or more above the median and 91 controls (43 girls and 48 boys) with normal weight participated the follow-up. The Offer Self-Image Questionnaire, Revised (OSIQ-R) was used to assess self-image at baseline and on follow-up. In the OSIQ-R, a low total raw score implies positive adjustment, while a high raw score implies poor adjustment and a negative self-image. The study design was doubly correlated (pairs and time), and a linear mixed model was used in the statistical analysis. RESULTS In OSIQ-R total scores, a comparative improvement was observed in girls with normal weight. Among these girls, significant change scores compared to zero were seen in impulse control, social functioning, vocational attitudes, self-confidence, self-reliance, body image, sexuality, and ethical values. In girls with excess weight, none of the change scores compared to zero were statistically significant. When the girls with normal and excess weight were compared, the difference in change scores was largest in sexuality and vocational attitudes. Change scores compared to zero were significant in sexuality and idealism for boys with excess weight, and in impulse control, mental health, self-reliance, and sexuality for normal weight boys. When the boys with excess and normal weight were compared, no statistically significant differences emerged in change scores. CONCLUSION In mid-adolescent girls, the influence of overweight and obesity on the development of self-image is substantial. Weight management programs directed at overweight adolescent girls should include psychological interventions aiming to diminish self-image distress, especially that associated with feelings, attitudes, and behavior towards the opposite sex, as well as future career plans.
Collapse
Affiliation(s)
- Mauno Mäkinen
- />Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mauri Marttunen
- />Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- />National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Komulainen
- />Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Viacheslav Terevnikov
- />Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Veikko Aalberg
- />Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lindberg
- />Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
30
|
Sikorski C, Luppa M, Luck T, Riedel-Heller SG. Weight stigma "gets under the skin"-evidence for an adapted psychological mediation framework: a systematic review. Obesity (Silver Spring) 2015; 23:266-76. [PMID: 25627624 DOI: 10.1002/oby.20952] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 09/30/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Research consistently shows a negative view of individuals with obesity in the general public and in various other settings. Stigma and discrimination can be considered chronic stressors, as these factors have a profound impact on the psychological well-being of the affected individuals. This article proposes a framework that entails a mediation of the adverse effects of discrimination and stigmatization on mental well-being through elevated psychological risk factors that are not unique to weight but that could affect overweight and normal-weight individuals alike. METHODS A systematic review was conducted to assess the prevalence of psychological risk factors, such as self-esteem and coping, in individuals with obesity. RESULTS Forty-six articles were assessed and included for detailed analysis. The number of studies on these topics is limited to certain dimensions of psychological processes. The best evaluated association of obesity and psychosocial aspects is seen for self-esteem. Most studies establish a negative association of weight and self-esteem in children and adults. All studies with mediation analysis find a positive mediation through psychological risk factors on mental health outcomes. CONCLUSIONS This review shows that elevated psychological risk factors are existent in individuals with obesity and that they may be a mediator between weight discrimination and pathopsychological outcomes.
Collapse
Affiliation(s)
- Claudia Sikorski
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany; Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, New York, USA
| | | | | | | |
Collapse
|