Patterns of weight control strategies predict differences in women's 4-year weight gain

A synthesis of early antecedents of eating behavior and weight status in girls: The legacy of girls' NEEDS project

Dr. Leann Birch, an innovator in the field of children's eating behavior, was the first scientist to synergize the fields of developmental psychology and nutrition science. One of Leann's groundbreaking projects was the Girls' NEEDS Project (GNP), an NIH-funded observational study of the longitudinal development of eating and weight-related behaviors of girls across middle childhood and adolescence. At the time of GNP, obesity prevalence during childhood had roughly doubled during the previous two decades, research interest in dieting had increased as societal expectations of the 'thin ideal' got even thinner, and little was known about how environmental factors such as parenting influenced the development of maladaptive eating and weight-related behaviors. GNP resulted in over 70 publications, covering a range of topics from girls' dietary intake and physical activity to parental influences on girls' eating behavior, thus laying the groundwork for many topics in the obesity, food parenting, and dieting literature today. Therefore, this narrative review aims to summarize and synthesize the literature that resulted from the GNP and provide implications for future work building from this foundation.

Predictors of Weight-Control Behavior in Healthy Weight and Overweight Korean Middle-Aged Women

Although obesity level is considered to influence weight-control behavior, few studies have examined how predictors of weight-control behavior differ according to obesity level. We compared the predictors of weight-control behavior in healthy weight and overweight middle-aged Korean women. This study used a comparative cross-sectional design. In total, 352 middle-aged women (131 overweight and 221 healthy) who visited community centers in eight Korean cities participated in the study. Participants completed self-report questionnaires concerning perceived health, body dissatisfaction, health-related concerns, self-esteem, and weight-control behavior. Scores for weight-control behavior in the overweight group were higher than those in the healthy weight group. Stepwise multiple regression showed that health-related concerns, body dissatisfaction, socioeconomic status, and self-esteem predicted weight-control behavior in the overweight group. Perceived health, socioeconomic status, meal regularity, health-related concerns, and age predicted weight-control behavior in the healthy weight group. The findings indicate that nursing strategies should differ according to obesity level to improve weight-control behavior in middle-aged women. In community or clinical settings, nurses are advised to develop customized weight control programs based on obesity levels in middle-aged women.

Understanding the relationship between negative emotional eating and binge eating: The moderating effects of acting with awareness and non-reactive mindfulness

OBJECTIVES

Negative emotional eating and binge eating are positively related, occur in diverse populations, and may be driven by similar mechanisms. Mindfulness facets such as acting with awareness, describe, non-judgement, non-reactive, and observe may moderate the relationship between these maladaptive eating phenotypes.

METHOD

A cross-sectional study assessed emotional eating-depression (Emotional Eating Scale-Revised, depression subscale), trait mindfulness facets (Five Facet Mindfulness Questionnaire-Short Form), and binge eating severity (Binge Eating Scale) in adults (N = 258).

RESULTS

Emotional eating-depression was less strongly associated with binge eating severity in participants with higher acting with awareness mindfulness. Emotional eating-depression was more strongly associated with binge eating severity in participants with higher non-reactive mindfulness.

CONCLUSIONS

Acting with awareness and non-reactive mindfulness may be important treatment targets in concurrent presentations of emotional eating-depression and binge eating.

The interaction of negative psychological well-being and picky eating in relation to disordered eating in undergraduate students

The extant literature on picky eating focuses on children, leaving adults understudied. A sparse and mixed evidence base suggests relationships exist between picky eating and disordered eating in adults. The present study furthered this research by examining shared negative psychological correlates as moderators that may strengthen relationships between picky eating and disordered eating in undergraduate students. Participants (N = 509; 76.3% female) completed a cross-sectional survey assessing picky eating (Adult Picky Eating Questionnaire), disordered eating (Binge Eating Scale and Eating Disorder Examination-Questionnaire), and negative psychological correlates including anxiety, depression, and stress (Depression, Anxiety and Stress Scale - 21 Items), inflexible eating (Inflexible Eating Questionnaire), obsessive compulsive disorder (Short Obsessive Compulsive Disorder Screener), and social eating anxiety (adapted Social Phobia Scale) symptoms. Positive relationships were observed between picky eating and binge eating, dietary restraint, eating concerns, overall eating pathology, and all negative psychological correlates. Moderation analyses examined if negative psychological correlates strengthened relationships between picky eating and disordered eating. Higher inflexible eating and anxiety and stress symptoms interacted with higher picky eating in relation to disordered eating, specifically eating concerns. Interactions between picky eating and negative psychological correlates did not explain variance in binge eating, dietary restraint, and overall eating pathology. Findings complement research demonstrating overlap between picky eating and disordered eating and highlight specific negative psychological correlates that may strengthen relationships between picky eating and disordered eating. Researchers and clinicians interested in concurrent picky eating and disordered eating should consider these negative psychological correlates given their potential to worsen disordered eating.

Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

Disordered eating includes core eating disorder symptoms present in diverse populations. The extant literature has focused on associations between negative emotional eating and disordered eating to the exclusion of positive emotional eating. Emotion regulation may help explain relationships between emotional eating and disordered eating. Emotion regulation difficulties was examined as a moderator of relationships between negative and positive emotional eating and disordered eating including dietary restraint, eating, weight, and shape concerns, and global scores of disordered eating, a general index of disordered eating. A cross-sectional study was employed using a university student population in the United States. Participants completed surveys assessing negative (Dutch Eating Behavior Questionnaire; Emotional Appetite Questionnaire) and positive (Emotional Appetite Questionnaire) emotional eating, emotion regulation (Difficulties in Emotion Regulation Scale), and disordered eating (Eating Disorder Examination Questionnaire). Moderation analyses were calculated with emotion regulation difficulties as the moderator of relationships between negative and positive emotional eating and disordered eating. Across two separate measures of negative emotional eating, higher negative emotional eating was associated with higher weight concerns and global scores of disordered eating when emotion regulation difficulties was average and increased (+1 SD above average). Higher positive emotional eating was associated with lower dietary restraint and global scores of disordered eating when emotion regulation difficulties was decreased (-1 SD below average). Emotion regulation difficulties strengthened relationships between negative, not positive, emotional eating and disordered eating. Research and clinical implications for the contribution of emotional eating and emotion regulation on disordered eating were discussed.

Change in self-efficacy, eating behaviors and food cravings during two years of calorie restriction in humans without obesity

Calorie restriction (CR) enhances longevity in humans who are normal weight, overweight and obese. While dietary regimens can change self-efficacy, eating behaviors, and food cravings in individuals with obesity, the responses of these measures to prolonged CR in individuals who are exclusively not obese is unknown. The aim of this analysis was to test the effects of a two-year CR intervention on self-efficacy and eating attitudes and behaviors in humans without obesity by analyzing data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE 2) study. Participants (n = 218, BMI range = 21.3-29.0 kg/m2) were randomized to a 25% CR group or an ad libitum (AL) group. Eating attitudes and behaviors and self-efficacy were assessed using validated questionnaires at baseline, month 12, and month 24. Dietary restraint and self-efficacy increased in the CR compared to the AL group (ES ≥ 0.32). Increased self-efficacy was negatively related to weight change (ρ < -0.24). In the CR group, males showed a reduction in cravings for carbohydrates and fats at month 24, whereas females did not. The CR group showed elevations in state hunger, which were transient, and disinhibited eating (ES ≥ 0.37). In individuals without obesity, dietary restraint and self-efficacy could be important in promoting long-term CR for individuals looking to use CR as a tool to improve longevity.

Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India

Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2's QOL did not differ from Class 3's QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = -0.05, 95% CI = -0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = -0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = -0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.

Association of Obesity Subtypes in the Longitudinal Assessment of Bariatric Surgery Study and 3-Year Postoperative Weight Change

OBJECTIVE

The study objective was to empirically identify subgroups of patients with obesity and investigate their association with postoperative weight change.

METHODS

A longitudinal analysis of 2,458 adults in the Longitudinal Assessment of Bariatric Surgery (LABS) study was used. Baseline data were used to identify subgroups. The outcome was 3-year weight change after bariatric surgery.

RESULTS

We identified four classes (subtypes) of obesity, which could be characterized as diabetes with low rates of high-density lipoprotein (Class 1), disordered eating (Class 2), mixed (Class 3), and extreme obesity with early onset (Class 4). Approximately 98% of participants in Class 1 had diabetes compared with < 40% in the other classes. There were high rates of binge eating in Class 2, and more than 92% of those in this class reported eating when not hungry. Class 4 was characterized by a higher BMI at baseline. Adults in Class 4 lost an average of 25.0% (males) and 30.3% (females) of their baseline weight over 3 years. In contrast with participants in Class 1, those in Classes 2 and 3 had significantly larger 3-year weight losses than their peers in Class 4.

CONCLUSIONS

Obesity is a heterogeneous disease. Bariatric surgery may be most beneficial for adults with disordered eating.

Impact of Experimentally Induced Cognitive Dietary Restraint on Eating Behavior Traits, Appetite Sensations, and Markers of Stress during Energy Restriction in Overweight/Obese Women

Weight loss has been associated with changes in eating behaviors and appetite sensations that favor a regain in body weight. Since traditional weight loss approaches emphasize the importance of increasing cognitive dietary restraint (CDR) to achieve negative energy imbalance, it is difficult to untangle the respective contributions of energy restriction and increases in CDR on factors that can eventually lead to body weight regain. The present study aimed at comparing the effects of energy restriction alone or in combination with experimentally induced CDR on eating behavior traits, appetite sensations, and markers of stress in overweight and obese women. We hypothesized that the combination of energy restriction and induced CDR would lead to more prevalent food cravings, increased appetite sensations, and higher cortisol concentrations than when energy restriction is not coupled with induced CDR. A total of 60 premenopausal women (mean BMI: 32.0 kg/m2; mean age: 39.4 y) were provided with a low energy density diet corresponding to 85% of their energy needs during a 4-week fully controlled period. At the same time, women were randomized to either a condition inducing an increase in CDR (CDR+ group) or a condition in which CDR was not induced (CRD- group). Eating behavior traits (Three-Factor Eating Questionnaire and Food Craving Questionnaire), appetite sensations (after standardized breakfast), and markers of stress (Perceived Stress Scale; postawakening salivary cortisol) were measured before (T = 0 week) and after (T = 4 weeks) the 4-week energy restriction, as well as 3 months later. There was an increase in CDR in the CDR+ group while no such change was observed in the CDR- group (p=0.0037). No between-group differences were observed for disinhibition, hunger, cravings, appetite sensations, perceived stress, and cortisol concentrations. These results suggest that a slight increase in CDR has no negative impact on factors regulating energy balance in the context of energy restriction.

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls

PURPOSE

To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model.

METHODS

Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership.

RESULTS

Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity.

CONCLUSION

Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Affect systems, changes in body mass index, disordered eating and stress: an 18-month longitudinal study in women

Background: Evidence suggests that stress plays a role in changes in body weight and disordered eating. The present study examined the effect of mood, affect systems (attachment and social rank) and affect regulatory processes (self-criticism, self-reassurance) on the stress process and how this impacts on changes in weight and disordered eating. Methods: A large sample of women participated in a community-based prospective, longitudinal online study in which measures of body mass index (BMI), disordered eating, perceived stress, attachment, social rank, mood and self-criticism/reassurance were measured at 6-monthly intervals over an 18-month period. Results: Latent Growth Curve Modelling showed that BMI increased over 18 months while stress and disordered eating decreased and that these changes were predicted by high baseline levels of these constructs. Independently of this, however, increases in stress predicted a reduction in BMI which was, itself, predicted by baseline levels of self-hatred and unfavourable social comparison. Conclusions: This study adds support to the evidence that stress is important in weight change. In addition, this is the first study to show in a longitudinal design, that social rank and self-criticism (as opposed to self-reassurance) at times of difficulty predict increases in stress and, thus, suggests a role for these constructs in weight regulation.

Metabolic dysfunction following weight cycling in male mice

Background

Combatting over-weight or obesity can lead to large fluctuations in an individual’s body weight, often referred to as weight cycling or “yo-yo” dieting. Current evidence regarding the potentially damaging effects of these changes is conflicting.

Methods

Here, we assess the metabolic effects of weight cycling in a murine model, comprising three dietary switches to normal or high fat diets at 6 week intervals; male C57BL/6 mice were fed either a control (C) or high fat (F) diet for 6 weeks (n=140/group). C and F groups were then either maintained on their initial diet (CC and FF respectively) or switched to a high fat (CF) or control (FC) diet (n=35/group). For the final 6 week interval, CC and CF groups were returned to the control diet (CCC and CFC groups) while FC and FF groups were placed on a high fat diet (FCF and FFF) (n=28/group).

Results

For the majority of metabolic outcomes changes aligned with dietary switches; however assessment of neuropeptides and receptors involved in appetite regulation and reward signalling pathways reveal variable patterns of expression. Furthermore, we demonstrate that multiple cycling events leads to a significant increase in internal fat deposition, even when compared to animals maintained on a high fat diet (Internal Fat: FCF: 7.4 ± 0.2g vs. FFF: 5.6 ± 0.2g; p<0.01).

Conclusions

Increased internal adipose tissue is strongly linked to the development of metabolic syndrome associated conditions such as type 2 diabetes, cardiovascular disease and hypertension. While further work will be required to elucidate the mechanisms underlying the neuronal control of energy homeostasis, these studies provide a causative link between weight cycling and adverse health.

Using Propensity Score Methods To Assess Causal Effects of Mothers' Dieting Behavior on Daughters' Early Dieting Behavior

BACKGROUND

A high prevalence of dieting has been reported among preadolescent females. It is important to understand factors influencing the emergence of dieting because dieting is associated with increased likelihood of overeating, greater weight gain over time, and other chronic health problems. Previous studies suggest that mothers' own dieting behavior influences their daughters' dieting (i.e., modeling). Because it is not possible to randomly assign girls to a mother who is dieting versus not dieting, causal inference regarding the effects of mothers' modeling behaviors on daughters' dieting is not straightforward.

METHODS

In an observational study, data were collected on four occasions of measurement across a 6-year period, with 2-year intervals between assessments on 181 girls and their parents. Propensity score methods were used to estimate the causal effects of mothers' dieting on the emergence of daughters' dieting between ages 7 and 11, examining the moderating effect of weight status.

RESULTS

Girls whose mothers were currently dieting were significantly more likely to diet before age 11 than those whose mothers were not currently dieting, and this effect did not vary by girls' or mothers' weight status.

CONCLUSIONS

We conclude by discussing the implications of the effects of mothers' dieting on daughters' early dieting as well as the potential of propensity score methods in the field of obesity compared with traditional methodology such as regression analysis.

Weight-Control Methods, 3-Year Weight Change, and Eating Behaviors: A Prospective Nationwide Study of Middle-Aged New Zealand Women

BACKGROUND

The effectiveness of women's weight-control methods and the influences of dieting on eating behaviors remain unclear.

OBJECTIVES

Our aim was to determine the association of various weight-control methods at baseline with weight change to 3 years, and examine the association between baseline weight-control status (trying to lose weight, trying to prevent weight gain or no weight-control attempts) and changes in intuitive eating and binge eating at 3 years.

DESIGN

A nationally representative sample of 1,601 New Zealand women (40 to 50 years) was recruited and completed a self-administered questionnaire at baseline regarding use of variety of weight-control methods. Information on demographic characteristics, weight, height, food habits, binge eating, and intuitive eating were collected at baseline and 3 years.

STATISTICAL ANALYSES

Linear and logistic regression models examined associations between both weight status and weight-control methods at baseline and weight change to 3 years; and baseline weight-control status and change in intuitive eating from baseline to 3 years and binge eating at 3 years. χ(2) tests were used to cross-sectionally compare food habits across the weight status categories at both baseline and 3 years.

RESULTS

Trying to lose weight and the use of weight-control methods at baseline were not associated with change in body weight to 3 years. There were a few differences in the frequency of consumption of high-energy-density foods between those trying to lose or maintain weight and those not attempting weight control. Trying to lose weight at baseline was associated with a 2.0-unit (95% CI 0.7 to 3.4, P=0.003) reduction in intuitive eating scores by 3 years (potential range=21 to 105), and 224% (odds ratio=3.24; 95% CI 1.69 to 6.20; P<0.001) higher odds of binge eating at 3 years.

CONCLUSIONS

The apparent ineffectiveness of dieting and weight-control behaviors may reflect misconceptions about what constitutes healthy eating or energy-dense foods. Dieting may reduce women's ability to recognize hunger and satiety cues and place women at increased risk of binge eating.

The Theory of Planned Behaviour and dietary patterns: A systematic review and meta-analysis

OBJECTIVE

Promoting adherence to healthy dietary patterns is a critical public health issue. Models of behaviour, such as the Theory of Planned Behaviour (TPB) allow programme designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns.

METHODS

A systematic literature search was conducted to identify relevant studies. Random-effects meta-analysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables.

RESULTS

In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r+=0.61) followed by perceived behavioural control (PBC, r+=0.46) and subjective norm (r+=0.35). The association between intention and behaviour was r+=0.47, and between PBC and behaviour r+=0.32. Moderator analyses revealed that younger participants had stronger PBC-behaviour associations than older participants had, and studies recording participants' perceptions of behaviour reported significantly higher intention-behaviour associations than did those using less subjective measures.

CONCLUSIONS

TPB variables were found to have medium to large associations with both intention and behaviour that were robust to the influence of key moderators. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behaviour.

Patterns of weight-control behavior among 15 year old girls

OBJECTIVE

The objectives were to identify and predict patterns of weight-control behavior in 15 years old (yo) girls and to examine weight-control group differences in energy intake.

METHOD

Participants included 166 girls assessed every 2 years (ys) from age 5 to 15. Latent class analysis was used to identify patterns of weight-control behaviors. Antecedent variables (e.g., inhibitory control at 7 ys), and concurrent variables (e.g., BMI and dietary intake at 15 ys) were included as predictors. Assessments were a combination of survey, interview, and laboratory measures.

RESULTS

Latent class analysis (LCA) identified four classes of weight-control behaviors, nondieters (26%), and three dieting groups, namely lifestyle (16%), dieters (43%), and extreme dieters (17%). Levels of restraint, weight concerns, and dieting frequency increased across groups, from nondieters to extreme dieters. Body mass index (BMI) at 5 ys and inhibitory control at 7 ys predicted weight-control group at 15 ys; for example, with every one point decrease in inhibitory control, girls were twice as likely to be extreme dieters than nondieters. Girls in the extreme dieters group were mostly classified as under-reporters and had the lowest self-reported intake, but ate significantly more in the laboratory.

DISCUSSION

Among 15 yo girls, "dieting" includes a range of both healthy and unhealthy behaviors. Risk factors for membership in a weight-control group are present as early as 5 ys. Patterns of intake in the laboratory support the view that lower reported energy intake by extreme dieters is likely due under-reporting as an intent to decrease intake, not actual decreased intake.

Dieting and restrained eating as prospective predictors of weight gain

Research in normal weight individuals paradoxically suggests that measures of attempted eating restriction might represent robust predictors of weight gain. This review examined the extent to which measures of dieting (e.g., self-reported weight loss dieting in the past year) and dietary restraint (e.g., the Cognitive Restraint scale from the Three-Factor Eating Questionnaire) have prospectively predicted weight change. We located and reviewed 25 prospective studies containing 40 relevant comparisons. Studies were limited to those in which participants were non-obese (with a mean BMI between 18.5 and 30) and averaged at least 12 years old. Neither measure predicted future weight loss. Fifteen of the 20 comparisons (75%) that examined measures of dieting significantly predicted future weight gain whereas only 1 of 20 (5%) that examined restrained eating measures did so. Two plausible explanations for these findings are that: (1) dieters and restrained eaters do not differ in terms of an underlying proneness toward weight gain, but restrained eating represents a more effective means of preventing it; and (2) normal weight individuals who diet do so because they are resisting a powerful predisposition toward weight gain which dieting ultimately fails to prevent. Recent dieting in non-obese individuals may be a valuable proxy of susceptibility to weight gain. This easily assessed characteristic could identify individuals for whom obesity prevention interventions would be particularly appropriate.

The moderating role of negative urgency on the prospective association between dietary restraint and binge eating

It is well documented that negative urgency, a personality trait characterized by a tendency to act impulsively in the face of negative emotions, and dietary restraint independently increase risk to binge eat; however, it is unclear how these factors interact to alter risk for such behavior. It may be that individuals high on negative urgency, who also engage in dietary restraint, are at a greater risk to binge eat than individuals low on negative urgency. Accordingly, we sought to investigate whether negative urgency moderated the prospective association between dietary restraint and binge eating frequency among a sample of college women. We hypothesized that women who engaged in dietary restraint would report higher binge eating frequencies across the first semester of college and that this effect would be strengthened among individuals higher on negative urgency. Results indicated that negative urgency moderated the prospective association between dietary restraint and binge eating frequency. This effect was found to be "protective but reactive," such that low levels of dietary restraint protected against binge eating frequency at low to moderate levels of negative urgency, but this buffering effect was lost at high levels of negative urgency where binge eating frequency was equal across all levels of dietary restraint. These findings demonstrate that negative urgency and dietary restraint interact to differentially alter risk for binge eating frequency, and individuals high on negative urgency are at the greatest risk to engage in more frequent binge eating regardless of level of dietary restraint.

Relationship between body satisfaction with self esteemand unhealthy body weight management

INTRODUCTION

A favorable or unfavorable attitude about self was named self esteem. According to Maslow theory to achieve quality of life and happiness, one must reach the gradual fulfillment of human needs, including a high degree of own self-esteem. Body dissatisfaction is a negative distortion of one's body which is especially mentioned by the women. Many studies have shown links between self esteem, body dissatisfaction, health and behaviors. this study intends to determine relationship between body satisfaction, self esteem and unhealthy weight control behaviors between women.

METHODS

This cross-sectional study was done on 408 women employees in Isfahan University and Isfahan University of Medical Sciences during 1390. They were chosen according to the stratified random sampling method. Inclusion criteria were 1) willing to participate in the study and 2) lack of serious physical defect 3) not being in pregnancy or breastfeeding course. Exclusion criteria was filling out questionnaires incompletely. Data collection tool was a multidimensional questionnaire which comprised of 4 sections as following: demographic (5items), A self-administrative questionnaire for body Satisfaction (7 items), Rosenberg Self-Esteem Scale (10 items) and a standard Weight Control Behavior Scale (18 items). Cranach's alpha was 0.9 or higher for the different sections. Finally, collected data was analyzed with SPSS18 using the independent T-test, one-way ANOVA, Pearson correlation coefficient, regression, Spearman correlation.

RESULTS

Frequencies of participants by weight category were 14.1% for obese, 35.3% for overweight, 47.6% for normal weight. The mean body satisfaction score in the studied women was 63.26 ± 16.27 (from 100). Mean score of self esteem was 76.70 ± 10.45. 51.5% of women had medium self esteem, 47.5% had high self esteem. Pearson correlation showed that the variables of body Satisfaction (r = 0.3, P = 0.02), BMI (r = - 0.14, P < 0.003), education level (r = 0.22, P < 0.001), income (r = 0.14, P < 0.004), consumption of fruit (r = 0.13, P < 0.008) all correlated with self-esteem significantly. Women with higher self esteem used higher fruits had a good nutrition overall (r = 0.11, P = 0.02). 92.15%, 10.8% of women respectively participated in one of healthy and unhealthy weight control behavior. There was not any Relationship between self esteem and healthy weight control behavior while finding showed reverse relationship between self esteem and Unhealthy Dieting Behaviors.

CONCLUSION

It seemed women identity in our society tied to social appreciations that formed and supported by body satisfaction. When they feel their current appearance is differ from ideal appearance, they feel down and have lower self esteem and used unhealthy dieting behavior and low fruits daily. Due to importance of precise self evaluation, self esteem can be used to design and conduct public health programs, especially for women.

Perceived importance of dietary protein to prevent weight gain: a national survey among midlife women

OBJECTIVE

Evaluate reported use of the practice of "eating more protein" to prevent weight gain among midlife women.

DESIGN

Cross-sectional national survey.

PARTICIPANTS

One thousand eight hundred twenty-four midlife women (40-60 y) from the 9 United States geographic regions, primarily married (71%), white (76%), and well educated; half were premenopausal (49%).

OUTCOMES

Frequency of dietary practices to prevent weight gain, Weight Efficacy Lifestyle score, self-reported weight change and body mass index over the past 2 years, and current protein intake.

ANALYSIS

Linear regression models determined associations between weight change, protein intake, and reported use of the practice of "eating more protein" to prevent weight gain.

RESULTS

Most women correctly identified good protein sources, and the majority could indicate the daily percent dietary energy recommended from protein. "Eating more protein" to prevent weight gain was reported by 43% of women as a practice to prevent weight gain and was associated with weight loss over a 2-year period and with increased percent energy from protein.

CONCLUSIONS AND IMPLICATIONS

Reported use of the practice of "eating more protein" was associated with weight loss over 2 years. Education regarding dietary protein requirements may enhance the use of this practice.

Behavior and weight correlates of weight-control efforts in Australian women living in disadvantage: The READI study

Background

With increasing obesity rates worldwide, more and more people are actively attempting to lose weight or avoid weight gain, but relatively little is known about what specific behaviors comprise these efforts and which, if any, are associated with better weight control over time.

Methods

This paper reports relationships between body weight, weight-control efforts and related behaviors over a three-year period in 1,634 Australian women. The women were purposefully recruited from 80 disadvantaged neighborhoods in Victoria, Australia. Weight loss efforts were categorized as trying to lose weight, trying to prevent weight gain and no weight-control efforts. Behavioral correlates examined included different kinds of physical activity and consumption of a number of specific foods types.

Results and discussion

Self-reported body weight at baseline was higher in women trying to lose weight. Frequency of consumption of low energy density foods was positively associated with reported weight-control efforts, as was frequency of reported total and leisure-time physical activity. Longitudinal associations between changes in weight-control efforts and changes in behaviors were consistent with the cross-sectional findings. At three-year follow up, however, weight-control efforts were not associated with change in body weight. More detailed analyses of specific food choices suggested that part of the explanation of no effect of reported weight-control efforts and weight over time might be that people are not as well-informed as they should be about the energy density of some common foods. In particular, those reporting engagement in weight-control efforts reported reducing consumption of carbohydrate-containing foods such as bread and potatoes more than is justified by their energy content, while they reported increasing consumption of some high energy density foods (e.g., cheese and nuts).

Conclusion

It is tentatively concluded that women living in disadvantaged neighborhoods understand messages about weight-control (more activity and foods with lower fat and lower energy density) but that some foods eaten more by women engaged in weight control may reduce the effectiveness of these efforts.

History of weight cycling does not impede future weight loss or metabolic improvements in postmenopausal women

OBJECTIVE

Given that the repetitive loss and regain of body weight, termed weight cycling, is a prevalent phenomenon that has been associated with negative physiological and psychological outcomes, the purpose of this study was to investigate weight change and physiological outcomes in women with a lifetime history of weight cycling enrolled in a 12-month diet and/or exercise intervention.

METHODS

439 overweight, inactive, postmenopausal women were randomized to: i) dietary weight loss with a 10% weight loss goal (N=118); ii) moderate-to-vigorous intensity aerobic exercise for 45 min/day, 5 days/week (n=117); ii) both dietary weight loss and exercise (n=117); or iv) control (n=87). Women were categorized as non-, moderate- (≥3 losses of ≥4.5 kg), or severe-cyclers (≥3 losses of ≥9.1 kg). Trend tests and linear regression were used to compare adherence and changes in weight, body composition, blood pressure, insulin, C-peptide, glucose, insulin resistance (HOMA-IR), C-reactive protein, leptin, adiponectin, and interleukin-6 between cyclers and non-cyclers.

RESULTS

Moderate (n=103) and severe (n=77) cyclers were heavier and had less favorable metabolic profiles than non-cyclers at baseline. There were, however, no significant differences in adherence to the lifestyle interventions. Weight-cyclers (combined) had a greater improvement in HOMA-IR compared to non-cyclers participating in the exercise only intervention (P=.03), but no differences were apparent in the other groups.

CONCLUSION

A history of weight cycling does not impede successful participation in lifestyle interventions or alter the benefits of diet and/or exercise on body composition and metabolic outcomes.

Rationale and consequences of reclassifying obesity as an addictive disorder: neurobiology, food environment and social policy perspectives

The rapid increase in the prevalence of obesity is a priority for investigators from across numerous disciplines, including biology, nutritional science, and public health and policy. In this paper, we systematically examine the premise that common dietary obesity is an addictive disorder, based on the criteria for addiction described in the Diagnostic and Statistical Manual (DSM) of Mental Disorders of the American Psychiatric Association, version IV, and consider the consequences of such a reclassification of obesity for public policy. Specifically, we discuss evidence from both human and animal studies investigating the effects of various types and amounts of food and the food environment in obese individuals. Neurobiological studies have shown that the hedonic brain pathways activated by palatable food overlap considerably with those activated by drugs of abuse and suffer significant deficits after chronic exposure to high-energy diets. Furthermore, food as a stimulus can induce the sensitization, compulsion and relapse patterns observed in individuals who are addicted to illicit drugs. The current food environment encourages these addictive-like behaviors where increased exposure through advertisements, proximity and increased portion sizes are routine. Taking lessons from the tobacco experience, it is clear that reclassifying common dietary obesity as an addictive disorder would necessitate policy changes (e.g., regulatory efforts, economic strategies, and educational approaches). These policies could be instrumental in addressing the obesity epidemic, by encouraging the food industry and the political leadership to collaborate with the scientific and medical community in establishing new and more effective therapeutic approaches.

Unhealthy and healthy weight control behaviours among bus operators

BACKGROUND

Urban bus operators are an occupational group with high rates of overweight and obesity. Understanding methods bus operators use for weight control may be important; there may be increased risk for these workers to engage in less healthy weight management behaviours due to stressful working conditions.

AIMS

To examine the prevalence of unhealthy and healthy weight control behaviours used by bus operators and examine associations between use of unhealthy weight control behaviours and work-related and sociodemographic variables.

METHODS

Bus operators from four different transit garages were invited to complete a self-administered survey; height and weight were measured by research staff. Unhealthy and healthy weight control behaviours, work hours, work schedule and social support were measured with self-report items on the employee survey. Logistic regression analysis was conducted to estimate associations.

RESULTS

Nearly 60% of bus operators endorsed at least one unhealthy method; over 50% reported skipping meals, 30% fasted and 10% reported taking diet pills in the past year. Bus operator gender, race, body mass index status and hours worked per week showed significant associations with using at least one unhealthy weight control behaviour.

CONCLUSIONS

Worksite interventions should emphasize the benefit of healthy eating and physical activity but should also address the use of less healthy methods for weight control for individuals employed in transportation occupations.

Longitudinal and secular trends in parental encouragement for healthy eating, physical activity, and dieting throughout the adolescent years

PURPOSE

Parental encouragement for healthy eating and physical activity has been found to be associated with the long-term healthy habits of adolescents, whereas parental encouragement to diet has been associated with disordered eating behaviors among adolescents. However, little is known about how parental encouragement changes as adolescents grow older (longitudinal trends), or how parental encouragement has changed over time (secular trends). This study examined 5-year longitudinal and secular trends in adolescents' report of their parents' encouragement to eat healthily, be physically active, and diet.

METHODS

Project Eating Among Teens surveyed a cohort of Minnesota adolescents (n = 2,516) in the years 1999 and 2004. Mixed-model regressions were used to assess changes in adolescents' reports of parental encouragement from early to middle adolescence (middle school to high school) and from middle to late adolescence (high school to post-high school), and secular changes in parental encouragement among middle adolescents between the years 1999 and 2004.

RESULTS

Longitudinally, there were significant decreases in parental encouragement to eat healthy food, be active, and diet between early and middle adolescence. Between middle and late adolescence, among males parental encouragement for all behaviors decreased, whereas among females parental encouragement to diet increased. Few secular changes in parental encouragement were observed between 1999 and 2004.

CONCLUSION

Given the importance of parental support for healthy eating and physical activity, efforts should be made to help parents maintain a high level of encouragement for their children's healthy behavior throughout adolescence. Parents of late adolescent females should aim to decrease the pressure on their daughters to diet during these critical developmental years.