Adolescent Engagement in a Binge-Eating Behavioral Health Intervention: Influence of Perceptions of Physical Appearance and Locus of Control.

Idia B Thurston,E Thomaseo Burton,Rebecca C Kamody

doi:10.3390/children8020102

Abstract

Traditional weight management approaches focused solely on weight loss as a measure of success may lead youth to internalize negative beliefs about their appearance, and feel they have little control over their health. We examined how perceptions of appearance and health-related locus of control (HRLOC) influenced engagement and outcomes in a behavioral health intervention for binge eating. Thirty adolescents aged 14–18 years completed measures of self-perception, HRLOC, and eating behaviors. Half (n = 15) completed baseline assessments only, while the other half participated in a 10-week intervention targeting dysregulated eating behaviors. Analyses revealed negative perceptions of physical appearance and internal HRLOC were higher at baseline among youth who completed the intervention compared to those who completed baseline assessments only. Among those completing the intervention, however, greater internal HRLOC and more positive perception of physical appearance at baseline was associated with greater reduction in objective binge episodes and emotional eating post-intervention. Findings of the present study suggest that while having a more negative perception of one’s appearance may initially motivate youth to participate in weight-related interventions, such perceptions can actually lead to poorer health outcomes, and further supports the extant literature on the benefits of interventions that engender positive body image.

Highlights

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Loss of control eating is well-established as comorbid with obesity in youth, and has been identified as a possibly salient treatment target for both adverse physical and mental health outcomes [1,2,3,4]
Termed weight-normative approaches tend to emphasize personal responsibility for weight management and support the belief that weight loss is key to improving most health issues [8]

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Termed weight-normative approaches tend to emphasize personal responsibility for weight management and support the belief that weight loss is key to improving most health issues [8] This style of intervention may contribute to the internalization of negative beliefs about weight and physical appearance, and lead to decreased feelings of control of one’s health (i.e., health-related locus of control (HRLOC)). Weight-normative approaches may lead to negative affect and a sense of invalidation, thereby increasing the likelihood of youth seeking comfort in food to soothe and regulate these emotional experiences [16] Both excess weight and loss of control eating behaviors are complex health concerns influenced by genetic and environmental factors, many of which are not within the control of the individual [8]. Given the extant literature on the detrimental impact of negative self-perceptions on one’s sense of control over one’s health [8,12,13,15], we hypothesized that youth who completed the intervention would have more positive perceptions of their physical appearance and greater sense of internal HRLOC compared to youth who ended the intervention early

Materials and Methods

Results

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