Unhealthy Weight Loss Practices Research Articles

The Health Risks of Obesity Have Been Exaggerated.

The Health Risks of Obesity Have Been Exaggerated.

The influence of gender on the evaluation of anorexia nervosa

A stereotype exists that anorexia nervosa (AN) is a "female" disorder. As a result, men with AN may face harsher stigmatization from their peers or go undiagnosed. The shifting standards model provides a framework to explore how gender stereotypes impact perceptions of AN. Participants (N = 438) were given a vignette of a person with symptoms of AN labeled as either male or female. Assessments were experimentally manipulated according to the shifting standards perspective: participants were asked if they were concerned (or convinced) that the target had AN and then indicated the severity of behavioral symptoms (calorie reduction, pounds lost per week, and hours of exercise) needed to make them concerned (or convinced) of AN. Participants were more likely to state that the male target had AN compared to the female target (p = .036) whereas women were more likely to believe an individual had AN than men, regardless of the target gender (p < .001). In addition, men required that the male target have more severe symptoms to assign an AN diagnosis than women (p = .005). In general, severity ratings for symptoms were quite high, indicating a normalization of unhealthy weight loss practices. These results confirm that gender affects the perception of AN, though they do not conform to expectations within the shifting standards model. Instead, they suggest that a male target is more readily identified as having AN than a female target with AN when exhibiting identical symptoms.

School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol.

BackgroundObesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old.Methods/DesignFollowing quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up.DiscussionIt is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents.Trial registrationUMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).

Relationship Between Current Substance Use and Unhealthy Weight Loss Practices Among Adolescents.

To determine the relationship between current substance use and unhealthy weight loss practices (UWLP) among 12-to-18 year olds. Participants were 12-to-18 year olds who completed the 2013 Youth Risk Behavior Survey in Florida (N = 5620). Current alcohol, tobacco, and marijuana use was self-reported based on last 30-day use. UWLP was defined based on self-report of at least one of three methods to lose weight in last 30-days: (1) ≥24 h of fasting, (2) diet pill use, and (3) laxative use/purging. The reference group included those with no reported UWLP. Logistic regression models adjusted for age, gender, race/ethnicity, academic performance, age-sex-specific body mass index percentiles, and perceived weight status were fitted to assess relationships between UWLP and current substance use. About 15 and 41 % of adolescents reported ≥1 UWLP and use of ≥1 substance in the last 30-days, respectively. Over half (60.1 %) of adolescents who reported substance use engaged in UWLP (p < 0.0001). The prevalence of current alcohol use (50.6 %) was the highest among those who reported UWLP, followed by marijuana (31.9 %), tobacco (19.7 %), and cocaine (10.5 %) use. Adolescents who reported current tobacco [adjusted odds ratio (AOR) 2.7, 95 % confidence interval (CI) 2.1-3.6], alcohol (AOR 2.2, 95 % CI 1.9-2.6), or marijuana (AOR 2.1, 95 % CI 1.7-2.5) use had significantly higher odds of UWLP compared to their non-user counterparts. This cross-sectional study shows that substance use and UWLP behaviors are likely to co-exist in adolescents. Further studies are necessary to determine the temporal relationship between substance use and UWLP. It is recommended that intervention programs for youth consider targeting these multiple health risk behaviors.

Nutritional and weight management behaviors in low-income women trying to conceive.

To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared with women not trying to conceive. This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16-40 years who were low income, racially diverse, (n=1,711), and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. A total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements, or herbs (13.5% compared with 8.8%; adjusted odds ratio [OR] 1.97, 95% confidence interval [CI] 1.11-3.49), using laxatives or diuretics or inducing vomiting (7.7% compared with 3.0%; adjusted OR 2.70, CI 1.23-5.91), and fasting for 24 hours (10.7% compared with 5.5%; adjusted OR 2.15, CI 1.03-4.51). There were no significant differences between the two groups in amount of exercise, current smoking status, or current alcohol consumption Furthermore, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. II.

Relationships between depression, gender, and unhealthy weight loss practices among overweight or obese college students

IntroductionUnhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students. MethodsStudents (body mass index between 25.0 and 34.9kg/m2) from three Southern California universities (Mage=22years, SD=4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N=404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form. ResultsTwenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (eB=1.14 [confidence interval, CI: 1.08–1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (eB=1.04 [CI: 0.93–1.16]). ConclusionAmong an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.

Diet Pills, Powders, and Liquids

About 35% of healthy weight adolescent females describe themselves as overweight, and 66% report planning to lose weight.Body weight dissatisfaction is associated with unhealthy weight loss practices including diet pill/powder/liquid (PPL) use. Few studies have examined diet PPL use in healthy weight adolescent females; therefore, Youth Risk Behavior Survey data (n =247) were analyzed to identify predictors of use. Descriptive statistics and logistic regression analyses were conducted using Statistical Package for the Social Sciences Complex Samples software. Social cognitive theory served as the framework guiding the analysis. Approximately 8% of healthy weight females reported using diet PPL for weight loss. Describing self as overweight, planning to lose weight, being offered drugs at school, fasting to lose weight, cigarette/alcohol use, vomiting, and laxative use were significantly associated (p < .05) with diet PPL use. Health professionals, including school nurses, must assess for unhealthy weight loss practices in healthy weight females, in order to adequately address related issues.

Weight Perception And Trying To Lose Weight: Differences By Gender, Weight Status, And Physical Activity

Due to the increased societal focus on body weight and body image, children may be critical of their weight and trying to lose weight. Recent studies have shown a significant portion of children and adolescents, including those classified as normal weight, misperceive their weight status and report trying to lose weight. Many have also reported unhealthy weight loss practices. PURPOSE: To determine: 1) the percentage of children who perceive themselves as "too heavy/too fat;" 2) the percentage of children trying to lose weight; 3) differences in those trying to lose weight by weight status, gender, and physical activity (PA). METHODS: Participants were 359 (208 girls, 151 boys) fifth grade students (mean age 10.6 years) participating in baseline measurements of a school-based heart health intervention in fall 2008 and 2009. Students completed a health behavior survey including questions on body weight perception and if they were trying to lose weight. BMI percentiles were used to classify weight status: normal weight (5-85th percentile), overweight (>85-95th) and obese (>95th). Participants also reported 7-day PA frequency. Descriptive statistics and an independent t-test were used for statistical analysis. RESULTS: The prevalence of overweight and obesity was 17% and 18%, respectively. Twenty one percent of children reported feeling "too heavy/too fat," and 42% reported trying to lose weight. Of those trying to lose weight, 47% were normal weight, 53% were overweight or obese, and 63% were female. The mean PA frequency was not significantly different between those trying to lose weight and those who were not (4.6 + 2.2 and 4.4 + 2.1 days/week, respectively; p=0.44). CONCLUSIONS: While 35% of the sample was overweight or obese, only 21% of the total sample viewed themselves as too heavy. Over 40% of children reported trying to lose weight, of which nearly half were normal weight. Factors other than body weight, including self-esteem, cultural practices, peer influences, and media use, may affect weight perceptions and weight loss attempts. The two questions used in this study may be useful for identifying children who are at risk for practicing inappropriate weight loss behaviors and require follow up questioning. Future research is necessary to determine how children interpret questions about body size and weight loss.

Disordered Eating and Unhealthy Weight Loss Practices: Which Adolescents Are at Highest Risk?

Early diagnosis of unhealthy weight loss practices (UWLP) among adolescents improves treatment outcomes. Analysis of population-based school survey data in Oregon demonstrated that the 11.6% reporting UWLP were more likely to perceive themselves as overweight, depressed, and to have abused substances. Targeted screening of adolescents can help identify those with UWLP.

Weight Management in Amateur Wrestling

Context:Unhealthy weight loss practices continue to plague amateur wrestling. The National Collegiate Athletic Association weight loss guidelines are beneficial but have not solved the problem.Evidence Acquisition:All relevant databases through 2008 were searched using PubMed. The references of relevant articles were then searched for additional publications.Study Type:Clinical review.Results:New rules approved by the National Collegiate Athletic Association have been implemented in an attempt to prevent drastic weight loss practices in wrestlers. Although some are effective, such as establishing a minimum wrestling weight and decreasing the period between weigh-ins and actual wrestling, unsafe weight loss practices still occur.Conclusion:The attempts made by the National Collegiate Athletic Association to prevent drastic weight loss in wrestling have been effective to some degree. The mind-set of athletes, coaches, and clinicians needs to change if further improvements are to be made.

A Mediation Analysis of the ATHENA Intervention for Female Athletes: Prevention of Athletic-Enhancing Substance Use and Unhealthy Weight Loss Behaviors

To explain, through mediation analyses, the mechanisms by which ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives), a primary prevention and health promotion intervention designed to deter unhealthy body shaping behaviors among female high school athletes, produced immediate changes in intentions for unhealthy weight loss and steroid/creatine use, and to examine the link to long-term follow-up intentions and behaviors. In a randomized trial of 1668 athletes, intervention participants completed coach-led peer-facilitated sessions during their sport season. Participants provided pre-test, immediate post-test, and 9-month follow-up assessments. ATHENA decreased intentions for steroid/creatine use and intentions for unhealthy weight loss behaviors at post-test. These effects were most strongly mediated by social norms and self-efficacy for healthy eating. Low post-test intentions were maintained 9 months later and predicted subsequent behavior. ATHENA successfully modified mediators that in turn related to athletic-enhancing substance use and unhealthy weight loss practices. Mediation analyses aid in the understanding of health promotion interventions and inform program development.

Weight-Loss Practices and Weight-Related Issues Among Youth With Type 1 or Type 2 Diabetes

OBJECTIVE—The purpose of this study was to describe the weight-loss practices and weight-related issues reported by youth with diabetes, according to sex and diabetes type.RESEARCH DESIGN AND METHODS—A total of 1,742 female and 1,615 male youth aged 10–21 years with type 1 or type 2 diabetes completed a SEARCH for Diabetes in Youth study visit during which height, weight, and A1C were measured. A survey assessed weight-related issues and weight-loss practices.RESULTS—Although more common in youth with type 2 diabetes, youth with type 1 diabetes also reported weight-related concerns and had elevated BMI. Among youth who had ever tried to lose weight (n = 1,646), healthy weight-loss practices (diet [76.5%] and exercise [94.8%]) were the most common, whereas unhealthy practices (fasting [8.6%], using diet aids [7.5%], vomiting or laxative use [2.3%], and skipping insulin doses [4.2%]) were less common. In sex-specific multivariable models including age, race/ethnicity, diabetes type, BMI category, and glycemic control, obese females and overweight/obese males were more likely to report ever practicing any unhealthy weight-loss practice than normal-weight youth. These practices were associated with poor glycemic control for female but not male subjects. All unhealthy weight-loss practices except fasting were more common in female than in male subjects. Dieting, fasting, and using diet aids were all more common in youth with type 2 diabetes than in those with type 1 diabetes.CONCLUSIONS—Given the prevalence of overweight and obesity among youth with type 1 or type 2 diabetes, health care professionals caring for youth with diabetes need to pay particular attention to identifying youth, particularly females, with unhealthy weight-loss practices.

The Female Athlete Triad

The female athlete triad (Triad) refers to the interrelationships among energy availability, menstrual function, and bone mineral density, which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. With proper nutrition, these same relationships promote robust health. Athletes are distributed along a spectrum between health and disease, and those at the pathological end may not exhibit all these clinical conditions simultaneously. Energy availability is defined as dietary energy intake minus exercise energy expenditure. Low energy availability appears to be the factor that impairs reproductive and skeletal health in the Triad, and it may be inadvertent, intentional, or psychopathological. Most effects appear to occur below an energy availability of 30 kcal.kg(-1) of fat-free mass per day. Restrictive eating behaviors practiced by girls and women in sports or physical activities that emphasize leanness are of special concern. For prevention and early intervention, education of athletes, parents, coaches, trainers, judges, and administrators is a priority. Athletes should be assessed for the Triad at the preparticipation physical and/or annual health screening exam, and whenever an athlete presents with any of the Triad's clinical conditions. Sport administrators should also consider rule changes to discourage unhealthy weight loss practices. A multidisciplinary treatment team should include a physician or other health-care professional, a registered dietitian, and, for athletes with eating disorders, a mental health practitioner. Additional valuable team members may include a certified athletic trainer, an exercise physiologist, and the athlete's coach, parents and other family members. The first aim of treatment for any Triad component is to increase energy availability by increasing energy intake and/or reducing exercise energy expenditure. Nutrition counseling and monitoring are sufficient interventions for many athletes, but eating disorders warrant psychotherapy. Athletes with eating disorders should be required to meet established criteria to continue exercising, and their training and competition may need to be modified. No pharmacological agent adequately restores bone loss or corrects metabolic abnormalities that impair health and performance in athletes with functional hypothalamic amenorrhea.

Effect of Measured Versus Predicted Thoracic Gas Volumes on Percent Body Fat in Wrestlers

0504 Disordered eating habits and unhealthy weight loss practices are two major problems in the sport of wrestling. Based on recommendations by the National Wrestling Coaches Association, the Delaware Interscholastic Athletic Association implemented a Weight Certification Program for all high school wrestlers. According to the program, airdisplacement plethysmography was used if percent body fat (%BF) using bio-electrical impedance analysis was appealed. PURPOSE: To determine whether the equation used predict thoracic gas volume (Vtgpred) was accurate when testing a relatively young group of wrestlers. METHODS: Thoracic gas volume was measured and predicted in 63 high school wrestlers. In addition, differences between %BF, body density (Db), and minimum wrestling weight (MWW) measurements attained using Vtgmeas and Vtgpred were also examined. RESULTS: Vtgpred (3.369 ± .043 L) and Vtg meas (3.355 ± .074 L) were not significantly different (p = 0.80). However, a Bland-Altman plot of Vtgpred and Vtg meas showed three distinct patterns for the low, medium, and high thoracic gas volumes. A t-test performed on the three groups showed that subjects with a Vtgmeas < 3.0 L (N = 16) had a significantly higher Vtgpred than Vtgmeas (p Ü 0.0001). A significant difference was also found in subjects with a Vtgmeas > 3.75 L (N = 17), but the trend was to under-predict Vtgmeas. The subjects with volumes between 3.0 – 3.75 L (N = 30) had no significant difference between Vtgpred and Vtg meas. The significant differences between the two volumes in groups outside of the 3.0 to 3.75 L range produced significant differences in Db, %BF, and MWW (p Ü 0.05). Thus, this study documents that Vtgpred under- or over-estimated Vtg meas in 52% (n = 33) of the wrestlers and accurately predicted Vtg in 48% (n = 30) of the wrestlers. CONCLUSION: The use of prediction equations to set guidelines for %BF and MWW in wrestlers should be done with the knowledge of its limitations.

Treatment of Obese Binge Eater

It is now widely recognized that there is a subgroup of obese individuals with a significantly disordered eating behavior characterized by binge eating and psychosocial impairment. Many therapeutic approaches for the treatment of obese binge eaters including cognitive-behavioral therapy, treatment of obesity, nutritional counseling, psychoeducation, psychotherapy, motivation enhancement therapy, and medication have their own benefits. Treatment programs for obesity and eating disorders (binge eater, bulimia) have tended to adopt very different approaches to the eating behavior (dieting vs cessation of dieting) and body image (weight loss vs accepting one's current weight). Despite these differences, eating disorders, obesity, and unhealthy weight loss practices have a number of shared personal, socioenvironmental, and behavioral problems. It is important to integrate the treatment approaches to the spectrum of problems related to eating and weight (eating disorders, obesity, and unhealthy weight loss practices).

Integrating the Prevention of Eating Disorders and Obesity: Feasible or Futile?

The rate of obesity in adults and youth has doubled in the past 20 years; during this same period there has been an increase in the prevalence of “dysfunctional eating behaviors,” including eating disorders and unhealthy weight loss practices. Despite the fact that obesity, eating disorders, and unhealthy weight loss practices are cultivated in the same cultural context—an increasingly “toxic” environment regarding food and weight—these problems are regarded as distinct, with different origins, courses, and approaches to prevention and treatment. In this article, we present conceptual and practical reasons for adopting an integrated approach to the prevention of the spectrum of problems related to eating and weight (i.e., eating disorders, obesity, and unhealthy weight loss practices), suggest personal, socioenvironmental, and behavioral factors to be included in an integrated approach to prevention, and provide some ideas for developing an integrated program using a media literacy/advocacy approach. We conclude with a discussion of challenges to the development of interventions aimed at the broad spectrum of weight-related problems and suggestions for addressing these challenges.

Certifying Wrestlers' Minimum Weight

High school and college wrestlers often attempt to "cut weight" before a tournament in an effort to wrestle in the lightest possible weight class and thereby gain an edge on opponents. Some wrestlers use unhealthy weight-loss practices, and last fall three college wrestlers died after extreme weight cutting.

The Relationship Among Ego Orientation, Attitudes Toward Masculinity, and the Weight Loss Behaviors of High School Wrestlers

LEARNING OUTCOME:To identify the potential influence of certain psychosocial factors on the weight loss behaviors of high school wrestlers. The purpose of this study was to test for associations among ego orientation, attitudes toward masculinity, and the weight loss behaviors of a purposive sample of high school wrestlers in western and central New York. With a response rate of 51%, 104 high school wrestlers answered a researcher developed questionnaire adapted from Duda and Nicholls (1992); Pleck, Sonenstein, and Ku (1993), and Steen and Brownell (1990). The questionnaire was administered by the primary author in the high school settings. Results indicated that the average subject began losing (“cutting”) weight at age 14 and underwent 5 weight cutting cycles during the competitive season. The average subject utilized fluid restriction once every two weeks and food restriction once per week in order to lose weight. Pearson's product moment correlations revealed that attitudes toward masculinity had a significant, positive relationship with lifetime weight loss, use of weight loss methods and both the frequency and extent of weight loss during the competitive season (p ≤ 0.05). Ego orientation was positively correlated with extent of weight loss during the season (p ≤ 0.05). These findings suggest that certain psychosocial factors linked to gender identity may influence the weight loss behaviors of high school wrestlers. This has implications for a newly emerging area of research on men's health, which may assist individuals involved in athletics and health care in identifying those wrestlers most likely to engage in unhealthy weight loss practices.

Current dieting, weight loss history, and weight suppression: Behavioral correlates of three dimensions of dieting

The present study investigated three dimensions of dieting (current dieting, history of dieting, weight suppression) and behaviors related to energy balance in a community sample of 999 women. The three dimensions, current dieting status, history of dieting, and weight suppression, were examined in relation to dietary intake, eating behaviors, physical activity, and weight concerns. Twenty-two percent of the women were current weight loss dieters, 8.3% were currently dieting for weight maintenance, and 69.3% were not currently dieting. Twenty-eight percent of the women were weight suppressers. Current dieting for weight loss or weight maintenance was associated with lower percent of kilocalories from fat (33% vs. 35% among nondieters), less frequent consumption of sweet foods, more frequent consumption of vegetables and fruits, more frequent self-weighing, and lower tolerance for weight gain prior to taking action (10 lb vs. 14 lb among nondieters). Current dieters and those with an extensive history of dieting self-reported a greater number of healthy and unhealthy weight loss practices during the past year, and they scored higher on measures of low-fat eating behaviors and restrained eating. Weight suppression was associated with higher physical activity levels and lowfat eating behaviors. Distinguishing weight suppression from current dieting status may provide insight into the behaviors related to successful weight loss maintenance, whereas measures of dieting history might be useful in clinical contexts.

Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study.

To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness. Survey. The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness. Body concerns, binge eating, frequent dieting, vomiting, and laxative or diuretic use among adolescents. Adolescents with chronic illness reported higher body dissatisfaction and engaged in more high-risk weight-loss practices than adolescents without chronic illness. This trend was consistent across the different conditions and was not limited to those with a nutrition-related condition such as diabetes. The trend remained after conducting logistic regression and controlling for age, race, socioeconomic status, and body mass index. Adolescents with chronic illness are at high risk for engaging in unhealthy weight-loss practices and should be screened and targeted for prevention and treatment.