Open-label placebos reduce weight in obesity: a randomized controlled trial.

Obesity is a major public health problem worldwide. Different approaches are known to face this problem, for example, dieting, surgery, or drug interventions. It has also been shown that placebos may help to reduce weight and hunger feelings, but the use of placebos is linked to problems with respect to the patient-healthcare-provider relationship. However, recent studies demonstrated that even placebos without deception (open-label placebos) affect symptoms such as pain, anxiety, or emotional distress. Here we aimed to examine whether an open-label placebo may help to lose weight in obesity. Our study included fifty-seven overweight and obese patients who aimed to lose weight using a combination of diet and sports. Patients were randomly divided into two groups. Participants in the open-label placebo group received two placebos each day. A treatment-as-usual group received no pills. Primary outcome included changes of body weight. Secondary outcomes were change of eating behavior and self-management abilities. After 4 weeks we found that participants in the open-label placebo condition lost more weight than the treatment-as-usual group. Furthermore, OLP treatment affected eating behavior. No effects for self-management abilities were found. Although further research is necessary, open-label placebos might help individuals to lose weight.

Factorial validation of the children's eating behavior questionnaire and the association between the eating behaviors assessed and BMI Z score in Chinese preschoolers aged 2-5 years.

OBJECTIVE: This study aimed to evaluate the validity and reliability of the Children's Eating Behavior Questionnaire (CEBQ) among Chinese preschool children aged 2-5 years. Additionally, we investigated the associations between eating behaviors assessed by the CEBQ and body mass index (BMI). METHODS: A cross-sectional study was conducted with a sample of Chinese preschool children aged 2 to 5 years (n = 11,780). The CEBQ was employed to assess participants' eating behaviors, and factor analysis of the CEBQ was conducted; sex and age differences in eating behaviors were examined. Correlations between children's BMI z scores and eating behaviors were analyzed via linear regression analysis controlling for age; sex; ethnicity; maternal age, education level, ethnicity and BMI; paternal age, education level, ethnicity and BMI. RESULTS: The factor analysis confirmed the eight-factor structure of the CEBQ, which explained 67.57% of the total variance. Two items were excluded owing to low factor loadings. The subscales showed satisfactory internal reliability (Cronbach's alpha range: 0.76-0.90). Significant sex and age differences were observed for several CEBQ subscales, and BMI z scores were found to be associated with various eating behavior subscales. CONCLUSIONS: This study's findings support the validity and reliability of the CEBQ for assessing eating behaviors among Chinese preschool children, and children's eating behaviors might be affected by age and sex. Furthermore, BMI was found to be associated with specific eating behaviors. Understanding these associations can inform interventions that promote healthy eating habits in this population.

Reliability and validity of the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in a sample of individuals with depressive disorders.

BACKGROUND: Food addiction (FA) is strongly associated with depressive symptoms. The reliability and validity of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) were not previously determined in clinical samples in Brazil. This study aimed to assess the psychometric properties of the Brazilian version of the mYFAS 2.0 in adult individuals with depressive disorders. METHODS: The data stems from a survey investigating FA in a convenience sample of subjects diagnosed with a depressive disorder. Participants answered mYFAS 2.0 and scales for binge eating, depressive and anxiety symptoms, and alcohol and nicotine use. Height and weight were measured to calculate the Body Mass Index (BMI). We evaluated the factor structure, reliability, convergent, discriminant, criterion, and incremental validity. RESULTS: The sample encompassed 303 participants with a mean age of 37.03 ± 11.72 years, 84.16% of whom were women. The Cronbach's alpha for the mYFAS 2.0 was satisfactory (alpha = 0.915). The best goodness-of-fit model was a single factor, and mYFAS 2.0 showed convergent validity with binge eating and discriminant validity with the alcohol and nicotine use measures. Food addiction presented a weak positive correlation with depressive and anxiety symptoms and BMI. Three food addiction symptoms provided the best balance between sensitivity (80.95%) and specificity (74.81%). Incremental validity over binge eating symptoms was confirmed (t = 4.040, ß = 0.681, p < 0.001). CONCLUSIONS: The Brazilian mYFAS 2.0 performed satisfactorily in this clinical sample of participants with a depressive disorder. These findings suggest it may be a brief, useful, and valid food addiction screening tool for this group.

Food addiction is a dysfunctional consumption of energetically dense, hyper-palatable, and ultra-processed foods that may lead to addictive behaviors. It is associated with mental disorders such as eating, mood, and anxiety disorders, which negatively impact the quality of life for individuals affected. Therefore, healthcare providers need to assess food addiction. The Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a brief instrument consisting of 13 questions developed to assess FA. Although it was previously adapted for Brazilian Portuguese in a non-clinical sample, this is the first study in Brazil to investigate this tool in a psychiatric sample. The main aim of our study was to evaluate the psychometric properties of the Brazilian version of the mYFAS 2.0 in individuals with a Depressive Disorder. The results suggested that mYFAS 2.0 had satisfactory psychometric properties in this sample, and it may be a brief, useful, and valid scale to screen food addiction in individuals with depressive states.

Controlled and Real-Life Investigation of Optical Tracking Sensors in Smart Glasses for Monitoring Eating Behavior Using Deep Learning: Cross-Sectional Study.

BACKGROUND: The increasing prevalence of obesity necessitates innovative approaches to better understand this health crisis, particularly given its strong connection to chronic diseases such as diabetes, cancer, and cardiovascular conditions. Monitoring dietary behavior is crucial for designing effective interventions that help decrease obesity prevalence and promote healthy lifestyles. However, traditional dietary tracking methods are limited by participant burden and recall bias. Exploring microlevel eating activities, such as meal duration and chewing frequency, in addition to eating episodes, is crucial due to their substantial relation to obesity and disease risk. OBJECTIVE: The primary objective of the study was to develop an accurate and noninvasive system for automatically monitoring eating and chewing activities using sensor-equipped smart glasses. The system distinguishes chewing from other facial activities, such as speaking and teeth clenching. The secondary objective was to evaluate the system's performance on unseen test users using a combination of laboratory-controlled and real-life user studies. Unlike state-of-the-art studies that focus on detecting full eating episodes, our approach provides a more granular analysis by specifically detecting chewing segments within each eating episode. METHODS: The study uses OCO optical sensors embedded in smart glasses to monitor facial muscle activations related to eating and chewing activities. The sensors measure relative movements on the skin's surface in 2 dimensions (X and Y). Data from these sensors are analyzed using deep learning (DL) to distinguish chewing from other facial activities. To address the temporal dependence between chewing events in real life, we integrate a hidden Markov model as an additional component that analyzes the output from the DL model. RESULTS: Statistical tests of mean sensor activations revealed statistically significant differences across all 6 comparison pairs (P<.001) involving 2 sensors (cheeks and temple) and 3 facial activities (eating, clenching, and speaking). These results demonstrate the sensitivity of the sensor data. Furthermore, the convolutional long short-term memory model, which is a combination of convolutional and long short-term memory neural networks, emerged as the best-performing DL model for chewing detection. In controlled laboratory settings, the model achieved an F1-score of 0.91, demonstrating robust performance. In real-life scenarios, the system demonstrated high precision (0.95) and recall (0.82) for detecting eating segments. The chewing rates and the number of chews evaluated in the real-life study showed consistency with expected real-life eating behaviors. CONCLUSIONS: The study represents a substantial advancement in dietary monitoring and health technology. By providing a reliable and noninvasive method for tracking eating behavior, it has the potential to revolutionize how dietary data are collected and used. This could lead to more effective health interventions and a better understanding of the factors influencing eating habits and their health implications.

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

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

Anticipatory and Consummatory Responses Across Reward Domains in Adolescents With Anorexia Nervosa.

OBJECTIVE: Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing. METHOD: Adolescents with AN (n = 71) and HC (n = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non-food). Anticipatory (Food and Non-food) and Consummatory Pleasure (Non-food) scores were compared between adolescents with AN and HC using independent t-tests. RESULTS: TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (t(110) = 7.80, p < 0.001) and Non-food (t(110) = 4.36, p < 0.001), and Consummatory Pleasure (t(110) = 2.60, p = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (t(108) = 0.88, p = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE-Q subscales and global score (r(68) = -0.38, p = 0.002) and positively correlated with food intake at a laboratory buffet meal (r(61) = 0.53, p < 0.001). DISCUSSION: Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study.

Influence of age and self-stigmatization on social eating and drinking issues in French outpatients living with and beyond head and neck cancer: a mixed-method study.

PURPOSE: Social eating (SE) is a corner stone of daily living activities, quality of life (QoL), and aging well. In addition to feeding functional disorders, patients with head and neck cancer (HNC) face individual and social psychological distress. In this aging population, we intended to better assess the influence of age on these challenges, and the role of self-stigmatization limiting SE in patients with and beyond HNC. METHODS: This was an exploratory multicenter cross-sectional mixed method study. Eligibility criteria were adults diagnosed with various non-metastatic HNC, before, during, or until 5 years after treatment. SE disorders were explored with the Performance Status Scale Public Eating rate (PSS-HN PE). In the quantitative part of the study, SE habits, Functional Assessment of Cancer Therapy Body Image Scale (FACT-MBIS) and specific to HNC (FACT-HN35) were also filled in by the patients. In the qualitative study, the semi-structured interview guide was drawn out to explore stigma, especially different dimensions of self-stigmatization. RESULTS: A total of 112 patients were included, mean age 64.7 years, 23.2% of female. One-third (n = 35) of patients had an abnormal PSS-HN PE rate < 100. Younger patients had more often an impaired Normalcy of Diet mean (70.4 vs 82.7, p = .0498) and PE rates (76 vs 86.9, p = .0622), but there was no difference between age subgroups in MBIS nor FACT-HN scores. Seventy patients (72.2%) found SE and drinking « important¼ to « extremely important¼ in their daily life. The qualitative study reported self-stigmatization in two older patients and strategies they have developed to cope with in their behaviors of SE. CONCLUSION: This study confirms that SE remains of high concern in patients with and beyond HNC. Even in older patients experiencing less often functional feeding disorders, body image changes and SE issues are as impaired as in younger patients and need to be addressed.

Food Neophobia and Avoidant/Restrictive Food Intake among Adults and Related Factors.

Avoidant/restrictive food intake disorder (ARFID) includes age-inappropriate feeding behaviors in eating patterns, including food neophobia, defined as refusal or reluctance to eat new or unknown foods. This study aimed to assess the prevalence of ARFID and food neophobia among adults and determine the related characteristics of these risks. The study used an anonymous survey questionnaire consisting of three parts as the research tool. The first part of the questionnaire was a metric and concerned socio-demographic data. The Food Neophobia Scale (FNS) and the Nine-Item Avoidance/Restrictive Food Disorder Screen Questionnaire (NIAS) were used to evaluate the eating disorders. The survey included 309 people (60.2% women, 39.8% men) aged 18-77 years. NIAS results indicated that 15.2% of the subjects showed food selectivity, and 11.0% had food anxiety. In the FNS assessment, 42.4% had a low risk of food neophobia, 38.2% a medium risk, and 19.4% a high risk. A higher risk of food neophobia correlated with higher NIAS scores, indicating a higher risk of ARFID (p = 0.00231). The NIAS score increased with the risk of food neophobia (p = 0.000). Respondents at low risk of neophobia were most likely to avoid several products (83.97%), while in the high-risk group, 56.67% did not want to eat a favorite food enriched with a new ingredient. A higher risk of neophobia was correlated with more food avoidance and adverse reactions to new foods (p = 0.000). A higher risk of food neophobia is strongly correlated with a higher risk of ARFID. Although demographics did not significantly impact NIAS results, some trends were noted, such as higher scores among older and underweight people. Those with a higher risk of food neophobia show more food avoidance and a greater reluctance to experiment with new ingredients. Public education should emphasize that eating disorders affect both sexes equally, with tailored interventions for high-risk groups such as the elderly, rural populations, and those with lower education. Health policies should promote access to nutrition education, psychological support, and diverse food options, while further research is needed to improve targeted interventions.

[A longitudinal study among female college students' eating behaviors and food group intake based on the change in eating habit stages].

Objectives　This study aimed to longitudinally determine the eating behavior and food group intake of female students to examine the relationship between eating behaviors and intention to improve eating habits (change in eating habits stages) and help health education use the behavior change theory.Methods　This one-year longitudinal study included 130 female students from Japanese colleges. The stage at which eating habits and behaviors (skipping breakfast, eating out, instant food intake, and snacking) and intake of food groups rich in protein, calcium, vitamins, minerals, carbohydrates, and fats and oils were assessed. The stages were as follows; pre-contemplation or contemplation (lower group), preparation (middle group), and action or maintenance (upper group). A self-assessment questionnaire was administered to evaluate eating behaviors and food group intake frequencies using a 5-point Likert scale. P-values of <.05 were considered statistically significant.Results　A cross-sectional comparison of eating behaviors and food group intake scores demonstrated significant differences between the stages only in snacking behavior. The upper group consumed snacks significantly less frequently than the middle and lower groups. After one year, a longitudinal comparison of eating behaviors and food group intake scores revealed significant differences in the intake of food groups rich in vitamins and minerals (green and yellow vegetables), fats and oils in the pre-contemplation stage, intake of food groups rich in vitamins/minerals (green and yellow vegetables) and frequency of skipping breakfast in the preparation stage, and frequency of eating out and snacking in the action stage. Each stage demonstrated a decreasing trend in food intake and an increasing trend in the frequency of skipping breakfast, eating out, and snacking. The percentages of students whose eating habits stage dropped during the second year were 49.0%, 100%, and 77.8% in the preparation, action, and maintenance stages, respectively. This indicates that there are cases in which readiness reverses in stages with improved eating habits.Conclusion　In health education on eating habits, it is vital to understand the changes in eating habit stages for each eating behavior and details of actual eating behaviors and habits. Thus, health education should align to the needs of each individual to support them in transforming and maintaining a higher stage of change in their eating habits.

Variations of Eating Behaviors Among Vietnamese Preschool Children and Their Association With Children's Anthropometric Z-Scores: Results From Analyses of the Children's Eating Behavior Questionnaire in 10 000 Children.

Eating behaviors, which are shaped during childhood, are one of the important factors influencing children's growth. This study aimed to investigate the variations in eating behaviors among Vietnamese preschool children aged 3 to 6 years using the Children Eating Behavior Questionnaire (CEBQ) and their association with anthropometric Z-scores. A cross-sectional study was conducted on 10 172 children from 36 to 72 months old, recruited from three different socioeconomic regions of Hanoi. Differentiation of eating behaviors between two sexes was observed across all age groups, but most obvious at 36 to 48 months of age. The subscales of emotional overeating (EOE), enjoyment of food (EF), and desire to drink (DD) were higher in 60- to 72-month age groups and vice versa for slowness in eating (SE) and emotional undereating (EUE) subscales. Analyses using the general linear model showed that CEBQ subscales were associated with anthropometric Z-scores in both girls and boys.

Obesity-related behaviors and health-related quality of life in socioeconomically vulnerable children: A cross-sectional study.

PURPOSE: This study aims to explore obesity-related behaviors (ORB) and health-related quality of life (HRQoL) in socioeconomically vulnerable children, while also examining potential associations between these variables. DESIGN AND METHODS: A total of 721 children enrolled in after-school care programs for socioeconomically vulnerable children participated in this study. Height (in cm) and weight (in kg) were measured directly by trained research assistants. ORB, including eating behaviors and physical activity, was assessed utilizing the Nutrition Quotient Questionnaire. HRQoL was measured utilizing the PedsQL™ 4.0. Data were analyzed using logistic regression. RESULTS: The findings revealed that participants exhibited lower levels of ORB and reduced HRQoL, particularly in the physical health dimension of HRQoL. Inadequate physical activity and poor dietary habits were strongly associated with a 2.625-fold (OR = 2.625, 95% CI = 1.867-3.691) and a 4.251-fold (OR = 4.251, 95% CI = 2.466-7.328) increase, respectively, in the likelihood of having low HRQoL. Surprisingly, the study did not find a significant link between ORB levels and obesity, and obesity status did not predict a higher probability of low HRQoL. CONCLUSIONS: This study underscores the need for tailored interventions designed specifically for children from socioeconomically vulnerable families to address their unique challenges. PRACTICE IMPLICATIONS: This research provides valuable insights for pediatric nurses and healthcare providers, highlighting the crucial role of promoting healthy ORB in socioeconomically vulnerable children to address disparities in childhood obesity and HRQoL.

Clinical Relevance of Food Addiction in Higher Weight Patients across the Binge Eating Spectrum.

Food addiction (FA) is associated with greater severity on many eating-related correlates when comorbid with binge eating disorder (BED) but no study has established this relation across the whole spectrum of binge eating, i.e., from no BED to subthreshold BED to BED diagnosis. This study aims to examine the effect of the presence of FA on the severity of eating behaviors and psychological correlates in patients without BED, subthreshold BED or BED diagnosis. Participants (n = 223) were recruited at a university center specialized in obesity and eating disorder treatment and completed a semi-structured diagnostic interview and questionnaires measuring eating behaviors, emotional regulation, impulsivity, childhood interpersonal trauma, and personality traits. They were categorized by the presence of an eating disorder (no BED, subthreshold BED, or BED) and the presence of FA. Group comparisons showed that, in patients with BED, those with FA demonstrated higher disinhibition (t(79) = -2.19, p = 0.032) and more maladaptive emotional regulation strategies (t(43) = -2.37, p = 0.022) than participants without FA. In patients with subthreshold BED, those with FA demonstrated higher susceptibility to hunger (t(68) = -2.55, p = 0.013) and less cooperativeness (t(68) = 2.60, p = 0.012). In patients without BED, those with FA demonstrated higher disinhibition (t(70) = -3.15, p = 0.002), more maladaptive emotional regulation strategies (t(53) = -2.54, p = 0.014), more interpersonal trauma (t(69) = -2.41, p = 0.019), and less self-directedness (t(70) = 2.14, p = 0.036). We argue that the assessment of FA provides relevant information to complement eating disorder diagnoses. FA identifies a subgroup of patients showing higher severity on many eating-related correlates along the binge eating spectrum. It also allows targeting of patients without a formal eating disorder diagnosis who would still benefit from professional help.

Association between personality traits, eating behaviors, and the genetic polymorphisms FTO-rs9939609 and MAO-A 30 bp u-VNTR with obesity in Mexican Mayan children.

Introduction: Genetic variants that control dopamine have been associated with obesity in children through loss of control of satiety and impulses, the manifestation of addictive eating behaviors, and specific personality traits. The variants include FTO-rs9939609 and the MAO-A 30 pb u-VNTR low-transcription alleles (LTA). Objective: To evaluate the genetic association of FTO-rs9939609 and the MAO-A LTA, along with personality traits and eating behavior with obesity in Mayan children from Mexico. Methods: We cross-sectionally evaluated 186 children (70 with obesity and 116 with normal weight) 6-12 years old from Yucatan, Mexico. Nutritional status was defined with body mass index (BMI) percentiles. Personality traits were evaluated with the Conners and TMCQ tests; eating behavior was evaluated with the CEBQ test. Genotyping with real-time PCR and TaqMan probes was used for FTO-rs9939609, whereas PCR amplification was used for MAO-A u-VNTR. Results: High-intensity pleasure (p = 0.013) and moderate appetite (p = 0.032) differed according to nutritional status. Heterozygous FTO-rs9939609 T/A children showed higher mean scores of low-intensity pleasure (p = 0.002) and moderate appetite (p = 0.027) than homozygous T/T. Hemizygous boys having MAO-A LTA showed significantly higher mean scores of anxiety (p = 0.001) and impulsivity (p = 0.008). In multivariate models, only LTA alleles of MAO-A explained obesity in boys (OR = 4.44; 95% CI = 1.18-16.63). Conclusion: In the present study, MAO-A u-VNTR alleles were associated with obesity in multivariate models only in boys. These alleles might also have a role in personality traits such as anxiety and impulsivity, which secondly contribute to developing obesity in Mayan boys.

Disordered eating behavior and dietary intake prior to metabolic and bariatric surgery.

BACKGROUND: Disordered eating is a concern for patients seeking metabolic and bariatric surgery (MBS), but little is known about how these behaviors are reflected in typical dietary intake prior to surgery. OBJECTIVES: This study examined the relationships between disordered eating behavior and the content and context of typical dietary intake among patients seeking MBS using an innovative combination of rigorous self-report and interview assessments. SETTING: Participants were recruited from two academic medical centers in the United States. METHODS: Adults were enrolled prior to MBS. Participants completed the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV) and then reported details of their dietary intake for three consecutive days using a validated 24-hour dietary recall system. RESULTS: Among the sample (n = 140), objective overeating (OOE) was prevalent and related to greater daily energy and macronutrient intake. Individuals engaging in recurrent OOE were also more likely to consume meals past 8 pm Findings failed to identify significant associations between other disordered eating behaviors, such as objective binge eating (OBE), and contextual factors related to dietary intake. CONCLUSIONS: The timing of eating may play a greater role in recurrent overeating than social and physical aspects of the environment. Individuals reporting frequent OOE before MBS may benefit from targeted education and intervention aimed at reducing OOE and subsequently promoting better adherence to dietary recommendations.

Patients with diabetes and obesity exhibit characteristics in eating and coping behaviors and personality traits.

Aims/introduction: In patients with diabetes, obesity is an aggravating factor for glycemic control and its vascular complications. However, the psychological and behavioral characteristics of those patients with obesity have not been fully clarified. This study investigated eating and coping behavior, personality traits, quality of life (QOL), and depression status in patients with diabetes with or without obesity. Materials and methods: Questionnaires obtained from 567 patients with diabetes at Dokkyo Medical University were analyzed. Eating behavior, coping behavior, personality traits, QOL, and depression status were evaluated by the Eating Behavior Questionnaire, Brief COPE, Japanese Ten-Item Personality Inventory, EuroQol 5 Dimensions-5 Level, and Patient Health Questionnaire-9, respectively. Participants were divided according to body mass index (BMI) into a non-obese group (BMI < 25), obese group (BMI 25-35), and high-degree obese group (BMI ≥ 35), and results were compared between groups. Results: On all items of the Eating Behavior Questionnaire, scores were higher in the obese and high-degree obese groups than non-obese group, indicating worse eating behavior. In coping behavior, significant intergroup differences were found in self-distraction, substance use, using emotional support, using instrumental support, and venting. As for personality traits, the obese group had significantly lower conscientiousness and higher emotional instability than the non-obese group. There was no significant difference in QOL or depression status. Conclusions: These results suggest that there are some characteristics in eating and coping behaviors and some personality traits between obese and non-obese patients with diabetes. Treatment based on such characteristics may be useful for patients with diabetes and obesity. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-024-00721-w.

Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students.

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of body mass index (BMI) with the weekly frequency of moderate-intensity physical activity, eating behavior, and the use of the Internet or games among Korean middle school students. METHODS: The data of 23,583 Korean middle school students were collected from the 2023 Korean Student Health Examination. The collected data were analyzed using frequency, chi-square, and multivariate logistic regression analyses. RESULTS: The results also showed that the higher the BMI, the greater the likelihood of moderate-intensity physical activity. The likelihood of breakfast intake reduced as the BMI increased. However, the likelihood of using the Internet or games increased with an increase in BMI. The results revealed that 28% (6594 of 23,583) of middle school students rarely participate in moderate-intensity physical activity, while 32% (7553 of 23,583) participate only once or twice a week. The results also showed that the higher the BMI, the higher the likelihood of moderate-intensity physical activity. Among those who were underweight, the odds ratio (OR) of 3-4 days of participation in moderate-intensity physical activity was 0.764 (95% confidence interval [CI]: 0.664-0.880; p < 0.001). Among those who were healthy, the OR of more than 5 days of participation was 1.279 (95% CI: 1.131-1.446; p < 0.001). Among those who were overweight, the OR of 3-4 days and more than 5 days of participation was 1.172 (95% CI: 1.019-1.348; p = 0.026) and 1.181 (95% CI: 1.011-1.380; p = 0.036), respectively. The likelihood of the use of the Internet or games increased with an increase in BMI. The OR of the use of the Internet or games was 0.876 (95% CI: 0.806-0.952; p = 0.002) and 0.824 (95% CI: 0.743-0.913; p < 0.001) among those who were healthy and those who were overweight, respectively. However, the likelihood of breakfast intake reduced as the BMI increased. Among those who were underweight, the OR of always eating breakfast and mostly eating breakfast was 1.299 (95% CI: 1.114-1.515; p < 0.001) and 1.236 (95% CI: 1.045-1.461; p = 0.013), respectively. Among those who were healthy, the OR of always eating breakfast was 1.157 (95% CI: 1.026-1.305; p = 0.018). Among those who were overweight, the OR of mostly eating breakfast was 1.215 (95% CI: 1.030-1.433; p = 0.021). CONCLUSIONS: Given this, outdoor sports may increase adolescents' participation in physical activities by helping them break away from repetitive ball games and increasing their overall interest and participation in physical activities. Overall, our results suggest the need to move away from traditional physical education and develop engaging physical activity programs that motivate students to participate in moderate-intensity physical activities.

What Is the Relationship between Chronotype and Disordered Eating in Adolescents? The EHDLA Study.

BACKGROUND: Evidence assessing the relationship between chronotype and disordered eating in adolescents is scarce. The current study tried to evaluate the association between chronotype and disordered eating in a sample of Spanish adolescents. METHODS: This secondary cross-sectional study analyzed data from the Eating Healthy and Daily Life Activities (EHDLA) study. The sample consisted of 703 adolescents (56.3% girls) aged between 12 and 17 years from the Valle de Ricote (Region of Murcia, Spain). Chronotype was assessed using the Morningness/Eveningness Scale in Children (MESC). Disordered eating was evaluated by two psychologists using the Sick, Control, One, Fat, and Food (SCOFF) questionnaire. RESULTS: Adolescents with an eveningness chronotype showed a higher SCOFF score (estimated marginal mean [M] = 1.1; 95% confidence interval [CI] 0.7 to 1.5) in comparison with adolescents with a morningness chronotype (M = 0.7; 95% CI 0.5 to 0.8) (p = 0.010), as well as with those with an intermediate chronotype (M = 0.6; 95% CI 0.5 to 0.8) (p = 0.032). A higher predictive probability of having disordered eating was identified in adolescents with an eveningness chronotype (39.5%; 95% CI 22.8% to 59.1%), compared to adolescents with an intermediate chronotype (14.9%; 95% CI 10.8% to 20.1%) (p = 0.008) and with their counterparts with a morningness chronotype (16.9%; 95% CI 11.6% to 24.0%) (p = 0.021). CONCLUSIONS: This study reveals that adolescents with an eveningness chronotype are more likely to exhibit disordered eating behaviors compared to those with morningness or intermediate chronotypes. These findings highlight the importance of considering chronotype in adolescent health, particularly in developing targeted interventions to prevent eating disorders.

Association of Salty and Sweet Taste Recognition with Food Reward and Subjective Control of Eating Behavior.

Sweet and salty tastes are highly palatable and drive food consumption and potentially uncontrolled eating, but it remains unresolved whether the ability to recognize sweet and salty affects food reward and uncontrolled eating. We investigate the association of sweet and salty taste recognition with liking and wanting and uncontrolled eating. Thirty-eight, mainly female (68%) participants of the Obese Taste Bud study, between 22 and 67 years old, with a median BMI of 25.74 kg/m2 (interquartile range: 9.78 kg/m2) completed a taste test, the Leeds Food Preference Questionnaire to assess food reward, the Power of Food Scale (PFS) and the Three-Factor Eating Questionnaire to assess different aspects of uncontrolled eating. Better salty taste recognition predicted greater implicit wanting for high-fat savory foods (ß = 0.428, p = 0.008) and higher PFS total (ß = 0.315; p = 0.004) and PFS present subscale scores (ß = 0.494, p = 0.002). While neither sweet nor salty taste recognition differed between lean individuals and individuals with obesity, those with greater trait uncontrolled eating showed significantly better salty taste recognition (U = 249.0; p = 0.009). Sweet taste recognition did not associate with food reward or uncontrolled eating. Better salty but not sweet taste recognition associates with a greater motivation for, but not liking of, particularly savory high-fat foods and further relates to greater loss of control over eating. Salty taste perception, with taste recognition in particular, may comprise a target to modulate food reward and uncontrolled eating.

Exploring weight-related self-monitoring as a potential risk factor for eating disorder symptoms in adults - A systematic review and meta-analysis.

OBJECTIVE: Weight-related self-monitoring (WRSM), which involves the intentional tracking of body weight metrics, has been considered a potential risk factor for eating disorders. Therefore, the aim of this study was to systematically summarize the current state of the literature and to quantify the possible association between WRSM and eating disorder symptoms in adults. METHOD: Preregistration was carried out using PROSPERO (ID CRD42022366133). The PubMed, PsycInfo, and Web of Science databases were searched until December 21, 2023. A study had to be 1) be available in English or German, 2) be peer-reviewed and quantitative, 3) include adult participants (age ≥18 years) from the general population, 4) assess eating disorder symptoms via at least one of the following questionnaires: EDI, EAT, FEV, TFEQ, DEBQ, EDE-Q, Munich ED-Quest or IEG, and 5) include WRSM. Data analyses included descriptive analyses and three-level meta-analysis, corrected for correlations, for the global score and the different subscales of the eating disorder questionnaires. RESULTS: A total of 28 studies (n = 17,370 participants), with an overall fair methodological quality, were included in the systematic review. Out of these studies, nine studies with n = 13,507 participants were ultimately analyzed in the meta-analysis. The three-level meta-analysis did not reveal a significant association between WRSM and the eating disorder global score (r = 0.13, 95% CI [-0.02, 0.28]; p = 0.08), with this pattern also being evident in the subgroup analysis (diet monitoring). DISCUSSION: WRSM alone does not generally translate into an increased risk of disordered eating symptoms in the general population. We assume that individual factors are likely to determine whether the use of WRSM could lead to eating disorder symptoms. These factors should be accounted for in future research.

Unraveling the role of social support in eating behavior among children and adolescents in Shanghai, China: exploring the mediating role of self-efficacy and the moderating influence of BMI and weight concern.

Objective: This study explores the intricate relationship between social support and eating behaviors in children and adolescents, considering the mediating role of eating self-efficacy and the moderating effects of body mass index (BMI) and weight concern. Methods: Data from 1986 primary and secondary school students aged 8 to 17 in Shanghai, China, were analyzed using moderated mediation analysis. Results: The results demonstrate a robust positive association between social support and eating self-efficacy, particularly prominent among individuals with low BMI (effect = 0.506, 95% CI [0.376, 0.636]). Moreover, the study highlights that eating behavior is influenced not only by eating self-control (ß = -0.054, 95% CI [-0.062, -0.046]) but also by the interaction term between individuals' perceptions of their body weight (ß = -0.0008, 95% CI [-0.0015, -0.0001]). Conclusion: Eating self-efficacy serves as a mediator in the relationship between social support and eating behavior, modulated by BMI and weight concern. Importantly, high weight concern significantly strengthens the mediating effect of eating self-efficacy on the relationship between social support and eating behavior, regardless of BMI.