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Smith KE, Goldschmidt AB. Treatment of Binge-Eating Disorder Across the Lifespan: An Updated Review of the Literature and Considerations for Future Research. Curr Obes Rep 2024; 13:195-202. [PMID: 38363468 PMCID: PMC11150297 DOI: 10.1007/s13679-024-00553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions. RECENT FINDINGS Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence. Predictors, moderators, and mediators of treatment outcome remain poorly understood; individuals with BED continue to experience significant barriers to treatment; and research is needed to address suboptimal treatment response. Recent work has highlighted the potential of adaptive interventions and investigation of novel mechanisms to address these gaps. Research on BED treatment continues to grow, though critical questions must be answered to improve treatment efficacy across the lifespan.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA, 90033, USA.
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Lister NB, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit A, Cooper K, Kyle TK, Heeren FA, Hunter KE, McMaster CM, Johnson BJ, Seidler AL, Jebeile H. Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design. Nutr Res Rev 2024; 37:32-42. [PMID: 36788665 PMCID: PMC7615933 DOI: 10.1017/s0954422423000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P Garnett
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Kids Research, Sydney Children's Hospital Network, Westmead, New South Wales2145, Australia
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Denise E Wilfley
- School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales2145, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, 2nd Floor, Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia Grunseit
- The Children's Hospital at Westmead, Nutrition and Dietetics, Weight Management Services, Westmead, New South Wales, NSW 2145, Australia
| | | | | | - Faith A Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M McMaster
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia5042, Australia
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
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Parke A, Eschle T, Keatley D. Risk factors for momentary loss of control and subsequent abandonment of self-devised dietary restraint plans in adults with weight-loss goals: a behaviour sequence analysis approach. Psychol Health 2024; 39:691-709. [PMID: 35791507 DOI: 10.1080/08870446.2022.2094929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The current study aims to improve understanding of events leading to lapses of dietary restraint, and to identify pathways to perseverance or abandonment of weight loss efforts in response to lapses. In addition, Behaviour Sequence Analysis (BSA) was also evaluated as an analytical tool in dietary behaviour. DESIGN A sample of 176 adults who were engaging in self-imposed dietary restraint for weight loss were recruited to participate. MAIN OUTCOME MEASURES Participants were instructed to provide a detailed written timeline of an episode where they lapsed in their dietary restraint plan. They were instructed to report their preceding behaviours and internal states, and social and environmental contexts, leading up to and after their lapse in dietary restraint. RESULTS Lapses in dietary restraint were precipitated by negative internal states in the presence of cues for highly palatable foods. In addition, abandonment of weight loss efforts after lapsing was preceded by dichotomous thinking, whereas perseverance was preceded by a more neutral, flexible interpretation of the lapse in self-control. CONCLUSION BSA has identified that neutral evaluation of inevitable lapses in dietary restraint are predictive of continuation with weight loss efforts, highlighting the importance of individual tolerance of lapses in self-regulation.
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Affiliation(s)
- Adrian Parke
- Psychology Division, Education and Social Sciences, University of West of Scotland, Paisley, Renfrewshire, UK
- Researchers in Behaviour Sequence Analysis (ReBSA)
| | - Timothy Eschle
- Psychology Division, Education and Social Sciences, University of West of Scotland, Paisley, Renfrewshire, UK
| | - David Keatley
- Researchers in Behaviour Sequence Analysis (ReBSA)
- Murdoch University, Perth, WesternAustralia
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Parker MN, Moursi NA, Adekola PE, Bloomer BF, Te-Vazquez J, Nwosu EE, Lazareva J, Jones JL, Yang SB, Turner SA, Brady SM, Chen KY, Tanofsky-Kraff M, Yanovski JA. Youth's energy intake during a laboratory-based loss-of-control eating paradigm: Associations with reported current dieting. Eat Behav 2024; 53:101877. [PMID: 38640597 PMCID: PMC11144072 DOI: 10.1016/j.eatbeh.2024.101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/26/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
Dieting is theorized as a risk factor for loss-of-control (LOC)-eating (i.e., feeling a sense of lack of control while eating). Support for this association has largely relied on retrospective self-report data, which does not always correlate with objectively assessed eating behavior in youth. We hypothesized that during a laboratory-based LOC-eating paradigm, children and adolescents who reported current (at the time of the visit) dieting would consume meals consistent with LOC-eating (greater caloric intake, and intake of carbohydrates and fats, but less intake of protein). Participants were presented with a buffet-style meal and instructed to "Let yourself go and eat as much as you want." Current dieting (i.e., any deliberate change to the amount or type of food eaten to influence shape or weight, regardless of how effective the changes are) was assessed via interview. General linear models were adjusted for fat mass (%), lean mass (kg), height, sex, protocol, race and ethnicity, pre-meal hunger and minutes since consumption of a breakfast shake. Of 337 participants (Mage 12.8 ± 2.7y; 62.3 % female; 45.7 % non- Hispanic White and 26.1 % non-Hispanic Black; MBMIz 0.78 ± 1.11), only 33 (9.8 %) reported current dieting. Current dieting was not significantly associated with total energy intake (F = 1.63, p = .20, ηp2 = 0.005), or intake from carbohydrates (F = 2.45, p = .12, ηp2 = 0.007), fat (F = 2.65, p = .10, ηp2 = 0.008), or protein (F = 0.39, p = .53, ηp2 = 0.001). Contrary to theories that dieting promotes LOC-eating, current dieting was not associated with youth's eating behavior in a laboratory setting. Experimental approaches for investigating dieting are needed to test theories that implicate dieting in pediatric LOC-eating.
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Affiliation(s)
- Megan N Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Nasreen A Moursi
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA
| | - Praise E Adekola
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Bess F Bloomer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Jennifer Te-Vazquez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Ejike E Nwosu
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Julia Lazareva
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Jeremiah L Jones
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Shanna B Yang
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sara A Turner
- Nutrition Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, & Obesity Branch, National Institute of Diabetes and Digestive and Kidney Disorders, NIH, 10 Center Drive, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), 10 Center Drive, Room 1-3330, Bethesda, MD 20892, USA
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Boulanger B, Bégin C, Bédard A, Lévy-Ndejuru J, Carbonneau É, Lemieux S. A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI. Appl Physiol Nutr Metab 2024. [PMID: 38527328 DOI: 10.1139/apnm-2023-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.
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Affiliation(s)
- Benoît Boulanger
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
| | - Julia Lévy-Ndejuru
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Élise Carbonneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
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Christensen Pacella KA, Wossen L, Hagan KE. Low Overlap and High Heterogeneity Across Common Measures of Eating Disorder Pathology: A Content Analysis. Assessment 2024:10731911241238084. [PMID: 38519835 DOI: 10.1177/10731911241238084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
This study evaluated symptoms assessed in common measures of eating disorder pathology and tested overlap to evaluate the extent to which measures may be interchangeable. Six measures were included: Bulimia Test-Revised, Eating Attitudes Test-26, Eating Disorder Diagnostic Scale, Eating Disorder Examination Questionnaire, Eating Pathology Symptoms Inventory, and Questionnaire for Eating Disorder Diagnoses. Content overlap was quantitatively estimated using the Jaccard Index. Mean overlap was low (.195), likely due to the wide range of symptoms (87) assessed. The mean overlap of each measure with all others was .117 - .267, and the overlap among individual measures was .083 - .382. Implications of low overlap among measures include variable characterization of eating disorder phenotypes and the risk for lower generalizability of findings due to measurement variability.
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Jeune SC, Graziano P, Campa A, Coccia CC. Interoception and self-regulation of eating behaviors and weight status in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38442359 DOI: 10.1080/07448481.2024.2319200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To determine the associations between interoception, self-regulation, eating behaviors, and weight status among college students. PARTICIPANTS 229 female undergraduates, predominantly classified as Juniors (51.1%) and identified as Hispanic/Latinx (75%) with a mean age of 23.4 (SD = 6.3), were examined. METHODS Cross-sectional data using baseline measures from a larger, longitudinal study, were examined. Confirmatory factor analyses and structural equation modeling were conducted to test hypotheses. RESULTS Interoception was directly associated to self-regulation. Interoception and self-regulation were inversely associated with non-purposeful eating. Non-purposeful eating was directly associated with weight status. CONCLUSION This study provided empirical evidence on the associations between interoception, self-regulation, eating behaviors, and weight status. Our results support the need for programs that target college students' cognitive skills to reduce unhealthy eating behaviors and optimize weight status. Future interventions are needed to enhance interoception and self-regulation skills so that college students can be more purposeful in their eating habits.
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Affiliation(s)
- Shanté C Jeune
- Department of Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Adriana Campa
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| | - Catherine C Coccia
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
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Kalan RE, Smith A, Mason TB, Smith KE. Independent associations of food addiction and binge eating measures with real-time eating behaviors and contextual factors: An exploratory ecological momentary assessment study. Appetite 2024; 192:107127. [PMID: 37980955 PMCID: PMC10843748 DOI: 10.1016/j.appet.2023.107127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/26/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
Food addiction (FA) is a concept centered around the addictive potential of highly palatable processed foods, though there is debate over the discriminative validity of FA as a distinct construct from binge-eating symptomatology. This study explored how trait measures of FA and binge-eating symptoms independently and interactively predicted eating behaviors and posited correlates of FA and binge eating measured via ecological momentary assessment (EMA). Adult participants (N = 49) who met the criteria for FA and/or binge-eating disorder completed baseline measures of FA (Yale Food Addiction Scale [YFAS 2.0]) and binge-eating symptoms (Eating Pathology Symptom Inventory [EPSI] binge eating scale) followed by a 10-day EMA protocol. Generalized linear mixed models examined the independent effects of YFAS 2.0, EPSI, and their interaction predicting EMA outcomes. Higher YFAS 2.0 symptom count scores were uniquely related to greater EMA-measured overeating, loss of control eating, negative and positive affect, and impulsivity when controlling for EPSI scores. Conversely, higher EPSI scores were uniquely related to greater EMA-measured eagerness and urge to eat, and expectancies that eating would improve mood. No interaction effects were significant. These results highlight potential distinctions between phenomena captured by FA and other measures of binge eating, in that FA symptoms may be a marker of heightened binge-eating severity, emotional arousal, and impulsivity.
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Affiliation(s)
- Rachel E Kalan
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Alexandro Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA.
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Goldschmidt AB, Goldstein SP, Schmiedek F, Stalvey E, Irizarry B, Thomas JG. State-level working memory and dysregulated eating in children and adolescents: An exploratory ecological momentary assessment study. Int J Eat Disord 2024; 57:93-103. [PMID: 37888341 PMCID: PMC10872824 DOI: 10.1002/eat.24087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited. METHODS We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone-based ecological momentary assessment. Linear mixed effects models estimated group-level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating. RESULTS LOC-OW were less accurate on numerical WM tasks compared to OW and NW (ps < .01); groups did not differ on spatial task accuracy (p = .41). Adjusting for between-subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within-subject effects (reflecting variations in moment-to-moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p = .013). There were no associations between WM performance and LOC eating severity (ps > .05). CONCLUSIONS Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory-based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored. PUBLIC SIGNIFICANCE STATEMENT Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal-weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment-to-moment basis.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine/Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Stephanie P. Goldstein
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Florian Schmiedek
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
| | - Erin Stalvey
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Bailey Irizarry
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
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Weinstock M, Thornton LM, Raynor HA, Mazzeo SE, LaRose JG, Caccavale LJ, Tatum KL, Bean MK. Parent involvement approach and changes in eating pathology within an adolescent obesity intervention. Eat Behav 2023; 51:101807. [PMID: 37659210 PMCID: PMC10840818 DOI: 10.1016/j.eatbeh.2023.101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Although adolescents with obesity have heightened risk for eating pathology, the impact of differential parent involvement on eating pathology after obesity treatment is unknown. We examined differences in eating pathology in adolescents whose parents were randomized to distinct interventions within adolescent obesity treatment. METHODS Participants were 82 adolescent/parent dyads (adolescents: 63 % female; 55 % racial/ethnically marginalized) enrolled in TEENS+, a 4-month behavioral weight loss intervention. Parents were randomized to either a parent weight loss treatment (TEENS+PWL) or parent skills training (TEENS+PAC). Adolescents completed the Eating Disorder Examination-Questionnaire with Instructions (EDE-Q-I) and Child Depression Inventory (CDI) at baseline, 4 m, and 7 m. Group differences in eating pathology (global score; eating concern, weight concern, shape concern, restraint) and depression across time points were evaluated with linear mixed models. RESULTS No significant differences were observed between TEENS+PAC and TEENS+PWL in eating pathology or depression, nor were there group by time interactions. Time point differences were observed for all EDE-Q-I and CDI outcomes, except eating concerns; pairwise contrasts revealed a variety of change patterns. Weight and shape concerns decreased from 0 to 4 m; observed reductions were maintained at 7 m. Restraint was highest at 4 m and decreased at 7 m but did not return to baseline. EDE-Q-I global scores significantly declined over time. Depression decreased over time, but a significant difference was only observed between 0 and 7 m. CONCLUSIONS Neither parent intervention yields harm related to eating pathology in adolescents engaged in obesity treatment. Obesity treatment does not appear to have iatrogenic effects on eating pathology in adolescents.
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Affiliation(s)
- Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica Gokee LaRose
- Department of Health and Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Laura J Caccavale
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina L Tatum
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Melanie K Bean
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
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11
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Boutelle KN, Pasquale EK, Strong DR, Eichen DM, Peterson CB. Reduction in eating disorder symptoms among adults in different weight loss interventions. Eat Behav 2023; 51:101787. [PMID: 37639734 DOI: 10.1016/j.eatbeh.2023.101787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/21/2023] [Indexed: 08/31/2023]
Abstract
Restriction of food intake and counting calories as part of weight loss programs are thought to trigger eating behaviors and attitudes which can lead to eating disorders. We have developed a treatment model, Regulation of Cues (ROC), that targets appetitive traits, including food responsiveness and satiety responsiveness, which could address overeating at an implicit level and reduce risk of detrimental behaviors and attitudes. This manuscript evaluates eating disorder symptoms, attitudes, and behaviors among adults with overweight or obesity randomized to ROC, behavioral weight loss (BWL), a combination of ROC + BWL (ROC+) and an active comparator (AC). Participants included 271 adults with a body mass index of 25 to 45, age 18 to 65 years, and a lack of comorbidities that could interfere with participation. Assessments occurred at baseline, mid-treatment (6 months), post-treatment (12-months) and 6- and 12-month follow-up. During treatment, participants in all four arms showed decreases in Eating, Weight, and Shape concerns on the Eating Disorder Examination-Questionnaire and binge eating symptoms on the Binge Eating Scale which were maintained at 6-month follow-up but increased at the 12-month follow-up. Both the ROC+ and BWL arms showed increases in Restraint during treatment which dissipated after treatment ended. This study contributes to a growing body of literature demonstrating that weight loss programs are not associated with increases in eating disorder symptoms. Future studies should evaluate interventions to maintain improvements in eating disorder symptoms following weight loss programs.
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Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Ellen K Pasquale
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92037, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
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12
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Silva WRD, Ferreira EB, Marôco J, da Silva Júnior SI, Teodoro MA, Campos JADB. Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model. Percept Mot Skills 2023; 130:2388-2409. [PMID: 37864461 DOI: 10.1177/00315125231207270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.
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Affiliation(s)
- Wanderson Roberto da Silva
- Graduate Program in Food, Nutrition, and Food Engineering, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Eric B Ferreira
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
- Statistics Department, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - João Marôco
- William James Center for Research (WJCR), Instituto Universitário (ISPA), Lisbon, Portugal
| | - Sinézio I da Silva Júnior
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Micaela A Teodoro
- Graduate Program in Nutrition and Longevity, School of Nutrition, Federal University of Alfenas (UNIFAL-MG), Alfenas, Brazil
| | - Juliana A D B Campos
- Graduate Program in Food, Nutrition, and Food Engineering, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil
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13
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Bourke M, Pila E. Body-related self-conscious emotions, self-compassion, and dietary restraint in Canadian undergraduate university students: A multilevel mediation and moderation analysis. Int J Eat Disord 2023; 56:2131-2141. [PMID: 37610052 DOI: 10.1002/eat.24049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Self-compassion has an inverse association with dietary restraint however, the mechanisms linking self-compassion and dietary restraint are not clear. This study aimed to determine to what extent self-compassion was inversely concurrently related to dietary restraint, indirectly through body-related self-conscious emotions, and to what extent trait self-compassion moderated the concurrent within-person association between body-related self-conscious emotions and dietary restraint. METHOD Data was collected from 224 Canadian university students who reported on trait self-compassion at baseline and body-related shame, guilt, envy, and embarrassment, and dietary restraint biweekly between November 2020 and August 2021. RESULTS Results from a 2-1-1 multilevel mediation model showed that trait self-compassion was indirectly concurrently related to dietary restraint through body-related shame, guilt, envy, and embarrassment. Results from the moderation model showed that there was a significant positive concurrent within-person association between body-related shame, envy, and embarrassment, but not guilt, with dietary restraint. These relationships were not moderated by trait self-compassion. DISCUSSION This study adds to our understanding of the concurrent association between body-related self-conscious emotions and dietary restraint, and the mechanisms through which self-compassion is related to dietary restraint. Given body-related self-conscious emotions were related to dietary restraint at both the within-person and between-person level, both compassion-focused interventions that aim to improve general levels of body-related self-conscious emotions and interventions that aim to overcome spikes in these emotions compared with one's usual level are warranted. PUBLIC SIGNIFICANCE STATEMENT Negative body-related self-conscious emotions were related to higher levels of dietary restraint both across individuals and within individuals over time; and may play a mechanistic role in linking self-compassion with dietary restraint. Interventions aimed at reducing negative body-related self-conscious emotions are warranted in the prevention of eating disorder psychopathology.
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Affiliation(s)
- Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Eva Pila
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
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14
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Raspovic A, Prichard I, Salim A, Yager Z, Hart L. Body image profiles combining body shame, body appreciation and body mass index differentiate dietary restraint and exercise amount in women. Body Image 2023; 46:117-122. [PMID: 37290141 DOI: 10.1016/j.bodyim.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/10/2023]
Abstract
This project aimed to establish whether meaningful body image profiles (BIPs) could be identified across measures of body shame, body appreciation, and body mass index (BMI), and whether these profiles could differentiate key health behaviours. Data came from 1200 adult women who responded to an online body image survey. Latent profile analysis was used to identify BIPs based on relative levels of body shame, body appreciation and BMI. Differences in dietary restraint and weekly exercise amount were investigated according to BIP membership. Latent profile analysis revealed four unique BIPs; 1. Appreciative BIP (AP-BIP); 2. Medium Shame BIP (MS-BIP); 3. High Shame BIP (HS-BIP) and 4. Average BIP (AV-BIP). Dietary restraint and exercise amount differed significantly according to BIP in most comparisons. Women in the High Shame BIP exhibited the highest dietary restraint and lowest exercise. Women in the Appreciative BIP exhibited the lowest dietary restraint and highest exercise. Body shame and body appreciation intersect with BMI to form unique profiles (BIPs) that differentiate dietary restraint and exercise. Using BIPs to tailor interventions designed to promote healthful diet and exercise should be considered in public health initiatives.
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Affiliation(s)
- Anita Raspovic
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia.
| | - Ivanka Prichard
- Health & Exercise Science, College of Nursing & Health Sciences, Flinders University, Adelaide 5001, Australia; SHAPE Research Centre, Flinders University, Adelaide 5001, Australia; Caring Futures Institute, Flinders University, Adelaide 5001, Australia
| | - Agus Salim
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne 3001, Australia
| | - Laura Hart
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
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15
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Warschburger P, Wortmann HR, Walter LP, Bergmann MM, Gisch UA. Stability and longitudinal association between Body Mass Index and maladaptive eating behaviors in older adults: Results from the NutriAct Family Study (NFS). Eat Behav 2023; 50:101778. [PMID: 37421906 DOI: 10.1016/j.eatbeh.2023.101778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Due to the increasing prevalence of overweight and obesity with age and associated health risks, older adults are an important target group to promote healthy weight. Evidence indicates that maladaptive eating behaviors are associated with higher BMI. However, older adults are often neglected in this research field. This prospective study aims to clarify the temporal relationship between BMI and maladaptive eating behaviors among older adults. METHODS In total, 964 participants of the NutriAct Family Study (Mage = 63.34 years) completed web-based questionnaires two times (M = 3.33 years apart). BMI was assessed via self-reported height and weight, and maladaptive eating behaviors with the Dutch Eating Behavior Questionnaire (DEBQ). The stability and longitudinal associations were analyzed using cross-lagged models. RESULTS Cross-sectional analysis showed positive correlations between BMI and emotional (r = 0.218), external (r = 0.101), as well as restrictive eating (r = 0.160). All maladaptive eating behaviors (β > 0.684) and BMI (β > 0.922) were longitudinally stable. No significant bidirectional relationships were found between BMI and maladaptive eating behaviors over time, except for BMI predicting restrictive eating (β = 0.133). CONCLUSION The observed cross-sectional, but not longitudinal associations between BMI and maladaptive eating behaviors underline the need for prospective study designs to deepen the understanding of the role of maladaptive eating behaviors in weight management among the general population. Maladaptive eating behaviors among older adults may have already consolidated and play a smaller role in explaining weight course, compared to early life like childhood.
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Affiliation(s)
- Petra Warschburger
- NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Germany; University of Potsdam, Department of Psychology, Counseling Psychology, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Hanna R Wortmann
- NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Germany; University of Potsdam, Department of Psychology, Counseling Psychology, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Lena P Walter
- University of Potsdam, Department of Psychology, Counseling Psychology, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany.
| | - Manuela M Bergmann
- NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Germany; German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Schneunert-Allee 114-116, 14558 Nuthetal, Germany.
| | - Ulrike A Gisch
- NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Germany; University of Potsdam, Department of Psychology, Counseling Psychology, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany; Justus-Liebig-Universität Gießen, Senckenbergstraße 3, 35390 Gießen, Germany.
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16
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D'Adamo L, Sonnenblick RM, Juarascio AS, Manasse SM. Relations between forms of dietary restraint, restriction, and loss-of-control eating among adolescents seeking weight control: An ecological momentary assessment study. Eat Behav 2023; 50:101791. [PMID: 37544108 PMCID: PMC10528310 DOI: 10.1016/j.eatbeh.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study aimed to: 1) compare rates of dietary restraint and restriction between adolescents with and without loss-of-control (LOC) eating who were seeking weight control and 2) examine temporal relations between restraint/restriction and LOC eating. METHOD 37 adolescents seeking weight control (mean age: 15.4 ± 1.5; 62 % White; 57 % female; mean BMI percentile = 97.3 ± 3.1) completed a one-week ecological momentary assessment protocol and reported on dietary restraint/restriction and eating behavior prior to beginning a weight control intervention. Chi-square tests examined differences in frequency of restraint/restriction between participants with and without LOC eating. Multilevel models examined associations between dietary restraint/restriction and LOC eating at the next survey and on the next day. RESULTS Of 37 participants, 15 (41 %) reported engaging in LOC eating. Participants with LOC eating more frequently endorsed several forms of restraint and restriction versus participants without LOC eating. Attempting to avoid enjoyable foods and attempting to limit eating at one survey predicted greater likelihood of LOC eating at the next survey. CONCLUSIONS Findings suggest that attempted restraint, but not actual restriction, was associated with LOC eating. Research should explore additional factors that may influence these relationships, which could inform weight control treatments that address restraint/restriction.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA; Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Ross M Sonnenblick
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
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17
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Fekih-Romdhane F, Azzi V, Malaeb D, Sarray El Dine A, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the Inflexible Eating Questionnaire (IEQ) in a non-clinical sample of adults. J Eat Disord 2023; 11:115. [PMID: 37430320 DOI: 10.1186/s40337-023-00835-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The Inflexible Eating Questionnaire (IEQ) is an 11-item instrument designed to evaluate the behavioural and psychological components of inflexible eating. However, the psychometric properties of the instrument have been infrequently examined, and no previous work has examined its utility in the context of the Middle East. METHODS A total of 826 Lebanese citizens and residents completed a novel Arabic translation of the IEQ, as well as previously validated measures of body appreciation, functionality appreciation, and disordered eating. RESULTS The unidimensional factor structure of the IEQ was upheld through both exploratory and confirmatory factor analyses, with all 11 items retained. We obtained evidence of scalar invariance across gender and found that there were no significant differences in observed IEQ scores between men and women. IEQ scores were also found to have adequate composite reliability and adequate patterns of concurrent validity. CONCLUSION The present findings provide support for the psychometric properties of the Arabic version of the IEQ in examining inflexible eating in Arabic-speaking adults in Lebanon. Inflexible or rigid dietary restraint reflects an all-or-none approach that encompasses feeling compelled to obey a set of self-imposed dieting rules (e.g., avoiding high-calorie food, calorie counting, fasting to lose weight and/or skipping meals), having a sense of self-control and feeling empowered when adhering to these rules, and not respecting or following internal/external cues of hunger, satiety, and appetite. Therefore, the inflexible eating construct is composed of two dimensions, the first one is behavioural (i.e., obeying restrictive dietary rules) and the second one is psychological (i.e., the belief that following these rules is a consistent must). Until recently, the measures designed to assess inflexible eating focused on the behavioral dimension, while omitting to account for the psychological processes underlying the construct. To bridge this gap, the Inflexible Eating Questionnaire (IEQ), an 11-item self-report measure, was developed to assess both the behavioural and psychological components of dietary restraint. To date, the IEQ is not yet validated in Arabic. Through the present study, we aimed to examine the psychometric properties of an Arabic translation of the IEQ, which would in turn facilitate improved research and clinical practices related to dietary restraint in Arabic-speaking nations. Overall, findings provided support for the good psychometric qualities of the Arabic version of the IEQ, which suggests its utility for detecting inflexible eating in Arabic-speaking adults.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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18
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Ravaioli F, De Maria N, Di Marco L, Pivetti A, Casciola R, Ceraso C, Frassanito G, Pambianco M, Pecchini M, Sicuro C, Leoni L, Di Sandro S, Magistri P, Menozzi R, Di Benedetto F, Colecchia A. From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients. Nutrients 2023; 15:2778. [PMID: 37375682 DOI: 10.3390/nu15122778] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Liver transplantation (LT) is a complex surgical procedure requiring thorough pre- and post-operative planning and care. The nutritional status of the patient before, during, and after LT is crucial to surgical success and long-term prognosis. This review aims to assess nutritional status assessment and management before, during, and after LT, with a focus on patients who have undergone bariatric surgery. We performed a comprehensive topic search on MEDLINE, Ovid, In-Process, Cochrane Library, EMBASE, and PubMed up to March 2023. It identifies key factors influencing the nutritional status of liver transplant patients, such as pre-existing malnutrition, the type and severity of liver disease, comorbidities, and immunosuppressive medications. The review highlights the importance of pre-operative nutritional assessment and intervention, close nutritional status monitoring, individualised nutrition care plans, and ongoing nutritional support and monitoring after LT. The review concludes by examining the effect of bariatric surgery on the nutritional status of liver transplant recipients. The review offers valuable insights into the challenges and opportunities for optimising nutritional status before, during, and after LT.
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Affiliation(s)
- Federico Ravaioli
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Nicola De Maria
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Lorenza Di Marco
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Alessandra Pivetti
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Riccardo Casciola
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Carlo Ceraso
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Gabriella Frassanito
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Martina Pambianco
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Maddalena Pecchini
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Chiara Sicuro
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
| | - Laura Leoni
- Division of Metabolic Diseases and Clinical Nutrition, Department of Specialistic Medicines, University Hospital of Modena and Reggio Emilia, Largo del Pozzo 71, 41125 Modena, Italy
| | - Stefano Di Sandro
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena "Policlinico", University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Paolo Magistri
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena "Policlinico", University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Renata Menozzi
- Division of Metabolic Diseases and Clinical Nutrition, Department of Specialistic Medicines, University Hospital of Modena and Reggio Emilia, Largo del Pozzo 71, 41125 Modena, Italy
| | - Fabrizio Di Benedetto
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena "Policlinico", University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Antonio Colecchia
- Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, University of Modena & Reggio Emilia, 41121 Modena, Italy
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Bandelin-Franke L, Schenk L, Baer NR. To Eat or Not to Eat-A Qualitative Exploration and Typology of Restrictive Dietary Practices among Middle-Aged and Older Adults. Nutrients 2023; 15:nu15112466. [PMID: 37299430 DOI: 10.3390/nu15112466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Favorable diets often include restrictive practices that have proven health benefits, even if initiated later in life. The aim of this qualitative study is to gain a comprehensive understanding of Restrictive Dietary Practices (RDPs) among a sample of middle-aged and older German adults (aged 59-78 years). We conducted 24 narrative in-depth interviews and analyzed the data using qualitative content analysis (Kuckartz). Following an inductive thematic approach, a typology was reconstructed comprising four typical RDP characteristics: I. The Holistically Restraining Type, II. The Dissonant-savoring Restraining Type, III. The Reactively Restraining Type, and IV. The Unintentionally Restraining Type. These types differed regarding the practical implementation of, e.g., restrictive food choice into everyday routines, barriers to do so, as well as with respect to attitudes and motives underlying RDPs. The major motives for adopting a RDP involved health, well-being, ethical, and ecological concerns. The most prominent barriers to a 'successful' adoption of RDPs were the enjoyment of food and the desire for spontaneity and freedom of (food) choice. Our study offers an in-depth understanding of the aspects that shape the widespread practice of dietary restriction among middle-aged and older adults. Lifeworld-related changes in RDPs and possible 'type shiftings' are discussed as well as the meaning and chances of RDPs for public health promotion.
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Affiliation(s)
- Lena Bandelin-Franke
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Nadja-Raphaela Baer
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Oikarinen N, Jokelainen T, Heikkilä L, Nurkkala M, Hukkanen J, Salonurmi T, Savolainen MJ, Teeriniemi AM. Low eating self-efficacy is associated with unfavorable eating behavior tendencies among individuals with overweight and obesity. Sci Rep 2023; 13:7730. [PMID: 37173366 PMCID: PMC10182077 DOI: 10.1038/s41598-023-34513-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Success in long-term weight management depends partly on psychological and behavioral aspects. Understanding the links between psychological factors and eating behavior tendencies is needed to develop more effective weight management methods. This population-based cross-sectional study examined whether eating self-efficacy (ESE) is associated with cognitive restraint (CR), uncontrolled eating (UE), emotional eating (EE), and binge eating (BE). The hypothesis was that individuals with low ESE have more unfavorable eating behavior tendencies than individuals with high ESE. Participants were classified as low ESE and high ESE by the Weight-Related Self-Efficacy questionnaire (WEL) median cut-off point. Eating behavior tendencies were assessed with Three Factor Eating Questionnaire R-18 and Binge Eating Scale, and additionally, by the number of difficulties in weight management. The difficulties were low CR, high UE, high EE, and moderate or severe BE. Five hundred and thirty-two volunteers with overweight and obesity were included in the study. Participants with low ESE had lower CR (p < 0.03) and higher UE, EE, and BE (p < 0.001) than participants with high ESE. Thirty-nine percent of men with low ESE had at least two difficulties in successful weight control while this percentage was only 8% in men with high ESE. In women, the corresponding figures were 56% and 10%. The risk of low ESE was increased by high UE [OR 5.37 (95% CI 1.99-14.51)], high EE [OR 6.05 (95% CI 2.07-17.66)], or moderate or severe BE [OR 12.31 (95% CI 1.52-99.84)] in men, and by low CR [OR 5.19 (95% CI 2.22-12.18)], high UE [OR 7.20 (95% CI 2.41-19.22)], or high EE [OR 23.66 (95% CI 4.79-116.77)] in women. Low ESE was associated with unfavorable eating behavior tendencies and multiple concomitant difficulties in successful weight loss promotion. These eating behavior tendencies should be considered when counseling patients with overweight and obesity.
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Affiliation(s)
- Noora Oikarinen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | | | - Laura Heikkilä
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marjukka Nurkkala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Hukkanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Tuire Salonurmi
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markku J Savolainen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Department of Medicine, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna-Maria Teeriniemi
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland.
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Azzi R, Samaha S, Malaeb D, Akel M, Azzi V, Hallit S, Obeid S. The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation. BMC Psychiatry 2023; 23:335. [PMID: 37173734 PMCID: PMC10175933 DOI: 10.1186/s12888-023-04847-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN. METHODS This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175). RESULTS Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia. CONCLUSION Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.
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Affiliation(s)
- Reine Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Serena Samaha
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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Smith KE, Varnado A, Thomas JG, Vithiananthan S, Jones DB, Papasavas P, Bond DS. Characterizing the Course of Loss of Control Eating and Prognostic Factors Following Bariatric Surgery: an Exploratory Analysis. Obes Surg 2023; 33:1170-1177. [PMID: 36808385 PMCID: PMC10079698 DOI: 10.1007/s11695-023-06497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Postoperative loss of control eating (LOCE) has detrimental associations with weight outcomes and mental health following bariatric surgery. However, little is known regarding LOCE course following surgery and preoperative factors that predict remittance, continuance, or development of LOCE. The present study aimed to characterize LOCE course in the year following surgery by identifying four groups: individuals with (1) postoperative de novo LOCE, (2) maintained LOCE (endorsed at pre- and post-surgery), (3) remitted LOCE (endorsed only at pre-surgery), and (4) those who never endorsed LOCE. Exploratory analyses examined group differences in baseline demographic and psychosocial factors. MATERIALS AND METHODS A total of 61 adult bariatric surgery patients completed questionnaires and ecological momentary assessment at pre-surgery and 3-, 6-, and 12-month postoperative follow-ups. RESULTS Results showed that 13 (21.3%) never endorsed LOCE prior to or after surgery, 12 (19.7%) developed LOCE after surgery, 7 (11.5%) evidenced remittance from LOCE after surgery, and 29 (47.5%) maintained LOCE prior to and after surgery. Relative to those who never endorsed LOCE, all groups who evidenced LOCE before and/or after surgery reported greater disinhibition; those who developed LOCE reported less planned eating; and those with maintained LOCE reported less satiety sensitivity and greater hedonic hunger. CONCLUSION These findings highlight the importance of postoperative LOCE and need for longer-term follow-up studies. Results also suggest a need to examine the longer-term impact of satiety sensitivity and hedonic eating on LOCE maintenance, and the extent to which meal planning may buffer risk for de novo LOCE following surgery.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA.
| | - Aimee Varnado
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI, 02903, USA
| | | | - Daniel B Jones
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Pavlos Papasavas
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
| | - Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
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23
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Spivak-Lavi Z, Latzer Y, Katz R. The role of mothers' involvement in their daughters' self-esteem and dieting behaviors. Health Care Women Int 2023; 45:512-536. [PMID: 36947584 DOI: 10.1080/07399332.2023.2183205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 02/17/2023] [Indexed: 03/23/2023]
Abstract
This study presents an initial effort to develop disordered eating pathology (DEP) prevention program with an emphasis on maternal involvement. Disordered eating pathology representing a range of behaviors and attitudes, from negative body image to full-blown eating disorder. It appears mainly in adolescent females and related to psychological and familial factors, including maternal modeling of thinness. A sample of 118 Israeli girls (11-12) was divided into three groups: participants in the program in parallel with their mothers, participants without their mothers, and control. Participants completed self-report questionnaires. Groups were tested three times: pre-intervention, post-intervention, and follow-up. For those girls who participated in parallel with their mothers, higher self-esteem was associated with fewer pathological diet behaviors. Findings deepen understanding of the risk factors involved in the development of DEP. The main study contribution is the important role mothers play in preventing DEP among their daughters.
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Affiliation(s)
- Zohar Spivak-Lavi
- Department of Social Work, Yezreel Valley College, Emek Yezreel, Israel
| | - Yael Latzer
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Eating Disorders Institution, Psychiatric Division, Rambam Health Care Campus, Haifa, Israel
| | - Ruth Katz
- Department of Human Services, Yezreel Valley College, Emek Yezreel, Israel
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Lister NB, Jebeile H, Khalid R, Pryde S, Johnson BJ. Deconstructing Complex Interventions: Piloting a Framework of Delivery Features and Intervention Strategies for the Eating Disorders in Weight-Related Therapy (EDIT) Collaboration. Nutrients 2023; 15:nu15061414. [PMID: 36986143 PMCID: PMC10056322 DOI: 10.3390/nu15061414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/06/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background: weight-management interventions vary in their delivery features and intervention strategies. We aimed to establish a protocol to identify these intervention components. (2) Methods: a framework was developed through literature searches and stakeholder consultation. Six studies were independently coded by two reviewers. Consensus included recording conflict resolutions and framework changes. (3) Results: more conflicts occurred for intervention strategies compared to delivery features; both required the updating of definitions. The average coding times were 78 min (SD: 48) for delivery features and 54 min (SD: 29) for intervention strategies. (4) Conclusions: this study developed a detailed framework and highlights the complexities in objectively mapping weight-management trials.
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Affiliation(s)
- Natalie B. Lister
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney 2145, Australia
- Correspondence:
| | - Hiba Jebeile
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney 2145, Australia
| | - Rabia Khalid
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
| | - Samantha Pryde
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide 5042, Australia
| | - Brittany J. Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide 5042, Australia
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25
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dos Santos Quaresma MVL, Marques CG, Magalhães ACO, Cirillo L, Ciudi RB, Oliveira LS, dos Santos RVT, Nakamoto FP. Prevalence of dietary supplement consumption among CrossFit practitioners. NUTRIRE : REVISTA DE SOCIEDADE BRASILEIRA DE ALIMENTACAO E NUTRICAO = JOURNAL OF THE BRAZILIAN SOCIETY OF FOOD AND NUTRITION 2023; 48:9. [PMID: 38625281 PMCID: PMC9924833 DOI: 10.1186/s41110-023-00193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
Purpose We aimed to verify the prevalence of dietary supplements among CrossFit practitioners (CFPs), considering gender and training status. Still, we aimed to determine the type, reasons, and associated factors of dietary supplement utilization among CFPs. Methods This is a cross-sectional, exploratory, and descriptive study with the snowball sampling method. Data were collected through online questionnaires using the Google Forms® tool. We included CFPs aged 18-64 years, from Aug 1, 2020, to Sept 31, 2020. The questionnaire contained questions to assess the prevalence, type, and reasons for supplement use; also, we assessed information about sociodemographic variables and the prevalence of the main chronic morbidities. To analyze aspects of eating behavior and sleep-related parameters, we applied the three-factor eating questionnaire (TFEQ)-R21 and the Pittsburgh Sleep Quality Index questionnaire (PSQI), respectively. Results We assessed one hundred twelve (n = 112; 57 men; 55 women) CFPs (28.9 ± 7.64 years old; body mass index (BMI), 25.5 ± 4.83 kg/m2). Eighty-seven (50 men; 37 women; 28.2 ± 6.66 years old; BMI, 25.4 ± 4.55 kg/m2) reported using dietary supplements. Whey protein was the most used supplement (n = 70), followed by creatine (n = 54). Cognitive restraint (a dimension of eating behavior) score was higher in supplement users than in non-users (51.7 ± 18.6 vs. 42.6 ± 20.5; p = 0.040). Sleep-related parameters did not differ between supplement users and non-users. The most associated factors to supplement use were sex (being man; OR, 7.99; p = 0.007), sleep quality (poor; OR, 5.27; p = 0.045), CrossFit level (as prescribed (RX); OR, 4.51; p = 0.031), and cognitive restraint (OR, 1.03; p = 0.029). Conclusion The CFPs, especially RX and Elite ones, showed a higher prevalence of supplement utilization. Anabolic-related supplements (i.e., whey protein and creatine) were the most used; moreover, several CFPs used supplements not supported by scientific evidence. Cognitive restraint score was higher in supplement users than in non-users. RX level, being men, and poor sleep quality were associated with supplement utilization. These data draw attention to the necessity of nutritional education for CrossFit coaches and athletes. Broader studies are necessary to confirm our findings.
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Affiliation(s)
| | | | - Ana Carolina Oumatu Magalhães
- Centro Universitário São Camilo, Curso de Nutrição, São Paulo, SP Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP Brazil
| | - Letícia Cirillo
- Centro Universitário São Camilo, Curso de Nutrição, São Paulo, SP Brazil
| | | | | | - Ronaldo Vagner Thomatieli dos Santos
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP Brazil
- Departamento de Biociências, Universidade Federal de São Paulo, Santos, SP Brazil
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Markey CH, Strodl E, Aimé A, McCabe M, Rodgers R, Sicilia A, Coco GL, Dion J, Mellor D, Pietrabissa G, Gullo S, Granero‐Gallegos A, Probst M, Maïano C, Bégin C, Alcaraz‐Ibáñez M, Blackburn M, Caltabiano ML, Manzoni GM, Castelnuovo G, Hayami‐Chisuwa N, He Q, Fuller‐Tyszkiewicz M. A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates. Br J Health Psychol 2023; 28:136-155. [PMID: 35942590 PMCID: PMC10086804 DOI: 10.1111/bjhp.12616] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 07/05/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.
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Affiliation(s)
- Charlotte H. Markey
- Department of Psychology, Health Sciences CenterRutgers UniversityCamdenNew JerseyUSA
| | - Esben Strodl
- School of Psychology and CounsellingQueensland University of TechnologyBrisbaneQldAustralia
| | - Annie Aimé
- Department of Psychoeducation and PsychologyUniversité du Québec en OutaouaisSaint‐JérômeQCCanada
| | - Marita McCabe
- School of Health SciencesSwinburne UniversityMelbourneVic.Australia
| | - Rachel Rodgers
- Department of Applied PsychologyNorth Eastern UniversityBostonMassachusettsUSA
- Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHRU MontpellierMontpellierFrance
| | - Alvaro Sicilia
- Health Research Centre and Department of EducationUniversity of AlmeriaAlmeriaSpain
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | - Jacinthe Dion
- Department of Health SciencesUniversite du Quebec a ChicoutimiChicoutimiQCCanada
| | - David Mellor
- School of PsychologyDeakin UniversityMelbourneVic.Australia
| | - Giada Pietrabissa
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human MovementUniversity of PalermoPalermoItaly
| | | | - Michel Probst
- Department of Rehabilitation SciencesKU LeuvenLeuvenBelgium
| | - Christophe Maïano
- Department of Psychoeducation and PsychologyUniversité du Québec en OutaouaisSaint‐JérômeQCCanada
| | | | | | | | | | - Gian Mauro Manzoni
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano, IRCCS, San Giuseppe HospitalOggebbioItaly
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Naomi Hayami‐Chisuwa
- Graduate School of Human Life and EcologyOsaka Metropolitan UniversityOsakaJapan
| | - Qiqiang He
- School of Health SciencesWuhan UniversityWuhanChina
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Chew HSJ, Li J, Chng S. Improving adult eating behaviours by manipulating time perspective: a systematic review and meta-analysis. Psychol Health 2023:1-17. [PMID: 36691788 DOI: 10.1080/08870446.2023.2169320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 11/28/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
There is a growing body of research on improving health behaviours through future thinking but that in improving eating behaviour remains unclear. Hence, we conducted a systematic review and meta-analysis on the effectiveness of time perspective manipulation in improving adult eating behaviours. Articles published from inception through 17 March 2022 were retrieved from eight databases (CINAHL, Embase, ProQuest, PsycINFO, PubMed, Scopus, The Cochrane library, and Web of Science). Meta-analysis was conducted using random effects models with effect sizes reported in Hedges' g. Sixteen experimental studies were included, representing 1,914 participants with mean ages ranging from 20.5 to 44.1 years old and mean baseline BMI of 22.0 kg/m2 to 37.2 kg/m2. The interventions included were episodic future thinking (EFT; n = 12), message framing (n = 2), and varying inter-meal intervals (IMI; n = 2) in improving food choices, food intake and portion size. Two studies reported significant interventional effectiveness for domain-specific EFT while all studies on message framing and IMI reported significant interventional effectiveness. Message framing seemed to be more effective when both temporal distance and valence frames were manipulated. However, the pooled effect sizes of all the interventions did not result in a significant interventional effect (n = 5; g = -0.49; 95% confidence interval (CI) = -1.44, 0.47; p = 0.23; I2=87.2%). More rigorous research is needed to ascertain the effectiveness of manipulating time perspective in improving eating behaviours before such interventions are more widely used.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jiayi Li
- Yale-NUS College, National University of Singapore, Singapore, Singapore
| | - Samuel Chng
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore, Singapore
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Schultz A, Maurer L, Alexandrowicz RW. Strengths and weaknesses of the German translation of the Inflexible Eating Questionnaire and of eating disorder assessment in general. Front Psychol 2022; 13:1002463. [PMID: 36600707 PMCID: PMC9806356 DOI: 10.3389/fpsyg.2022.1002463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Objective The present article introduces the German translation of the Inflexible Eating Questionnaire (IEQ-G), performs a psychometric evaluation, and explores the relationship of Inflexible Eating to the subscales of the Eating Disorder Examination-Questionnaire (EDE-Q) and Obsessive-Compulsive (OC) symptoms. Methods The cross-sectional study was carried out in the German-speaking area. A paper and pencil survey was completed by 612 females and 442 males of the general population. Results SEM analyses showed that the IEQ-G allows for calculating a total score and invariance tests were mostly promising. As a side result, the original 4-factorial structure of the EDE-Q could not be replicated, but a 3 dimensional solution proved convincing. From a psychometric point of view, the IEQ-G outperformed the EDE-Q. On a latent level, Inflexible Eating was remarkably strong related to OC-symptoms and the EDE-Q subscales. Discussion The detail analyses revealed that Eating Disorder assessment in general lacks subgroup-specific aspects, for instance, regarding gender or dietary preferences, important for early diagnosis and screening of ED. The IEQ-G proved applicable in a German speaking adult population and recommends itself for cross-cultural studies.
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Mason TB, Dolgon-Krutolow A, Smith KE, Leventhal AM. Body Dissatisfaction and Binge Eating: The Moderating Roles of Sweet Taste Reward Sensitivity and Dietary Restraint among Tobacco Product Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15523. [PMID: 36497598 PMCID: PMC9740665 DOI: 10.3390/ijerph192315523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Body dissatisfaction is a key predictor of binge eating, yet less is known about factors that may potentiate the association between body dissatisfaction and binge eating. This study examined self-reported dietary restraint and sweet taste reward sensitivity as candidate moderators of the association between body dissatisfaction and binge eating in adults. A convenience sample of 221 tobacco product users completed measures of eating disorder pathology and sweet taste reward sensitivity. Results revealed that elevated sweet taste reward sensitivity strengthened the positive association between higher body dissatisfaction and binge eating. However, there was no main effect, or moderation effect, of dietary restraint on binge eating. The findings of this study demonstrate the key role of sweet taste reward sensitivity in potentiating the association between body dissatisfaction and binge eating. Sweet taste reward sensitivity may serve as a key dispositional factor for uncontrolled eating.
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Affiliation(s)
- Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
| | - Anna Dolgon-Krutolow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
| | - Kathryn E. Smith
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
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Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review. Br J Nutr 2022; 128:1565-1586. [PMID: 34658329 DOI: 10.1017/s0007114521004219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.
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Péneau S, Bénard M, Robert M, Allès B, Andreeva VA, Courtois F, Touvier M, Leys C, Bellisle F. Validation of the Flexible and Rigid Cognitive Restraint Scales in a General French Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12519. [PMID: 36231817 PMCID: PMC9564632 DOI: 10.3390/ijerph191912519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Distinguishing between flexible and rigid cognitive restraint (CR) may be useful for understanding the role of CR in dietary behavior and weight status. This study aimed to translate and adapt the flexible and rigid CR scales to the French context and test their psychometric properties. Construct validity, internal consistency, and test-retest reliability were examined in a sample of 620 individuals. Confirmatory factor analysis of the scales found a two-factor structure (flexible CR: 12 items; rigid CR: 15 items) that provided a good fit and supported the initial solution (χ2 = 584.7, df = 322, CFI = 0.96, RMSEA = 0.052 [0.045, 0.059], TLI = 0.95). Higher flexible and rigid CR were associated with higher CR overall, emotional eating (TFEQ-R21) and eating disorders (SCOFF), and lower intuitive eating (IES-2). In addition, higher flexible CR was associated with lower impulsivity (BIS-11) while higher rigid CR was associated with higher uncontrolled eating (TFEQ-R21) and lower self-esteem (RSES), satisfaction with life (SWLS), and optimism (LOT-R). Flexible and rigid CR internal consistency was satisfactory (McDonald ω = 0.77 and 0.74, respectively) and test-retest reliability was good (ICC = 0.81 and 0.79, respectively). This study validated a flexible and rigid CR tool in a French population and confirmed that these two types of CR represent distinct eating behaviors.
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Affiliation(s)
- Sandrine Péneau
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Marc Bénard
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Margaux Robert
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Valentina A. Andreeva
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Frédéric Courtois
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
| | - Christophe Leys
- Faculty of Psychological Sciences, Université Libre de Bruxelles, Avenue Franklin Roosevelt, 50-CP191, 1050 Brussels, Belgium
| | - France Bellisle
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), 93017 Bobigny, France
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Hubert PA, Fiorenti H, Duffy VB. Feasibility of a Theory-Based, Online Tailored Message Program to Motivate Healthier Behaviors in College Women. Nutrients 2022; 14:nu14194012. [PMID: 36235664 PMCID: PMC9572712 DOI: 10.3390/nu14194012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to test the feasibility of an online survey and tailored message program in young women. Recruited from college campuses, women (n = 189) completed an online survey assessing preference for and behaviors toward diet and physical activity as well as theory-based influencers of these behaviors (knowledge/information, motivation, and confidence). Health messages were tailored to the participant’s survey responses and learning style to address misconceptions and motivate or reinforce healthy physical activity and dietary behaviors. Most women reported the survey as relevant (92%) and useful for reflecting on their health (83%), with survey responses variable in level of nutrition and physical activity knowledge, motivation, and confidence. Each woman received four tailored messages—most reported the messages as relevant (80%) and learning new information (60%). Across all messages, nearly half of the participants (~48%) reported willingness to try or maintain healthier behaviors and confidence in their ability. Body size discrepancy and dietary restraint had small effects message responses of information learned, and the motivation and confidence in trying healthier behaviors. In summary, these data support the feasibility of this online tailored message program. The college women found the tailored message program acceptable and useful to motivate healthier behaviors. The findings provide direction for behaviorally focused interventions to improve dietary and physical activity behaviors.
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Katcher JA, Suminski RR, Pacanowski CR. Impact of an Intuitive Eating Intervention on Disordered Eating Risk Factors in Female-Identifying Undergraduates: A Randomized Waitlist-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12049. [PMID: 36231362 PMCID: PMC9566585 DOI: 10.3390/ijerph191912049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Dietary restraint and low body appreciation are common among female-identifying undergraduates and are related to the development of disordered eating, which female-identifying undergraduates engage in throughout college. Training students in intuitive eating, an approach that promotes eating by internal cues, may be a way to ameliorate dietary restraint and low body appreciation, ultimately decreasing disordered eating. The purpose of this study was to examine the impact of a five-week intuitive eating intervention on dietary restraint, body appreciation, and intuitive eating in female-identifying undergraduates. A five-week intuitive eating intervention (NCT0394700) was facilitated by two Registered Dietitians. One treatment group (TG) (n = 7) and one waitlist control group (WLCG) (n = 7) participated in the trial. From baseline to post-intervention, there was a significant decrease in dietary restraint, t(12) = -2.88, p = 0.01, and a significant increase in intuitive eating, t(12) = 4.03, p = 0.002, in the TG compared to the WLCG. The intervention had replicable effects on all outcome variables. Measurements at the five-week follow-up suggested the impact was sustained. This study provides preliminary data suggesting an intuitive eating intervention may help improve disordered eating risk factors by decreasing dietary restraint and increasing intuitive eating in female-identifying undergraduates.
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Han J, Zhuang K, Yi H, Jiang Y, Ling Y, Fan L, Liu Y, Chen H. "Neurotic people tend to eat less when disinhibited": The mediating role of food-related cognitive flexibility in restrained eaters. Appetite 2022; 179:106309. [PMID: 36115512 DOI: 10.1016/j.appet.2022.106309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aims to reveal the individual differences in Neuroticism and cognitive flexibility among successful restrained eaters (SREs), unsuccessful restrained eaters (UREs), and non-restrained eaters (NREs). Moreover, this study is dedicated to investigating whether certain personality traits and cognitive flexibility could concurrently influence disinhibited eating behaviors among restrained eaters and reveal the pathways through which they interact. METHODS Female participants aged 17 and 24 years (NREs = 23; SREs = 24; UREs = 23) were assessed with body mass index (BMI) and appetite state measurement, the Dutch Eating Behavior Questionnaire (DEBQ), the NEO Five-Factor Inventory (NEO-FFI), and the Positive and Negative Affect Schedule. To measure behavioral and neural responses related to cognitive flexibility, participants were required to complete a food-related switching task, and their brain activities were recorded through the technique of electroencephalography (EEG). Here we analyzed two widely investigated components-the N2 and P3 components that separately relate to conflict monitoring and response inhibition. RESULTS The behavioral performance of food-related task switching did not show significant between-group differences. However, in comparison to NREs and SREs, UREs elicited larger N2 and lower P3 amplitudes during task switching. In addition, UREs exhibited a lower level of Neuroticism than SREs and NREs. Furthermore, food-related task switching induced N2 amplitude fully mediated the association between Neuroticism and disinhibited eating behavior in restrained eaters controlled for BMI and negative affect. Importantly, when a parallel mediation model with N2 and P3 was built concurrently, N2 was still able to fully mediate the association. CONCLUSION According to behavioral and neural evidence, increased N2 amplitude induced by food-related task switching totally mediated the negative association between Neuroticism and disinhibited eating in restrained eaters.
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Affiliation(s)
- Jinfeng Han
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Kaixiang Zhuang
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Haijing Yi
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Yan Jiang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Ying Ling
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Linlin Fan
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Yong Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China; Faculty of Psychology, Southwest University, Chongqing, 400715, China.
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House ET, Lister NB, Seidler AL, Li H, Ong WY, McMaster CM, Paxton SJ, Jebeile H. Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires. Int J Eat Disord 2022; 55:1171-1193. [PMID: 35809028 PMCID: PMC9545314 DOI: 10.1002/eat.23769] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This review aimed to examine the validity of self-report screening questionnaires for identifying eating disorder (ED) risk in adults and adolescents with overweight/obesity. METHOD Five databases were searched from inception to September 2020 for studies assessing validation of self-report ED screening questionnaires against diagnostic interviews in adolescents and adults with overweight/obesity. The review was registered with PROSPERO (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=220013). RESULTS Twenty-seven papers examining 15 questionnaires were included. Most studies validated questionnaires for adults (22 of 27 studies), and most questionnaires (12 of 15) screened for binge eating or binge-eating disorder (BED). The Eating Disorder Examination Questionnaire (sensitivity = .16-.88, specificity = .62-1.0) and Questionnaire on Eating and Weight Patterns (sensitivity = .07-1.0, specificity = .0-1.0) were most frequently validated (six studies each). Five studies of three questionnaires were in adolescents, with the Adolescent Binge-Eating Disorder Questionnaire having highest sensitivity (1.0) but lower specificity (.27). Questionnaires designed to screen for BED generally had higher diagnostic accuracy than those screening for EDs in general. DISCUSSION Questionnaires have been well validated to identify BED in adults with overweight/obesity. Validated screening tools to identify other EDs in adults and any ED in adolescents with overweight/obesity are lacking. Thus, clinical assessment should inform the identification of patients with co-morbid EDs and overweight/obesity. PUBLIC SIGNIFICANCE Individuals with overweight/obesity are at increased risk of EDs. This review highlights literature gaps regarding screening for ED risk in this vulnerable group. This work presents possibilities for improving care of individuals with overweight/obesity by reinventing ED screening tools to be better suited to diverse populations.
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Affiliation(s)
- Eve T. House
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
| | - Natalie B. Lister
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials CentreUniversity of SydneySydneyNew South WalesAustralia
| | - Haozhen Li
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Wee Yee Ong
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Caitlin M. McMaster
- Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia,Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Susan J. Paxton
- School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Hiba Jebeile
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
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Smith JM, Serier KN, McLaughlin EA, Witkiewitz K, Sebastian RM, Smith JE. Development and psychometric evaluation of an empirically-derived daily checklist of weight control: Consumption-reduction strategies and health-focused strategies in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1577-1583. [PMID: 33048649 DOI: 10.1080/07448481.2020.1810691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/18/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Objective: Many college women report engaging in weight control strategies, yet little is known about which strategies are used and how often. The current study's goal was to evaluate the factor structure of a comprehensive list of weight control behaviors used in the previous 24-hours. Participants: Undergraduate women (N = 286) were recruited from a southwestern university. Methods: Participants reported their weight control strategies for the previous 24 hours on a checklist compiled from previous studies. Results: Exploratory and confirmatory factor analyses indicated that a 14-item, 2-factor ("Consumption-reduction", "Health-focused" Strategies) structure was a good fit of the data. Tests of longitudinal measurement invariance found support for using the checklist to make meaningful comparisons across time. Conclusions: This study developed a checklist of past 24-hour weight-control strategy usage, thereby providing a step toward developing an instrument that may be used for weight control or early intervention for disordered eating.
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Affiliation(s)
- Jamie M Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Kelsey N Serier
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Elizabeth A McLaughlin
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Riley M Sebastian
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Jane Ellen Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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Nunes CL, Carraça EV, Jesus F, Finlayson G, Francisco R, Silva MN, Santos I, Bosy-Westphal A, Martins P, Minderico C, Sardinha LB, Silva AM. Changes in food reward and intuitive eating after weight loss and maintenance in former athletes with overweight or obesity. Obesity (Silver Spring) 2022; 30:1004-1014. [PMID: 35347875 DOI: 10.1002/oby.23407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to explore the following: 1) the impact of Champ4Life's intervention on intuitive eating and food reward; and 2) associations between changes in eating behavior and changes in body composition. METHODS A total of 94 former athletes (mean [SD], BMI = 31.1 [4.3] kg/m2 , age = 43.0 [9.4] years, 34% female) assigned to intervention (n = 49) and control groups (n = 45) underwent 4 months of active weight loss (WL) followed by 8 months of WL maintenance. Intuitive eating and food reward were assessed by the Intuitive Eating Scale and the Leeds Food Preference Questionnaire, respectively. RESULTS The WL was -4.8% (4.9%) and 0.3% (2.6%) for the intervention and control groups, respectively. Participants reported a decrease in fat bias for explicit/implicit wanting and explicit liking after 4 months and 1 year. For intuitive eating, the unconditional permission to eat decreased after 4 months, and the body-food choice congruence increased after 1 year. Changes in unconditional permission to eat and in body-food choice congruence were positively and negatively associated with both Δweight and with Δfat mass, respectively. Changes in explicit wanting for fat and taste bias were associated with Δweight. CONCLUSIONS Food reward decreased after a moderate WL intervention. Participants successfully maintained their reduced weight, and most of the changes in eating behavior remained significant at the end of the follow-up period. Lifestyle interventions aiming at WL should also consider intuitive eating and food reward.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Eliana V Carraça
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Graham Finlayson
- Appetite Control Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Rúben Francisco
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Marlene N Silva
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direcção-Geral da Saúde, Lisbon, Portugal
| | - Inês Santos
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES): Lusophone University, Lisbon, Portugal
- Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Cláudia Minderico
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, Centro Interdisciplinar de Performance Humana (CIPER), Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
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Wiss DA, Brewerton TD, Tomiyama AJ. Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding. Eat Weight Disord 2022; 27:1249-1267. [PMID: 34476763 DOI: 10.1007/s40519-021-01293-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/23/2021] [Indexed: 12/22/2022] Open
Abstract
In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic-pituitary-adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders-each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding "protective measure" theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.Level of evidence: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- David A Wiss
- Community Health Sciences Department, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA.
| | - Timothy D Brewerton
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, CA, 90095, USA
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Tie B, Chen G, He J. Validation of the inflexible eating questionnaire in a large sample of Chinese adolescents: psychometric properties and gender-related differential item functioning. Eat Weight Disord 2022; 27:1029-1037. [PMID: 34137005 DOI: 10.1007/s40519-021-01239-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aim of this study was to provide preliminary psychometric evidence for the Chinese version of the Inflexible Eating Questionnaire (C-IEQ) among a large sample of Chinese adolescents. METHODS For testing the psychometric properties of the C-IEQ, a total of 2241 (Mage = 13.91 years; 46.4% boys) adolescents from mainland China responded to the survey. Confirmatory factor analysis (CFA) was used to examine the factor structure of the C-IEQ. Measurement invariance by gender was examined by both multi-group CFA and differential item functioning (DIF). Convergent validity of the C-IEQ was assessed via examining the correlations between the C-IEQ scores and theoretically related constructs (e.g., orthorexia nervosa symptomatology, eating disorder symptomatology, and body image inflexibility). RESULTS The unidimensional structure with correlated errors of the C-IEQ showed good model fit (χ2 = 1674.05, df = 44, p < 0.001; CFI = 0.93; TLI = 0.91; RMSEA = 0.13; SRMR = 0.06). The C-IEQ had an adequate internal consistency (α = 0.89) and demonstrated strong measurement invariance across genders. Moreover, the scores of the C-IEQ showed significant correlations with theoretically correlated constructs: orthorexia nervosa symptomatology (girls; r = 0.53 p < 0.001, boys; r = 0.45 p < 0.001), eating disorder symptomatology (girls; r = 0.32 p < 0.001, boys; r = 0.25 p < 0.001) body image inflexibility (girls; r = 0.41 p < 0.001, boys; r = 0.36 p < 0.001), suggesting good convergent validity of the C-IEQ. CONCLUSION The C-IEQ showed good psychometric properties in a sample of Chinese adolescents and can be used in future studies to assess eating-specific psychological inflexibility among Chinese adolescents. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Bijie Tie
- School of Education, Zhengzhou University, Zhengzhou, Henan, China
| | - Gui Chen
- College of Educational Science, Hengyang Normal University, Hengyang, Hunan, China
| | - Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China.
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Dondzilo L, Mills C, Pollitt S, MacLeod C. Enhanced capacity to switch but not to maintain: The basis of attentional bias to high calorie foods in restrained eaters. Appetite 2022; 172:105969. [PMID: 35150792 DOI: 10.1016/j.appet.2022.105969] [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: 10/25/2021] [Revised: 01/13/2022] [Accepted: 02/08/2022] [Indexed: 11/02/2022]
Abstract
It has been argued that high restrained eaters (i.e., people who fluctuate between restrictive food intake and overeating) are characterised by a heightened attentional bias to high calorie foods. However, the validity of this hypothesis has not yet been convincingly established. The current study sought to empirically evaluate this hypothesis using two directional measures of attentional bias: the well-established dot probe bias assessment task and the more novel Chase the Food bias assessment task. The latter attentional assessment approach has the capacity to differentiate between attentional switching and attentional maintenance within a complex and dynamic food environment. Participants (61 high restrained eaters and 38 low restrained eaters) completed the dot probe task and the Chase the Food task. Findings obtained on the dot probe task did not reveal a group difference in terms of biased attentional responding towards high calorie vs. low calorie food. Conversely, the two groups were found to differ on one of the measures obtained on the Chase the Food task. Specifically, high restrained eaters, as compared to low restrained eaters, demonstrated speeded attentional switching to high calorie foods, rather than a greater ability to maintain attention on high calorie foods when required to do so. These novel findings imply that high restrained eaters are potentially characterised by facilitated attentional switching towards high calorie foods. Implications are discussed including the possibility of targeting biased attentional switching using training variants of the Chase the Food task in interventions designed to reduce maladaptive eating behaviours.
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Affiliation(s)
- Laura Dondzilo
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia.
| | - Caitlin Mills
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
| | - Shannon Pollitt
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
| | - Colin MacLeod
- Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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Burmester V, Butler GK, Terry P. Intranasal oxytocin reduces attentional bias to food stimuli. Appetite 2022; 168:105684. [PMID: 34496275 DOI: 10.1016/j.appet.2021.105684] [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: 10/06/2020] [Revised: 08/24/2021] [Accepted: 09/04/2021] [Indexed: 11/28/2022]
Abstract
Attentional biases to food-related stimuli have been demonstrated in response to hunger as well as during restrained eating. Such biases are often associated with obesity, but healthy-weight individuals who do not self-report hunger have also demonstrated attentional biases to stimuli signalling food using laboratory-based cognitive tasks. Levels of the anorectic neuropeptide oxytocin are elevated by food intake and, when administered intranasally, oxytocin inhibits food intake in the laboratory. To investigate whether oxytocin can affect appetite via an action on attentional processes, 40 adults (29 women; mean age 24.0 years old) self-administered 24 IU of oxytocin or placebo intranasally. Forty minutes after administration, participants ate a small snack to maintain alertness and ameliorate deprivation-induced hunger before starting a computerized dot-probe attentional bias task that presented 180 trials of paired visual stimuli comprising neutral, food, social and/or romantic images (500 ms presentation time). Reaction times to probe stimuli that appeared after the offset of the visual images indicated a significant attentional bias to food pictures after placebo; this effect was significantly attenuated by oxytocin, p < .001. The effect of oxytocin on attentional bias to the food pictures was not altered by the type of stimulus paired with the food image, and was independent of BMI, age, sex, self-rated eating behaviour, and self-reported parental bonding; however, the effect was modulated by self-reported food cravings and trait stress. The findings support and extend previous work which has suggested that oxytocin can counteract attentional biases to food-related stimuli in a sample with anorexia by demonstrating the same effect for the first time in a cohort who do not have an eating disorder.
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Affiliation(s)
- V Burmester
- Faculty of Medicine, Department of Brain Sciences, Imperial College London, 7N11c Commonwealth Building Hammersmith Hospital, 72 Du Road, London W12 0NN, UK.
| | - G K Butler
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Penrhyn Road, Kingston Upon Thames, Surrey KT1 2EE, UK
| | - P Terry
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Penrhyn Road, Kingston Upon Thames, Surrey KT1 2EE, UK
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Childhood maltreatment and disordered eating: The mediating role of emotion regulation. Appetite 2022; 172:105952. [DOI: 10.1016/j.appet.2022.105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 11/19/2022]
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Knippenberg A, Robinson GA, Wincup C, Ciurtin C, Jury EC, Kalea AZ. Plant-based dietary changes may improve symptoms in patients with systemic lupus erythematosus. Lupus 2022; 31:65-76. [PMID: 34978516 PMCID: PMC8793314 DOI: 10.1177/09612033211063795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Previous studies have reported that patients affected by systemic lupus erythematosus (SLE) are interested in using diet to treat fatigue, cardiovascular disease and other symptoms. However, to date, there is insufficient information regarding the ways for patients to modify their diet to improve SLE symptoms. We investigated the relationship between the eating patterns of SLE patients and their self-reported disease symptoms and general aspects of health. METHODS A UK-based, online survey was developed, in which patients with SLE were asked about their attitudes and experiences regarding their SLE symptoms and diet. RESULTS The majority (>80%) of respondents that undertook new eating patterns with increased vegetable intake and/or decreased intake of processed food, sugar, gluten, dairy and carbohydrates reported benefiting from their dietary change. Symptom severity ratings after these dietary changes were significantly lower than before (21.3% decrease, p<0.0001). The greatest decreases in symptom severity were provided by low/no dairy (27.1% decrease), low/no processed foods (26.6% decrease) and vegan (26% decrease) eating patterns (p<0.0001). Weight loss, fatigue, joint/muscle pain and mood were the most cited symptoms that improved with dietary change. CONCLUSION SLE patients who changed their eating patterns to incorporate more plant-based foods while limiting processed foods and animal products reported improvements in their disease symptoms. Thus, our findings show promises in using nutrition interventions for the management of SLE symptoms, setting the scene for future clinical trials in this area. Randomised studies are needed to further test whether certain dietary changes are effective for improving specific symptoms of SLE.
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Affiliation(s)
| | - George A Robinson
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
- Centre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, London, UK
| | - Chris Wincup
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis, Division of Medicine, University College London, London, UK
| | - Elizabeth C Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, London, UK
| | - Anastasia Z Kalea
- Division of Medicine, University College London, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
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The Association of Restrained Eating and Overeating during COVID-19: A Cross-Lagged Model. Nutrients 2021; 13:nu13124535. [PMID: 34960087 PMCID: PMC8709275 DOI: 10.3390/nu13124535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022] Open
Abstract
Widespread overeating has been found during the 2019 coronavirus (COVID-19) pandemic. The present study investigated whether pre-pandemic restrained eating (RE) predicted overeating during the pandemic, and further explored the behavioral (mortality threat, negative affect) mechanisms underlying this association. An eight-month longitudinal survey was conducted with a large sample of 616 undergraduates from Southwest university. From September 2019 to April 2020, three measurements were conducted. RE was tested before the pandemic (T1), and data of mortality threat, negative affect, and overeating were collected at the middle (T2) and end of (T3) the COVID-19 crisis in China. The correlation results showed that baseline RE was positively associated with mortality threat, negative affect, and overeating at T2 and T3. Moreover, negative affect and mortality threat were positively correlated with overeating. Results from longitudinal mediation showed that baseline RE would positively predict T3 overeating through T2 negative affect, but not T2 mortality threat. This study supports and extends the counterregulatory eating hypothesis that RE positively predicts future overeating, especially through negative emotions. These findings further reveal the core psychological mechanism underlying this positive RE-overeating relation in the context of COVID-19, indicating that the individuals with higher RE could not cope with negative affect adequately, contributing to more overeating.
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Cheung V, Aylward L, Tabone L, Szoka N, Abunnaja S, Cox S. Hunger mediates the relationship between food insecurity and binge eating among bariatric surgery candidates. Surg Obes Relat Dis 2021; 18:530-537. [PMID: 35067460 DOI: 10.1016/j.soard.2021.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/13/2021] [Accepted: 12/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The food insecurity-obesity paradox suggests that people lacking access to adequately nutritious foods are more susceptible to disordered eating. However, the mechanisms underlying the relationship between food insecurity and binge eating are not well understood. OBJECTIVES This study sought to assess the role of eating behaviors (i.e., cognitive restraint, disinhibition, and hunger) as mediators between food insecurity and binge eating among a sample of preoperative bariatric candidates. SETTING University hospital in the Appalachian region of the United States. METHODS A total of 369 adults seeking bariatric surgery were included in this cross-sectional study. Patients completed validated measures of food insecurity and eating behaviors as part of a routine psychological evaluation prior to bariatric surgery. RESULTS Food insecurity was significantly related to binge eating symptoms (r[369] = .14, P < .01) and hunger (r[369] = .11, P < .05). Hunger mediated the relationship between food insecurity and binge eating (b = 1.23, standard error = .62, 95% confidence interval .08-2.54). Food insecurity was not associated with restraint (r[369] = .06, P = .27) or disinhibition (r[369] = .02, P = .69). CONCLUSIONS Food insecurity presents a unique pathway to binge eating that has several implications for intervention prior to bariatric surgery. Identification of food insecurity and the subsequent effects on eating behaviors is crucial to understanding the factors relevant to disordered eating prior to bariatric surgery.
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Affiliation(s)
- Vien Cheung
- University of New Mexico Addiction and Substance Abuse Program, Albuquerque, New Mexico.
| | - Laura Aylward
- West Virginia University School of Medicine, Morgantown, West Virginia; Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Lawrence Tabone
- West Virginia University School of Medicine, Morgantown, West Virginia; Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Nova Szoka
- West Virginia University School of Medicine, Morgantown, West Virginia; Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Salim Abunnaja
- West Virginia University School of Medicine, Morgantown, West Virginia; Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Stephanie Cox
- West Virginia University School of Medicine, Morgantown, West Virginia; Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia
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Hagerman CJ, Stock ML, Beekman JB, Yeung EW, Persky S. The ironic effects of dietary restraint in situations that undermine self-regulation. Eat Behav 2021; 43:101579. [PMID: 34800913 PMCID: PMC10124920 DOI: 10.1016/j.eatbeh.2021.101579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
Dietary restraint, defined as the cognitive effort to restrict eating, can paradoxically make individuals more susceptible to unhealthy eating when their ability to self-regulate is threatened. Past experiments have found that, in situations that elicit low self-control and/or unhealthy cravings, participants with higher dietary restraint eat more than those with lower restraint. However, these relationships have never been examined in a free-living environment. The current daily diary study examined if dietary restraint would exacerbate the associations between poor self-control and unhealthy cravings with overconsumption, namely, eating more than usual and binge eating. College women (N = 121, M age = 19) reported their restrained eating behavior and completed seven daily surveys. Multilevel analyses showed a significant interaction between dietary restraint and daily self-control on eating more than usual (b = -0.13, p = .001) and binge eating (b = -0.22, p < .001). Lower daily self-control was associated with eating more than usual and with more binge eating that day, but only among women with higher dietary restraint. Dietary restraint also moderated the effect of cravings on eating more than usual (b = 0.10, p = .007); this relationship was stronger for women with higher restraint. Stronger cravings were associated with more binge eating regardless of restraint. Results suggest that situations that undermine self-control are more strongly associated with overeating among those with higher dietary restraint. Findings can inform strategies to reduce overconsumption among restrained eaters.
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Affiliation(s)
- Charlotte J Hagerman
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA; Weight, Eating, and Lifestyle Science (WELL) Center, Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA.
| | - Michelle L Stock
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Janine B Beekman
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Ellen W Yeung
- Department of Psychological and Brain Sciences, The George Washington University, 2125 G St. NW, Washington, DC 20052, USA
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, Building 31, Room B1B36, 31 Center Dr., MSC 2073, Bethesda, MD 20892, USA
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Validation of the Dutch Eating Behavior Questionnaire in a Romanian Adult Population. Nutrients 2021; 13:nu13113890. [PMID: 34836141 PMCID: PMC8619088 DOI: 10.3390/nu13113890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: Obesity, part of the triple global burden of disease, is increasingly attracting research on its preventive and curative management. Knowledge of eating behavior can be useful both at the individual level (to individualize treatment for obesity) and the population level (to implement more suitable food policies). The Dutch Eating Behavior Questionnaire (DEBQ) is a widely used international tool to assess eating behavior, i.e., emotional, external and restricted eating styles. The aim of this study was to validate the Romanian version of DEBQ, as obesity is a major concern in Romania. (2) Methods: Our study tested the psychometric properties of the Romanian version of DEBQ on an adult population and explored the associations of eating behavior with weight status (3) Results: The study showed a factor load similar to the original version of the questionnaire and a very good internal validity (Cronbach’s alpha fidelity coefficient greater than 0.8 for all scales of the questionnaire) for the Romanian version of DEBQ and showed that all of the scales positively correlated with body mass index in both men and women. (4) Conclusions: This study will enable the use of the DEBQ Romanian version on the adult population of Romania where the findings could be incorporated into developing better strategies to reduce the burden of nutrition-related diseases.
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Hubert PA, Mahoney M, Huedo-Medina TB, Leahey TM, Duffy VB. Can Assessing Physical Activity Liking Identify Opportunities to Promote Physical Activity Engagement and Healthy Dietary Behaviors? Nutrients 2021; 13:3366. [PMID: 34684366 PMCID: PMC8540570 DOI: 10.3390/nu13103366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023] Open
Abstract
Improving our understanding of what physical activities are enjoyed and the factors that are associated with physical activity liking can promote participation in regular physical activity. We aimed to study physical activity (PA) liking in college women by modelling interactions between body size perception and dietary behaviors on PA liking, and by examining discrepancies between PA liking versus engagement on body size perception and dietary behaviors. Women (n = 251; 74% white) utilized an online survey to report their level of liking for PA types (scored into a PA liking index) and frequency of PA participation. They also reported their perceived body size, level of dietary restraint, and frequency of consuming foods (scored into a diet quality index). In multivariate analyses, a greater perceived body size was directly associated with lower PA liking and indirectly through greater dietary restraint but lower diet quality. Healthiest dietary behaviors were reported by women who both liked and engaged in PA. Women who reported high PA liking but low PA participation reported a higher dietary restraint and lower diet quality. These findings support the empowerment of women across all body sizes to identify physical activities that they enjoy. Health promotion efforts should encourage women to couple physical activity liking and engagement with a healthy level of dietary restraint and consumption of a healthy diet.
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Affiliation(s)
| | | | | | | | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (P.A.H.); (M.M.); (T.B.H.-M.); (T.M.L.)
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Watson P, Le Pelley ME. A meta-analysis of the relationship between eating restraint, impaired cognitive control and cognitive bias to food in non-clinical samples. Clin Psychol Rev 2021; 89:102082. [PMID: 34547636 DOI: 10.1016/j.cpr.2021.102082] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 08/10/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
AIM Food restriction is argued to be a precursor for unhealthy preoccupation with food, possibly leading to the development of an eating disorder. We updated previous meta-analyses that examined the relationship between eating restraint and deficits in either general or food-related attentional and inhibitory control. We hypothesized that inconsistencies in the literature around eating restraint, impaired cognitive control, impulsivity and cognitive biases for food could be attributed to the scale used to measure eating restraint. METHOD A (preregistered) subgroup meta-analysis examined whether patterns of impaired cognitive control and cognitive bias for food in predominantly healthy (non-clinical) samples differed as a function of the scale used to measure eating restraint. A series of exploratory meta-analyses were carried out for specific attentional bias tasks. In total 57 datasets were included. RESULTS The subgroup analysis did not provide evidence that the relationship between eating restraint and impaired or biased cognitions differed significantly as a function of restraint scale. Heterogeneity across studies was high. When examining specific attentional bias tasks there was no evidence that increased eating restraint was associated with increased attentional bias or distraction by food cues, regardless of which scale was used to measure eating restraint. CONCLUSIONS There is little experimental evidence for the common narrative that increased eating restraint is related to impaired cognitive control generally or increased cognitive bias for food, in non-clinical samples.
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