Friend or foe? A qualitative study exploring the relationship of people with obesity and food consumption

Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity

INTRODUCTION

Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change.

METHODS

Nineteen adults with a history of obesity living in the United Kingdom were interviewed through video conferencing between May 2020 and March 2021. Semi-structured interviews and socio-demographic questionnaires were used, and data analysed through hermeneutic phenomenology informed reflexive thematic analysis.

RESULTS

Three main themes were created: living with convenience and normalcy: the increased accessibility of unhealthy food, people interacting with digital media for positive practice change, and the need to prioritise prevention in schools, the National Health Service and the food industry.

CONCLUSIONS

The food environment was the major barrier, while interactions with social media was the most important opportunity to adopt healthy practices. The National Health Service was considered an obesogenic environment, something relevant since it has been traditionally recognised as an obesity management system. The perceptions from individuals with a history of obesity provide new suggestions on the influence of previously overlooked environments to design more adequate and effective interventions and policies that consider, more than in the past, the environments where people spend their lives.

Methods to assess ambivalence towards food and diet: a scoping review

BACKGROUND

Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects.

METHODS

In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet.

RESULTS

We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire.

CONCLUSION

This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

Consideration of nutrients of public health concern highlighted in the Dietary Guidelines for Americans 2020-2025 among a large sample of US primary shoppers

The objective of this research is to estimate the proportion of consumers who consider nutrients identified in the Dietary Guidelines for Americans 2020-2025 (DGA) as being of public health concern during food choice using a large, population-weighted sample of U.S. residents. A question was included in a bi-monthly survey of consumer scanner panel members, asking whether respondents considered each of eight nutrients in a check-all-that-apply format. Four of these nutrients are under-consumed nutrients, while three are nutrients to avoid. Calories was additionally included, as over-consumption of calories causes weight gain. Weighted mean proportions and 95% confidence intervals were estimated. The survey was administered to a population-weighted sample of 42,018 US consumers participating in a consumer scanner panel in May-June 2021 by an online survey firm that maintains the consumer panel. Over one-quarter of respondents considered none of the nutrients. Each under-consumed nutrient of public health concern was considered by less than 30% of respondents, ranging from a low of 14.5% for potassium (95%CI = 14.3-14.7%) to a high of 28.9% for dietary fiber (95%CI = 28.7-29.1%). Nutrients to be avoided were considered by higher percentages of the sample, ranging from 31.8% for saturated fats (95%CI = 31.6-32.0%) to 46.1% for added sugars (95%CI = 45.8-46.3%). Respondents considered an average of just over 2.4 total nutrients, with a greater focus on nutrients to avoid, including calories (weighted mean = 1.55), than under-consumed nutrients (weighted mean = 0.89). Over one-quarter of consumers considered no nutrients of public health concern. Consumers focused more on nutrients to avoid rather than under-consumed nutrients. Promoting increased awareness of important under-consumed nutrients may improve public health.

The perceived role of food and eating among turkish women with obesity: A qualitative analysis

The studies show the link between Body Mass Index (BMI) and higher food responsiveness despite negative physical, social, and psychological outcomes. The descriptive studies examining what makes individuals with higher BMI values more likely to respond to food are limited, while there is none in the Turkish sample. This study aims to understand the subjective relationship of women with obesity/overweight related to food in Turkish culture. Turkish adult women (aged 22-54) who have BMI higher than 25 (overweight/obesity) participated in semi-structured interviews focusing on how they relate to food and obesity. Participants were reached through Ankara Etlik Zübeyde Hanım Obstetrics and Gynecology Hospital Obesity outpatient service. Audio-recorded interviews were analyzed predominantly inductively by thematic analysis principles. Analysis of these interviews reflected three main themes: (1) the act of eating: "I don't know why I eat when I'm full", (2) being overweight: "I am the kind of person who constantly tries to lose weight", and (3) sources of distress. The results indicated the dynamic relationship between the desire to eat, chronic stress, perceived unavailability of close ones, and low sense of self-worth among adult women with obesity/overweight. The other indication is the effect of culture in shaping the relationship dynamics, the sources of distress, and the eating patterns in developing and maintaining obesity.