Eating behaviors最新文献

This longitudinal study examined whether body image concerns (general; sporting) predicted eating disorder psychopathology, and whether the link differed according to nature of sport engagement. Participants were competitive sports engagers, non-competitive sports engagers, or sports non-engagers. At baseline, 510 adults completed online measures of sports demographics, eating psychopathology and body image. Eating psychopathology and body image measures were taken at follow-up (6 months later). Competitive sports engagers had better body image than the other two groups. Poorer body appreciation and better appearance-related body image predicted higher eating disorder psychopathology. Engaging in sports competitively may be beneficial for body image. However, positive appearance-related sporting body image may pose a risk for later eating psychopathology.

Eating disorder (ED) behaviors and depression are associated with numerous negative outcomes, including lower quality of life and functional impairment. College women are at elevated risk for both. Prior research indicates ED behaviors, including binge eating, self-induced vomiting, and fasting, predict increases in future depressive symptoms. However, symptom heterogeneity in EDs is common, and all disordered eating, or its associated distress, cannot be captured by the endorsement of behaviors. Impairment that results from ED behaviors may be a comparable, or stronger, predictor of depressive symptoms. We sought to characterize the longitudinal relationship between ED-related functional impairment, ED behaviors, and depressive symptoms. College-aged women [N = 304; 72 % white, mean (SD) age = 18.45 (0.88)] completed an online survey in August (baseline), and then three months later in November (follow-up). Baseline ED-related functional impairment, but not baseline ED behaviors, significantly predicted depressive symptoms at follow-up, controlling for baseline depressive symptoms, negative affect, and body mass index. Findings indicate ED-related functional impairment is a risk factor for increases in depressive symptoms across one semester of college, irrespective of ED behavior engagement, weight status, and dispositional negative affect. Intervening upon ED-related functional impairment may reduce or prevent future depressive symptoms among college-aged women.

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 (M_age 12.8 ± 2.7y; 62.3 % female; 45.7 % non- Hispanic White and 26.1 % non-Hispanic Black; M_BMIz 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, η_p² = 0.005), or intake from carbohydrates (F = 2.45, p = .12, η_p² = 0.007), fat (F = 2.65, p = .10, η_p² = 0.008), or protein (F = 0.39, p = .53, η_p² = 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.

Exposing children to adults eating a raw vegetable with positive facial expressions (‘positive modelling’) increases children's consumption of the modelled vegetable. However, whether repeated versus a single exposure to positive modelling enhances this effect, and whether it generalises to a non-modelled vegetable, remains to be examined. Hence, this study examined the effect of a single exposure, versus repeated, exposure to positive modelling on children's acceptance and intake of a modelled and non-modelled vegetable. Children aged 5–6 years (N = 153; 81 males, 72 females) were randomised to one of three conditions in which they had i) a single or ii) repeated exposure to a video of adults eating raw broccoli with positive facial expressions or iii) were exposed to a no-food control video. Children's acceptance (measured as willingness to try and number of tastes), intake and liking of a modelled (raw broccoli) and non-modelled vegetable (raw mangetout) were measured. Children had greater raw broccoli consumption and liking if they had received repeated exposure to positive modelling, compared to children who had received a single exposure, but not compared to children in the control condition. Children's mangetout intake was greater in the single (versus repeated) positive condition, but this effect was not dependent on time. There was no effect on children's vegetable acceptance. Repeatedly exposing children to adults enjoying a vegetable encourages children's intake of the modelled vegetable in comparison to a single exposure. Thus, repeated exposure to others' food enjoyment may be a practical and useful strategy to encourage children's vegetable consumption.

Binge eating (BE) is a significant public health concern due to its prevalence and impact on mental and physical health. While research has suggested both negative affect and appetitive traits are associated with BE, few studies have investigated these constructs concurrently. Structural equation modeling (SEM) evaluated relationships between negative affect, reward-related appetitive traits, and BE among 293 adults with overweight or obesity (OW/OB) seeking treatment for BE, overeating, and weight management (m age = 46.6; m body mass index[BMI] = 34.5; 81.2 % female; 20.1 % Latinx, 60.8 % White non-Latinx). BE was related to negative affect (β = 0.53; p < 0.01) and appetitive traits (β = 1.53; p < 0.001). Negative affect and appetitive traits were related to one another (r = 0.42; p < 0.001), and the full model accounted for 77 % of the variance in BE. In an exploratory follow-up analysis, multigroup SEM evaluated the above relationships in models stratified by sex. Exploratory findings demonstrated both negative affect and appetitive traits were related to BE across sex, particularly when examining BE cognitions and behaviors. However, relationships in men depended upon BE assessment tool. These findings highlight that both negative affect and appetitive traits are related to BE, and jointly may represent significant risk and maintenance factors, particularly in adults with OW/OB. Our findings also highlight the importance of future investigation of sex differences in BE and the potential impact of assessment method.

Objective

Anorexia nervosa (AN) is often treated in the acute setting, but relapse after treatment is common. Cognitive-behavioral therapy (CBT) is useful in the post-acute period, but access to trained providers is limited. Social support is also critical during this period. This study utilized a user-centered design approach to develop and evaluate the usability of a CBT-based mobile app and social networking component for post-acute AN support.

Method

Participants (N = 19) were recently discharged from acute treatment for AN. Usability testing of the intervention was conducted over three cycles; assessments included the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), the Mobile Application Rating Scale (MARS), a social media questionnaire, and a semi-structured interview.

Results

Interview feedback detailed aspects of the app that participants enjoyed and those needing improvement. Feedback converged on three themes: Logistical App Feedback, boosting recovery, and Real-World App/Social Media Use. USE and MARS scores were above average and SUS scores were “good” to “excellent” across cycles.

Conclusion

This study provides evidence of feasibility and acceptability of an app and social networking feature for post-acute care of AN. The intervention has potential for offering scalable support for individuals with AN in the high-risk period following discharge from acute care.

We aimed to examine whether (a) parents' childhood family mealtime experiences (CFM) (e.g., mealtime communication-based stress) and parents' socio-demographic characteristics (e.g., education level) predict parents' health-related parenting strategies (e.g., discipline), (b) health-related parenting strategies for eating and physical activity predict youth's health-related outcomes (e.g., dietary intake), (c) parenting strategies mediate the relationship between CFM and youth outcomes. A path model was used to examine the above-mentioned relationships. Data were obtained from the baseline assessment of a randomized clinical trial evaluating the efficacy of a family-based intervention to promote quality diet and increase physical activity. Participants were 280 Hispanic youth (52.1 % female, M_age = 13.01 ± 0.83) with unhealthy weight (M_{Body Mass Index %tile} = 94.55 ± 4.15) and their parents (88.2 % female, M_age = 41.87 ± 6.49). Results indicated that childhood mealtime communication-based stress and mealtime structure were positively associated with control. Appearance weight control was positively associated with monitoring, discipline, limit-setting, and reinforcement. Parental mealtime control had positive associations with discipline, control, and limit-setting. Emphasis on mother's weight was positively associated with reinforcement. We also found positive associations between parental monitoring and youth's physical QOL and between parental discipline and fruits and vegetables intake. No mediating effect was found. Findings demonstrated significant effects of parents' childhood experience on parenting strategies, which in turn was associated with the youths' health-related outcomes. These results suggest the intergenerational effects of parent's childhood experience on their youth's health-related outcomes.

The Hierarchical Taxonomy of Internalizing Dimensions for Eating Disorders model positions eating disorder (ED) symptoms on an internalizing dimension alongside anxiety and mood symptoms. Symptom dimensions falling under the internalizing subfactors of distress (e.g., social anxiety) and fear/avoidance (e.g., panic, compulsions, checking) may differentially guide treatment. We examined relations between fear of negative evaluation and intolerance of uncertainty (core features of social anxiety and obsessive-compulsive disorder, respectively) and ED-related impairment and potential diagnostic differences. We hypothesized that: (a) fear of negative evaluation and intolerance of uncertainty would be related to ED-related impairment, (b) the relation between fear of negative evaluation and impairment would be strongest among individuals with “binge-eating syndromes” (i.e., bulimia nervosa [BN], binge-eating disorder [BED]), and (c) the relation between intolerance of uncertainty and impairment would be strongest among individuals with “weight-phobic syndromes” (i.e., anorexia nervosa [AN], BN, atypical AN). Participants (N = 236) included children/adolescents and adults evaluated for outpatient ED treatment. Participants completed questionnaires and semi-structured diagnostic interviews. Greater fear of negative evaluation and greater intolerance of uncertainty were related to greater clinical impairment, and the strength of these relations depended on ED diagnosis. Fear of negative evaluation was related to impairment among individuals with AN and atypical AN, and intolerance of uncertainty was related to impairment for individuals with AN, BN, and atypical AN. We identified fear of negative evaluation and intolerance of uncertainty as correlates of clinical impairment, highlighting the potential utility of developing treatments to target these internalizing constructs, especially for individuals with weight-phobic syndromes.

Introduction

Over 40 % of United States Veterans Health Administration (VHA) primary care patients have obesity. Few patients use VHA's flagship weight management program, MOVE! and there is little information on other behavioral weight management program use.

Methods

The national United States cohort included over 1.5 million primary care patients with obesity, age 18–79, based on VHA administrative data. Gender stratified multivariable logistic regression identified correlates of weight management use in the year after a patient's first primary care appointment (alpha of 0.05). Weight management use was defined as MOVE! or nutrition clinic visits.

Results

The cohort included 121,235 women and 1,521,547 men with 13 % and 7 % using weight management, respectively. Point estimates for specific correlates of use were similar between women and men, and across programs. Black patients were more likely to use weight management than White patients. Several physical and mental health diagnoses were also associated with increased use, such as sleep apnea and eating disorders. Age and distance from VHA were negatively associated with weight management use.

Conclusions

When assessing multiple types of weight management visits, weight management care in VHA appears to be used more often by some populations at higher risk for obesity. Other groups may need additional outreach, such as those living far from VHA. Future work should focus on outreach and prevention efforts to increase overall use rates. This work could also examine the benefits of tailoring care for populations in greatest need.

Recent evidence has highlighted that a moderate degree of disordered eating has become the norm among the general population. While previous research has demonstrated that individuals with eating disorders exhibit heightened weak central coherence (i.e., attention to detail) and cognitive rigidity, and this plays a key role in the development and maintenance of the disorders, less is known about the relationship between disordered eating and these cognitive styles in subclinical community samples. A community sample of females completed self-report measures of weak central coherence, cognitive rigidity and eating disorder pathology. Unlike previous studies in the area, we first excluded participants with a diagnosis of eating disorder and then confined the analyses to those without clinically significant disordered eating. In line with the clinical literature, we found both cognitive rigidity and weak central coherence to correlate with severity and frequency of disordered eating behaviours and cognitions, suggesting the relationship also exists in subclinical samples. If replicated and expanded upon, these findings may bear important implications for the prevention and early identification of disordered eating in the community.