Effects of repeated weight cycling on non-alcoholic steatohepatitis in diet-induced obese mice.

Lifestyle interventions remain the treatment of choice for patients with obesity and metabolic complications, yet are difficult to maintain and often lead to cycles of weight loss and regain (weight cycling). Literature on weight cycling remains controversial and we therefore investigated the association between weight cycling and metabolic complications using preexistent obese mice. Ldlr-/-.Leiden mice received a high-fat diet (HFD) for 20 weeks to induce obesity. Subsequently, weight-cycled mice were switched between the healthy chow diet and HFD for four 2-week periods and compared to mice that received HFD for the total study period. Repeated weight cycling tended to decrease body weight and significantly reduced fat mass, whereas adipose tissue inflammation was similar relative to HFD controls. Weight cycling did not significantly affect blood glucose or plasma insulin levels yet significantly reduced plasma free fatty acid and alanine transaminase/aspartate transaminase levels. Hepatic macrovesicular steatosis was similar and microvesicular steatosis tended to be increased upon weight cycling. Weight cycling resulted in a robust decrease in hepatic inflammation compared to HFD controls while hepatic fibrosis and atherosclerosis development were not affected. These results argue against the postulate that repeated weight cycling leads to unfavorable metabolic effects, when compared to a continuous unhealthy lifestyle, and in fact revealed beneficial effects on hepatic inflammation, an important hallmark of non-alcoholic steatohepatitis.

Changes in affect longitudinally mediate associations between emotion regulation strategy use and disordered eating.

BACKGROUND: Trait-level emotion regulation (ER) difficulties are associated with eating disorders (EDs) transdiagnostically. However, little research has examined whether within-person fluctuations in ER longitudinally predict ED behaviors in daily life or the mechanisms of ER effects. Investigating daily ER could help us better understand why people experience ED behaviors at a given time. We examined whether day-to-day changes in adaptive (e.g., cognitive reappraisal) and maladaptive (e.g., rumination) ER longitudinally predicted core ED behaviors (binge eating, purging, dieting) and whether changes in affect mediated effects. METHOD: Female participants (N = 688) ages 15-30 from the Michigan State University Twin Registry reported their adaptive and maladaptive ER use, negative affect (NA), positive affect (PA), binge eating, purging, and dieting on 49 consecutive days. Using structural equation modeling, we examined whether within-person fluctuations in ER predicted same- and next-day ED behaviors and whether changes in affect mediated longitudinal ER effects. RESULTS: Greater maladaptive ER predicted increased likelihood of same-day binge eating and next-day binge eating and purging. The association between maladaptive ER and next-day binge eating and purging was mediated by increased next-day NA. In contrast, dieting was more closely related to changes in PA. Adaptive ER did not predict reduced likelihood of any ED behavior. CONCLUSIONS: Maladaptive ER may longitudinally increase risk for binge eating and purging by amplifying NA. Interventions focused on decreasing maladaptive ER and subsequent NA might help disrupt binge eating-purging cycles. Conversely, results add to evidence that PA fluctuations may play a unique role in maintaining restrictive behaviors. PUBLIC SIGNIFICANCE: Little is known about how daily changes in emotion regulation may impact disordered eating. We found that maladaptive emotion regulation (e.g., rumination) was associated with a higher likelihood of binge eating and purging on the next day because it predicted increased next-day negative affect. In contrast, dieting was more closely tied to fluctuations in positive affect. Targeting daily emotion regulation and affective processes may help disrupt cycles of disordered eating.

The burden of overweight/obesity and weight-related behaviors attributable to food addiction in emerging adults.

While food addiction has been positively associated with excess weight and disordered eating behaviors, this has not been examined in representative samples of emerging adults, who are at elevated risk for these outcomes. This study investigated relationships of food addiction with weight outcomes, weight perception, and weight-control behaviors in emerging adults and estimated the population attributable fraction to food addiction. Data from an observational cohort study were collected in seven annual waves from 2010 to 2016. A nationally representative sample of 2785 10th grade students was recruited from schools within each U.S. census region (73% participation) (mean ± SD baseline age = 16.3 ± 0.5years). Wave 7 retention was 81% (n = 2323, 60% female, mean ± SD = 22.6 ± 0.5 years). Outcomes included current BMI, BMI change from baseline - wave 7, increased weight status in wave 7 (increased weight status from baseline-wave 7), perceived overweight, dieting, any weight-control behavior, and extreme weight-control behaviors. Food addiction was measured in wave 7 using the modified Yale Food Addiction Scale. Relative risk of the outcomes associated with food addiction, and population attributable fraction, were estimated using adjusted log-binomial or robust Poisson regression analyses accounting for the complex survey design. Food addiction prevalence was 4.7%. Participants with food addiction were primarily females (91%); food addiction was uncorrelated with other sociodemographics. Food addiction was associated with 48%-167% increased RR for all outcomes, but these were attenuated after adjustment for confounders (31%-64%). The population attributable fraction for food addiction ranged from 2% (high wave 7 BMI) - 5% (extreme weight-control behaviors). Although the population attributable fraction estimates indicate that the public health burden of these outcomes attributable to food addiction may be relatively minor, food addiction may signal the presence of several adverse mental health symptoms.

Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study.

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.

A Qualitative Model of Weight Cycling.

Weight cycling is a likely consequence of striving to lose weight after internalizing body image ideals, making upward social comparisons, and experiencing weight stigma. Despite weight cycling's potential physical and psychological consequences, the interplay of weight cycling, social pressures, and experienced and internalized stigma have not been qualitatively explored. Thus, through in-depth interviews of 36 weight-cycling adults, this study sought to understand how people negotiate weight cycling. Interviews informed the development of a qualitative model of weight cycling, which was derived from a theory-neutral inductive analysis. The model's stages included entering the cycle, undergoing the cycle, and challenging the cycle. Participants were triggered to enter the cycle due to weight stigma caused by social pressures. Within the cycle, interviewees internalized weight stigma and engaged in disordered weight management behaviors. Some participants challenged the cycle by becoming more self-aware and mitigating their toxic dieting behaviors. However, it was very difficult, if not impossible, for many to fully exit weight cycling and the restraints of previous weight management thinking and patterns. Our investigation underscores the seriousness of weight cycling and suggests ways to combat weight cycling on both macro and individual levels. It may also be useful to consider weight cycling as disordered eating in hopes of shifting society's dangerous focus on rapid weight loss.

Genetics of Exercise and Diet-Induced Fat Loss Efficiency: A Systematic Review.

Physical exercise and dieting are well-known and effective methods for fat loss and improving cardiovascular health. However, different individuals often react differently to the same exercise regimen or dietary plan. While specific individuals may undergo substantial fat loss, others may observe only limited effects. A wide range of inter-individual variability in weight gain and changes in body composition induced by physical exercises and diets led to an investigation into the genetic factors that may contribute to the individual variations in such responses. This systematic review aimed at identifying the genetic markers associated with fat loss resulting from diet or exercise. A search of the current literature was performed using the PubMed database. Forty-seven articles met the inclusion criteria when assessing genetic markers associated with weight loss efficiency in response to different types of exercises and diets. Overall, we identified 30 genetic markers of fat-loss efficiency in response to different kinds of diets and 24 in response to exercise. Most studies (n = 46) used the candidate gene approach. We should aspire to the customized selection of exercise and dietary plans for each individual to prevent and treat obesity.

Twenty-year associations between disordered eating behaviors and sociodemographic features in a multiple cross-sectional sample.

BACKGROUND: Disordered eating behaviors (DEB) impact on health and wellbeing worldwide. This study aimed to examine sociodemographic trends in the prevalence of DEB over 20 years in the Australian general population. METHODS: Data were derived from five sequential cross-sectional surveys (1998, 2008, 2009, 2016 and 2017) with population-representative samples of adults and adolescents residing in South Australia (N = 15 075). DEBs investigated were objective binge eating (OBE), strict dieting/fasting, and purging. Sociodemographic data included gender, age, educational level, work and marital status, and residence. RESULTS: OBE prevalence increased significantly. Strict dieting/fasting also increased from 1998 to 2008/9 but remained stable between 2008/9 and 2016/7. Purging prevalence did not change significantly over time. All survey years were associated with a significantly higher odds of OBE, and strict diet/fasting compared to 1998. Lower age, a higher Accessibility Remoteness Index of Australia (ARIA) score, higher body mass index (BMI), higher educational attainment, and not being in a married or de facto relationship were independently associated with greater adjusted odds for endorsing OBE. Younger age, female gender, and higher BMI were also independently associated with greater adjusted odds for endorsing strict dieting/fasting. CONCLUSIONS: The increased prevalence of DEBs in various strata of Australian society has both public health and clinical implications. The results refute the stereotype that eating disorders (EDs) predominantly affect young women. They build impetus for future research on EDs among men and older individuals, with a view to developing tailored public health and clinical interventions for these populations.

A Slim Majority: The Influence of Sex Ratio on Women's Body Dissatisfaction and Weight Loss Motivations.

The current investigation examined whether women's perceptions of the sex ratio (ratio of women to men) in the local population influence their body dissatisfaction and weight loss motivations. A higher ratio of women to men in a given population signifies a relative abundance of same-sex mating competitors, intensifying female intrasexual competition. Five studies (N = 1,776) tested the hypotheses that women's perceptions of a female-skewed sex ratio would correspond to increased feelings of intrasexual competitiveness and perceptions of unfavorable mating prospects, which would, in turn, be associated with heightened body dissatisfaction and weight loss motivations. Among university and community women (Studies 1and 2), perceptions of a female-skewed sex ratio corresponded to greater intrasexual competitiveness, increased body dissatisfaction, and increased dieting inclinations. Among single women, assessments of a female-skewed sex ratio corresponded to perceptions of unfavorable mating prospects, increased romantic pressure to alter their appearance, and higher body dissatisfaction (Study 3). Studies 4 and 5 experimentally manipulated perceived sex ratio. Women in the female-skewed condition felt less satisfied with their weights and shapes, but only if they believed the manipulation (Study 4). In Study 5, using a within-subjects design, women who evaluated a male-skewed (vs. female-skewed) dating profile array subsequently desired to lose less weight. Findings suggest women's perceptions of their social environments may contribute to body image and dieting motivations.

Resistance training volume does not influence lean mass preservation during energy restriction in trained males.

This study investigated the effects of a relatively high- versus moderate-volume resistance training program on changes in lean mass during caloric restriction. Thirty-eight resistance-trained males were randomized to perform either a high-volume (HVG; 5 sets/exercise) or a moderate-volume (MVG; 3 sets/exercise) resistance training program. Both groups were supervised during lower body training. Participants consumed 30 kcal/kg for 6 weeks after 1 week of weight maintenance (45 kcal/kg), with protein intake fixed at 2.8 g/kg fat-free mass. Muscle thickness of the m. rectus femoris, body composition, contractile properties, stiffness, mood, and sleep status were assessed at pre-, mid-, and post-study. No significant group × time interaction was observed for muscle thickness of the m. rectus femoris at 50% (∆ [post-pre] 0.36 ± 0.93 mm vs. ∆ -0.01 ± 1.59 mm; p = 0.226) and 75% length (∆ -0.32 ± 1.12 mm vs. ∆ 0.08 ± 1.14 mm; p = 0.151), contractility, sleep, and mood in the HVG and MVG, respectively. Body mass (HVG: ∆ -1.69 ± 1.12 kg vs. MVG: ∆ -1.76 ± 1.76 kg) and lean mass (∆ -0.51 ± 2.30 kg vs. ∆ -0.92 ± 1.59 kg) decreased significantly in both groups (p = 0.022), with no between-group difference detected (p = 0.966). High-volume resistance training appears to have neither an advantage nor disadvantage over moderate-volume resistance training in terms of maintaining lean mass or muscle thickness. Given that both groups increased volume load and maintained muscle contractility, sleep quality, and mood, either moderate or higher training volumes conceivably can be employed by resistance-trained individuals to preserve muscle during periods of moderate caloric restriction.

Parental dieting impacts inpatient treatment outcomes for adolescents with restrictive eating disorders.

OBJECTIVE: Parental feeding practices and disordered eating are potential risk factors for the development of disordered eating in children and adolescents. This study measured the relationship between parental dieting behaviours and inpatient treatment outcomes for adolescents with restrictive eating disorders (EDs). METHOD: Parents of adolescents with restrictive EDs (N = 45) admitted to a specialty integrated inpatient-partial hospital meal-based ED treatment programme completed questionnaires assessing parental eating and exercise behaviours. Adolescent clinical data, including percentage median body mass index (%mBMI) at admission and discharge and rate of weight gain, were abstracted from the electronic medical record. RESULTS: Adolescents whose parents reported dieting had a slower rate of weight gain (3.47 lbs./week) compared to participants whose parents were not dieting (4.54 lbs./week; p = 0.017). Additionally, participants whose parents reported dieting had a lower %mBMI at programme discharge (M = 93.56) than participants whose parents did not report dieting (M = 95.99; p = 0.033). CONCLUSION: Parental dieting behaviours may impact an adolescent's response to inpatient ED treatment. Findings suggest a need to assess parental dieting behaviour, and when appropriate, provide additional psychoeducation regarding the potential risks of weight or shape-focussed dialogue and the benefits of modelling adaptive meal behaviours.

The association between sexual orientation and eating disorders-related eating behaviours in adolescents: A systematic review and meta-analysis.

BACKGROUND: Sexual orientation is usually developed during the adolescence, which coincides with the eating disorders peak onset. This paper aims to explore existing literature to identify whether there is an association between sexual orientation and eating disorder-related eating behaviours (EDrEBs) in this age-group. METHODS: This review was based on the PRISMA guidelines, covering the published articles between 1990 and 2021. A meta-analysis of the proportion of sexual orientation and the adjusted odds ratio (OR) with 95% confident intervals was reported. RESULTS: Ten studies (412,601 participants) were included in this review. The results demonstrated adolescents identified as minority sexual orientation, particularly homosexual males were with higher OR of EDrEBs, as follows: Homosexual (binge eating: M = 7.20, F = 2.14; purging: M = 5.40, F = 2.41; diet pills use: M = 3.50, F = 2.59; dieting: M = 3.10, F = 1.75); Bisexual (binge eating: M = 4.60, F = 2.26; purging: M = 4.44, F = 2.37; diet pills use: M = 3.42, F = 2.30; dieting: M = 2.36, F = 1.86). CONCLUSIONS: Adolescents who were of a minority sexual orientation were more vulnerable to EDrEBs than their heterosexual peers. Healthcare professionals and sexual minority communities should be primed to facilitate earlier recognition and access to services in these vulnerable groups.

The Role of Intermittent Fasting and Dieting on Cognition in Adult Population: A Systematic Review of the Randomized Controlled Trials.

OBJECTIVE: A healthy diet is a modifiable risk factor that may impact cognition. A unique type of diet may include intermittent fasting (IF), an eating pattern in which individuals go extended periods with little or no meal intake, intervening with periods of normal food intake. IF has multiple health benefits including maintenance of blood glucose levels, reduction of insulin levels, depletion or reduction of glycogen stores, mobilization of fatty acids, and generation of ketones. IF has shown neuroprotective effects as it may lead to increased neurogenesis in the hippocampus, which may contribute to cognitive resilience. Diets including IF were examined as lifestyle modifications in the prevention and management of cognitive decline. METHODS: A systematic literature search was conducted for randomized controlled trials (RCTs) which assessed the effect of dieting on cognitive functions in adults. RESULTS: Dietary Approaches to Stop Hypertension (DASH), low-glycemic diets, and caloric restriction have shown improvement in cognitive function; however, there was a negative impact on problem-solving in those with comorbid cardiovascular disease. There is also contradictory evidence that caloric restriction and diet alone may not be sufficient for the improvement of cognitive functions and that exercise may have better efficacy on cognition. CONCLUSION: IF is considered a safe intervention, and no adverse effects were found in the reviewed studies; however, evidence is limited as there were only 9 low-quality RCTs that assessed the impact of IF on cognition. DASH, low-glycemic diets, and exercise may have effective roles in the management and prevention of cognitive decline, although further research is needed.

Autobiographical memory specificity and restrained eating: examining the influence of priming with images of healthy and unhealthy foods.

BACKGROUND: Dietary restraint has been linked to deficits in the ability to recall detailed memories of personally experienced events (referred to as autobiographical memory specificity). As priming with healthy foods increases the salience of restraint it would be expected to lead to greater deficits in memory specificity. OBJECTIVE: To determine if priming word cues with images of healthy or unhealthy foods would influence the specificity of memory retrieval, and if deficits in memory specificity would be more evident in those reporting higher levels of dietary restraint, or currently dieting. METHODS: Sixty female undergraduates self-reported if they were currently dieting and completed measures of mood, restraint, and disinhibition, and a modified version of the autobiographical memory task. Participants were presented with positive and negative words (unrelated to eating concerns) and asked to retrieve a specific memory in response to each cue. A food image was shown prior to each word cue; half of the participants were primed with images of healthy foods and half with images of unhealthy foods. RESULTS: As expected, participants primed with healthy foods retrieved fewer specific memories than did those primed with unhealthy foods. However, neither restraint nor current dieting behaviour was associated with memory specificity. CONCLUSIONS: Differences in memory specificity between the priming conditions cannot be explained in terms of increased salience of restraint. However, it is plausible that unhealthy images led to an increase in positive affect, which in turn improved memory specificity. LEVEL OF EVIDENCE: Level I: Evidence obtained from: at least one properly designed experimental study.

Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review.

Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.

The role of dieting, psychopathological characteristics and maladaptive personality traits in Orthorexia Nervosa.

BACKGROUND: Pursuing a healthy diet is not a dysfunctional behavior, but dieting could be an important etiological factor for Orthorexia Nervosa (ON). The aim of this study was to investigate the role of diet in groups with high/low orthorexic tendencies. Moreover, some psychopathological characteristics associated with ON and maladaptive personality traits were investigated. METHODS: The sample consisted of three groups: two were on a diet and had high (HIGH-D; n = 52) or low (LOW-D; n = 41) orthorexic tendencies. The other was composed of people with high orthorexic tendencies not on a diet (HIGH; n = 40). Participants filled out self-report questionnaires to investigate orthorexic tendencies, eating disorders features, obsessive-compulsive symptoms, perfectionism, depressive/anxious symptomatology, and maladaptive personality traits. RESULTS: The HIGH-D group showed more orthorexic tendencies than the HIGH group. More maladaptive personality traits and anxiety symptoms have been highlighted in HIGH and HIGH-D groups. The HIGH group had more eating disorder characteristics than other groups. Only the HIGH-D group showed more depressive symptoms than the LOW-D group. CONCLUSIONS: The features of HIGH and LOW-D groups suggest that diet alone could not explain ON, even if it could be a possible factor related to ON. Therefore, people with high orthorexic tendencies, psychopathological features, and maladaptive personality traits could be in a prodromic condition for disordered eating habits and deserve clinical attention.

Commentary on: "What is restrained eating and how do we identify it?": Unveiling the elephant in the room.

This paper is a commentary on Polivy, Herman and Mills' (2020) article, entitled "What is restrained eating and how do we identify it?". Polivy et al.'s paper makes a useful contribution by providing guidelines to researchers for choosing the most appropriate measure of restraint for their research questions. However, the authors assume that restrained eating can be appropriately conceptualized as a trait, an assumption I question. They also assume that restrained eating has a causal influence on the outcomes (e.g., counterregulatory eating, negative affect eating, binge eating) with which it has been associated, which I also question. Finally, they ignored a second prominent model for conceptualizing dieting behavior, the Three-Factor Model of Dieting. The Three-Factor Model decomposes the construct of restrained eating into two types of dieting (current weight loss dieting and weight suppression) that do appear to be causally related to eating control and one type (restrained eating to avoid excessive consumption) that modulates likelihood of overeating but does not cause it. I conclude by noting that scientific progress is best served by promoting, not avoiding, discussion and debate about a multiplicity of perspectives on topics of interest, especially when incompatible hypotheses and data exist on such topics.

Differential Effects of Intuitive and Disordered Eating on Physical and Psychological Outcomes for Women with Young Children.

OBJECTIVES: Pressure to lose weight can increase the risk of developing disordered eating behaviours, negative body image and depressive symptomatology. Eating intuitively may counteract these negative outcomes. This research examined the unique relationship between intuitive eating and disordered eating on body mass index (BMI), body image and depressive symptoms for women of young children. METHODS: A survey of women with a child aged between six and 48 months, included the Intuitive Eating Scale, Eating Attitudes Test-26, Body Shape Questionnaire and Edinburgh Postnatal Depression Scale. Multivariate analysis of variance (MANOVA) was conducted as an omnibus test to estimate the effect of intuitive and disordered eating on BMI, negative body image and depressive symptoms. RESULTS: Of the 419 sample (M age = 32.06), 32% were classified with disordered and 32% with intuitive eating. MANOVA and regression analysis found disordered eating positively associated with depressive symptoms, (ß = 0.303) and negative body image (ß = 0.318). Intuitive eating was associated with lower depressive symptoms (ß = - 0.183) and negative body image (ß = - 0.615). Disordered eating (ß = - 0.194) and intuitive eating (ß = - 0.586) both contributed to lower BMI, with the association stronger for intuitive eating. CONCLUSION: The early parenting period involves a high risk for developing disordered eating behaviours. Eating patterns are modifiable factors, illustrating the potential for positive and preventive health outcomes through adopting intuitive eating behaviours. There is an opportunity for healthcare professionals to promote physical and psychological health including for women in the early parenting period.

Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology.

OBJECTIVE: Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression [DWS] here). METHOD: In this exploratory study, we compared the relationships between traditional weight suppression (TWS) and DWS and a variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub-clinical bulimia nervosa. RESULTS: TWS and DWS were correlated (r = 0.40, p < 0.001). TWS was only significantly related to a measure of physical activity whereas DWS was related to 14 outcomes. DWS showed consistent positive relations with behavioural outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns). CONCLUSIONS: Findings indicated much more consistent relationships between the novel DWS measure and bulimic characteristics than with the TWS measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.

Body Satisfaction and Associated Predictors Among Baby Boomer Women in Rural and Urban Manitoba.

Purpose: This study examines body satisfaction, weight attitudes, dieting behaviours, and aging concerns of baby boomer women (BBW; born 1946-1965) from rural and urban Manitoba.Methods: Primary data collection occurred November 2015, and 1083 participants completed the Body Image and Food Choice Survey. Four strata of BBW were represented to examine differences between older and younger BBW and location of residence. Multinomial logistic regression models were fit to determine predictors of weight and appearance satisfaction. Odds ratios and 95% confidence intervals were considered significant at p ≤ 0.05.Results: Fifty-three percent of participants were satisfied with their appearance, whereas only 34% were satisfied with their weight. Ninety-one percent desired to lose weight (29.9 ± 29.3 lbs). Aging anxiety was evident for 46% of participants and associated with appearance satisfaction (χ2 = 27.46, df = 4, p < 0.001). Body work and dieting behaviours were used to mitigate body dissatisfaction, and media influence was associated with both appearance (χ2 = 76.17, df = 6, p < 0.001) and weight satisfaction (χ2 = 67.90, df = 6, p < 0.001). Desired weight change, appearance stress, appearance importance, and self-rated health predicted both weight and appearance satisfaction.Conclusions: There is a need for greater awareness of aging women's body image concerns and the need for age-appropriate tools/resources to help dietitians support women achieve a healthy body image.

Validation of the Teruel Orthorexia Scale and relationship to health anxiety in a U.S. sample.

BACKGROUND: Scholarly investigation into orthorexia nervosa is relatively new, leading several scholars to develop new measures to adequately assess the concerns thought to underlie this condition. A promising new measure of orthorexia, the Teruel Orthorexia Scale (TOS), was developed using a Spanish sample. PURPOSE: This study was the first to investigate the psychometric properties of the English version of the TOS in a U.S. SAMPLE: This study also examined the long-hypothesized relationship between orthorexia and health anxiety. METHODS: We used exploratory factor analysis (EFA) to evaluate the factor structure of the TOS. We also used correlational methods to test theorized relationships with related concerns. RESULTS: ESEM supported a 16-item, 2-factor model. Correlations between the modified TOS (i.e., TOS-16) subscales and measures of obsessive-compulsive and eating disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS-16. There was a moderate positive correlation between orthorexia nervosa and health anxiety and, together, pursuit of healthy eating and preoccupation with healthy eating accounted for a significant amount of variance in health anxiety after controlling for eating disorder symptoms. CONCLUSION: Overall, this research suggests that the TOS-16 demonstrates psychometric properties as good as or better than other measures commonly used to assess the construct in a U.S. SAMPLE: In addition, findings support the consideration of health anxiety as a possible feature of orthorexia nervosa. LEVEL OF EVIDENCE: Level V, descriptive research.