Shape Concern Research Articles

Shape and weight concern as a moderator of program outcomes from the Prevention Across the Spectrum RCT

Results Moderation was indicated by significant interaction effects for group (Media Smart; Life Smart; HELPP; Control) X moderator (high shape and weight concern; low shape and weight concern) X time (post-program; 6-month followup; 12-month follow-up), with baseline entered as a covariate. Such effects were found for shape concern, weight concern, eating concern, regular eating, body dissatisfaction, and physical activity. Post-hoc testing found Media Smart participants with high baseline shape and weight concern experienced a reduction in risk at 12-month follow-up for 4 of the 6 variables. Discussion This study shows it is possible for a school-based program to reduce eating disorder risk factors in participants with high baseline risk of an eating disorder.

Clinical presentation of eating disorders in young males at a tertiary setting.

BackgroundYoung males with eating disorders are a neglected study population in eating disorders. The aim of this study was to provide knowledge about the clinical presentation of eating disorders in young males.MethodsThe data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project (N ~ 1000), a prospective, ongoing registry comprising consecutive paediatric (<18 years) tertiary eating disorder referrals. Young males with DSM-5 eating disorders (n = 53) were compared with young females with eating disorders (n = 704).ResultsThere was no significant difference in the prevalence of diagnosis of bulimia nervosa (2 % vs 11 %, p = 0.26) among sexes. Males had comparable duration of illness (9 months; p = 0.28) and a significantly earlier age of onset (M = 12 years; p <0.001). Shape concern (2.39 vs 3.57, p <0.001) and weight concern (1.97 vs 3.09, p <0.001) were lower in males, and body mass index z score (−1.61 vs −1.42, p = 0.29) and medical compromise (odds ratio [OR] = 0.64, 95 % CI: 0.36, 1.12) were comparable. Males had a two-folder higher odds of being diagnosed with unspecified feeding or eating disorders (40 % vs 22 % for females, p = 0.004). Driven exercise to control weight and shape was common and comparable in prevalence among males and females (51 % vs 47 %, p = 0.79) and males were less likely to present with self-induced vomiting (OR = 0.23, 95 % CI: 0.09, 0.59).ConclusionBoys with eating disorders are an understudied group with similarities and differences in clinical presentation from girls with eating disorders. Parents and physicians are encouraged to consider changes in weight, disturbed vital signs, and driven, frequent exercise for the purposes of controlling weight or shape, as possible signs of eating disorders among male children. Diagnostic classification, assessment instruments, conceptualisation, and treatment methods need to be refined to improve application to young males.

Exploring the relationship between eating disorder symptoms and substance use severity in women with comorbid PTSD and substance use disorders

Background: Eating disorders (ED) and substance use disorders (SUD) commonly co-occur, especially in conjunction with posttraumatic stress disorder (PTSD), yet little is known about ED and ED symptoms in women presenting to addiction treatment programs. Objective: We examined the association between ED symptoms and substance use frequency and severity in a sample of women with a DSM IV diagnosis of current SUD and PTSD enrolled in SUD treatment. Method: Participants were 122 women from four substance abuse treatment sites who participated in a multi-site clinical trial through the National Institute of Drug Abuse Clinical Trials Network (NIDA CTN). The Eating Disorder Examination-Questionnaire (EDE-Q), the Clinician’s Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were administered at baseline and correlational analyses were performed. Variables that significantly correlated with EDE-Q total and subscale scores were entered into a linear regression analysis. Results: Scores on the EDE-Q Global scale, as well as the Eating Concern, Weight Concern and Shape Concern subscales of the EDE-Q were significantly associated with Caucasian race/ethnicity, past 30 day opiate use, higher ASI Psychiatric Subscale score and lower ASI Employment Subscale score. Conclusion: Although exploratory, these findings suggest that there may be a relationship between addiction severity, use of certain drugs of abuse and eating disorder symptoms, particularly those involving weight and shape concerns in women with comorbid PTSD and SUD.

Patterns of body image concerns and disordered weight- and shape-related behaviors in heterosexual and sexual minority adolescent males.

This study investigates body image concerns and disordered weight- and shape-related behaviors across adolescence and young adulthood in males and how patterns vary by sexual orientation. Participants were 5,388 males from the U.S. national Growing Up Today Study. In 2001, 2003, and 2005 (spanning ages 15-20 years), participants reported sexual orientation, past-year desire for toned/defined muscles and concerns with weight and shape, and past-year binge eating, restrictive dieting, purging (vomiting or laxative use), and use of products to increase muscularity (e.g., creatine, steroids). Latent class analyses identified 2 patterns at ages 15-16 years and 3 patterns at 17-18 and 19-20 years: healthy (all ages; low body image concerns and weight- and shape-related behaviors; 54-74% of observations), muscle-concerned (ages 17-18 and 19-20; relatively high muscularity concern and product use; 18-21% of observations), and lean-concerned (all ages; relatively high weight and shape concern, dieting, and binge eating; 19-28% of observations). Latent transition analyses revealed that sexual minority males (i.e., mostly heterosexual, gay, and bisexual) were more likely than completely heterosexual males to be lean-concerned at ages 17-18 and 19-20 years and to transition to the lean-concerned class from the healthy class. There were no sexual orientation differences in odds of being muscle-concerned. Both heterosexual and sexual minority males are at risk for presenting body image concerns and weight- and shape-related behaviors that may have deleterious health consequences. Results suggest the need for screening for concerns and behaviors related to leanness and muscularity in early adolescence among all males, regardless of sexual orientation.

The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders

The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology.

It’s Not Me, It’s You: Perceptions of Partner Body Image Preferences Associated With Eating Disorder Symptoms in Gay and Heterosexual Men

This study explored perceptions of partner body image preferences and symptoms of disordered eating in gay and heterosexual men. Participants were male college students (n = 201; M age = 20.46), and over one third identified as gay. We compared discrepancies between participants’ current and ideal body type and participants’ current body type and the body type they believed they should have to attract a dating partner. For gay men, the discrepancy between their current body and the body they believed they should have to attract a dating partner was significantly greater than the discrepancy between their current and ideal body types. In gay and heterosexual men, the discrepancy between current body and the body they believed they should have to attract a dating partner predicted eating, shape, and weight concern. Results suggest that perceptions of partner body image preferences may contribute to eating disorder pathology in men.

Mindfulness-based prevention for eating disorders: A school-based cluster randomized controlled study.

Successful prevention of eating disorders represents an important goal due to damaging long-term impacts on health and well-being, modest treatment outcomes, and low treatment seeking among individuals at risk. Mindfulness-based approaches have received early support in the treatment of eating disorders, but have not been evaluated as a prevention strategy. This study aimed to assess the feasibility, acceptability, and efficacy of a novel mindfulness-based intervention for reducing the risk of eating disorders among adolescent females, under both optimal (trained facilitator) and task-shifted (non-expert facilitator) conditions. A school-based cluster randomized controlled trial was conducted in which 19 classes of adolescent girls (N = 347) were allocated to a three-session mindfulness-based intervention, dissonance-based intervention, or classes as usual control. A subset of classes (N = 156) receiving expert facilitation were analyzed separately as a proxy for delivery under optimal conditions. Task-shifted facilitation showed no significant intervention effects across outcomes. Under optimal facilitation, students receiving mindfulness demonstrated significant reductions in weight and shape concern, dietary restraint, thin-ideal internalization, eating disorder symptoms, and psychosocial impairment relative to control by 6-month follow-up. Students receiving dissonance showed significant reductions in socio-cultural pressures. There were no statistically significant differences between the two interventions. Moderate intervention acceptability was reported by both students and teaching staff. Findings show promise for the application of mindfulness in the prevention of eating disorders; however, further work is required to increase both impact and acceptability, and to enable successful outcomes when delivered by less expert providers.

Intimate partner violence among women with eating disorders during the perinatal period.

ABSTRACTObjective Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%–8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown.Method We studied women from a population‐based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physical and emotional IPV during and after the perinatal period was investigated among women with lifetime ED, with (n = 174) or without pregnancy shape and weight concern and/or purging behaviors (n = 189), and women with no ED (n = 8723).Results Women with lifetime ED showed higher prevalence of IPV during and after the perinatal period (physical = 9.6%–14.3% and emotional = 24.1%–28.1%). Lifetime ED was associated with higher odds of physical IPV during the perinatal period (odds ratio: 2.34, 95% confidence interval: 1.11–4.93, p = .03). Lifetime ED with and without pregnancy shape and weight concerns and/or purging was associated with higher odds of IPV after the perinatal period, and higher odds of reporting emotional IPV at all time points. Associations were moderated by partner's response to pregnancy and maternal experience of childhood sexual abuse.Discussion Mothers with ED and their children may be vulnerable to negative effects due to maternal ED and IPV combined, both of which have been associated with severe and long‐lasting harmful consequences. Partner's response to pregnancy and maternal experience of childhood sexual abuse might contribute to the association between ED and IPV perinatally. © 2015 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:727–735)

Development, psychometric properties and preliminary clinical validation of a brief, session-by-session measure of eating disorder cognitions and behaviors: The ED-15.

In the treatment research literature on other psychological disorders, there is a move towards session-by-session symptom measurement. The necessary measures need to be brief, focused on core features since the last session, and readily available to clinicians. There is no measure in the eating disorders that meets those criteria. This research reports the development and validation of such a self-report questionnaire. The authors generated and refined a brief set of attitudinal and behavioral items. The resulting questionnaire (the ED-15) and an existing measure (Eating Disorders Examination-Questionnaire; EDE-Q) were completed by a large nonclinical adult sample (N = 531), a group of self-reported eating disorder sufferers (N = 63), and a group of women (N = 33) diagnosed with bulimia nervosa or atypical bulimia nervosa and undertaking cognitive-behavioral therapy. Factor analysis identified two scales (Weight and Shape Concerns; Eating Concerns), with strong internal consistency and test-retest reliability. Correlations with the EDE-Q (r = 0.889) indicates that the ED-15 and EDE-Q measure near-identical constructs. The ED-15 differentiated self-reported eating-disordered and nonclinical groups to the same degree as the longer EDE-Q. Session-by-session analysis of the CBT treatment group demonstrated that the different ED-15 scales changed in different patterns across therapy. The ED-15 is not proposed as an alternative to existing measures, but as a complementary tool, used to measure session-by-session change for clinical and research purposes. Future research will track changes in ED-15 scores across therapy, to determine the importance of very early response to therapy and sudden changes.

Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis.

To report the results of a systematic review and meta-analysis examining whether weight loss interventions improve body image in obese/overweight individuals. Medline, Current Contents, and the Cochrane database were searched to identify studies involving obese/overweight adults who were enrolled in weight loss interventions in which body image was quantitatively assessed. Outcomes assessed were changes in body shape concern, body size dissatisfaction, and body satisfaction (intervention vs comparator/control group). Seven studies were included in the systematic review (4 in the meta-analysis). All but 1 study involved female participants only. The type of weight loss intervention varied between studies as did the type of control/comparator group. In 3 studies, there was no significant difference in body image outcomes, whereas in 4 studies, improvement in body image was significantly more pronounced in the intervention vs the control/comparator group. Meta-analysis revealed that improvements in body shape concern (standardized difference: -0.52; 95% confidence interval [CI]: -1.04 to 0.00), body size dissatisfaction (standardized difference: -0.66; 95% CI: -0.88 to -0.45), and body satisfaction (standardized difference: 0.74; 95% CI: 0.09 to 1.38) significantly favored the intervention over the comparator/control group (P<0.05). The results of this systematic review/meta-analysis lend support to the notion that weight loss interventions may improve body image. This is a noteworthy finding that has clear clinical applicability because body image affects psychological well-being and the ability of an individual to maintain weight loss. Future research should determine which weigh loss interventions are associated with optimal improvements in body image and maintenance of weight loss.

Decreasing body dissatisfaction using a brief conditioning intervention

ObjectiveBody dissatisfaction in females is common and a risk factor for the development of an eating disorder. This study tested whether body dissatisfaction could be improved using a brief conditioning intervention in which photographs of participants' bodies were selectively paired with positive social stimuli (smiling faces) and photographs of other bodies were paired with neutral or negative social stimuli (neutral and frowning faces). Method39 women (mean age = 22.46; 64.1% Caucasian) with high body dissatisfaction were randomized to either the evaluative conditioning intervention (n = 22) or to a delayed waitlist control condition (n = 17). Body dissatisfaction (specifically, shape and weight concern), restraint, eating concern, and self-esteem were assessed at baseline, post treatment and again after four and 12 weeks. ResultsCompared to women in the delayed waitlist control condition, women in the treatment condition demonstrated a significant decrease in shape and weight concern, and a significant increase in self-esteem. Similar trends were found for the control condition after they completed the intervention. Changes at post treatment related to body dissatisfaction were maintained at 12-week follow-up. ConclusionsRepeatedly pairing photographs of an individual's body with positive social feedback may lead to improved body image and self-esteem.

Perfectionism and disordered eating in overweight woman

IntroductionPerfectionism constitutes a risk factor for the development of eating disorders. In overweight women, knowledge about the nature of this association is scarce. ObjectivesTo investigate the relationship between perfectionism, eating behaviors and affect in overweight women. MethodsThe Portuguese versions of the Eating Disorder Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (mean age=43.85±11.89years; mean BMI=32.82±5.43kg/m2). ResultsCorrelations between Socially Prescribed Perfectionism/SPP, EDEQ total (T) and its dimensional scores (Weight and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Dietary Restraint/DR) were significant (r>.30; p>.001). Self-Oriented Perfectionism/SOP was significantly correlated with EDEQ-T, WSCD and DR (r=.20). Participants with high (>M+SD) vs. low (<M-SD) SOP and SPP had significantly higher means in EDEQ-T, WSCD, EC and DR (p<.001). Linear regression showed that SPP was predictor of EDEQ-T and EC (p<.001). ConclusionsSPP and SOP are related to disordered eating in overweight women.

Preocupação com a forma do corpo de graduandos de Farmácia-Bioquímica

Objetivo Identificar a preocupação com a forma do corpo de estudantes de Farmácia-Bioquímica e sua relação com variáveis sociais e laborais e com o estado nutricional. Métodos Participaram 346 discentes com média de idade de 20,2 (DP = 2,4) anos, sendo 278 (80,3%) do sexo feminino. Utilizou-se o Body Shape Questionnaire (BSQ). As validades fatorial e convergente e a consistência interna (α) do BSQ foram estimadas. Utilizaram-se como índices de ajustamento o qui-quadrado pelos graus de liberdade (χ2/gl), o Comparative Fit Index (CFI), o Normed Fit Index (NFI) e o Root Mean Square Error of Approximation (RMSEA). O escore médio de preocupação com a forma do corpo foi obtido por meio de algoritmo gerado na análise fatorial confirmatória. Para comparar os escores médios segundo as variáveis de interesse, utilizou-se Análise de Variância (ANOVA). Resultados O BSQ apresentou, para a amostra de estudo, adequada validade (χ2/gl = 3,29; CFI = 0,87, NFI = 0,82, RMSEA = 0,08) e confiabilidade (α = 0,97) após ajustamento. Verificou-se que as mulheres (p &lt; 0,001) apresentaram maior preocupação com a forma do corpo que os homens. Além disso, os estudantes que avaliaram o curso como pior que as expectativas iniciais (p = 0,048), que consomem medicamentos por causa dos estudos (p &lt; 0,001), que já pensaram em desistir do curso (p = 0,002) e foram classificados com sobrepeso/obesidade (p &lt; 0,001) também apresentaram alta preocupação com a forma do corpo. Conclusão As varáveis sexo, avaliação em relação ao curso, ingestão de medicamentos por causa dos estudos, pensamento em desistir do curso e o estado nutricional apresentaram relação significativa com a preocupação com a forma do corpo entre os estudantes.

Readiness and Motivation for Change Among Young Women With Broadly Defined Eating Disorders

Readiness and motivation for change were examined in 32 women with broadly defined eating disorders who took part in a 10-week Cognitive Behavioral Therapy (CBT)-based group intervention. Readiness for change and eating disorder psychopathology were assessed before and after the intervention. The results revealed significant negative associations between degree of eating disorder symptoms and degree of readiness for change before the intervention started. In particular, higher levels of eating concern, shape concern, and body dissatisfaction were associated with lower motivation for change. No significant associations between degree of readiness for change before the intervention started and changes in eating disorder symptoms at the end of intervention were found. Readiness for change increased from the beginning to the end of the intervention, indicating that group CBT may be a cost-effective and time-efficient way of enhancing readiness and motivation for change in individuals with eating psychopathology.

Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity.

A randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors. A total of 1316 grade 7 and 8 girls and boys (mean age=13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups. Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys. A group×time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls. Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems.

The internalization of weight bias is associated with severe eating pathology among lean individuals

ObjectiveThe internalization of weight bias is associated with clinically significant eating pathology among overweight adults. However, these relationships have not yet been assessed in lean individuals, who may perceive themselves to be overweight and subsequently internalize weight bias. The aim of the present study, therefore, was to determine whether lean individuals internalize weight bias and if the internalization of weight bias among lean respondents is associated with eating pathology. MethodParticipants were 197 lean (mean BMI: 22.28±1.89, range 15.80–24.98) adults who completed the Weight Bias Internalization Scale (WBIS) and measures of disordered eating behaviors and attitudes via an anonymous online survey. ResultsBased on convergence of responses from the EDE-Q and QEWP-R, and using DSM-5 behavioral criteria, 10% and 15% of participants were classified into a binge eating and binge/purge group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology. Bivariate correlations revealed positive associations between WBIS score and BMI, depression, and all EDE-Q subscales (restraint, eating concern, shape concern, weight concern). Logistic regressions indicated that internalized weight bias was significantly associated with binge/purge behaviors (OR=4.67, 95% CI: 2.38–9.17, p<.001) and binge eating (OR=2.29, 95% CI: 1.26–4.19, p<.01). DiscussionThese novel findings suggest that lean individuals may internalize weight bias. Importantly, the internalization of weight bias among lean individuals is associated with clinically significant eating pathology.

The LEAP (Learn to Eat at Peace) Eating Disorders Program: overview &amp; evaluation

The Geelong Clinic's 40-day LEAP (Learn to Eat at Peace) Eating Disorders Inpatient Program is unique as consumers have had considerable input in the development and ongoing review of the program. The LEAP philosophy emphasises trust, dignity, individualised treatment, and skill acquisition. The program involves staff-supported meals and groups facilitated by a multidisciplinary team. The aim of this study was to evaluate if there were changes in patients' clinical symptoms following the program. Participants were eating disorder (ED) patients (n = 43), aged 16 to 55 years. Data was collected through self-report measures at admission and discharge from the program. Repeated-measures ANOVAs were used to assess changes in variables including restraint over eating, eating concern, shape concern, weight concern, body mass index, depression, anxiety, and stress. Results indicated statistically significant improvements across all variables. Effect sizes were large (partial eta-squared = .14 to .58), indicating clinical significance. At discharge, 85% of patients agreed that they were satisfied with therapy and with therapists. Findings provide empirical evidence that following the LEAP Program, patients report significant improvements in ED symptoms and general psychopathology, and were satisfied with treatment. Findings support the importance of consumer involvement, using a collaborative approach, and multidisciplinary treatment of EDs. This abstract was presented in the Treatment in Community and Inpatient Settings stream of the 2014 ANZAED Conference.

Eating Disorder Examination Questionnaire (EDE‐Q): Norms for Undergraduate Japanese Women

The aim of the present study was to provide normative data for the Eating Disorder Examination Questionnaire (EDE-Q) among undergraduate Japanese women and to compare these data to norms obtained from previous studies. Undergraduate Japanese women (n = 289), aged 18-24 years, were administered the EDE-Q. The mean global score in the present study was 1.55 (SD = 1.03). Japanese women reported significantly higher scores of shape concern and weight concern in spite of lower body mass index but a significantly lower score of restraint, compared with women in other normative studies. There were significant differences with respect to the occurrence of some specific eating disorder behaviours between Japanese women and women in the previous studies. Differences in normative data for the EDE-Q between young Japanese women and young women in the previous studies suggest that there may be certain cultural differences in eating disorder psychopathology.

Validation of the Eating Disorder Examination Questionnaire: an online version.

Internet-based interventions can facilitate an anonymous environment for the management of eating disorders and there is a need for online assessment tools to be readily available. The present study aimed to validate an online version of the Eating Disorder Examination Questionnaire (EDE-Q) and to compare the goodness-of-fit of five models of EDE-Q data, using a sample of university students in Hong Kong. The EDE-Q data were collected online from 310 Hong Kong university students. Confirmatory factor analysis was used to compare the validity of the original four-factor EDE-Q with that of the three-factor, two-factor, one-factor and brief one-factor models. The superior model was further examined for scale reliability, convergent validity and construct validity using contrast-group comparisons. The brief one-factor model consisting of eight Weight and Shape Concern items was the only model to provide an acceptable fit to the data. Estimations of internal consistency and scale validity were conducted using contrast-group comparisons and convergent validity, with satisfactory results. The brief one-factor model was the only one among the alternate models that provided good fit to the data. The brief model is promising for use in research and has good practical application because the model was satisfactorily tested in terms of internal consistency, ability to discriminate between genders, and good association with other measures of similar constructs. By validating an online version of the EDE-Q using a university sample with a cultural background different from Western culture, the present study complements findings from previous research on the EDE-Q.

Hierarchical trait predictors of healthy diet: a comparison between US and Chinese young consumers

AbstractThe purpose of this study was to examine the hierarchical trait predictors of health diet among 541 US and Chinese college‐aged consumers. A path model was first tested among the combined US and Chinese sample, then separately among US and Chinese samples. Five‐factor personality traits were found to influence the healthy diet through the mediations of health motivation (as an internal motive) and body shape concern (as an external motive). Conscientiousness was found to be a consistent predictor of health motivation and healthy diet among both US and Chinese college students. Unlike the previous findings, openness to experience was not found to be a significant predictor of healthy diet among the US sample, although it was still a significant predictor among the Chinese sample.