Effects of a reality TV cosmetic surgery makeover program on eating disordered attitudes and behaviors

OBJECTIVE: To evaluate the effects of a reality TV cosmetic surgery program on eating disordered attitudes, behaviors, mood, anxiety, and self-esteem. METHOD: Participants (N=147 women) completed baseline surveys and were subsequently randomly assigned to one of two conditions: one in which they watched a reality TV cosmetic surgery program (The Swan) and one in which they watched a reality TV home improvement program (Clean Sweep). Assessments were conducted immediately post-video and two weeks later. RESULTS: Women in the cosmetic surgery program group who reported higher internalization of the thin-ideal at baseline manifested lower self-esteem at posttesting. Among White women, those who watched the cosmetic surgery program reported greater perceptions of media pressures to be thin and stronger endorsement of their ability to control their body's appearance after watching the video. These differences persisted over a two-week follow-up period. DISCUSSION: Reality TV cosmetic surgery makeover programs may contribute to eating disordered attitudes and behaviors among young women, particularly those who have internalized the thin body-ideal. These findings seem to be especially applicable for White women; however, they should be further investigated with more diverse and international samples.     

The natural history of disordered eating behavior and attitudes in adult women

This paper reports a survey of natural history of eating behavior and attitudes to weight and shape in British women attending a family planning clinic. Sixty-two women completed a battery of standardized tests, followed by a second questionnaire 18 months later. This rescreening represents the first report of an adult sample not self-defined as ill. The Eating Attitudes Test (EAT)-26 total score showed stability over time (r =.68) but a/so showed a nonsignificant increase in the number of “cases.” The self-reported weight and desired weight increased slightly but statistically over the whole sample in the follow-up period. Analysis of group variances showed evidence of a heterogeneity of variance which was more marked than evidence of group mean effects between responders and nonresponders. The self-reported heights were stable but self-report of historical weight limits showed impossible inconsistencies such that any data related to these must be interpreted with caution. We recommend that future follow-up studies report analysis of loss to follow-up both by group means and variances, that inconsistent responses be counted and explored, and that both group mean changes over time and correlations be reported since they convey different information.     

The influence of a behavioral weight management program on disordered eating attitudes and behaviors in children with overweight

Background

Behavioral interventions targeting children with overweight have been successful in facilitating weight loss; however, there is concern that these programs produce disordered eating attitudes among youth.

Objective

The purpose of this research was to determine whether youth with overweight receiving one of two behavioral interventions were more likely to report an increase in disordered eating attitudes over time compared to a waitlist control and to determine psychosocial predictors of eating-disordered attitudes at 6-month follow-up.

Design

Participants were randomized to one of two behavioral lifestyle interventions or a waitlist control. Data were collected at baseline, post-treatment, and 6-month follow-up.

Participants/setting

Participants were 68 youths with overweight, aged 8 to 13 years, and their parent(s) who lived in rural north central Florida. The project ran from January 2006 to January 2008.

Intervention

Each treatment condition consisted of 12 group sessions over 16 weeks.

Main outcome measures

Parents completed a demographic form and the Child Feeding Questionnaire. Children completed the Children's Eating Attitudes Test, Schwartz Peer Victimization Scale, and Children's Body Image Scale.

Statistical analyses performed

Mixed 2×2 analyses of variance were used to examine the effect of treatment on eating attitudes. Hierarchical linear regression was used to assess whether baseline levels of psychosocial variables predicted disordered eating attitudes at follow-up, controlling for baseline eating attitudes and treatment condition.

Results

Youth who participated in the behavioral interventions did not report significant increases in disordered eating attitudes over time compared to the waitlist control. Across all conditions, higher levels of body dissatisfaction, peer victimization, parent restrictive feeding practices, and concern for child weight at baseline predicted higher levels of disordered eating attitudes at follow-up.

Conclusions

These findings do not provide evidence that behavioral interventions lead to an increase in unhealthy eating attitudes and behaviors. Future research should examine the effects of incorporating eating disorder prevention in pediatric weight management programs.     

Associations between friends' disordered eating and muscle-enhancing behaviors

Dieting, unhealthy weight control and muscle-enhancing behaviors are common among adolescents: friends are a probable source of influence on these behaviors. The present study uses data provided by nominated friends to examine associations between friends' disordered eating and muscle-enhancing behaviors and participants' own behaviors in a diverse sample of American youth. Male and female adolescents (mean age = 14.4) completed surveys and identified their friends from a class roster; friends' survey data were then linked to each participant. Participants (N = 2126) who had at least one nominated friend were included in the analytic sample. Independent variables were created using the same weight control and muscle-enhancing behaviors reported by nominated friends, and were used in logistic regression models to test associations between participants' and their friends' behaviors, stratified by gender. Results indicated that dieting, disordered eating and muscle-enhancing behaviors were common in this sample, and selected friends' behaviors were associated with the same behaviors in participants. For example, girls whose friends reported extreme weight control behaviors had significantly greater odds of using these behaviors than girls whose friends did not report these same behaviors (OR = 2.39). This research suggests that friends' weight- and shape-related behaviors are a feature of social relationships, and is the first report demonstrating these associations for muscle-enhancing behaviors. Capitalizing on the social element may be important to the development of increasingly effective intervention and prevention programs.     

Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study

Background

Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood.

Objective

To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood.

Design

Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999-2010).

Participants/setting

The study population included 2,287 young adults (55% girls, 52% nonwhite). The sample included a younger group (mean age 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age 15.9±0.8 at baseline and 26.2±0.9 years at follow-up).

Statistical analyses performed

Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline.

Results

In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors 10 years later. Tracking was particularly consistent for the older girls and boys transitioning from middle adolescence to middle young adulthood.

Conclusions

Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts before the onset of harmful behavioral patterns as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood.     

Primary and secondary control over eating behaviors

The relationships between subjective control, body image, and eating behaviors were examined within the framework of the Optimization in Primary and Secondary Control model (OPS model; Heckhausen, 1999). This model characterizes control as an adaptive and strategic process in which the target of control includes internal as well as external states, and in which the purpose is either to facilitate goal pursuit by engaging with the goal or managing the consequences of goal failure by disengaging from the goal. A convenience sample of 180 Australian women (age: M = 26.49, SD = 5.03) completed the Optimization of Primary and Secondary Control Scale (OPS scale Heckhausen, 1999), as well as measures of attitudinal and behavioral factors comprising Stice's (1994) dual-pathway model of bulimia. A series of path analyses revealed that the control strategies involved in goal engagement are directly associated with increased dietary restraint and purging, whereas the control strategies involved in goal disengagement are indirectly associated with these factors, and with negative affect, by way of reduced body dissatisfaction and reduced frequency of appearance comparisons. These results suggest that goal engagement strategies, which are typically adaptive in other contexts, are associated with potentially hazardous attitudes and behaviors in the context of the body. The results also suggest that an ability to disengage from body weight goals is associated with a reduced likelihood of developing disordered eating.     

Personal identities and disordered eating behaviors in Mexican American women

Eating disorder behaviors are prevalent in Latina populations. This study tested Schwartz's (2006) theoretical view that a broad array of personal identities serves as an internal resource during acculturation and prevents internalization of dysfunctional weight related beliefs. Sixty-six Mexican American women completed measures of personal identities, fat self-definition, eating disorder symptoms and acculturation. Results show that few positive and many negative personal identities predict higher eating disorder scores and effects are mediated through the fat self-definition. Characteristics of personal identities may influence internalization of cultural values related to weight. Interventions focused on overall identity may prevent eating disorders in Latinas.     

Sociotropic cognition and eating disordered attitudes and behavior in young adults

Sociotropic cognition is a mindset characterized by a strong need for social approval and fear of interpersonal rejection. Sociotropic cognition has been associated with depression and health risk behavior in women, but few studies have specifically addressed eating disordered attitudes and behaviors, and studies including men are lacking. The purpose of the present study was to assess the influence of sociotropic cognition on eating-related attitudes and behaviors in men and women. Participants were N = 362 undergraduate students (51% female; mean age = 19.2 ± 1.43) who completed measures of sociotropic cognition, depressed mood, eating disordered attitudes and behaviors, body shape satisfaction, and physical activity. Using hierarchical regression, the results demonstrated that sociotropic cognition was associated with greater dietary restraint, body shape, eating, and weight concerns, emotional eating, and global eating disordered score. Body shape dissatisfaction and emotional eating were found to mediate the relationship between sociotropic cognition and eating disordered behaviors. Sociotropic cognition appears to be an important predictor of body shape dissatisfaction and eating disordered behaviors in a non-clinical sample. Individuals high in sociotropic cognition may engage in eating disordered behavior in response to fears of social evaluation. These findings have implications for prevention and treatment of eating disorders. Cognitive-behavioral intervention strategies are suggested to reduce sociotropic cognition and its influence on eating disordered behavior.     

Weight history over a forty-year time period

BACKGROUND: Mortality and disease risk assessments consider body mass index (BMI), among other parameters. Nowadays optimal BMI is discussed controversially as risk assessments are usually performed using BMI of arbitrarily chosen age points. A more comprehensive approach could be based on BMI history. However, longitudinal studies investigating BMI are rare. OBJECTIVES: To determine pragmatically different weight history patterns over forty years. DESIGN: Longitudinal study with four follow-ups over forty years, elucidating risk factors for peripheral vessel diseases as the original goal. SUBJECTS: There were 343 male subjects whose weight was measured both at baseline and at follow-ups. RESULTS: Based on pragmatic methods the following eight patterns were found: "stable" (24.8%), "stable and increasing" (28.6%), "stable and decreasing" (9.0%), "hill" (10.0%), "valley" (7.0%), "yo-yo" (14.0%), continually "increasing" (6.4%%), and continually "decreasing" (0.3%). In subjects over 45 years at baseline, stable patterns were most frequent (42%), and descending patterns became more prominent. CONCLUSIONS: The determination of different weight history patterns in a longitudinal study is possible with the use of a pragmatic procedure. Applying such weight history patterns to the mortality risk assessment of overweight could add new aspects to that risk assessment.     

Perceptions of control over eating disorder and social behaviors

Clinicians have long recognized that eating-disordered individuals experience themselves as having limited control in important spheres of life. Unfortunately, researchers have tended to address control as a unidimensional construct. This study examined the multidimensional nature of perceived control. Specifically, the relationship between eating disorder characteristics and perceptions of control over ordinary social behaviors and eating-disordered behaviors was investigated. Measures of subjective perceptions of control over social and symptomic behaviors along with standard eating disorder inventories were administered to 84 male and 198 female undergraduate volunteers. Results indicate markedly different gender-linked patterns of perceived control. Eating disorder characteristics were associated with perceptions of symptomatic dyscontrol. Finally, interpersonal context significantly affected perceptions of control. This investigation underscores the importance of conceptualizing control in a multidimensional manner.     

Preoccupation with weight and disordered eating behaviors of entering students at a university in Lebanon

OBJECTIVES: This research explores the prevalence of preoccupation with weight indicators and disordered eating behaviors among entering university students, and identifies factors associated with these indicators and behaviors. METHOD: Data was collected by means of a self-administered questionnaire. Comparisons were made by gender, mother's education, and body mass index (BMI). RESULTS: The final sample included 954 students. The indicators held most "often" included a desire to be thinner, and an awareness of caloric content. The behaviors engaged in "most" often included strenuous exercising, and avoiding particular foods. Both indicators and behaviors varied by gender and body mass index. DISCUSSION: The prevalence of indicators and behaviors is high. Body mass index is a critical variable to consider in the development of interventions. Further research should explore the context surrounding these indicators and behaviors.     

Stressful life events and disordered eating behaviors: findings from Project EAT

Associations between stressful life events and disordered eating behaviors were examined in 1708 older adolescents. Stressful life events were positively associated with extreme weight control behaviors and binge eating in both male and female respondents, emphasizing the importance of screening for disordered eating behaviors among adolescents who report experiencing stressful life events.     

Exploring the co-morbidity of attention-deficit/hyperactivity disorder with eating disorders and disordered eating behaviors in a nationally representative community-based sample

Emerging evidence signifies the co-occurrence of attention-deficit/hyperactivity disorder (ADHD) with clinical and sub-threshold disordered eating behaviors. However, many existing studies have assessed this co-occurrence among inpatient or intensive outpatient populations. The purpose of this study was to examine the co-occurrence of ADHD with clinical eating disorders and disordered eating behaviors in a nationally representative sample via a secondary data analysis of data from the National Longitudinal Study of Adolescent Health (n = 4,862; 2,243 males; 2,619 females). Results reveal that females have higher rates of co-occurrence of ADHD and diagnosed eating disorders than males (1.05% vs. 0.20%, p < .01). When controlling for age and race, ADHD predicted diagnosed eating disorders in females (incidence rate ratio (IRR): 2.06; 95% CI: 1.09–3.88; p < .05), but did not predict diagnosed eating disorders in males. With regard to disordered eating behaviors, when controlling for age, gender, and race, ADHD significantly predicted disordered eating behaviors (OR: 1.82; 95% CI: 1.21–2.74). When stratifying by type of disordered eating behavior, ADHD predicted binging and/or purging behavior (OR: 2.86; 95% CI: 1.78–4.61), but not restrictive behaviors. Implications of study findings pertain to both secondary/targeted prevention efforts in addition to tertiary prevention via patient-specific treatment plans.     

Flavonoid intake and cognitive decline over a 10-year period

In the PAQUID (Personnes Agées Quid) study, the authors prospectively examined flavonoid intake in relation to cognitive function and decline among subjects aged 65 years or older. A total of 1,640 subjects free from dementia at baseline in 1990 and with reliable dietary assessment were reexamined four times over a 10-year period. Cognitive functioning was assessed through three psychometric tests (Mini-Mental State Examination, Benton's Visual Retention Test, "Isaacs" Set Test) at each visit. Information on flavonoid intake was collected at baseline. A linear mixed model was used to analyze the evolution of cognitive performance according to quartiles of flavonoid intake. After adjustment for age, sex, and educational level, flavonoid intake was associated with better cognitive performance at baseline (p = 0.019) and with a better evolution of the performance over time (p = 0.046). Subjects included in the two highest quartiles of flavonoid intake had better cognitive evolution than did subjects in the lowest quartile. After 10 years' follow-up, subjects with the lowest flavonoid intake had lost on average 2.1 points on the Mini-Mental State Examination, whereas subjects with the highest quartile had lost 1.2 points. This gradient persisted after adjustment for several other potential confounders. This study raises the possibility that dietary flavonoid intake is associated with better cognitive evolution.     

Orthopaedic operations: variation in case-mix over a 10-year period.

The variation in case-mix of patients admitted for routine (non-emergency) orthopaedic surgery at a Staffordshire orthopaedic hospital over a 10-year period was studied, with the aid of the BUPA Schedule of Surgical Procedures. Over this period there was a 2% decrease in the total number of operations performed. There was a marked reduction in the number of 'minor' operations performed, and a marked increase in the number of 'major' and more complex operations performed. The overall workload, as judged by estimated surgeons' fees, rose by 43%. This study offers clear support to the claim that the complexity of orthopaedic operations performed has significantly increased over a ten-year period.     

裕固族3～6岁儿童营养状况6年对比分析

目的:了解裕固族3～6岁儿童6年前后(2003年与2009年)营养状况的变化情况,探讨该人群当前可能存在的营养相关性疾病,为我国少数民族儿童营养干预提供依据。方法:采用随机整群抽样的方法,随机抽取甘肃省肃南县裕固族聚居区140例3～6岁裕固族儿童,进行24h回顾法结合记账法的膳食调查及体格检查,并与6年前的调查结果进行对比分析。结果:调查对象膳食构成仍以粮谷类为主,动物性食物及豆类的摄入量较6年前有明显的提高,蔬菜类摄入量下降;多种营养素的摄入量较6年前有较大幅度提高,但是维生素A、维生素C、钙、锌的摄入量仍未能达到推荐摄入量(RNI)的60%;体格发育状况较6年前得到一定的改善。结论:裕固族3～6岁儿童营养状况较6年前得到了改善,但是一些营养素摄入不足问题依然存在,提示有必要提高该群体新鲜蔬菜、水果、蛋类等食物的摄入量,进一步改善该人群营养状况。     

Subliminal activation of abandonment- and eating-related schemata: relationship with eating disordered attitudes in a nonclinical population

OBJECTIVE: Previous research has demonstrated that subliminal abandonment cues can facilitate eating behavior. It is believed that such eating is a response to the activation of specific core schemata. However, the precise nature of those schemata has not been established. This study examined whether the presentation of subliminal abandonment and food/shape cues results in the activation of abandonment-related or food-related schemata. METHOD: Eighty-two women were exposed to one of three subliminal cues- an abandonment cue ("lonely"), an appetitive cue ("hungry"), and a neutral cue ("gallery"). They subsequently completed Stroop tasks to measure activation of relevant schemata. RESULTS: Subliminal presentation of abandonment cues led to the activation of food- and shape-related schemata. In contrast, subliminal appetitive cues resulted in an activation of abandonment-related schemata. CONCLUSIONS: The results show preliminary support for a multilevel cognitive model, involving indirect links between subliminal cue type and the activation of eating-related cognitions.     

Persistence of personal health practices over a 1-year period

A large amount of research has been devoted to identifying the psychosocial and demographic correlates of personal preventive health practices. An additional factor to consider, however, is the stability of personal health practices over time. At least over short periods, the prediction of current behavior may be substantially improved by having information about an individual's previous performance of the practice being studied. To address this question, data from Wave 1 (1979) and Wave 2 (1980) of the National Survey of Personal Health Practices were examined. Using nine health practices as indices, performance reported at Wave 1 was used to predict performance of that same practice as reported at Wave 2, 1 year later. A two-step analysis strategy was followed to estimate how much more variance could be explained when the behavioral reports were added to a list of psychosocial and demographic predictors. Results showed that over the 1-year interval, the Wave 1 behavioral reports were by far the strongest predictors of their corresponding measures obtained at Wave 2. The explained variance was increased substantially for most of the nine health practices, suggesting a strong tendency for persistence of the practices. Psychosocial and demographic variables tended to account for much smaller amounts of variance and often dropped out of the prediction equation when the Wave 1 behavior report was entered in the second step of analysis. Health practices other than the corresponding Wave 1 index did not improve prediction of the Wave 2 index greatly. The tendency for previous behavior to persist may overshadow the influence of other factors and account for the modest amounts of explained variance that are usually found for psychosocial and demographic indices in cross-sectional surveys. Although stability does not imply rigidity or impossibility of change, the strength of prediction found in these data attest to the "force of habit" that community interventions can encounter.