Dietary Restraint Research Articles

Internalized Stigma as a Transdiagnostic Factor for Women with Eating Disorders

ABSTRACT This study aimed to examine how internalized weight bias (IWB), body surveillance, and body shame relate to eating pathology in women with diagnosed eating disorders (EDs) across the weight spectrum. Previous research has examined these variables in primarily non-clinical populations, binge eating disorder, and higher weight populations. In a sample of 98 women with diagnosed EDs, the association of IWB, body surveillance, and body shame on the severity of ED symptoms was examined with hierarchical multiple regression analyses. Results indicate that IWB, body surveillance, and body shame significantly predicted global eating pathology, F (4, 93) = 40.74, p < .001. IWB, body surveillance, and body shame related to global eating pathology, even after controlling for previous weight bias experiences. Analyses with specific symptom clusters found that only body surveillance predicted dietary restraint, only IWB and body shame predicted overvaluation of shape/weight, and only IWB predicted body dissatisfaction. The findings in this study provide initial support for internalized stigma variables (IWB, body surveillance, and body shame) related to ED pathology in a transdiagnostic clinical eating disorder sample across the weight spectrum. Results suggest that further examination of internalized stigma is needed within ED treatment.

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

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.

Infant Feeding Varies Across Eating Behavior and Feeding Modalities in Mothers With Low Income

ObjectiveTo examine if eating behaviors in mothers with low income relate to attitudes toward infant feeding and whether associations differed between breastfeeding and formula-feeding mothers. DesignCross-sectional study. ParticipantsForty postpartum women (aged ≥ 18 years, body mass index ≥ 25 and < 40 kg/m2) in the Louisiana Women, Infants, and Children program participated in a telehealth postpartum intervention for health and weight loss. Main Outcome Measure(s)Maternal eating behaviors and infant feeding styles, assessed 6–8 weeks after birth (baseline) using validated questionnaires. AnalysisSignificance was detected using independent t tests, chi-square tests for independence, or linear models (P < 0.05). ResultsMost mothers formula-fed (n = 27, 68%). In formula-feeding mothers, maternal disinhibition and perceived hunger were positively associated with restrictive infant feeding (β = 0.41, P <0.001 and β = 0.41, P = 0.001, respectively). These relationships were significantly higher (Δ = −0.85, P = 0.006 and Δ = −0.59, P = 0.003, respectively) than among breastfeeding mothers. Comparatively, pressuring/overfeeding was lower in formula-feeding mothers than among breastfeeding mothers with dietary restraint (Δ slopes: 1.06, P = 0.02). Conclusions and ImplicationsIn this cohort of mothers with low income, maternal eating behavior was associated with infant feeding styles only when feeding modality was considered. Mothers may benefit from education on how their eating behaviors can influence their infants and children.

The moderating role of self-compassion on the relationship between emotion-focused impulsivity and dietary restraint in a diverse undergraduate sample

ObjectiveHigh levels of emotion-focused impulsivity (e.g., negative urgency) are significantly related to disordered eating behaviors, including dietary restraint. The objective of the current study was to understand the moderating role of self-compassion between emotion-focused impulsivity and dietary restraint in a diverse undergraduate sample. We hypothesized that high levels of self-compassion would protect individuals with high levels of emotion-focused impulsivity from engaging in high levels of dietary restraint. MethodParticipants (n = 607, Mage = 18.8, 63 % female, 45.3 % White) completed the UPPS-P, Eating Disorder Examination Questionnaire, and the Self-Compassion Questionnaire as part of a larger study examining eating behaviors in college students. ResultsNegative urgency, but not positive urgency, was related to dietary restraint. Self-compassion moderated the relationship between both forms of impulsivity and dietary restraint, such that individuals with high emotion-focused impulsivity and high self-compassion had lower dietary restraint than individuals who had high emotion-focused impulsivity and low self-compassion. DiscussionEmotion-focused urgency is a risk factor for dietary restraint; both factors are highly correlated with more severe eating pathology, such as binging and purging behaviors. Self-compassion may buffer against the risk of emotion-focused impulsivity on engaging in dietary restraint behaviors in a community sample, which may inform our understanding of preventative interventions against eating pathology. These results should be replicated in clinical populations and across eating disorder diagnoses.

578-P: Telemedicine Intervention Is Effective in Changing Psychological and Behavioral Correlates of Weight Loss in the REAL HEALTH-Diabetes Trial

Prior studies have shown that telemedicine (telemed) weight loss interventions are non-inferior to in-person in achieving weight loss. The REAL-HEALTH Diabetes RCT studied the effectiveness of a group lifestyle intervention (LI) for weight loss in adults with T2D and overweight/obesity. Intervention was delivered either in-person (LI-IP) or via telephone (LI-Tele) . We found clinically significant weight loss with no difference between arms. We sought to determine whether there was a difference between the LI-IP and LI-Tele arms in change of psychological and behavioral correlates of weight loss from baseline to 6 months. We compared the change scores for psychological (diabetes-related distress, depression, diet self-efficacy and autonomous motivation for regulation of diet) and behavioral (dietary restraint, fat related diet behavior) measures between the LI-IP (n=69) and LI-Tele (n=72) groups. There was no significant difference between the groups in mean age (62 years) , percent male (44.7%) , race (79.4% white) , baseline HbA1c (7.7%) and baseline BMI (34.7 kg/m2) . At 6 months, scores for all the measures improved from baseline in both arms with no significant difference between LI-IP and LI-Tele (Table 1) , demonstrating that telemed LI was as effective as the in-person intervention at improving psychological and behavioral correlates of weight loss. Disclosure J. Vakharia: None. L.M. Delahanty: Advisory Panel; Lilly Diabetes, Omada Health, Inc., WW International, Inc., ZOE Limited. Stock/Shareholder; Jana Care Inc., Omada Health, Inc., ZOE Limited. T. Thaweethai: None. D.J. Wexler: Other Relationship; Elsevier, Novo Nordisk, UpToDate. Funding T32 DK007028

Digital Hazards for Feeding and Eating - meta-analysis and discussion of putative mechanisms

IntroductionEating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment.ObjectivesWe present systematically gathered and pooled quantitative evidence from our review and meta-analysis study which aimed to provide a quantitative synthesis of all available data linking problematic usage of the internet (PIU) and eating disorder and related psychopathology. We synthesize how PUI influences eating disorder and related psychopathology, and examine what the moderating parameters influencing this relationship are.MethodsOur systematic review and meta-analysis protocol was pre-registered electronically in PROSPERO international register and included case-control studies using correlational statistics of association between internet use (various facets) and eating disorder psychopathology. Experimental and prospective studies are systematically reviewed separately.ResultsThe meta-analysis comprised n=32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r=0.22 (s.e.=0.04, p&lt;0.001), body dissatisfaction r=0.16 (s.e.=0.02, p&lt;0.001), drive-for-thinness r=0.16 (s.e.=0.04, p&lt;0.001) and dietary restraint r = 0.18 (s.e.=0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups.ConclusionsThose findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology. Putative specific effects of PUI on EDs are discussed.DisclosureNo significant relationships.

Hunger Associations With Meal Timing and Adherence to Potential Meal Timing Recommendations for Weight Loss

ObjectivesPoor meal timing (MT) habits, such as irregular day-to-day eating and eating late at night, increase the risk for weight gain and developing chronic diseases such as type 2 diabetes and cardiovascular disease. We examined two potential barriers to improving MT habits, overall hunger level and time of day of greatest hunger, in relation to MT habits. We hypothesized that a greater overall hunger level and later onset of greatest hunger would associate with unhealthier MT habits and lower adherence to MT recommendations. MethodsThis was a secondary analysis of data from a cross-sectional study on diet and energy regulation in 116 healthy, nonsmoking adults (63% F; aged 29.4 ± 11.9 y; BMI 24.3 ± 3.8 kg/m2; race/ethnicity distribution: 76% white, 15% Asian American, 9% Black/African American/other). Three poor MT habits were examined: eating later in the day (later midpoint of ingestive period), eating late at night (2000–2259) and overnight (2300–0459); and having a shorter overnight fast. Hunger, assessed by the Eating Inventory, and self-reported time of day of greatest hunger, were examined in relation to MT patterns and categorical MT outcomes which, based on the literature, could represent desirable target cutoffs for improvements of MT habits (i.e., potential MT recommendations). MT was determined using the Meal Pattern Grid modified to assess MT on both weekdays and weekend days. ResultsAfter inclusion of all covariates (age, sex, race, physical activity, bed time, dietary restraint and disinhibition scores, sleep duration, and sleep quality), a higher hunger score was associated with a ≥ 13 h overnight fast (p < 0.05), suggesting that participants were able to achieve a longer overnight fast despite being hungrier. Additionally, higher hunger was marginally associated with eating less often late at night (8:00–10:59 pm) (p = 0.08). Time of day of greatest hunger was not associated with any MT variables examined. ConclusionsOur findings did not support the hypothesis that greater hunger prevents healthier MT patterns that have a longer interval of overnight fasting. Future studies are needed to determine if dietary approaches to reducing hunger promote adherence to healthy MT patterns. Funding SourcesNIDDK.

Dietary Restraint Constructs Are Associated With Diet Quality and Nutrient Intake

ObjectivesTo examine and compare reported food and nutrient intake in men and women who differ in cognitive restraint (CR) and disinhibition (D) scores. We hypothesize that average intake of sodium, total sugar, saturated fat, and Healthy Eating Index (HEI) scores of diet quality will differ between low and high D groups. Methods330 adults from a cross-sectional study who completed 3 dietary recalls and the three-factor eating questionnaire (TFEQ) were included in this analysis. Participants were classified into 4 groups based on TFEQ scores for CR and D: high CR + high D (CRD, n = 46); high CR + low D (CR, n = 104); low CR + high D (D, n = 42); and low CR + low D (LL, n = 138). The Automated Self-Administered 24-hour (ASA24) tool was used to obtain dietary recalls on 2 weekdays and 1 weekend day. Nutrient intakes were averaged for the 3 recalls, and HEI scores were calculated using the HEI-2015 scoring standards. Differences in average calories, sodium, total sugar, saturated fat, and HEI scores between groups were analyzed using analysis of covariance with age, sex, and BMI as covariates. ResultsThere were differences in average sodium and saturated fat intake, with CR group reporting lower sodium intake (p = 0.041) and lower saturated fat (p = 0.007) intake compared to the LL group only. There were no differences in calorie or total sugar intake between groups. Interestingly, added sugar intake based on HEI-2015 scoring showed group differences, with CR reporting lower added sugar intake than LL group (p = 0.042). HEI subscore for refined grain intake was also higher in LL group compared to CR (p = 0.002) and CRD (p = 0.023). Total HEI score was lower in LL (59.5 ± 1.0) compared to CR (65.1 ± 1.15, p = 0.002) and CRD (65.6 ± 1.75, p = 0.017). ConclusionsHigh cognitive restraint was associated with a more “healthful” diet with lower sodium and saturated fat intakes compared to groups with low restraint. While there were no associations between total sugar intake and cognitive restraint, reduced consumption of added sugar and refined grains were reported by the cognitively restrained participants, regardless of disinhibition status. Contrary to our hypothesis, high cognitive restraint was the predominant behavior associated with diet quality, not disinhibition. Funding SourcesFunding was provided through the USDA.

Motivation for dietary restraint, and disordered eating among adults experiencing food insecurity in the United States.

Does engaging in dietary restraint due to weight/shape concerns versus economic hardship differentially relate to disordered eating? The sample consisted of 582 adults experiencing food insecurity (FI) who completed online measures assessing severity of FI, disordered eating, loss of control over eating, and dietary restraint. Participants reported their motivation for dietary restraint with options consisting of weight/shape concerns, economic hardship (i.e., insufficient funds and prioritizing others' needs), mixed reasons, and other/I do not know. In the sample, 18% reported engaging in dietary restraint primarily due to weight/shape concerns, 33% due to economic hardship, 18% other/do not know, and 30% due to a mix of reasons. There were positive correlations between FI, economic hardship, dietary restraint, disordered eating, and loss of control over eating. Regression analyses revealed the association between dietary restraint and disordered eating does not differ across individuals who endorse economic hardship as a motivator for dietary restraint. Findings replicated with loss of control. However, the association between dietary restraint and disordered eating grew stronger as more dietary restraint due to weight/shape concerns was endorsed. No significant association emerged with loss of control. Research is needed to replicate findings and examine how patterns of food scarcity impacts disordered eating in food insecure populations with and without weight/shape concerns. Findings suggest that motivation for dietary restraint may influence associations with dietary restraint and the cognitive components of disordered eating, but not the behavioral components of disordered eating. Disordered eating due to dietary restraint is most commonly associated with weight and shape concerns; however, even when dietary restraint is due to economic reasons, it can still be associated with disordered eating.

Structural validity of the Eating Disorder Examination-Questionnaire: A systematic review.

ObjectiveThe main aim was to perform a systematic literature review of studies investigating the factor structure of the Eating Disorder Examination‐Questionnaire (EDE‐Q), a widely used measure of eating pathology. Secondary aims were to summarize the quality of reporting of latent variable (factor) analyses in these studies and review support for different factor solutions.MethodLiterature was identified through Scopus, Medline, PsycInfo, and ProQuest databases published up to February 23, 2022 and outreach via an international listserv. All studies published in English reporting factor analysis of the EDE‐Q were included with few restrictions. Sixty studies including 63,389 participants met inclusion criteria.ResultsThe originally proposed four‐factor solution received little empirical support, although few alternative models have been robustly evaluated. Items assessing shape and weight concerns frequently coalesce in factor solutions, suggesting that these constructs are closely related. Investigations of brief versions of the EDE‐Q have produced more consistent findings, suggesting that these measures, particularly a seven‐item version, might be useful alternatives to the full version. Quality of studies was reasonable, with important methodological elements of factor analysis often reported.DiscussionThe findings are of relevance to practitioners and researchers, suggesting that the “original” factor structure of the EDE‐Q should be reconsidered and that use of a seven‐item version is to be encouraged.Public SignificanceSelf‐report questionnaires are widely used in the assessment of disordered eating. The current study found that there is little consensus about the structure of a common measure of eating psychopathology. There is more consistent support for a brief, seven‐item, version assessing dietary restraint, body dissatisfaction, and overvaluation of weight and shape.

Appetite Changes in Weight Regain and Weight Maintenance After Roux-en-Y Gastric Bypass.

Roux-en-Y gastric bypass (RYGB) surgery produces significant weight loss. However, a number of patients experience weight regain years after surgery. Factors driving weight regain after surgical interventions are currently being explored. Our objective was to investigate appetite-related measures associated with weight regain after RYGB surgery. Using a cross-sectional design, 29 participants (49.6 ± 9.1years of age; current BMI 32.4 ± 4.7kg/m2, 43.6 ± 8.9months post-RYGB) were stratified into tertiles according to weight regain per month after nadir (weight maintenance (WM), n = 9; low weight regain (LWR), n = 10; and high weight regain (HWR), n = 10). The average weight regain was, by design, significantly different between the groups (WM = 2.2 ± 2.5kg; LWR = 10.0 ± 3.4kg; HWR = 14.9 ± 6.3kg regained, p < 0.05). Appetite (visual analog scales), olfactory performance ("sniffin sticks"), eating behaviors (Three Factor Eating Questionnaire), food reward (Leeds Food Preference Questionnaire), and appetite-related hormones (ghrelin, PYY, GLP-1 and leptin) were measured fasting and in response to a standardized test meal. Dietary restraint was significantly higher than clinical cutoffs in WM and LWR (p < 0.05). As expected, significant time effects were noted for ghrelin, PYY, and GLP-1, but there were no group differences. The results suggest that appetite-related outcomes are similar across individuals who have maintained weight loss and experienced regain following RYGB.

Examination of three-factor eating questionnaire subscale scores on weight loss and weight loss maintenance in a clinical intervention

BackgroundThe purpose of this study is to examine three-factor eating questionnaire (TFEQ) scores at baseline and post-intervention (6 months) on successful weight loss and weight maintenance in an 18-month behavioral weight management intervention for adults with overweight and obesity.MethodsTFEQ and weight were assessed at baseline, 6, and 18 months. Logistic regression models were used to examine scores at baseline on disinhibition, restraint, and perceived hunger factors in the TFEQ on 5% body weight loss at 6 months and 6-month scores to predict 5% weight maintenance at 18 months while controlling for age, sex, and baseline weight.ResultsParticipants (n = 287; age = 43.8 ± 10.36 years; female = 64.1%; weight = 222.5 ± 39.02 pounds; BMI = 34.73 ± 4.56) were included for analysis. Dietary restraint at baseline was the only significant predictor of 5% weight loss at 6 months. None of the TFEQ subscale scores at 6 months predicted 5% weight maintenance at 18 months. The model examining weight loss at 6 months accounted for 7% of the variance of the outcome and 11% of the variance of weight maintenance at 18 months.ConclusionDietary restraint is a unique eating behavior associated with weight loss at 6 months beyond other eating behaviors measured by the TFEQ in an adult sample enrolled in a weight loss intervention. No other subscale scores were significant at 6 months or at 18 months. Future research should consider how to promote flexible control and discourage adoption of rigid restraint behaviors since the latter is associated with disordered eating patterns.

Psychometric Evaluation of the Chinese Version of a Weight-Related Eating Questionnaire Using an Item Response Theory Approach

Valid and reliable measures are needed to identify individuals at risk of dietary restraint, emotional and external eating, and to customize weight loss education for more effective weight management. This study aimed to develop and validate a Chinese version of the Weight-Related Eating Behavior Questionnaire (WREQ-C) for assessing dietary restraint, emotional eating, and external eating. In stage one, the linguistic validation of the original English version of the WREQ (WREQ-E) was conducted. In stage two, the psychometric properties of the WREQ-C were first evaluated by item response theory-based (IRT) analyses. The reduced scale was then examined for convergent validity, structural validity (using a confirmatory factor analysis), population invariance, and test–retest reliability. The study included 1007 adults aged between 18 and 71 years. The IRT analysis optimally shortened the original WREQ-E from 16 to 13 items. A convergent validity analysis showed significant correlations between the WREQ-C subscales and the Chinese version of the Dutch Eating Behavior Questionnaire subscales (r = 0.63–0.82). The 13-item WREQ-C demonstrated good reliability (Cronbach’s α = 0.74–0.89) and validity for assessing the psychological aspects of eating behavior, including routine restraint, compensatory restraint, susceptibility to external cues, and emotional eating in Chinese adults.

Obesogenic eating behaviour and dietary intake in German children and adolescents: results from the GINIplus and LISA birth cohort studies

Background/objectivesThe transition to adolescence is characterised by considerable behavioural changes, including diet. This study describes the level of obesogenic eating behaviours in 10- and 15-year-olds, and their association with dietary intake.Subjects/methodsParticipants of the 10- and 15-year follow-ups of the German GINIplus and LISA birth cohort studies were included (N10 = 2257; N15 = 1880). Eating behaviours and dietary intake were assessed via self-report questionnaires. Sex-stratified, cross-sectional associations of “external eating”, “emotional eating” and “dietary restraint” (the latter at age 15 years only) with dietary intake (17 food groups—categorised into tertiles, macronutrients, and total energy) were assessed using multinomial logistic or multiple linear regression as required, adjusting for covariates and correcting for multiple testing.ResultsReported levels of eating behaviours were low in both age-groups. External eating was higher in 10-year-old males than females, while all eating behaviours were most pronounced in 15-year-old females. At 10 years, emotional eating was associated with medium vegetable intake in females (Relative Risk Ratio (RRR) = 1.84, p = 0.0017). At 15 years, external eating was associated with total energy (kJ) in females (β = 718, p = 0.0002) and high butter intake in males (RRR = 1.96, p = 0.0019). Dietary restraint in females was inversely associated with total energy (β = −967, p < 0.0001) and omega-3 fatty acids (Means Ratio (MR) = 0.94, p = 0.0017), and positively associated with high fruit (RRR = 2.20, p = 0.0003) and whole grains (RRR = 1.94, p = 0.0013).ConclusionObesogenic eating behaviour scores are low among children and adolescents of a predominantly high socioeconomic status population and present only few associations with specific aspects of diet, mainly among adolescent females.

The effect of a healthy food cue on choices from an online fast-food menu

The prevalence of unhealthy food cues in our environment is a major contributor to poor dietary behaviours. Emerging research has shown that changing the food environment through the co-presentation of a healthy food cue may subtly ‘nudge’ individuals towards making healthier choices. The present study aimed to investigate the effect of a healthy food cue on subsequent food and drink choices from an online fast-food ordering menu. Participants (N = 291 women) were first presented with a cue displaying either a healthy or unhealthy meal, or no cue control. They were then shown a pictorial menu with items presented in one of two orders - menu 1 (first item healthy), menu 2 (first item unhealthy) - and asked to choose one item from each of three sections (mains, drinks, desserts). Participants also completed a questionnaire measure of dietary restraint. Overall, participants made more healthy choices from menu 1 than 2. For menu 1, there was a significant interaction between experimental condition and restraint status, whereby restrained eaters made relatively more healthy choices following the healthy cue. This was particularly the case for ‘main’ meal items. The findings have real world implications for digital businesses on how to present food and drink items to nudge individuals towards healthier choices.

Appearance and performance‐enhancing drugs and supplements, eating disorders, and muscle dysmorphia among gender minority people

ObjectiveAppearance and performance‐enhancing drugs and supplements (APEDS) can be used to enhance muscle growth, athletic performance, and physical appearance. The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among gender minority people.MethodParticipants were 1653 gender minority individuals (1120 gender‐expansive [defined as a broad range of gender identities that are generally situated outside of the woman–man gender binary, e.g., genderqueer, nonbinary] people, 352 transgender men, and 181 transgender women) recruited from The Population Research in Identity and Disparities for Equality Study in 2018. Regression analyses stratified by gender identity examined associations of any APEDS use with eating disorder and muscle dysmorphia symptom scores.ResultsLifetime APEDS use was common across groups (30.7% of gender‐expansive people, 45.2% of transgender men, and 14.9% of transgender women). Protein supplements and creatine supplements were the most commonly used APEDS. Among gender‐expansive people and transgender men, lifetime use of any APEDS was significantly associated with higher eating disorder scores, dietary restraint, binge eating, compelled/driven exercise, and muscle dysmorphia symptoms. Any APEDS use was additionally associated with laxative use among gender‐expansive people. Among transgender women, use of any APEDS was not significantly associated with eating disorder or muscle dysmorphia symptoms.DiscussionAPEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in gender‐expansive people and transgender men, thus highlighting the importance of assessing for these behaviors and symptoms among these populations, particularly in clinical settings.Public SignificanceThis study aimed to examine APEDS use among gender minority people. We found that 30.7% of gender‐expansive (e.g., nonbinary) people, 45.2% of transgender men, and 14.9% of transgender women reported lifetime APEDS use, which was associated with eating disorder and muscle dysmorphia symptoms in transgender men and gender‐expansive people. Clinicians should assess for these behaviors in gender minority populations.

Types of Eating Disorder Prodrome in Adolescence: The Role of Decision Making in Childhood.

Psychiatric disorders like eating disorders (EDs) might be underpinned by differences in decision making. However, little previous research has investigated this potential relationship using longitudinal data. This study aimed to understand how components of decision making (delay aversion, risk adjustment, risk taking, quality of decision making and deliberation time) measured by the Cambridge Gambling Task in the United Kingdom’s Millennium Cohort Study (MCS; n = 11,303; female = 50.17%) at age 11 might explain clusters/types of ED prodrome involving body dissatisfaction, intention to lose weight, dietary restraint, excessive exercise and significant under/overweight measured in the MCS at age 14. Latent class analysis revealed two groups within the cohort: a non-prodromal eating pathology group, who were more likely to be of “average” weight, according to the UK90, with minimal disordered attitudes and behaviors in relation to eating and weight; and a second group with prodromal eating pathology, who had more body dissatisfaction, a desire to lose weight, were using dietary restriction and exercise to influence weight and were more likely to be “overweight” according to the UK90. Logistic regression showed that, after adjustment for confounding, higher risk-taking scores were associated with a 60% greater probability of being in the prodromal eating pathology group (b = 0.47, OR = 1.60, p < 0.01), and higher scores on quality of decision making were associated with a 30% lower probability of being in the prodromal eating pathology group (b = −0.34, OR = 0.70, p < 0.05). Helping young people to engage in moderate risk taking and improving decision making might reduce the later presence of ED prodromes.

Eating Disorder Examination-Questionnaire: Evaluating factor structures and establishing measurement invariance with Asian/Hawaiian/Pacific Islander, Black, and White American college men.

ObjectiveThis study evaluated the factor structure and invariance of the Eating Disorder Examination‐Questionnaire (EDE‐Q) in a sample of Asian/Hawaiian/Pacific Islander (n = 163), Black (n = 155), and White (n = 367) American university men.MethodTwelve different EDE‐Q factor structures reported in the literature were evaluated using multi‐group confirmatory factor analyses, and measurement invariance assessed.ResultsA respecified four‐factor structure proposed by Parker et al. (2016) showed superior fit and was invariant across groups. Significant differences emerged across all latent factors, with small to medium effects. Asian/Hawaiian/Pacific Islander men reported significantly higher scores on factors assessing Appearance Concern, Overvaluation of Shape/Weight, and Eating Concerns, and were more likely to endorse regular objective binge eating (OBE) and fasting episodes than their Black and White peers. Both White and Asian/Hawaiian/Pacific Islander men reported greater dietary restraint than Black men. Among this sample, frequencies of regular compensatory exercise ranged from 10% to 16%, fasting 6% to 14%, and OBEs 1% to 10%.DiscussionResults provide further support for the use of alternate EDE‐Q factor structures, especially among non‐White men. In this study, Asian/Hawaiian/Pacific Islander men reported the highest levels of ED psychopathology relative to White and Black men, indicating they might be particularly vulnerable to EDs.Public SignificanceThis study failed to find support for using the original Eating Disorder Examination‐Questionnaire four‐factor structure to detect disordered eating in Asian, Black, and White American college men. An alternate model proposed by Parker et al. in 2016 may be more appropriate. Asian men also reported the highest levels of eating psychopathology relative to their peers, suggesting they may be at high risk for developing eating disorders.

Self-Oriented Body Comparison and Self-Compassion: Interactive Models of Disordered Eating Behaviors Among Postpartum Women

Evidence suggests self-oriented body comparison (comparison of one’s postpartum body shape and weight to one’s prepregnant body shape and weight) is a critical factor associated with increased levels of disordered eating during the postpartum period. However, some postpartum women adopt a self-compassionate and acceptance-based perspective toward their body shape and weight changes. It is unclear whether self-compassion may buffer the associations between self-comparisons and disordered eating behaviors among postpartum women, which is the aim of the current study. A total of 306 postpartum women who gave birth in the past year completed an online survey asking about self-compassion, social comparison, broad eating pathology, dietary restraint, and binge eating. Results indicated that self-compassion appeared to buffer the associations between self-comparison and broad eating pathology and binge eating among postpartum women, such that for women with above-average levels of self-compassion, the associations between self-comparison and disordered eating was weaker than for women with average or below-average levels of self-compassion. Findings suggest self-compassion could be a potential target for intervention programs.

Sleep Disturbance and Changes in Energy Intake and Body Composition During Weight Loss in the POUNDS Lost Trial.

To examine associations between sleep disturbance and changes in weight and body composition and the mediating role of changes of appetite and food cravings in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) 2-year weight-loss diet intervention trial, this study included 810 overweight or obese individuals with baseline sleep disturbance assessment who were randomly assigned one of four diets varying in macronutrient composition. Changes in body weight and fat distribution were assessed by DEXA and computed tomography during the 2-year intervention. Participants were asked to provide sleep disturbance levels (no, slight, moderate, or great) at baseline and to recall their sleep disturbances since last visit at 6, 12, 18, and 24 months. Weight loss during the first 6 months was followed by 1.5 years of steady weight regain. Participants with greater sleep disturbance from baseline to 6 months showed significant losses of body weight (Ptrend <0.001) and waist circumference (Ptrend = 0.002) at 6 months, after multivariate adjustment. Compared with individuals without sleep disturbance at all from baseline to 6 months, those with slight, moderate, or great sleep disturbance showed an elevated risk of failure to lose weight (-5% or more loss) at 6 months, when the maximum weight loss was achieved, with an odds ratio of 1.24 (95% CI 0.87, 1.78), 1.27 (95% CI 0.75, 2.13), or 3.12 (95% CI 1.61, 6.03), respectively. In addition, we observed that the repeatedly measured levels of sleep disturbance over 2 years were inversely associated with the overall weight loss rate (weight changes per 6 months) (Ptrend <0.001). Further, sleep disturbances during weight loss from baseline to 6 months and weight regain from 6 months to 24 months were significantly predictive of total fat, total fat mass percent, and trunk fat percent changes during the 2 years. Our results also indicated that food cravings for carbohydrates/starches, fast food fats, and sweets; cravings, prospective consumption, hunger of appetite measurements; and dietary restraint, disinhibition, and hunger subscales measured at 6 months significantly mediated the effects of sleep disturbance on weight loss. In conclusion, our results suggested that more severe sleep disturbance during weight loss was associated with an elevated risk of failure to lose weight during the dietary intervention. Food cravings and eating behaviors may partly mediate these associations.