Weight-related Behaviors Research Articles

Compensatory health motivations and behaviors scale: Development, evaluation, psychometric properties and a preliminary validation

The “Compensatory Health Beliefs” scale assesses the degree to which one believes that unhealthy behaviours can be compensated through healthier ones. However, no validated scale to assess compensatory weight-related behaviors exists. The study's objective was to develop (Study 1) and validate (Study 2) a questionnaire measuring compensatory health motivations and behaviors (CHMB) and to assess their associations with body mass index (BMI) and psychological weight-related measures. An initial 34-item measure was constructed based on a target sample's (Study 1, n = 158) suggestions and refined based on expert feedback. The measure was then tested in a representative Canadian adult sample (N = 1400, 48.7% male). The sample was stratified by sex and age and then randomly split into two (N = 701 for exploratory factor analysis; N = 699 for confirmatory factor analysis (CFA) cross-validation). Fit indices, standardized Cronbach's alphas and the associations between the CHMB model with cognitive restraint, weight concerns, and BMI were assessed in multiple linear regression models controlling for age and sex. The final CHMB model (n = 17 items) consisted of four subscales: (1) motivation, (2) use on special occasions, (3) general use, (4) compensatory health beliefs. Fit indices (Goodness of Fit Index = 0.922) and Cronbach's alphas were good (α = 0.88). In multiple linear regression models, all CHMB subscales were associated with greater cognitive restraint in eating. Compensatory behavior use on special occasions was associated with greater weight concern (B = 0.12, p < .0001), while general compensatory behavior use was associated with lower weight concern (B = −0.07, p < .05). None of the subscales were associated with BMI. The validated CHMB scale allows for the assessment of compensatory health motivations and behaviors in a Canadian population. Research on whether this scale can predict weight changes and general health is needed.

Association of weight and shape concern with weight change and weight-related behaviors in behavioral weight loss treatment.

Weight and shape concern (WSC) is a facet of negative body image that is common among individuals with overweight/obesity seeking behavioral weight loss treatment (BWL), but remains understudied. This secondary analysis evaluates associations between WSC, weight change, and weight-related behaviors among individuals in a 24-week BWL. Adults (n = 32) with body mass index 25-50kg/m2 completed a baseline WSC questionnaire, measured weight at 12 and 24 weeks, measured physical activity via accelerometer, and completed 24-hour dietary recalls. Adherence to self-monitoring dietary intake and weight were assessed. A series of linear mixed models were used to evaluate associations between baseline WSC and weight change, as well as weight-related behaviors. Results revealed no significant effect of WSC on weight change. There were significant WSC x time interactions, such that those rating WSC "very important" decreased self-weighing and the "low importance" group decreased their caloric intake during treatment. The "pretty important" group had greater minutes of activity than the "low importance" group. Findings indicated that WSC may impact weight-related behaviors that contribute to BWL success. This trial was pre-registered on ClinicalTrials.gov (NCT03739151).

When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for USChristian Clergy.

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.

Comparing weight-related behaviors of young children with autism spectrum disorder during summer versus school months: Preliminary evidence

BackgroundSummer is an emerging area of concern for accelerated weight gain in children. Little is known about weight-related behaviors of children with Autism Spectrum Disorder (ASD) during summer. AimsTo compare weight-related behaviors of children with ASD during summer versus school months. Methods and proceduresCaregivers of children (mean age 5.7 years, ±1.8 years) with ASD participated in a within-person observational study and reported daily estimates of bed/wake times, daily food and beverage consumption, and screen time at home for 14 days during both school and summer months. Outcomes and resultsCaregivers reported their child (N = 14; 100 % ASD diagnosis, 71 % boys) engaged in an additional +42 min of daily screen time at home (95 % CI: 22.1, 62.5), an additional +11 min of screen time after 8:00PM (95 %CI: 4.4, 17.1), went to bed ∼30 min later and woke up ∼50 min later on summer days compared to school month days. Conclusions and implicationsInitial evidence suggests young children with ASD had higher amounts of daily screen time and later bed/wake time during summer compared to school. Further research in large diverse samples is warranted to help inform intervention design and delivery in this population.

Investigating the effects of rurality on stress, subjective well-being, and weight-related outcomes

PurposeRates of obesity are significantly higher for those living in a rural versus urban setting. High levels of stress and low levels of subjective well-being (SWB) have been linked to poor weight-related behaviors and outcomes, but it is unclear if these relationships differ as a function of rurality. This study investigated the extent to which living in a rural versus urban county ("rurality") moderated associations between stress / subjective wellbeing (predictors) and diet quality, dietary intake of added sugars, physical activity, and BMI (outcomes). MethodsParticipants were recruited from urban (n = 355) and rural (n = 347) counties in Washington State and self-reported psychological, demographic, and food frequency questionnaires while physical activity behavior was measured objectively. FindingsAfter controlling for relevant covariates, levels of stress were positively associated with added sugar intake for those living in the urban county while this relationship was non-significant for those residing in the rural county. Similarly, SWB was negatively associated with added sugar intake, but only for urban residents. County of residence was also found to moderate the relationship between SWB and BMI. Higher SWB was inversely associated with BMI for those living in the urban county while no relationship was observed for rural county residents. ConclusionsThese findings support the hypothesis that the relationships between stress / SWB and weight function differentially based on the rurality of the residing county. This work adds to the growing body of literature highlighting the role stress and SWB play in the rural obesity disparity.

Energy expenditure and weight-related behaviors in youth with Down syndrome: a protocol.

The consequences of obesity are ominous, yet healthcare professionals are not adequately preventing or treating obesity in youth with Down syndrome (DS). Total daily energy expenditure (TDEE) is the energy expended in 24 h through physical activity and life-sustaining physiologic processes. An individual's TDEE is essential for determining the daily caloric intake needed to maintain or change body weight. Successful prevention and treatment of obesity in youth with DS is severely compromised by the lack of data on TDEE and information on weight-related behaviors for this high-risk population. This manuscript describes the protocol for the federally funded study that is in process to determine daily energy expenditure in a large cohort of children with DS. This observational cross-sectional study will include a national sample of 230 youth with DS, stratified by age (5-11 and 12-18 years of age) and sex. Doubly Labeled Water analysis will provide the criterion body fat%, fat-free mass, and TDEE. To increase accessibility and decrease the burden on participants, the entire study, including obtaining consent and data collection, is conducted virtually within the participant's home environment on weekdays and weekends. The study team supervises all data collection via a video conferencing platform, e.g., Zoom. This study will (1) examine and determine average TDEE based on age and sex, (2) develop a prediction equation based on measured TDEE to predict energy requirements with a best-fit model based on fat-free mass, sex, age, and height and/or weight, and (3) use 24-hour dietary recalls, a nutrition and physical activity screener, wearable devices, and sleep questionnaire to describe the patterns and quality of dietary intake, sleep, and physical activity status in youth with DS. The lack of accurate information on energy expenditure and weight-related behaviors in youth with DS significantly impedes the successful prevention and treatment of obesity for this vulnerable population. The findings of this study will provide a further understanding of weight-related behaviors as obesity risk factors, currently not well understood for this population. This study will advance the science of weight management in individuals with disabilities and shift clinical practice paradigms.

Relationships of Maternal Employment and Work Impact with Weight-Related Behaviors and Home Environments of Mothers and Their School-Age Children.

The prevalence of obesity continues to rise. Preventing obesity, especially childhood obesity, is critically important. Parents, especially mothers, play a vital role in preventing childhood obesity. Numerous factors, such as maternal employment, may influence maternal weight-related practices and home environment characteristics that affect the risk of childhood obesity. Given the prevalence of both childhood obesity and maternal employment, this study was conducted to examine how weight-related maternal, child, and household behaviors as well as home environment characteristics differ by maternal employment hours and extends existing research by examining work impact on behaviors and home characteristics. U.S. mothers (n = 527) with at least one school-age child (6 to 11 years), who were between the ages of 25 and 54 years and the main food gatekeeper in the household completed an online survey. ANOVA comparisons of non-working, part-time employed, and full-time employed mothers revealed few differences in any of the variables studied. Cluster analysis of the 336 employed mothers based on six work impact scale scores found three unique clusters characterized as Enthusiastic Earners, Indifferent Earners, and Strained Earners. Few differences in sociodemographic and job characteristics occurred among clusters and the differences noted had small effect sizes. Clusters did not differ by maternal BMI or perceived child weight status. However, the clusters differed in numerous weight-related behaviors and home environment characteristics. Future research should aim to determine the direction of the associations of work impact with weight-related behaviors and home environments as well as identify potential strategies for overcoming the negative effects of employment on weight-related behaviors and environments and weight status as well as clarify other factors that may affect maternal work impact, such as time management, reasons for employment, and stress.

Associations of social jetlag with physical activity and sedentary behaviour in children and adolescents: A systematic review and meta-analysis.

Sleep and daytime movement behaviours occur co-dependently with each other within a finite 24 h day. Sleep parameters other than sleep duration, such as social jetlag and chronotype, have been linked to health problems and unhealthy behaviours among children and adolescents. Given the increasing number of studies examining sleep timing/chronotype and weight-related behaviours, including physical activity and sedentary behaviour, in the past decade, this systematic review and meta-analysis collated and evaluated the evidence on the relationships of social jetlag and chronotype with physical activity and sedentary behaviour among children and adolescents aged 3-17 years. Seven databases were searched on 16 March 2022, and 52 studies were identified as eligible for inclusion, 47 of which were suitable for the meta-analysis. A positive association was found between social jetlag and screen media use (r = 0.14, 95% CI: 0.04-0.24; I2 = 96%; p = 0.008). The morning chronotype was associated with a higher level of physical activity and a lower level of sedentary behaviour than the evening chronotype. No relationship was found between social jetlag and physical activity. The magnitude of heterogeneity among the included studies was high. Further experimental studies are urgently required to understand how circadian preference or misalignment affects activity behaviours. Interventions to promote an active lifestyle in young populations should consider their circadian preference, especially among individuals with the evening chronotype.

Examining demographic and psychosocial factors related to self-weighing behavior during pregnancy and postpartum periods

Black childbearing individuals in the US experience a higher risk of postpartum weight retention (PPWR) compared to their White counterparts. Given that PPWR is related to adverse health outcomes, it is important to investigate predictors of weight-related health behaviors, such as self-weighing (i.e., using a scale at home). Regular self-weighing is an evidence-based weight management strategy, but there is minimal insight into sociodemographic factors related to frequency. The Postpartum Mothers Mobile Study (PMOMS) facilitated longitudinal ambulatory weight assessments to investigate racial inequities in PPWR. Our objective for the present study was to describe self-weighing behavior during and after pregnancy in the PMOMS cohort, as well as related demographic and psychosocial factors. Applying tree modeling and multiple regression, we examined self-weighing during and after pregnancy. Participants (N = 236) were 30.2 years old on average (SD = 4.7), with the majority being college-educated (53.8%, n = 127), earning at least $30,000 annually (61.4%, n = 145), and self-identifying as non-Hispanic White (NHW; 68.2%, n = 161). Adherence to regular self-weighing (at least once weekly) was highest among participants during pregnancy, with a considerable decline after giving birth. Low-income Black participants (earning < $30,000) were significantly less likely to reach a completion rate of ≥ 80% during pregnancy (AOR = 0.10) or the postpartum period (AOR = 0.16), compared to NHW participants earning at least $30,000 annually. Increases in perceived stress were associated with decreased odds of sustained self-weighing after delivery (AOR = 0.79). Future research should consider behavioral differences across demographic intersections, such as race and socioeconomic status, and the impact on efficacy of self-weighing.

Patient and Provider Perceptions About Communication After Bariatric Surgery: A Qualitative Analysis

IntroductionCommunication between patients and providers can strongly influence patient behavior after surgery. The objective of this study was to assess patient and provider perceptions of how communication affected weight-related behaviors after bariatric surgery. Materials and methodsSemistructured interviews with bariatric surgery patients and providers were conducted from April-November 2020. Patients who had Medicaid within 3 y of surgery were defined as socioeconomically disadvantaged. Interview guides were derived from Andersen's Behavioral Model of Health Services and Torain's Framework for Surgical Disparities. Participants described postoperative experiences regarding diet, physical activity, and follow-up care. A codebook was developed deductively based on the two theories. Directed content analysis identified themes pertaining to patient-provider communication. ResultsForty-five participants were interviewed, including 24 patients (83% female; 79% White), six primary care providers, four health psychologists, five registered dietitians, and six bariatric surgeons. Four themes regarding communication emerged: (1) Patients experiencing weight regain did not want to follow-up with providers to discuss their weight; (2) Patients from socioeconomically disadvantaged backgrounds had less trust and required more rapport-building from providers to enhance trust; (3) Patients felt that providers did not get to know them personally, which was perceived as a lack of personalized communication; and (4) Providers often changed their language to be simpler, so patients could understand them. ConclusionsPatient-provider communication after bariatric surgery is essential, but perceptions about the elements of communication differ between patients and providers. Reassuring patients who have attained less weight loss than expected and establishing trust with socioeconomically vulnerable patients could strengthen care after bariatric surgery.

An online game-based intervention using quizzes to improve nutrition and physical activity outcomes among university students

Background: Adopting healthy weight-related behaviours in emerging adulthood has long-term health benefits. Digital interventions using game-elements have the potential to improve diet and physical activity outcomes. Universities are influential settings in shifting emerging adults’ behaviour and can deliver health-promoting interventions to young adults. Objectives: To investigate the effect of an online intervention using quiz-games on nutrition knowledge, diet quality, physical activity and sitting time in a sample of university students. Design: Randomised, single-blind, controlled trial. Setting: Two UK Universities including a total of 88 students from different faculties. Method: The intervention group ( n = 50) had access to 10 quiz-games and a website for 10 weeks. The control group ( n = 38) received no such resources. Main outcomes were nutrition knowledge, diet quality, physical activity and sitting time assessed by self-administered questionnaires. Frequency and performance of the quiz-games played, and the effect of time (days) on performance after playing a quiz-game for the second time, were also investigated. Results: No significant differences were found between groups over time in any of the outcomes. The outcomes remained non-significant when engagement rates with the quiz-games were considered. Among the 35 game-players ( n = 15 did not play any game), 15 played at least one quiz-game. Frequency of playing a quiz-game by all students ranged from 43 to 17 times, and mean scores (% of correct answers) ranged from 55% to 82%. When repeating a quiz-game within 8 days, the performance (score) was improved while after that point, performance remained the same or decreased. Conclusion: Online game-based interventions can be easily implemented in university settings. However, further research is needed on their design to enhance engagement and identify key factors affecting students’ behaviour to increase their effectiveness.

24-hour movement guidelines and weight status among preschool-aged children in Bangladesh: A community-level cross-sectional study.

Increasing levels of urbanization and digitization in Bangladesh may be adversely associated with children's weight status and related movement behaviors. This study examined the prevalence of obesity, physical activity (PA), sedentary behavior, and sleep among young children from a district town in northern Bangladesh and identified factors associated with unhealthy weight status. Population-based cross-sectional study involving all kindergarten schools in Jamalpur District town. Schools and children aged 4-7 years were randomly selected and had their weight and height measured. Mothers completed a questionnaire on their child's PA, recreational screen time, and sleep and sociodemographic factors. Children's weight status was based on World Health Organization (WHO) categories. Meeting the PA recommendation was based on the WHO guidelines for children and adolescents, and meeting the sedentary behavior and sleep recommendations was based on the Canadian/Australian 24-hour movement guidelines for children and young people. A total of 585 children and their parents were included in the study. Overall, 15% of children were overweight or obese. Three-quarters of children met the sleep guideline, and 50% met the PA guideline. Less than one third of children (31%) met the recreational screen time guideline, whereas 15% met all three guidelines. However, when adjusted for all predictors in the model, maternal education, family income, and child's age were significantly associated with overweight/obesity. Children with higher maternal education level were 2.3 times (AOR=2.33, 95% CI: 1.19-4.78) more likely to be overweight/obese. Children in families with a higher monthly income had 1.9 times (AOR=1.95, 95% CI: 1.14, 3.35) higher risk of being overweight/obese. Prioritizing maternal education (mother-centric interventions) can help address the high levels of childhood obesity in Bangladesh.

Conversational Agents and Avatars for Cardiometabolic Risk Factors and Lifestyle-Related Behaviors: Scoping Review.

In recent years, there has been a rise in the use of conversational agents for lifestyle medicine, in particular for weight-related behaviors and cardiometabolic risk factors. Little is known about the effectiveness and acceptability of and engagement with conversational and virtual agents as well as the applicability of these agents for metabolic syndrome risk factors such as an unhealthy dietary intake, physical inactivity, diabetes, and hypertension. This review aimed to get a greater understanding of the virtual agents that have been developed for cardiometabolic risk factors and to review their effectiveness. A systematic review of PubMed and MEDLINE was conducted to review conversational agents for cardiometabolic risk factors, including chatbots and embodied avatars. A total of 50 studies were identified. Overall, chatbots and avatars appear to have the potential to improve weight-related behaviors such as dietary intake and physical activity. There were limited studies on hypertension and diabetes. Patients seemed interested in using chatbots and avatars for modifying cardiometabolic risk factors, and adherence was acceptable across the studies, except for studies of virtual agents for diabetes. However, there is a need for randomized controlled trials to confirm this finding. As there were only a few clinical trials, more research is needed to confirm whether conversational coaches may assist with cardiovascular disease and diabetes, and physical activity. Conversational coaches may regulate cardiometabolic risk factors; however, quality trials are needed to expand the evidence base. A future chatbot could be tailored to metabolic syndrome specifically, targeting all the areas covered in the literature, which would be novel.

Impact of delaying high school start times on weight and related behaviors - the START study

In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016–2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50–65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors – for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

Weight- and Health-focused Conversations in Racially/Ethnically Diverse Households With and Without a Child with Overweight/Obesity.

Studies indicate parent conversations focused on child weight, shape, or size are associated with unhealthy child weight and weight-related behaviors, whereas health-focused conversations are not. Little research has examined what these types of conversations sound like, how parents respond to them, and whether households with or without a child with overweight/obesity approach these conversations differently. This study used qualitative data to identify the weight- and health-focused conversations occurring in racially/ethnically diverse households. Children ages 5-7 and their families (n=150) from six racial/ethnic groups (i.e., African American, Hispanic, Hmong, Native American, Somali, White) participated in this mixed-methods study. Results showed that parents from households with and without a child with overweight/obesity engaged in similar weight- and health-focused conversations (qualitative themes = focus on growth; health consequences of having overweight/obesity; focus on dietary intake and physical activity; being direct about weight, shape or size; mixing weight- and health-focused conversations). In addition, findings showed that parents also engaged in different types of weight- and health focused conversations depending on whether the household had a child with overweight/obesity (qualitative themes = weight-based teasing; critiquing own weight) or without overweight/obesity (qualitative themes = differences in body shape and size are the norm; focus on modeling rather than talking). Results may be useful for informing public health interventions and for health care providers working with parents regarding weight- and health-focused conversations occurring in home environments of diverse children.

Helicopter Parenting Among Socio-Economically and Ethnically/Racially Diverse Emerging Adults: Associations with Weight-Related Behaviors.

Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-economic families, with little research examining weight-related health or with emerging adult children. The current study examined associations with emerging adult diet, physical activity, and body mass index (BMI) among a diverse population-based sample of parent and emerging adult dyads (n = 919). Helicopter parenting was highest among lower socioeconomic households and those identifying as Black, Indigenous, or people of color. Helicopter parenting was associated with both healthy and less healthy dietary behaviors across ethnic/racial groups, but was not associated with physical activity or BMI. Greater consideration of the cultural context related to helicopter parenting is needed before making conclusions about its benefits or harms.

A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States

Rationale and objectiveBlack men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South. MethodsWe conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches. ResultsPhysical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition. ConclusionsFindings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive “football-themed” weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South.

Treatment Approaches to Eating Disorders Among LGBTQIA+ Population: A Narrative Review

IntroductionHistorically, eating disorders (ED) have been regarded as the diseases of heterosexual, affluent white women. Instead, research shows that the population most at risk of ED is lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/aromantic/agender (LGBTQIA+). Indeed, in addition to many of the same sociocultural influences on body dissatisfaction faced by their peers, LGBTQIA+ individuals experience unique body- and gender-related concerns as well as high levels of stress due to interpersonal prejudice and discrimination.ObjectivesThis narrative review presents an overview of current research on treatment approaches to ED among LGBTQIA+ individuals.MethodsWe conducted a PubMed search for studies published after 1990 using terms that aimed to represent the primary concepts of “eating disorder” and “LGBTQIA+” and “therapy.” Next, we inductively created relevant macro-themes by synthesizing the data from the included articles.ResultsOf 123 PubMed studies, we included 12 studies and identified three relevant macro-themes. The first macro-theme, “ordinary treatments,” focused on efficacy studies of conventional ED therapies applied to this category of patients. In particular, the first study proved the efficacy of the dissonance-based intervention, engaging participants to induce cognitive dissonance concerning the thin-ideal standard of beauty; the second study showed that sexual minorities patients accessing day hospital treatment reported greater overall ED and comorbid symptoms but started treatment with higher scores and improved at a faster rate compared to heterosexual patients; the third study provided evidence that transgender/nonbinary individuals and cisgender individuals showed similar improvement in ED symptoms during higher levels of care treatment, but the first group had less improvement in depression and no improvement in suicidality during ED treatment. The second macro-theme, “relational approach,” investigated newer treatment paradigms involving family and school support, both revealing positive implications for eating and weight-related behaviors. The third macro-theme, “gender-affirming therapy,” focused on medical and surgical treatment toward gender transition, which has been shown to correlate with improvements in body image, ED psychopathology, and psychological functioning.ConclusionsMembers of the LGBTQIA+ community are at greater risk for ED; to our knowledge, there is no targeted treatment that considers the entirety of their experience. These findings denote the need to focus future research efforts on effective treatment strategies specific to sexual and gender identity groups.Disclosure of InterestNone Declared

Popularity Status Insecurity as a Risk Factor for Adolescents' Maladaptive Weight-Related Cognitions and Behaviors: Examining a Moderated Mediation Model.

Previous studies have identified popularity as a risk factor for adolescents' body image concerns and disordered eating behaviors, yet little is known about how adolescents' insecure feelings about their popularity status may be associated with these outcomes. To address this gap, this study examined whether popularity status insecurity was linked to weight-related cognitions and behaviors one year later and whether these links were mediated by body dissatisfaction and moderated by popularity status. A total of 233 Chinese 10th and 11th grade adolescents (41% girls; Mage = 15.81 years, SD = 0.68) participated in the study. The results showed that adolescents' popularity status insecurity was positively and indirectly related to greater future drive for thinness and restrained eating through the mediation of dissatisfied feelings about their own body shape only among those with average and low popularity, and these indirect effects were strengthened as adolescents' popularity decreased. Implications for prevention and intervention of eating disturbances for adolescents are discussed.

Abstract MP39: Associations of Disordered Eating and Weight Control Behavior With Cardiovascular Health Score: The Coronary Artery Risk Development in Young Adults Study

Introduction: Psychological and behavioral factors negatively impact cardiovascular health (CVH), defined by Life’s Simple 7. Few studies have investigated disordered eating and weight control behaviors and CVH, particularly outside of adolescence. Objective: To examine the cross-sectional and longitudinal associations of disordered eating and weight control behaviors with CVH among middle-aged adults. Methods: We studied CARDIA participants assessed between Y10 (1995-1996) and Y30 (2015-2016) excluding pregnant/breastfeeding individuals at Y10. The Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) was administered at Y10 and used to create the Problematic Relationship to Eating and Food (PREF) score, an aggregate measure (range 0-8) of eight disordered eating and weight-related behaviors (anxiety surrounding food, compensatory behaviors, overeating, loss of control, distress surrounding overeating, distress surrounding loss of control, shape concerns, time spent dieting). Diet, physical activity, smoking, blood pressure, cholesterol, glucose, and body mass index (BMI) were measured at Y10 and Y30 (except diet at Y7 and Y20) and used to define CVH categories Low-to-Moderate (0-9) or High (10-14). Logistic regression analyses were used to evaluate associations between PREF score and CVH category. Results: We included 2,040 participants (mean age 35.2 years, 55% female, 43% Black). At Y10, every 1-unit increment in PREF was associated with 19% higher odds of Low-to-Moderate vs. High CVH in adjusted models ( Table ). At Y30 after 20 years of follow-up (mean age 55.3 years), every 1-unit increment in PREF at Y10 was associated with 11% higher odds of Low-to-Moderate vs. High CVH at Y30 in adjusted models ( Table ). Further adjustment for Y10 BMI attenuated the relationship (OR=0.93, 95%CI: 0.87-0.99). Conclusion: Higher levels of problematic behaviors and attitudes towards eating are associated with less optimal CVH throughout middle-age, likely through weight increases.