Eating Self-efficacy Research Articles

Chrononutrition, eating behaviour, and metabolic health among obese patients elected for bariatric surgery

ABSTRACT There is evidence of the impact of chrononutrition on weight loss and metabolic control. However, the precise chrononutrition behaviours that promote these benefits are not fully described, and there are doubts if chrononutrition may be related to other eating behaviour features. The main aim was to evaluate the associations between chrononutrition and eating behaviour, and their relationships with anthropometric and biochemical parameters among obese patients elected for bariatric surgery. Eighty participants (76.3% females, mean age = 45 years, mean BMI = 41.6 kg/m2) attending bariatric surgery consultations at Centro Hospitalar Universitário de São João (Porto, Portugal) were assessed regarding chrononutrition (Chrononutrition Profile – Questionnaire) and eating behaviour (Three-Factor Eating Questionnaire – R21 and General Eating Self-Efficacy Scale). Height, weight, waist circumference, and biochemical values (total, HDL and LDL cholesterol, triglycerides and glycated haemoglobin) were collected. Eating window midpoint was positively correlated with uncontrolled eating and negatively with eating self-efficacy. Sleep duration and midpoint on free days negatively correlated with eating self-efficacy, mainly due to later waking times, supporting that predominantly later energy consumption may negatively impact eating behaviour.

Relationship between food insecurity and a gestational diabetes risk reduction intervention: outcomes among American Indian and Alaska Native adolescent and young adult females.

American Indian and Alaska Natives (AI/ANs) are disproportionately impacted by gestational diabetes mellitus (GDM), subsequent type 2 diabetes, and food insecurity. It is prudent to decrease risk of GDM prior to pregnancy to decrease the intergenerational cycle of diabetes in AI/AN communities. The purpose of this project is to describe and examine food insecurity, healthy eating self-efficacy, and healthy eating behaviors among AI/AN females (12-24 years old) as related to GDM risk reduction. Methods included: secondary analysis of healthy eating self-efficacy and behaviors, and household-level food insecurity measures from an randomized controlled trial that tested the effect of engagement in a GDM risk reduction educational intervention on knowledge, behavior, and self-efficacy for GDM risk reduction from baseline to 3-month follow-up. Participants were AI/AN daughters (12-24 years old) and their mothers (N = 149 dyads). Researchers found that more than one-third (38.1%) reported food insecurity. At baseline food insecurity was associated with higher levels of eating vegetables and fruit for the full sample (p = .045) and cohabitating dyads (p = .002). By 3 months healthy eating self-efficacy (p = .048) and limiting snacking between meals (p = .031) improved more in the control group than the intervention group only for cohabitating dyads. For the full sample, the intervention group had increases in times eating vegetables (p = .022) and fruit (p = .015), whereas the control group had declines. In the full sample, food insecurity did not moderate the group by time interaction for self-efficacy for healthy eating (p ≥ .05) but did moderate the group by time interaction for times drinking soda (p = .004) and days eating breakfast (p = .013). For cohabitating dyads, food insecurity did moderate self-efficacy for eating 3 meals a day (p = .024) and days eating breakfast (p = .012). These results suggest food insecurity is an important factor regarding the efficacy of interventions designed to reduce GDM risk and offer unique insight on "upstream causes" of GDM health disparities among AI/AN communities.

550-P: Food Insecurity and the Efficacy of a Gestational Diabetes (GDM) Risk Reduction Intervention—Healthy Eating Outcomes among American Indian and Alaska Native (AI/AN) Female Adolescents and Young Adults (FAYAs)

AI/ANs are unduly impacted by GDM and food insecurity. Employing a clinical trials design, this secondary analysis used Stopping GDM trial data to describe and explore food insecurity as a moderator of the efficacy of a GDM risk reduction intervention on healthy eating behaviors and self-efficacy at 3 months among AI/AN FAYAs. Participants were AI/AN FAYAs and their mothers. Assessments included mother’s food insecurity using USDA Household Food Security Survey Module and FAYA’s healthy eating self-efficacy using Self-Efficacy for Healthy Eating and healthy eating behaviors from CDC Youth Risk Behavior Surveillance System. The sample (N=149 dyads) was FAYAs (mean age 16.7±3.0 years) and their mothers, with 64% (n=95) living together. More than one-third (38.1%) reported food insecurity. At baseline food insecurity was associated with higher levels of eating vegetables and fruit for the full sample (p=.045) and cohabitating dyads (p=.002). By 3 months healthy eating self-efficacy (p=.048) and limiting snacking between meals (p=.031) improved more in the control group than the intervention group but only for cohabitating dyads. For the full sample the intervention group had increases in times eating vegetables (p=.022) and fruit (p=.015), while the control group had declines. In the full sample food insecurity did not moderate the group by time interaction for self-efficacy for healthy eating (p≥.05) but did moderate the group by time interaction for times drinking soda (p=.004) and days eating breakfast (p=.013). For cohabitating dyads food insecurity did moderate self-efficacy for eating 3 meals a day (p=.024) and days eating breakfast (p=.012). These results suggest food insecurity is an important factor regarding the efficacy of interventions designed to reduce GDM risk and offer unique insight on ‘upstream causes’ of GDM health disparities among AI/AN communities. Disclosure S.M.Sereika: None. S.A.Stotz: None. L.E.Hebert: None. L.Scarton: None. K.R.Moore: Consultant; Novo Nordisk. D.Charron-prochownik: None. The stopping gdm study group: n/a. Funding National Institutes of Health (R01NR014831)

Low eating self-efficacy is associated with unfavorable eating behavior tendencies among individuals with overweight and obesity

Success in long-term weight management depends partly on psychological and behavioral aspects. Understanding the links between psychological factors and eating behavior tendencies is needed to develop more effective weight management methods. This population-based cross-sectional study examined whether eating self-efficacy (ESE) is associated with cognitive restraint (CR), uncontrolled eating (UE), emotional eating (EE), and binge eating (BE). The hypothesis was that individuals with low ESE have more unfavorable eating behavior tendencies than individuals with high ESE. Participants were classified as low ESE and high ESE by the Weight-Related Self-Efficacy questionnaire (WEL) median cut-off point. Eating behavior tendencies were assessed with Three Factor Eating Questionnaire R-18 and Binge Eating Scale, and additionally, by the number of difficulties in weight management. The difficulties were low CR, high UE, high EE, and moderate or severe BE. Five hundred and thirty-two volunteers with overweight and obesity were included in the study. Participants with low ESE had lower CR (p < 0.03) and higher UE, EE, and BE (p < 0.001) than participants with high ESE. Thirty-nine percent of men with low ESE had at least two difficulties in successful weight control while this percentage was only 8% in men with high ESE. In women, the corresponding figures were 56% and 10%. The risk of low ESE was increased by high UE [OR 5.37 (95% CI 1.99–14.51)], high EE [OR 6.05 (95% CI 2.07–17.66)], or moderate or severe BE [OR 12.31 (95% CI 1.52–99.84)] in men, and by low CR [OR 5.19 (95% CI 2.22–12.18)], high UE [OR 7.20 (95% CI 2.41–19.22)], or high EE [OR 23.66 (95% CI 4.79–116.77)] in women. Low ESE was associated with unfavorable eating behavior tendencies and multiple concomitant difficulties in successful weight loss promotion. These eating behavior tendencies should be considered when counseling patients with overweight and obesity.

Eating self-efficacy: validation of a new brief scale.

Eating self-efficacy (ESE) is the belief in one's ability to self-regulate eating. Social and emotional situations may be differently challenging depending on the individual eating habits, body mass index and affects. Several ESE scales have been developed but most of them focus on weight management, dieting or healthy eating. The aim of the study was to validate a new brief scale assessing ESE in situations in which people face social or emotional pressures for excessive food intake. Study 1: A sample of 412 volunteer females (age M = 25.44 ± 5.03) completed a first 25-item version of the scale. Exploratory factor analysis (EFA) was conducted for selecting a subgroup of items composing the ESE brief scale (ESEBS). Study 2 assessed its psychometric properties through a Confirmatory Factor Analysis (CFA), analyzing the responses of 410 volunteer adults (273 females, 137 males). EFA of Study 1 evidenced a bifactorial structure. Four items for each factor were selected, explaining 63% of the variance. Study 2 confirmed the good fit of the bifactorial model (CFI = 0.9589; χ2 (19) = 62.852, p < 0.001; RMSEA = 0.075; SRMR = 0.040) and provided support for the measurement invariance of the scale across gender. The internal consistency was as follows: Social (α = 0.786), Emotional (α = 0.820). The concurrent validity of the subscales was demonstrated by significant latent negative correlations with measures of eating disorders and emotional eating. The 8-items ESEBS appears as a valid and reliable instrument to assess eating self-efficacy related to social and emotional situations. Future studies should evaluate its potential use in non-clinical and clinical research and interventions. Level V, descriptive cross-sectional study.

Eating self-efficacy as predictor of long-term weight loss and obesity-specific quality of life after sleeve gastrectomy: A prospective cohort study

BackgroundA person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery. ObjectiveWe investigated the association between ESE, weight loss, and obesity-specific quality of life (QOL) after sleeve gastrectomy (SG). SettingA single-center longitudinal study. MethodsData from adult patients were collected before SG, and at mean 16 months (±standard deviation 4 mo) and 55 (±4) months postoperatively. ESE was measured by the Weight Efficacy Lifestyle Questionnaire Short-Form. Multiple regression analyses were performed with excess body mass index loss (%EBMIL) and obesity-specific QOL as dependent variables. Age, sex, and other preoperative values were covariates in all models. ResultsOf 114 preoperative patients, 91 (80%) and 84 (74%) were available for follow-up 16 and 55 months after SG, respectively. Mean %EBMIL from baseline to 16 and 55 months was 76% (95% confidence interval: 71.9, 79.6) and 67% (95% confidence interval: 61.9, 72.2), respectively. Preoperative ESE scores improved significantly at both 16 and 55 months (P = .002) but did not predict postoperative %EBMIL or QOL at 55 months (β = −.08, P = .485). Greater change in ESE from 0 to 16 months predicted higher %EBMIL (β = .34, P = .013) at 55 months, and improvements in ESE from 0 to 55 months were significantly associated with higher %EBMIL (β = .46, P = .001) and obesity-specific QOL (β = .50, P < .001) 55 months after SG. ConclusionSignificant improvements in ESE were seen at 16 months, and remained high at 55 months after SG in this cohort. Patients who improved their ESE the most also experienced the highest weight loss and obesity-specific QOL 5 years postoperatively. Future research should address whether enhancement of ESE corresponds to sustained improvements in eating behavior after bariatric surgery.

Assessment of Stages and Processes of Change, Eating Self-Efficacy and Decisional Balance for Weight Loss in Obese Women Attending Nutrition Clinics

Background: The transtheoretical model is an effective theory in health promotion. In order to maximize success, this theory has been introduced into different weight loss interventions. Objectives: The purpose of this study was to assess the stages and processes of change, self-efficacy, and decisional balance for weight loss among obese women attending nutrition clinics as an attempt to direct nutrition interventions. Methods: In this descriptive study, ninety volunteered apparently healthy obese women aged 18 - 50 years with body mass index of 30 - 40 kg/m2 attending a nutrition clinic in Ardabil city were recruited. The subjects completed the translated and validated versions of University of Rhode Island Change Assessment, processes of change, weight efficacy lifestyle, and Decisional Balance scales as the transtheoretical model components before any intervention. The score on each subscale was calculated by averaging the scores obtained by all participants within each subscale. T-test was used to compare the mean total score of each scale with the mean score of its subscales. Results: The results showed that 46.7% of participants were in the advanced stages of weight loss. The mean score of behavioral processes was significantly lower than that of cognitive processes (2.33 ± 0.51 vs. 3.02 ± 0.45, P < 0.001). The minimum and maximum scores of confidence to resist the desire to eat were observed in availability and physical discomfort subscales (3.62 ± 1.83 and 4.54 ± 1.71, respectively). Nearly half of the subjects had lower scores than the mean total score in decisional balance. Conclusions: It seems that the assessment of stages and tailoring of interventions based on readiness to change are essential among obese women attending nutrition clinics. The strengthening behavioral processes, eating self-efficacy, and decisional balance for weight loss must also be considered.

Assessment of Stages and Processes of Change, Eating Self-Efficacy and Decisional Balance for Weight Loss in Obese Women Attending Nutrition Clinics

Assessment of Stages and Processes of Change, Eating Self-Efficacy and Decisional Balance for Weight Loss in Obese Women Attending Nutrition Clinics

The Effect of Self-Efficacy on Behavior and Weight in a Behavioral Weight-Loss Intervention.

To determine whether eating self-efficacy (ESE) and physical activity self-efficacy (PASE) are predictive of dietary intake, physical activity, and weight change within a behavioral weight-loss intervention, and whether dietary intake and physical activity mediate relationships between self-efficacy and weight change. The study sample included 246 participants from a randomized trial with complete data on study variables at 12 months. ESE, PASE, calories consumed, minutes of moderate-to-vigorous physical activity (MVPA), and weight were measured at baseline, 6, and 12 months. ESE at baseline was associated with 12-month percent weight loss (PWL), and was mediated by average calories consumed at 6 and 12 months. Change in ESE from baseline to 6 months was associated with calories consumed at 12 months and 12-month percent weight loss, but the mediated relationship was not significant. Baseline PASE was not associated with average MVPA at 6 and 12 months or 12-month PWL, but change in PASE from baseline to 6 months was associated with 12-month PWL through its effect on MVPA at 12 months. Increases in ESE and PASE during the active phase of the intervention are predictive of dietary intake, physical activity and weight loss at later points, but further research should include explorations of the reciprocal relationship between behavior and self-efficacy to better inform intervention strategies that target self-efficacy and promote behavior change. (PsycINFO Database Record

Emotional Eating, Nonpurge Binge Eating, and Self-Efficacy in Healthy Perimenopausal Women.

To examine the relationships among nonpurge binge eating, emotional eating, and diet-related self-efficacy in perimenopausal women, a population at risk for weight gain. Descriptive correlational study. Secondary analysis of baseline data for a weight gain prevention intervention, Mindful Restaurant Eating, with a sample of healthy perimenopausal women (n = 43). Controlling for age and body mass index, the binge eating severity was associated with emotional eating (partial r = .71; p ≤ .01) and was negatively associated with diet-related self-efficacy (partial r = -.49; p ≤ .05). There was a significant difference (p < .01) in emotional eating scores between women with moderate to high binge eating severity scores and those with low binge eating severity scores. Participants with higher binge eating severity also had less diet-related self-efficacy, especially with regard to resisting relapse and reducing calorie intake. Perhaps perceived loss of control, a central component to binge eating, negatively affects one's ability to consistently attain dietary goals, thus affecting self-efficacy. Interventions increasing diet-related self-efficacy may prove useful in decreasing the amount of excess calories consumed because of emotional eating and/or binge eating behavior.

Associations between depressive symptoms, self-efficacy, eating styles, exercise and body mass index in women

This article explores cross-sectional associations between depressive symptoms and body mass index (BMI) in women working in schools in the Greater New Orleans area. Self-efficacy for eating and exercise, eating styles, and exercise are examined as potential pathways. This is a secondary data analysis of 743 women who were participating in a workplace wellness randomized controlled trial to address environmental factors influencing eating and exercise behaviors using baseline data prior to the intervention. BMI was the primary outcome examined. Path analysis suggested that increased depressive symptoms were associated with increased BMI in women. Indirect effects of depressive symptoms on BMI were found for increased healthy eating self-efficacy, increased emotional eating, and decreased exercise self-efficacy. The association between greater healthy eating self efficacy and BMI was unexpected, and may indicate a suppressor effect of eating self-efficacy in the relationship between depressive symptoms and BMI in women. The findings suggest the importance of depressive symptoms to BMI in women. Targets for interventions to reduce BMI include targeting depressive symptoms and related sequelae including self-efficacy for exercise, and emotional eating. Further investigation of eating self-efficacy and BMI are recommended with particular attention to both efficacy for health eating and avoidance of unhealthy foods.

Relationship between maternal parenting and eating self-efficacy in overweight children when stressed

Emotional eating is associated with negative eating habits and obesity. Parents may be able to decrease the risk of emotional eating in children by promoting greater self-efficacy to engage in healthy eating behaviors. Our goal was to determine the relationship between certain parenting behaviors and eating self-efficacy (ESE) to consume healthy foods during times of emotional stress in a population of overweight/obese children. Eighty children (60% female; mean BMI percentile = 98.4%; 79.2% White) completed a survey that assessed their ESE when stressed, feeling down, or bored. Children also reported on mothers' parenting behaviors coded along three factors: acceptance-based parenting (AC), psychological control (PC), and firm control (FC). Correlations and multiple linear regression models were used for analysis. AC was positively correlated with ESE when stressed. PC and FC were inversely correlated with ESE when feeling down. In the multivariate regression, only FC was significantly inversely associated with ESE when feeling down. Results suggest that overweight children who perceive their mothers to exhibit firm control have lower ESE to make healthy choices when feeling sad. These results suggest that pediatric obesity programs should place a stronger focus on decreasing firm control behaviors among parents in order to help children engage in healthier eating behaviors.

Links Among Eating Disorder Characteristics, Exercise Patterns, and Psychological Attributes in College Students

This study examined associations among eating disorder characteristics, excessive exercise, and selected psychological attributes in college students ( N = 499). Male and female participants were recruited from university psychology courses and administered the Obligatory Exercise Questionnaire (OEQ), Mental Health Inventory, Eating Self-Efficacy Scale, Revised Restraint Scale, and Eating Disorder Inventory. Results confirmed the multidimensionality of excessive exercise for both males and females. Profiles of male and female exercisers were developed based on the clustering of scores on the OEQ’s factor analytically derived subscales. Specific qualitative aspects of exercise (e.g., emotionality and obsession), rather than the quantity of exercise, were found to be associated with eating disorder traits and, for some groups, psychological distress (PD). For other groups, such as female excessive exercisers, exercise seems to act as a coping mechanism, thereby lessening PD and enhancing well-being.

Validation francophone et québécoise de la sous-échelle Weight-Related Teasing du Perception of Teasing Scale chez les enfants

Resume Les moqueries que subissent les enfants au sujet de leur poids ont souvent des consequences deleteres. Sur le plan clinique, leur detection precoce est donc essentielle. Cependant, il n’existe pas de questionnaire valide en francais pour mesurer ces moqueries. Developpe pour les adultes le Perception of Teasing Scale (POTS) inclut une mesure des moqueries liees au poids (WT). Le but de l’etude est de traduire, d’adapter et de valider la sous-echelle WT du POTS pour les enfants francophones de six a neuf ans. Les participants sont 430 enfants (240 filles et 188 garcons, âge moyen = 7,51) du primaire. Ils completent deux fois a un intervalle de deux semaines trois instruments : la version en francais du POTS-WT, un questionnaire mesurant les troubles des conduites alimentaires (TCA) et un autre mesurant le sentiment d’efficacite personnelle specifique a l’alimentation (SEPA). L’indice de masse corporelle (IMC) est aussi calcule. La presente version du POTS-WT montre une bonne coherence interne, mais un indice test-retest plus faible. La frequence des moqueries correle positivement avec les TCA et negativement avec le SEPA. Aucune correlation n’est obtenue avec l’IMC. Les resultats appuient l’utilisation du POTS-WT en francais pour la recherche clinique et pour le depistage precoce.

Risky food safety behaviors are associated with higher BMI and lower healthy eating self-efficacy and intentions among African American churchgoers in Baltimore [corrected

BackgroundThere are an estimated 9.4 million cases of foodborne illness each year. Consumers have a key role in preventing foodborne illness, but differences in the practice of food safety behaviors exist, increasing risk for certain groups in the population. Identifying groups who are more likely to practice risky food safety behaviors can assist in development of interventions to reduce the disease burden of foodborne illnesses. The purpose of this investigation was to examine the relationships of health indicators and psychosocial factors with self-reported food safety behaviors.Methods and FindingsData were collected via questionnaire from 153 African Americans who attend churches in Baltimore City. Individuals reported high overall concern with food safety (mean score: 0.80±0.49 on a scale of −1 to +1) and practiced food safety behaviors with moderate overall frequency (mean score: 5.26±4.01 on a scale of −12 to +12), with considerable variation in reported frequencies depending on the food safety behavior. After adjusting for demographic variables, food safety behaviors were significantly associated with BMI and psychosocial variables. Riskier food safety behaviors were associated with higher body mass index (BMI) (β = −0.141 95%CI (−0.237, −0.044), p = 0.004). Self-efficacy for healthy eating (standard β [std. β] = 0.250, p = 0.005) and healthy eating intentions (std. β = 0.178, p = 0.041) were associated with better food safety behaviors scores.ConclusionsThese results show important relationships between weight-related health indicators, psychosocial factors and food safety behaviors that have not previously been studied. Interventions tailored to higher-risk populations have the potential to reduce the burden of food-related illnesses. Additional studies are needed to further investigate these relationships with larger and more diverse samples.

The Eating Disorder Recovery Self-Efficacy Questionnaire (EDRSQ): Change with treatment and prediction of outcome

The purpose of this study was to examine the predictive validity of the Eating Disorder Recovery Self-Efficacy Questionnaire (EDRSQ), an empirically-derived self-report instrument that assesses confidence to eat without engaging in eating disordered behavior or experiencing undue emotional distress (Normative Eating Self-Efficacy) and confidence to maintain a realistic body image that is not dominated by pursuit of thinness (Body Image Self-Efficacy). Participants were 104 female inpatients with anorexia nervosa (AN), subthreshold AN, or underweight bulimia nervosa who were treated at a specialized eating disorder clinic and completed the EDRSQ and Eating Disorder Inventory-2 (EDI-2) Drive for Thinness (DT) and Body Dissatisfaction (BD) subscales upon admission. A subset of patients completed the EDRSQ (n=81) and EDI-2 subscales (n=70) following inpatient treatment. Self-efficacy increased significantly during treatment. EDRSQ scores at admission were inversely related to length of hospital stay and posttreatment DT and BD subscales and positively related to partial hospital weight gain rate. The EDRSQ significantly predicted length of hospital stay and posttreatment BD above and beyond clinical indicators and eating disorder psychopathology at inpatient admission. Findings support the validity of the EDRSQ and suggest it is a useful predictor of short-term hospital treatment outcome in underweight eating disorder patients.

Motivation to Modify Lifestyle Risk Behaviors in Women Treated for Breast Cancer

To determine motivators of health behaviors (relevant to risk for chronic disease and cancer recurrence) after a cancer diagnosis. Eighty-six women who had been treated for breast cancer (mean age, 54.8 years; median time since diagnosis, 23.5 months) participated in this cross-sectional study (1997-1998). Respondents completed a questionnaire assessing overweight or obesity status, dietary fat intake, energy expenditure, motivational readiness for exercise and weight loss, and variables associated with readiness for exercise adoption and weight loss. Forty-six women (54%) were overweight or obese, and 47 women (55%) reported dietary fat intake of 30% or higher. Sixty-one women (72%) were in action/ maintenance stages for exercise adoption. A majority believed that diet and exercise can change the course of cancer. Overweight and obese women in the sample were more likely to be in early stages of motivational readiness for weight loss, and they reported significantly lower exercise self-efficacy and lower eating self-efficacy than their nonoverweight peers. However, they endorsed more benefits associated with weight loss than the nonoverweight subgroup. Thirty-three women (39%) reported both a low-fat diet and exercising at recommended levels. Only a minority of respondents reported consuming a diet low in fat and exercising at recommended levels, which suggests a need to improve both diet and exercise behaviors among women treated for breast cancer. Overweight and obese women reported low self-efficacy for exercise and eating, suggesting that interventions should focus on increasing self-efficacy for behavior change.