Increase In Dietary Restraint Research Articles

The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta‐analysis

SummaryIntroductionBehavioral weight management interventions (BWMIs) are an evidence‐based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta‐analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.MethodsSeven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta‐analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta‐analysis (SWiM) was applied for EBTs where meta‐analysis was not feasible.ResultsThe review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta‐analyses of data from three trials at intervention completion and post‐intervention (average of 28 weeks [±8]) revealed positive short‐term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow‐up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.ConclusionBWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.

Appetitive and Metabolic Responses to an Exercise versus Dietary Intervention in Adults with Obesity.

Dietary restriction (DIET) and aerobic exercise (AEX) interventions may impact energy balance differently. Our aim was to describe the effects of weight loss interventions via DIET or AEX on measures of energy balance. Adults with overweight or obesity were randomized to 12 weeks of DIET or AEX with similar calorie deficit goals. A study day was conducted before and after the intervention to assess subjective and hormonal (ghrelin, peptide-YY, glucagon-like peptide-1) appetite responses to a control meal, ad libitum energy intake (EI) at a single meal, and over three days of free-living conditions and eating behavior traits. Resting metabolic rate (RMR) was measured with indirect calorimetry and adjusted for body composition measured by dual X-ray absorptiometry. Non-exercise activity was measured using accelerometers. Forty-four individuals were included (age: 37 ± 9 years, body mass index: 30.6 ± 3.1 kg/m2). Both interventions resulted in weight and fat mass loss. The DIET group lost fat-free mass, although differences between groups were not significant (DIET: -1.2 ± 1.7 kg, p<0.001; AEX: 0.4 ± 1.5 kg, p=0.186; p=0.095 interaction). There were no differences in RMR after body composition adjustment. Both interventions were associated with an increase in dietary restraint (DIET: 4.9 ± 1.2, AEX: 2.8 ± 0.7; p<0.001 in both groups). Hunger decreased with DIET (-1.4 ± 0.5, p=0.003), and disinhibition decreased with AEX (-1.5 ± 0.5, p<0.001), although these changes were not different between groups (i.e., no group × time interaction). No other differences in appetite, EI, or non-exercise physical activity were observed within or between groups. AEX did not result in compensatory alterations in appetite, ad libitum EI, or physical activity, despite assumed increased energy expenditure. Modest evidence also suggested that disinhibition and hunger may be differentially impacted by weight loss modality.

Diet, eating behaviour and weight gain in men and women with overweight/obesity receiving varenicline for smoking cessation.

Because trying to quit smoking and not gain weight requires changes in two major behaviours simultaneously we explored eating behaviour in smokers with overweight/obesity making a quit attempt using guideline-based treatment. Participants were randomized to a carbohydrate-reduced or fat-reduced diet. The Three Factor Eating Questionnaire and Binge Eating Scale were completed by 48 of 64 participants in the low-carbohydrate and 47 of 58 in the fat-reduced group at randomization, after 6 and 14 weeks. At 6 weeks, no between group differences were seen in eating behaviour scores thus, we combined the sample for further analyses. In the combined sample, restraint increased (3.94 [95% CI 3.05, 4.83]), disinhibition (uncontrolled eating) decreased (-0.86 [95% CI-1.31, -0.41]) and binge eating decreased (-1.95 [95% CI -2.83, -1.06]), while hunger scores did not change (-0.43 [95% CI -0.89, 0.03]) after 14 weeks. In a general linear model, increase in dietary restraint (P = .012) and decrease in binge eating (P = .040) were associated with lower weight gain (model R2 adj = .147). In a smoking cessation program, dietary support regardless of diet was associated with increased dietary restraint and reduced binge eating. Because smoking cessation causes weight gain these results indicate that dietary support leads to eating behaviour changes that may prevent weight gain.

Short- And Long-term Effects Of High Intensity Interval Training On Dietary Intake In Cardiac Rehabilitation

PURPOSE: The aim of this study was to investigate short- and long-term compensatory effects on dietary intake following high intensity interval training (HIIT) compared with usual care moderate intensity continuous training (MICT) during and following a cardiac rehabilitation (CR) program. METHODS: Ninety-three patients with coronary artery disease enrolled in a 4-week CR program and were randomised to 1) 4x4-minute HIIT; or 2) 40-minutes of MICT (usual care). Patients were instructed to complete 3 weekly sessions (2 supervised, 1 home-based) for 4-weeks, and 3 weekly home-based sessions thereafter for 48-weeks. Only CR group-based dietary advice was provided. Dietary intake was measured by telephone-based 24-hour recall over two days at baseline, 4-weeks, 3-months, 6-months, and 12-months. The Three-Factor Eating Questionnaire was used to measure dietary behaviour, and fasting appetite was assessed by a 100mm visual analogue scale. Appetite hormones (ghrelin, PYY, leptin) were also analysed at baseline and 3-months. Data are mean change (95% confidence interval). RESULTS: There was no change over the study period or differences between HIIT and MICT for daily energy intake at 4-weeks [-0.1(-0.8,0.5) vs -0.4(-1.0,0.2) MJ; p=0.549] or 12-months [0.4(-0.6,1.3) vs 0.1(-0.9, 1.0) MJ; p=0.848]. There were also no group differences for macronutrients, saturated fat, or fibre. Over 4-weeks, an increase in dietary restraint for both HIIT and MICT [7(-1,15) vs 6(-2,16); time effect: p=0.028], coincided with an increase in hunger [6(1,10) vs 5(1,10)mm; time effect: p=0.001], but this was not evident at 12-months. There was a time x group effect for leptin with a reduction for HIIT and increase for MICT [-0.9(-1.9,0.2) vs 0.7(-0.3, 1.7) ng/ml; p=0.029), but no changes over time or group differences for ghrelin [7(-10,23) vs 4(-12,20) pg/ml; p=0.815] or PYY [13(-4,30) vs 2(-14,18) pg/ml; p=0.354]. CONCLUSIONS: Compared to moderate intensity exercise, HIIT did not result in compensatory increases of energy intake or indicators of poor diet quality. Furthermore, HIIT reduced leptin without compensatory effects on ghrelin or dietary intake. HIIT can therefore be included in CR programs as an adjunct or alternative to MICT, without concern for any undesirable dietary compensation. Funded by Wesley Medical Research

When Pizza Doesn’t Sound as Good as Usual: Restrained Versus Unrestrained Eaters’ Responses to Gluten-Free Menu Items

Increasing demand for gluten-free foods is driving restaurants to add gluten-free menu items. However, it remains unclear how gluten-free labels affect food consumption and overall evaluations of a dining experience. We conducted two studies to fill this gap. Results from Study 1 suggest that unrestrained eaters (i.e., people with low levels of dietary restraint) expect to decrease their food consumption when a menu item bears a gluten-free cue, whereas restrained eaters (i.e., people with high levels of dietary restraint) do not show such an effect. This negative impact of a gluten-free cue on consumption among unrestrained eaters is mediated by expected taste. Results from Study 2 show that when a gluten-free purchase is incentivized with immediate incentives (i.e., price discounts), an increase in dietary restraint leads to a heightened salience of a health goal. Such an effect is attenuated with delayed incentives (i.e., redeemable points). The health goal salience mediates the impact of dietary restraint on anticipated satisfaction with a gluten-free dining experience incentivized with immediate rewards. This research contributes to the hospitality literature and the broader literature on food consumption. Moreover, our findings suggest that managers need to focus on clearly communicating the appealing taste of gluten-free foods and aim at activating a health goal among unrestrained eaters.

Genetic predisposition, dietary restraint and disinhibition in relation to short and long-term weight loss

BackgroundInterindividual differences in response to weight loss and maintenance thereafter are ascribed to genetic predisposition and behavioral changes. ObjectiveTo examine whether body weight and short and long-term body weight loss were affected by candidate single nucleotide polymorphisms (SNPs) and changes in eating behavior or by an interaction between these genetic and behavioral factors. Methods150 healthy subjects (39 males, 111 females) aged 20–50y with a BMI of 27–38kg/m2 followed a very low energy diet for 8-weeks, followed by a 3-month weight maintenance period. SNPs were selected from six candidate genes: ADRB2, FTO, MC4R, PPARG, PPARD, and PPARGC1A. Changes in eating behavior were determined with the Three Factor Eating Questionnaire. ResultsA high genetic predisposition score was associated with a high body weight at baseline and more short-term weight loss. From the six selected obesity-related SNPs, FTO was associated with increased body weight at baseline, and the effect allele of PPARGC1A was positively associated with short-term weight loss, when assessed for each SNP separately. Long-term weight loss was associated with a larger increase in dietary restraint and larger decrease in disinhibition. ConclusionDuring long-term weight loss, genetic effects are dominated by changes in eating behavior.

Determinants of Weight Loss after an Intervention in Low-Income Women in Early Postpartum

Objective: Postpartum is a critical period for the development of obesity in women, yet there is limited research of factors associated with changes in weight during early postpartum. Therefore, the objective of this study was to identify determinants of weight loss after an intervention.Methods: A sample of women in early postpartum was recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics, doctors' offices, and neighborhood centers (N = 58). Women participated in an 8-week weight-loss intervention. Subjects were measured for weight and height and completed demographics, the Eating Stimulus Index, a nutrition knowledge test, a food-frequency questionnaire, and a household environment survey. Correlations and linear regression determined associations with the outcome variable weight loss, and hierarchical regression was used to determine the most significant predictors.Results: All subjects improved their nutrition knowledge, skills, convenience-eating resistance, and fruit and vegetable availability after the intervention. Responders had greater changes in dietary restraint, fruit juice servings, and discretionary energy than did nonresponders. Increases in dietary restraint, weight-management skills, and weight-loss self-efficacy and decreases in discretionary energy intake significantly predicted weight loss in individual regression analysis. After hierarchical regression analysis, improvement in dietary restraint was the most significant determinant, followed by decreases in total energy intake. Although weight-loss self-efficacy, weight-management skills, and discretionary energy intake significantly predicted weight loss when analyzed alone, these variables did not contribute to the prediction model revealed by this study.Conclusions: Positive changes in social cognitive theory constructs are associated with weight loss in low-income postpartum women. Dietary restraint, weight-management skills, weight loss self-efficacy, and reductions in total and discretionary energy are modifiable factors that should be emphasized in interventions designed for this population, but only dietary restraint and total energy intake were predicted in the model.

The Parent–Child Relationship as Predictor of Eating Pathology and Weight Gain in Preadolescents

The present study examined the role of attachment toward mother and father as a predictor of eating pathology and weight gain among preadolescent boys and girls. Self-report questionnaires and adjusted body mass index (BMI) were administered from a community sample of 601 preadolescents (8–11 years; 48% female) at baseline and once again 1 year later. Significant baseline associations were found between attachment toward both parents and several features of eating pathology. No baseline correlations were found between the attachment variables and adjusted BMI. However, after controlling for gender and baseline levels of eating pathology and weight, an insecure attachment toward mother significantly predicted increases in dietary restraint, eating concerns, weight concerns, and shape concerns, and adjusted BMI in the children 1 year later. An insecure attachment toward father was predictive for persistence in children's subjective binge eating episodes. The present study provides preliminary evidence for the longitudinal association between attachment and eating pathology and weight gain in preadolescents. Moreover, attachment toward mother and attachment toward father appear to be differently associated with their children's disordered eating attitudes and adjusted BMI. Future research should further elucidate the mechanisms underlying this differential association.

Dietary intervention promoting high intakes of fruits and vegetables: Short-term effects on eating behaviors in overweight-obese postmenopausal women

Objective To compare changes in eating behaviors in response to two dietary interventions: one focusing on restrictive messages to limit consumption of high-fat foods (LOFAT) and the other one based on non-restrictive messages to increase consumption of fruits and vegetables (HIFV). Methods Sixty-eight overweight-obese postmenopausal women were randomly assigned to one of the two 6-month dietary interventions that included three group sessions and ten individual sessions with a dietitian. Anthropometric variables and eating behaviors were measured at baseline, 3 months and 6 months. Results Body weight decreased significantly in both groups at 6 months compared to baseline (LOFAT: −3.5 ± 2.9 kg; HIFV: −1.6 ± 2.9 kg). At 6 months, dietary restraint score was higher in the LOFAT group compared to the HIFV group (12.7 ± 4.2 vs 10.5 ± 4.9; p < 0.05). Disinhibition and hunger decreased significantly in the HIFV group after 6 months while only hunger decreased in the LOFAT group. Conclusion A weight loss approach based on increasing fruit and vegetable consumption leads to a significant weight loss and is associated with a decrease in disinhibition and hunger without any increase in dietary restraint.

Effects of the addition of a resistance training programme to a caloric restriction weight loss intervention on psychosocial factors in overweight and obese post-menopausal women: A Montreal Ottawa New Emerging Team study

The aim of this study was to examine the effects of the addition of a resistance training programme to a caloric restriction weight loss intervention on psychosocial profile. The study sample consisted of 137 overweight and obese post-menopausal women. Participants were randomized to a caloric restriction group and caloric restriction + resistance training group. Psychosocial, anthropometric, and metabolic variables were measured before and after the 6-month weight loss intervention. Both groups presented similar weight loss and there were no significant differences between the caloric restriction group and caloric restriction + resistance training group for changes in psychosocial profile. Thereafter, all participants were classified into quintiles based on the amount of weight loss. In all quintiles, women markedly improved body esteem and self-esteem, and decreased hunger and perceived risk for diabetes mellitus (P < 0.05). However, significant increases in dietary restraint were observed in quintiles 2–5 (≥2.4 % body weight loss), decreases in disinhibition in quintiles 3–5 (≥4.9 %), increases in self-efficacy in quintiles 3–5 (≥4.9 %), and increases in health perceptions in quintile 5 (≥11.1%). The results of this study do not support the hypothesis that the addition of a resistance training programme to a caloric restriction weight loss intervention has additional benefits on psychosocial profile. Overall, the significant improvements in the psychosocial profile observed were mostly accounted for by the degree of weight loss.

A Low-Fat Vegan Diet Elicits Greater Macronutrient Changes, but Is Comparable in Adherence and Acceptability, Compared with a More Conventional Diabetes Diet among Individuals with Type 2 Diabetes

Background Although therapeutic diets are critical to diabetes management, their acceptability to patients is largely unstudied. Objective To quantify adherence and acceptability for two types of diets for diabetes. Design Controlled trial conducted between 2004 and 2006. Subjects/setting Individuals with type 2 diabetes (n=99) at a community-based research facility. Participants were randomly assigned to a diet following 2003 American Diabetes Association guidelines or a low-fat, vegan diet for 74 weeks. Main outcome measures Attrition, adherence, dietary behavior, diet acceptability, and cravings. Statistical analyses For nutrient intake and questionnaire scores, t tests determined between-group differences. For diet-acceptability measures, the related samples Wilcoxon sum rank test assessed within-group changes; the independent samples Mann-Whitney U test compared the diet groups. Changes in reported symptoms among the groups was compared using χ 2 for independent samples. Results All participants completed the initial 22 weeks; 90% (45/50) of American Diabetes Association guidelines diet group and 86% (42/49) of the vegan diet group participants completed 74 weeks. Fat and cholesterol intake fell more and carbohydrate and fiber intake increased more in the vegan group. At 22 weeks, group-specific diet adherence criteria were met by 44% (22/50) of members of the American Diabetes Association diet group and 67% (33/49) of vegan-group participants ( P=0.019); the American Diabetes Association guidelines diet group reported a greater increase in dietary restraint; this difference was not significant at 74 weeks. Both groups reported reduced hunger and reduced disinhibition. Questionnaire responses rated both diets as satisfactory, with no significant differences between groups, except for ease of preparation, for which the 22-week ratings marginally favored the American Diabetes Association guideline group. Cravings for fatty foods diminished more in the vegan group at 22 weeks, with no significant difference at 74 weeks. Conclusions Despite its greater influence on macronutrient intake, a low-fat, vegan diet has an acceptability similar to that of a more conventional diabetes diet. Acceptability appears to be no barrier to its use in medical nutrition therapy.

Neuromedin Beta: P73t Polymorphism in Overweight and Obese Subjects

Neuromedin beta (NMB) is a member of the bombesin-like peptide family expressed in brain, gastrointestinal tract, pancreas, adrenals and adipose tissue. The aim of our study was to compare the frequency of P73T polymorphism in overweight and obese patients (37 men: age 50.6+/-11.7 years, BMI 41.1+/-7.8 kg/m(2); 255 women: age 49.0+/-11.9 years, BMI 37.9+/-6.8 kg/m(2)) with that of healthy normal weight subjects (51 men: age 28.2+/-7.1 years, BMI 22.3+/-2.0 kg/m(2); 104 women: age 29.1+/-9.1 years, BMI 21.5+/-1.9 kg/m(2)) and to investigate the polymorphism's influence on anthropometric, nutritional and psychobehavioral parameters in overweight/obese patients both at the baseline examination and at a control visit carried out 2.5 years later, regardless of the patient s compliance with the weight reduction program. No significant differences in the genotype distribution were demonstrated between normal weight and overweight/obese subjects. Male T allele non-carriers compared to T allele carriers had higher energy (p=0.009), protein (p=0.018) and fat (p=0.002) intakes and hunger score (p=0.015) at the beginning of treatment. Male T allele non-carriers had a more favorable response to weight management at the follow-up, as they exhibited a significant reduction in waist circumference, energy intake and depression score as well as a significant increase in dietary restraint. No significant differences between carriers and non-carriers were demonstrated in women at the baseline examination. Both female T allele carriers and non-carriers demonstrated similar significant changes in nutritional parameters and in restraint score at the follow-up. Nevertheless, only female non-carriers showed a significant decrease in the hunger score.

"STOP regain": Are there negative effects of daily weighing?

Several recent studies suggest that daily weighing is important for long-term weight control, but concerns have been raised about possible adverse psychological effects. The "STOP Regain" clinical trial provides a unique opportunity to examine this issue both cross-sectionally and prospectively. Successful weight losers (N = 314) were randomly assigned to a control or to a face-to-face or Internet intervention designed to help them maintain their weight loss and were then followed for 18 months. The intervention groups reported increases in daily self-weighing, which were associated with successful weight loss maintenance. We found no evidence that increases in frequency of weighing or daily weighing per se had any adverse effects in this study population. Rather, increases in self-weighing were associated with increases in dietary restraint (p < .001), decreases in disinhibition (p < .003), and decreases in depressive symptoms (p < .002). Moreover, those who weighed daily at 18 months were less likely to report having >or=4 binge episodes per month (p = .03). Daily weighing appears to be an important aspect of weight loss maintenance and was not associated with adverse psychological effects.

Relations between dietary restraint, depressive symptoms, and binge eating: A longitudinal study

Temporal relations between dietary restraint, depressive symptoms, and binge eating were tested by means of three competing models positing that (1) dietary restraint and depressive symptoms predict future increases in binge eating, (2) binge eating predicts future increases in dietary restraint and depressive symptoms, and (3) binge eating is reciprocally related to these two factors. Longitudinal data from a community sample of Dutch females (N = 143; M age = 19.6) was used to test these relations while controlling for initial levels of these factors. Dietary restraint did not predict future increases in binge eating, nor did binge eating predict future increases in dietary restraint. Depressive symptoms predicted future increases in binge eating, but binge eating did not predict future increases in depressive symptoms. Although this study had limited statistical power, the pattern of relations and effect sizes suggest that depressive symptoms, but not dietary restraint, increase risk of binge eating for late adolescent females.

Predictors of Long‐term Weight Maintenance

The purpose of this study was to evaluate available variables of a long-term weight maintenance study to investigate possible factors predisposing to weight regain after a period of weight loss. The Maastricht Weight Maintenance Study is an ongoing longitudinal study of healthy men and women (29 men and 62 women; 18 to 65 years of age; BMI = 30.2 +/- 3.1 kg/m(2)). A variety of parameters were measured before and after a very-low-energy diet and after a follow-up of at least 2 years. Mean weight loss was 7.9 +/- 3.6 kg, and percent weight regain was 113.8 +/- 98.1%. Percent BMI regain was negatively associated with an increase in dietary restraint (r = -0.47, p < 0.05). Percent weight regain was negatively correlated with baseline resting metabolic rate (r = -0.38, p = 0.01) and baseline fat mass (r = -0.24, p = 0.05) and positively correlated with the magnitude of change in body weight (BW) expressed as maximum amplitude of BW (r = 0.21, p < 0.05). In addition, amplitude of BW was positively correlated with the frequency of dieting (r = 0.57, p < 0.01). The best predictors for weight maintenance after weight loss were an increase in dietary restraint during weight loss, a high baseline resting metabolic rate, a relatively high baseline fat mass favoring a fat-free mass-sparing effect during weight loss, a rather stable BW, and a low frequency of dieting. Therefore, BW maintenance after BW loss seems to be a multifactorial issue, including mechanisms that regulate an individuals' energy expenditure, body composition, and eating behavior in such a way that energy homeostasis is maintained.

Relation of weight maintenance and dietary restraint to peroxisome proliferator–activated receptor γ2, glucocorticoid receptor, and ciliary neurotrophic factor polymorphisms

Genetic variation in the peroxisome proliferator-activated receptor gamma2 (PPARgamma2), glucocorticoid receptor (GRL), and ciliary neurotrophic factor (CNTF) genes may play a role in the etiology of obesity. We examined biological, psychological, and genetic determinants associated with weight maintenance (WM) after weight loss. Subjects (n = 120) followed a 6-wk diet and then a 1-y period of WM. Body weight (BW), body composition, leptin concentration, attitude toward eating (measured with the Three-Factor Eating Questionnaire), physical activity, and the polymorphisms of the PPARgamma2, GRL, and CNTF genes were measured. BW loss was 7.0 +/- 3.1 kg. After 1 y, 21 subjects showed successful WM (<10% regain); 99 were unsuccessful (> or =10% regain). Compared with unsuccessful subjects, successful subjects had a higher increase in dietary restraint over time (4.8 +/- 5.0 and 1.8 +/- 3.9, respectively; P < 0.01) but significantly less sensation of general hunger (-4.0 +/- 4.9 and -1.2 +/- 2.7, respectively; P < 0.05). Successful subjects had a significantly different frequency distribution for the PPARgamma2 (P = 0.05) and GRL (P < 0.05) genes than did unsuccessful subjects. The more successful genotypes showed a higher baseline body mass index and waist circumference (PPARgamma2), a greater decrease in disinhibition of dietary restraint (GRL), and less sensation of hunger (GRL). The G/G genotype (GRL) was an independent predictor of successful WM. The different genotypes of the PPARgamma2 and GRL genes contribute to WM, either directly (GRL) or indirectly (PPARgamma2 and GRL) via baseline body mass index and waist circumference, and to changes in Three-Factor Eating Questionnaire scores.

CHANGES IN EATING BEHAVIORS AND MENSTRUAL FUNCTION OF FEMALE COLLEGIATE ATHLETES

It has been hypothesized that factors inherent in the sport setting place an athlete at risk for disordered eating and menstrual dysfunction. PURPOSE This longitudinal study examined changes in eating behaviors and menstrual function over 3 y in 41 female collegiate athletes representing 8 sports. METHODS Disordered eating and menstrual dysfunction were assessed by a health, weight, dieting, and menstrual history questionnaire administered during the preparticipation physicals. RESULTS Thirty nine percent (n=16) of the athletes reported an increase or persistence in menstrual cycle irregularity over the 3 y. The overall incidence of amenorrhea increased (P< 0.05), with 4 remaining amenorrheic and 4 athletes developing amenorrhea over the 3 y. Only 1 amenorrheic athlete became eumenorrheic. Thirty nine percent (n=16) of the athletes reported a stress fracture over the 3 y. A significant number (n=12) of those who suffered stress fractures reported amenorrhea at the time of, or the year preceding the fracture (P<0.05). None of the athletes reported a clinical diagnosis of anorexia or bulimia nervosa. Of athletes reporting they “might have” an eating disorder (n=6), 2 reported an improvement in their condition, while 4 reported a worsening or no change over the 3 y. Use of pathogenic weight control methods ranged from 2–42%. Few athletes reported an increase in the use of pathogenic weight control methods over the 3 y, and there was no identifiable relationship between the use of these methods and net weight change. Twenty-two percent (n=9) of athletes reported an increase in dietary restraint, while 29% (n=12) and 19% (n=8) reported a decrease or variable changes, respectively over the 3 y. CONCLUSION Participation in collegiate athletics may increase the risk of menstrual dysfunction (and accompanying stress fractures), while the association with disordered eating is more variable and, thus, no clear pattern could be identified.

Primary prevention of eating disorders: might it do more harm than good?

The aim of this pilot study was to evaluate a new school-based eating disorder prevention program designed to reduce dietary restraint. Forty-six school-girls, aged 13-14 years, took part. The intervention consisted of eight weekly sessions of 45 min duration. A battery of self-report questionnaires was administered before and after the intervention and 6 months later. Unlike previous prevention studies, there was not only an increase in knowledge at postintervention but there was also a decrease in target behavior and attitudes. However, these effects were short-lived since they had disappeared 6 months later: indeed, at 6-month follow-up there was an increase in dietary restraint compared with baseline. These findings suggest that the intervention had been counterproductive since it led to an increase in dietary restraint. They imply that school-based prevention programs may do more harm than good.

Primary prevention of eating disorders: Might it do more harm than good?

Objective The aim of this pilot study was to evaluate a new school-based eating disorder prevention program designed to reduce dietary restraint. Method: Forty-six schoolgirls, aged 13–14 years, took part. The intervention consisted of eight weekly sessions of 45 min duration. A battery of self-report questionnaires was administered before and after the intervention and 6 months later. Results: Unlike previous prevention studies, there was not only an increase in knowledge at postintervention but there was also a decrease in target behavior and attitudes. However, these effects were short-lived since they had disappeared 6 months later: indeed, at 6-month follow-up there was an increase in dietary restraint compared with baseline. Discussion: These findings suggest that the intervention had been counterproductive since it led to an increase in dietary restraint. They imply that school-based prevention programs may do more harm than good. © 1997 John Wiley & Sons, Inc. Int J Disord 22: 167–172, 1997.