Daily self-weighing compared with an active control causes greater negative affective lability in emerging adult women: A randomized trial

Age-related weight gain prevention may reduce population overweight/obesity. Emerging adulthood is a crucial time to act, as rate of gain accelerates and health habits develop. Evidence supports self-weighing (SW) for preventing weight gain; however, how SW impacts psychological states and behaviors in vulnerable groups is unclear. This study assessed daily SW effects on affective lability, stress, weight-related stress, body satisfaction, and weight-control behaviors. Sixty-nine university females (aged 18-22) were randomized to daily SW or temperature-taking (TT) control. Over 2 weeks, participants completed five daily ecological momentary assessments with their intervention behavior. A graph of their data with a trendline was emailed daily, with no other intervention components. Multilevel mixed models with random effect for day assessed variability in positive/negative affect. Generalized linear mixed models assessed outcomes pre- and post-SW or TT and generalized estimating equations assessed weight-control behaviors. Negative affective lability was significantly greater for SW versus TT. While general stress did not differ between groups, weight-related stress was significantly higher and body satisfaction was significantly lower post-behavior for SW but not TT. Groups did not significantly differ in the number or probability of weight-control behaviors. Caution is advised when recommending self-weighing to prevent weight gain for emerging adults.

The relationship between cannabis and anorexia nervosa: a scoping review

BACKGROUND

Relapse rates in Anorexia Nervosa (AN) remain high, warranting exploration of further treatments. Cannabinoid agonists are of interest as they have shown successful outcomes in the treatment of associated conditions, such as post-traumatic stress disorder. This scoping review explores the endocannabinoid system (ECS), benefits/harms/null effects of cannabinoid treatment, and harms of cannabis use in AN.

METHODS

PubMed, PsycINFO, Cochrane, and Web of Science were searched for studies published between 2010 and August 2023, with human participants that explored the ECS, cannabinoid treatment, or cannabis use, and included 1 or more keywords for both cannabis and AN in the title and or abstract. Reports describing secondary anorexia, reports not available in English, grey literature, reports combining data from AN with other conditions, and reports only reporting the prevalence of cannabis abuse/dependence were excluded. Data were extracted from 17 reports (n = 15 studies). For the ECS, outcomes included genetics such as allele expression related to the ECS, cannabinoid receptor availability, and circulating levels of endocannabinoids. For benefits/harms/null effects of cannabinoid treatment, outcomes included changes in weight, eating disorder (ED) symptoms, physical activity (PA), and hormones. For harms of cannabis use, outcomes included genetics related to cannabis use disorder and associations between cannabis use and ED symptoms.

RESULTS

Eight studies (n = 8 reports) found abnormalities in the ECS in AN including expression of related alleles, genotypes, and haplotypes, availability of cannabinoid receptors, and levels of endocannabinoids. Three studies (n = 5 reports) found benefits/harms/null effects of cannabinoid treatment. Benefits included weight gain, improved ED symptoms and reduced PA, while null effects included no changes in weight or ED symptoms, and harms included increased PA and lowered adipose hormones. Four studies (n = 4 reports) expanded upon harms of cannabis use, including genetic predispositions to cannabis use disorder, and compensatory behaviors related to cannabis use.

CONCLUSION

Limited evidence suggests that abnormalities in the ECS in AN may render cannabis a potential treatment for weight restoration and associated symptoms. Future research may wish to investigate individualized dosing approaches to maximize beneficial effects while minimizing harms. Level II Evidence: Scoping Review.

Are child maltreatment and intimate partner violence associated with adult disordered eating?

OBJECTIVE

Disordered eating is one of the most prevalent mental health concerns (Galmiche et al., 2019, Quick & Byrd-Bredbenner, 2013, Neumark-Sztainer et al., 2006). Studies show that child maltreatment increases the likelihood of disordered eating symptoms in adulthood (Caslini et al., 2016, Hazzard et al., 2019). However, these studies overlook abuse experiences later in life, such as intimate partner violence which may also be a significant contributing factor (Bundock et al., 2013). The proposed study will help identify whether childhood maltreatment and IPV are independent predictors and/or if the combination of the two are synergistic risk factors for adult disordered eating.

METHOD

We use data from 14,332 people from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants completed questionnaires assessing child maltreatment, intimate partner violence, and disordered eating symptoms. We will perform a series of logistic regression models to examine a) whether child maltreatment and intimate partner violence are independently associated with disordered eating and b) whether exposure to the combination of both child maltreatment and intimate partner violence is associated with worse outcomes for adult disordered eating compared to exposure to only one or none at all. We also propose a supplemental analysis to establish the robustness of these effects when accounting for the highest parental education, federal poverty percentage level, race/ethnicity, gender, and age.

PUBLIC SIGNIFICANCE

Disordered eating is a serious mental health concern, especially in an emerging adult population. Child maltreatment is consistently associated with disordered eating in adulthood. However, the independent or synergistic role of more recent abuse experiences, such as intimate partner violence, remains largely unknown. The proposed study provides insight into how both childhood abuse and intimate partner violence may be associated with disordered eating independently or in combination.

The impact of time restricted eating on appetite and disordered eating in adults: A mixed methods systematic review

This mixed-methods systematic review evaluated the effect of Time Restricted Eating (TRE) on adult participants' experience of hunger, appetite, and disordered eating. PubMed, CINAHL Plus with Full Text, PscyINFO, and Web of Science were searched for quantitative and qualitative original research articles in human adults that had an intervention with a daily eating window of ≤12 h and outcome measures related to hunger, appetite, or disordered eating. Differences in quantitative measures during TRE and qualitative themes were summarized. Qualitative and quantitative data were synthesized by assessing for convergence and divergence. Sixteen studies were included. TRE was associated with higher appetite at bedtime, and lower or unchanged morning fasting appetite. Evening results were mixed. Disordered eating questionnaires were not different as a result of TRE except in one study that found TRE associated with lower hunger. Qualitative themes converged with these findings, however also showed fear of hunger, eating in the absence of hunger, and eating-related stressors. TRE did not result in major changes to appetite or disordered eating symptoms. Bedtime hunger was higher in TRE. Assessment of subtle alterations in eating behavior, such as eating in the absence of hunger, would be beneficial for future research and intervention design.

Impact of an Intuitive Eating Intervention on Disordered Eating Risk Factors in Female-Identifying Undergraduates: A Randomized Waitlist-Controlled Trial

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.

Testing Theory-Based Expressive Writing Interventions to Reduce Disordered Eating Behaviors and Cognitions

Disordered eating includes both behaviors and cognitions and can cause many of the same negative health outcomes as clinically diagnosed eating disorders (e.g., growth retardation, nutritional deficiencies, and psychosocial disturbances). Compared to the general population, disordered eating is more common in college-age women. An experiment was conducted to test 8 expressive writing interventions in the context of disordered eating. Interventions were drawn from theory-based prevention programs, which included cognitive behavioral therapy, peer and media risk reduction, and cognitive dissonance theory. Dependent variables included emotions (e.g., sadness and hope), evaluation of the expressive writing interventions (e.g., engagement, clarity, ease, and interest), and re-evaluation of disordered eating behaviors and cognitions. Results show that 62.90% of participants had observed disordered eating in their peers. Sadness, with an action tendency related to increased inward evaluation, was the most typical emotional response upon completion of the expressive writing tasks. Interventions that were based on the principles of cognitive behavioral therapy led to the most positive outcomes including engagement and re-evaluation of current disordered eating behaviors and cognitions. Overall, it was concluded that expressive writing interventions are effective in eliciting emotions and causing a re-evaluation of harmful behaviors and cognitions in the context of disordered eating.

Self-weighing behavior in individuals with binge-eating disorder

This study examined self-weighing behaviors and correlates in patients with BED. Hypotheses: (1) women would weigh more frequently than men, (2) > weekly weighers would have higher restraint scores than < weekly weighers, (3) the self-weighing-restraint relationship would be stronger in women, (4) self-weighing frequency would be inversely related to BMI, and (5) self-weighing frequency and depression would be independently but not interactively related to BMI. The EDE, administered by trained doctoral-level interviewers, assessed self-weighing and eating-disorder psychopathology in 423 treatment-seeking individuals meeting DSM-5 BED criteria. Self-weighing frequency (1) did not differ by gender (Wald = 1.3; p = .3). (2) > weekly weighers reported significantly higher restraint (2.0±1.2 versus 1.6±1.3; t(421) = 3.1, p = .02). (3) No significant gender*self-weighing interaction on restraint (p = .99). (4) Self-weighing is inversely correlated with BMI (rho = -0.20; p < .001). 5) Self-weighing nor depression, nor self-weighing*depression interaction predicted BMI (p = .51). These analyses lay the groundwork for further investigation of the role of self-weighing in BED treatment.

Self-weighing among young adults: who weighs themselves and for whom does weighing affect mood? A cross-sectional study of a population-based sample

BACKGROUND

Self-weighing is widespread among young adults and is sometimes recommended by healthcare providers for weight management. The present study aims to deepen our understanding of who is frequently self-weighing among young adults, and to examine for whom self-weighing impacts mood based on weighing frequency and other eating and weight-related characteristics.

METHODS

Survey data were collected from a large population-based sample of young adults (31.1 ± 1.6y) participating in Project EAT-IV (n = 1719). Cross-sectional data were stratified across sex and analyzed with chi-square, t-tests, and linear and logistic regressions controlling for age, ethnicity/race, education level, and income.

RESULTS

Self-weighing frequency was higher among male and female young adults with a current eating disorder, those trying to lose weight or who endorsed any disordered eating behaviors or cognition, and females with higher BMI. Young adult females were significantly more likely than males to report that self-weighing impacted their mood (53% vs 27%, p < 0.05). Among both male and female young adults, there was a higher probability of participants reporting that self-weighing impacted their mood among those who were self-weighing more frequently, had higher BMI, were trying to lose weight, and endorsed disordered eating behaviors or cognitions.

CONCLUSION

Findings suggest that for many young adults, particularly females and those with weight-related concerns, self-weighing is a behavior that comes with emotional valence. The emotional consequences of self-weighing should be considered when making public health and clinical recommendations regarding the usefulness of self-weighing.

Yoga's impact on risk and protective factors for disordered eating: a pilot prevention trial

Yoga has been proposed as a strategy for improving risk and protective factors for eating disorders, but few prevention trials have been conducted. The purpose of this pilot study was to assess the feasibility and acceptability of a yoga series in female college students (n = 52). Participants were randomized to a yoga intervention (three 50-minute yoga classes/week for 10 weeks conducted by certified yoga teachers who received a 3-day intensive training) or a control group. Risk and protective factors, assessed at baseline, 5 and 10 weeks, included body dissatisfaction, negative affect, loneliness, self-compassion, positive affect, and mindfulness. Mixed models controlling for baseline levels of outcome variables were run. On average, participants attended 20 out of 30 yoga classes, and the majority of participants reported high levels of satisfaction with the yoga series. Appearance orientation decreased and positive affect increased in the yoga group relative to the control group. After controlling for baseline levels, the yoga group had a significantly higher positive affect than the control group. Changes in other outcomes were not statistically significant, as compared to the control condition. Future yoga research directions are discussed including education about body image, measure and sample selection, and use of an implementation science framework.

Self-Weighing and Visual Feedback Facilitates Self-Directed Learning in Adults Who Are Overweight and Obese

OBJECTIVE

Understanding how and why self-weighing works for some individuals but not others in weight management is vital. This study investigated how self-weighing and tracking of weight using a Web site facilitated a self-directed learning process in overweight or obese adults interested in losing weight.

DESIGN

Semistructured interviews with study completers (n = 47) and voluntary withdrawals (n = 10) about their experience after 6 and 12 months of using the program or when they withdrew.

ANALYSIS

Qualitative, guided by self-directed learning theory.

RESULTS

Although both completers and those who withdrew engaged in self-directed learning, often exemplifying the same concepts (eg, instrumental learning), experiences described a positive sense of control over weight in completers and a lack of sense of control in those who withdrew.

CONCLUSIONS AND IMPLICATIONS

Overall, it seemed that frequent self-weighing and visual feedback of body weight over time facilitated a self-directed learning process in both completers and those who withdrew. This research provides a rich understanding of how adults use self-weighing to facilitate self-directed learning for weight loss. Future studies assessing how self-weighing and visual displays of weight facilitate a self-directed learning process in diverse populations and age groups are necessary to better understand how self-weighing works and for whom self-weighing is beneficial.

Social anxiety symptoms moderate the link between obesity and metabolic function

BACKGROUND

Obesity is a well-known risk factor for elevated inflammation and insulin resistance. Social anxiety may moderate this relationship, such that individuals who areboth obese and socially anxious may have an even greater risk for elevated inflammation and insulin resistance than those who are obese but not socially anxious; the combination of obesity and social anxiety is markedly stressful.

METHODS

The current paper reports secondary analyses from the Biomarker wave of the Mid-Life in the United States (MIDUS) study (N = 1255), a publicly available dataset of American adults. Participants completed a standard scale measuring social anxiety symptoms and had their waist circumference, height, and weight measured by a staff member. They also provided a fasting blood sample that was assayed for CRP, IL-6, HOMA-IR, glucose, and insulin.

RESULTS

The interaction between obesity and social anxiety symptoms was significant. People with a larger waist circumference and more social anxiety symptoms had greater inflammation and insulin resistance relative to those with a larger waist circumference but less social anxiety symptoms. These results were similar for both measures of inflammation and were robust across both the unadjusted and adjusted models. The results were also largely replicated in models using body mass index (BMI) rather than waist circumference as the measure of obesity.

CONCLUSIONS

The current findings build on existing work about the health risks of obesity, extending it in an important new direction by demonstrating that these health risks are stronger among those who are also socially anxious. In fact, the magnitude of the relationship between obesity and metabolic function is 1.5 times stronger among those with more social anxiety symptoms. Thus, knowing whether a person is obese only provides one piece of the puzzle; knowing information about both obesity and social anxiety symptoms is critical for understanding who is most at risk for obesity-related health problems. Thus, a critical next step is for intervention scientists to examine health programs tailored to people who are both obese and socially anxious.

Psychological status and weight variability over eight years: Results from Look AHEAD

OBJECTIVE

Cross-sectional studies suggest an association between weight cycling and psychological status. Although this is often interpreted as suggesting that weight cycles "cause" psychological distress, the relationship could be bidirectional. This study provides a prospective analysis of the bidirectional association between weight variability and psychological status over an 8-year period in overweight/obese adults with Type 2 diabetes.

METHOD

Data were from the first 8 years of Look AHEAD, a randomized controlled trial comparing health outcomes in individuals with Type 2 diabetes assigned to an intensive lifestyle intervention designed to produce weight loss or a diabetes education and support control group. Psychological status (mental health, depressive symptoms, binge eating) was assessed via surveys and were examined in relation to weight variability at both baseline and year 8. Weight variability was derived from 8 possible annual measurements from participants who had a minimum of 3 consecutive body weight measurements (N = 4,774) and operationalized as the number of year-to-year cycles and the coefficient of variation across all available weight measurements.

RESULTS

Controlling for study group, higher baseline scores on mental health (Short Form-36 Mental Component Summary) and lower levels of depressive symptomatology (Beck Depression Inventory) and binge eating (Questionnaire on Eating and Weight Patterns) were associated with significantly less subsequent weight variability. The prospective association between weight variability and psychological status at year 8 was less robust.

CONCLUSIONS

These results suggest that the cross-sectional relationship between weight variability and psychological status is due primarily to poorer psychological function preceding greater weight instability. (PsycINFO Database Record

Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors

OBJECTIVE

Treatment for binge eating disorder (BED), a condition associated with both excess adiposity and psychological distress, has not typically produced significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment.

METHODS

In this study, 189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5 months of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end of treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires.

RESULTS

During treatment, there was a mean weight gain of 1.3 ± 12.0 lb. Twenty-two percent of the sample lost ≥ 5 lb, and 25% of the sample gained ≥ 8 lb. Results showed that baseline objective binge eating episodes predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in objective binge eating episodes from baseline to EOT were associated with changes in weight from EOT to follow-up.

CONCLUSIONS

Further investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted.

Yoga and body image: Findings from a large population-based study of young adults

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.

Contextual factors associated with eating in the absence of hunger among adults with obesity

Eating in the absence of hunger (EAH) is under-explored in adults with obesity. In this study, 50 adults with obesity recorded eating episodes and theoretically-relevant environmental, perceptual, and emotional correlates in the natural environment for 2weeks via ecological momentary assessment (EMA). Generalized linear models and mixed models were used to characterize correlates and consequences of EAH vs. non-EAH episodes/tendencies (within-subjects and between-subjects effects, respectively), time of day, and time of day×EAH interactions. Approximately 21% of EMA-recorded eating episodes involved EAH, and 70% of participants reported at least 1 EAH episode. At the within-person level, participants' EAH episodes were associated with greater self-labeled overeating than their non-EAH episodes. At the between-person level, participants who tended to engage in more EAH reported less self-labeled overeating than those who engaged in less EAH. Across EAH and non-EAH episodes, eating in the evening was associated with overeating, expecting eating to be more rewarding, greater alcoholic beverage consumption, eating alone, eating because others are eating, and eating while watching television. Significant EAH×time of day interactions were also observed but the pattern of findings was not consistent. Findings suggest that EAH may be a relevant target for reducing food intake in individuals with obesity given its high prevalence and association with perceptions of overeating, although results should be extended using objective measures of food intake. Associations between evening eating episodes and perceptual and environmental factors should be further explored.

Evaluating the Ecological Validity of the Dutch Eating Behavior Questionnaire Among Obese Adults Using Ecological Momentary Assessment

This study evaluated the ecological validity (i.e., accurate measurement of a construct as experienced in naturalistic settings) of the self-report Dutch Eating Behavior Questionnaire (DEBQ). Obese adults (N = 50) completed the DEBQ, followed by a 2-week ecological momentary assessment protocol that included measures of eating episodes and associated intrapersonal contextual factors. Results revealed that DEBQ Emotional Eating was associated with greater negative affect and less positive affect at both pre- and post-eating episode, as well as post-eating ratings of feeling driven to eat. DEBQ External Eating was positively associated with pre-eating expectations about enjoying the taste of food, but was unrelated to actual enjoyment reported post-eating; External Eating was positively associated with the post-eating ratings of feeling driven to eat. DEBQ Dietary Restraint was positively associated with pre-eating intentions to eat less to lose/avoid gaining weight. Overall, results provide some support for the ecological validity of the DEBQ.

Yoga in the treatment of eating disorders within a residential program: A randomized controlled trial

To investigate the effect of yoga on negative affect (an eating disorders risk factor), 38 individuals in a residential eating disorder treatment program were randomized to a control or yoga intervention: 1 hour of yoga before dinner for 5 days. Negative affect was assessed pre- and post-meal. Mixed-effects models compared negative affect between groups during the intervention period. Yoga significantly reduced pre-meal negative affect compared to treatment as usual; however, the effect was attenuated post-meal. Many eating disorders programs incorporate yoga into treatment. This preliminary evidence sets the stage for larger studies examining yoga and eating disorder treatment and prevention.

Three-Year Follow-Up of Participants from a Self-Weighing Randomized Controlled Trial

Frequent self-weighing is associated with weight loss maintenance. Several years ago, we investigated frequent self-weighing's effect on weight loss and found the participants lost a significant amount of weight. Three years after this trial's end, participants were contacted for an update on their weight and self-weighing frequency. Weight change and self-weighing frequency since the end of the study were assessed. We hypothesized that participants who maintained frequent self-weighing behavior would have maintained their weight loss. Out of 98 participants enrolled in the RCT, 37% (n = 36) participated in this follow-up study. Total weight loss during the trial for the follow-up participants was 12.7 ± 19.4 lbs (p < 0.001). Three years after intervention, participants regained 0.9 ± 4.34 lbs, a value that was not statistically different from zero (p = 0.75). This did not differ by gender (p = 0.655). Over 75% of these participants continued to weigh themselves at least once a week. Frequent self-weighing may be an effective, low-cost strategy for weight loss maintenance. Future research should further investigate the role of self-weighing in long-term weight gain prevention.

Self-weighing behavior in individuals with eating disorders

OBJECTIVE

To describe the frequency of self-weighing and reactions to prescribed weekly weighing among individuals with eating disorder (ED) diagnoses, and to compare individuals weighing more or less frequently on mass index (BMI) and the Eating Disorder Examination (EDE) subscales.

METHOD

Baseline EDE and demographics from five studies (N = 758).

RESULTS

Self-weighing was most frequent among individuals with anorexia nervosa (AN), followed by those with bulimia nervosa (BN) and binge eating disorder (BED). On average, participants reacted moderately negative to prescribed weekly weighing. No relationship between weighing frequency and BMI was evident in any sample. There was indication of greater pathology (i.e., restraint, shape concern, weight concern, global) in AN with more frequent weighing. In BN, mixed evidence emerged to support a relationship between more frequent weighing and higher shape concern, weight concern, and global score. In BED, higher restraint was found in those who weighed versus those who did not.

DISCUSSION

Weighing frequency in each eating disorder (ED) sample was to some extent associated with greater ED severity, but not BMI. Future research should examine relationships between self-weighing, reactions to changing weighing frequency, and ED symptomatology in both ED and non-ED groups to understand the impact of self-weighing in heterogeneous populations. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:817-821).

Self-Weighing Throughout Adolescence and Young Adulthood: Implications for Well-Being

OBJECTIVE

To describe the prevalence of self-weighing in the transition period from adolescence to young adulthood and examine cross-sectional and longitudinal associations between self-weighing and weight status, psychological, and behavioral outcomes.

DESIGN

Project Eating and Activity in Teens and Young Adults, a longitudinal cohort study that assessed variables 3 times over 10 years.

PARTICIPANTS

A total of 1,868 adolescents and young adults.

MAIN OUTCOME MEASURES

Weight, body mass index, weight disparity, body satisfaction, weight concern, self-esteem, depression, and unhealthy weight control behaviors.

ANALYSIS

Cross-sectional and longitudinal.

RESULTS

Significant positive correlations were found at each time point between self-weighing and weight concern for both genders. Self-weighing was significantly inversely related to self-esteem at each time point in female participants. Increases in endorsement of self-weighing were significantly related to decreases in body satisfaction and self-esteem and increases in weight concern and depression in female participants and to increases in weight concern in male participants.

CONCLUSIONS AND IMPLICATIONS

Findings suggest that self-weighing may not be an innocuous behavior for young people, particularly women. Interventions should assess potential harmful consequences of self-weighing in addition to any potential benefits. It may be appropriate for clinicians to ask about self-weighing, and if it is frequent, to explore motivations, perceived benefits, and potential adverse correlates or consequences.

Frequent Self-Weighing with Electronic Graphic Feedback to Prevent Age-Related Weight Gain in Young Adults

OBJECTIVE

An intervention using Wi-Fi scales and graphic e-mail feedback, the caloric titration method (CTM), to reduce age-related weight gain over 1 year among college students was evaluated.

METHODS

First-year college students (n = 167) were randomized to CTM or control (C) groups and provided Wi-Fi scales. The CTM group was instructed to weigh daily, view a weight graph e-mailed to them after weighing, and try to maintain their weight. The C group could weigh at any time but did not receive feedback. At 6 months and 1 year, the C group provided weights. For intention to treat analysis, an adjusted mixed model was used to analyze the effect of the intervention.

RESULTS

Baseline body mass index was 22.9 ± 3.0 kg/m(2) . Ninety-five percent of the CTM participants weighed ≥ 3 times/week, compared to 15% in the C group (P < 0.001). After 1 year, the C group had gained 1.1 ± .4 kg whereas the CTM group lost 0.5 ± 3.7 kg (F = 3.39, P = 0.035). The difference in weight change between the two groups at 1 year was significant (P = 0.004). Retention was 81%.

CONCLUSIONS

CTM intervention was effective in preventing age-related weight gain in young adults over 1 year and thus offers promise to reduce overweight and obesity.

Mediation of Weight Loss and Weight Loss Maintenance through Dietary Disinhibition and Restraint

Understanding the degree to which eating behaviors, such as disinhibition and restraint, are associated with weight loss and weight loss maintenance could contribute to further refinement of effective weight management intervention strategies. The purpose of this analysis was to examine if these factors mediate weight loss or weight loss maintenance using data from a randomized controlled trial testing a commercial weight loss program that delivered behavioral counseling and structured meal plans including prepackaged foods. Mediation analyses were used to examine whether changes in disinhibition and restraint mediated the relationship between intervention and weight change during initial weight loss (0-6 months), continued weight loss (6-12 months), or weight loss maintenance (12-24 months) phases. Only decreases in disinhibition between baseline and 6 months mediated the intervention effect on initial weight loss. Our results suggest the mediation effects of these eating behaviors are modest and other factors contribute to a larger, more complex long-term weight loss prognosis.

Does measuring body weight impact subsequent response to eating behavior questions?

OBJECTIVES

If being weighed impacts perceptions of eating behavior, it is important that the order of questionnaires and weighing be considered in research and practice. A quasi-experimental study was performed to examine whether being weighed immediately prior to completing a questionnaire affects responses to eating behavior questions. It was hypothesized that being weighed would serve as a priming stimulus and increase measures of dietary restraint, disinhibition, and hunger.

METHODS

Trained researchers collected a sample of volunteers (n = 355) in 8 locations in the United States on two Saturdays in the summer of 2011. Half of the participants were weighed immediately prior to completing the Three Factor Eating Questionnaire (TFEQ), with the remaining half weighed immediately after TFEQ completion.

RESULTS

A priori hypotheses were not supported despite replicating known relationships between weight, dietary restraint and disinhibition. Results indicated that being weighed first produced a difference in differences on disinhibition scores between low restraint score (95% CI = 4.65-6.02) and high restraint score (95% CI = 6.11-7.57) compared to being weighed after questionnaire completion (p = 0.003). However, this relationship was not significant when modeling restraint as a continuous variable, questioning the use of dichotomization.

CONCLUSIONS

Being weighed is unlikely to be a strong enough prime to significantly change scores on eating behavior questionnaires for everyone, but may allow differences in restraint status to become more evident. Researchers assessing dietary restraint should be wary of the possibility of producing different results when treating restraint as continuous or dichotomous, which could lead to different interpretations.

Self-Weighing: Helpful or Harmful for Psychological Well-Being? A Review of the Literature

Conflicting views as to the helpfulness or harmfulness of self-weighing for the control of body weight have been presented in the fields of obesity and eating disorders. Because self-weighing is increasingly being considered as an intervention to promote weight loss or prevent weight gain, it is timely to consider unintended psychological outcomes and behavioral correlates of this behavior. Twenty articles from the published literature examining self-weighing and psychological outcomes or weight control behaviors were reviewed. In evaluating self-weighing and affect (ten studies), self-esteem (four studies) and body evaluation (ten studies), and eating behaviors/cognitions (13 studies), in total, most studies found a negative relationship between self-weighing and outcomes (affect: 4/10, self-esteem: 3/4, body evaluation: 4/10, eating behaviors/cognitions: 6/13). Themes that emerged included relationships between self-weighing and negative outcomes for women and younger individuals, and lack of a relationship or positive outcomes for overweight, treatment seeking individuals. Though self-weighing has shown promise in aiding weight control, the degree to which weight loss, and not self-weighing, affects psychological outcomes is not clear. Further assessment of psychological outcomes in self-weighing research may be warranted, as this review suggests the potential for adverse effects of self-weighing in some individuals.

Frequent Self-Weighing and Visual Feedback for Weight Loss in Overweight Adults

Evidence has suggested that self-weighing may be beneficial for weight control in adults, but few studies have independently assessed the contribution of this behavior to weight loss. This study experimentally tested daily self-weighing and visual feedback (the Caloric Titration Method (CTM)) as a weight loss and weight loss maintenance intervention over 2 years. 162 overweight individuals were randomized to the CTM intervention or delayed treatment control group. In year 1, weight change was compared between groups, and in year 2, the control group started using the CTM while the intervention group continued using the CTM for maintenance. A significant difference in weight loss over the first year (CTM n = 70; 2.6 ± 5.9 kg versus control n = 65; 0.5 ± 4.4 kg, p = 0.019) was qualified by a group × gender × time interaction (p = 0.002) such that men lost more weight using the CTM. In year 2, the CTM group maintained their weight and the control group lost an amount similar to the intervention group in year 1. Daily self-weighing and visual feedback facilitated a minimal amount of weight loss and maintenance of this loss. Future research investigating characteristics of those who benefit from this type of self-directed intervention is warranted.

Weighing frequency among working adults: cross-sectional analysis of two community samples

OBJECTIVE

Self-weighing frequency is associated with lower body weight and less weight gain. This study describes self-weighing frequency in two samples of working adults from different fields: office-based and transit employees.

METHODS

Self-weighing frequency and demographic information were self-reported at baseline measurement of two worksite interventions. Data were collected from transit employees (n= 1479) enrolled in a worksite intervention between October and December of 2005 and office based employees (n=1747) in another worksite intervention between January 2006 and April 2007 in the Minneapolis, MN and St. Paul, MN metropolitan area. Trained staff measured height and weight. Multinomial logistic regression models examined associations between self-weighing frequency and body mass index, study sample, and gender adjusting for age, race, and education.

RESULTS

Odds ratios showed self-weighing frequency was significantly different between overweight and obese categories and between study samples. Office-based employees self-weighed more frequently than transit employees. Overweight employees self-weighed more frequently than obese employees.

CONCLUSION

While self-weighing outcomes and associations with obesity prevention and weight loss are still under investigation, these results may help in improving obesity intervention planning and informing worksite weight management programs by identifying how often working adults naturally engage in this behavior prior to weight loss interventions.

The Tracking Study: description of a randomized controlled trial of variations on weight tracking frequency in a behavioral weight loss program

BACKGROUND

Observational evidence from behavioral weight control trials and community studies suggests that greater frequency of weighing oneself, or tracking weight, is associated with better weight outcomes. Conversely, it has also been suggested that frequent weight tracking may have a negative impact on mental health and outcomes during weight loss, but there are minimal experimental data that address this concern in the context of an active weight loss program. To achieve the long-term goal of strengthening behavioral weight loss programs, the purpose of this randomized controlled trial (the Tracking Study) is to test variations on frequency of self-weighing during a behavioral weight loss program, and to examine psychosocial and mental health correlates of weight tracking and weight loss outcomes. This paper describes the study design, intervention features, recruitment, and baseline characteristics of participants enrolled in the Tracking Study.

METHODS/DESIGN

Three hundred thirty-nine overweight and obese adults were recruited and randomized to one of three variations on weight tracking frequency during a 12-month weight loss program with a 12-month follow-up: daily weight tracking, weekly weight tracking, or no weight tracking. The primary outcome is weight in kilograms at 24 months. The weight loss program integrates each weight tracking instruction with standard behavioral weight loss techniques (goal setting, self-monitoring, stimulus control, dietary and physical activity enhancements, lifestyle modifications); participants in weight tracking conditions were provided with wireless Internet technology (wi-fi-enabled digital scales and touchscreen personal devices) to facilitate weight tracking during the study.

CONCLUSION

This study was successful in recruiting adult male and female participants and is positioned to enhance the standard of care with regard to weight tracking recommendations.

Daily Self-Weighing to Control Body Weight in Adults: A Critical Review of the Literature

The objective of this study is to review the history of daily self-weighing for weight control, discuss the possibility that self-weighing may cause adverse psychological symptoms, and propose mechanisms that explain how self-weighing facilitates weight control. A systematic forward (citation) tracking approach has been employed in this study. In the early literature, experimental tests did not demonstrate a benefit of adding daily self-weighing to traditional behavioral modification for weight loss. More recent studies have shown that daily self-weighing combined with personalized electronic feedback can produce and sustain weight loss with and without a traditional weight loss program. Daily self-weighing appears to be effective in preventing age-related weight gain. Apart from these experimental findings, there is considerable agreement that the frequency of self-weighing correlates with success in losing weight and sustaining the weight loss. The early literature suggested frequent self-weighing may be associated with negative psychological effects. However, more recent experimental trials do not substantiate such a causal relationship. In conclusion, daily self-weighing may be a useful strategy for certain adults to prevent weight gain, lose weight, or prevent weight regain after loss. More research is needed to better understand the role of different types of feedback, who benefits most from self-weighing, and at what frequency.

Binge eating behavior and weight loss maintenance over a 2-year period

OBJECTIVE

To investigate the relationship between binge eating behavior and weight loss maintenance over a two-year period in adults.

DESIGN

Secondary data analysis using the Keep It Off study, a randomized trial evaluating an intervention to promote weight loss maintenance.

PARTICIPANTS

419 men and women (ages: 20 to 70 y; BMI: 20-44 kg/m2) who had intentionally lost ≥10% of their weight during the previous year.

MEASUREMENTS

Body weight was measured and binge eating behavior over the past 6 months was reported at baseline, 12 months and 24 months. Height was measured at baseline.

RESULTS

Prevalence of binge eating at baseline was 19.4% (n = 76). Prevalence of binge eating at any time point was 30.1% (n = 126). Although rate of weight regain did not differ significantly between those who did or did not report binge eating at baseline, binge eating behavior across the study period (additive value of presence or absence at each time point) was significantly associated with different rates of weight regain.

CONCLUSION

Tailoring weight loss maintenance interventions to address binge eating behavior is warranted given the prevalence and the different rates of weight regain experienced by those reporting this behavior.

Number of foods available at a meal determines the amount consumed

The number of foods available at a meal has been suggested as a major determinant of the amount consumed. Two studies conducted in humans test this idea by altering the number of foods available at a meal where participants eat the available foods ad libitum. In Study 1, dinner intake of twenty-seven young adults was measured. The amount consumed was measured when subjects were served either: (a) a composite meal (a protein rich food, a carbohydrate rich food, and a vegetable), (b) a low carbohydrate meal (protein rich food and vegetable), or (c) a vegetarian meal (carbohydrate rich food and vegetable). In Study 2, twenty-four subjects were given two different meals presented either as individual foods or as a composite meal (stir-fry or stew). Both studies show that the greater the number of foods offered at a meal, the greater the total intake. Study 2 demonstrated that the effects observed in Study 1 could not be attributed to different nutrient compositions, but was rather due to the presentation of the individual foods because the same foods that were offered as individual foods were combined to make the composite meal. The results demonstrate that the greater the number of foods offered at a meal, the greater the spontaneous intake of those foods. This finding is important because not only does it expand the concept of variety from the kinds of foods to the number of foods, but it presents an environmental variable that might contribute to overeating and obesity.