Subtypes of exercise are differentially associated with baseline eating disorder pathology and treatment outcome among individuals with bulimia nervosa.

OBJECTIVE: Individuals with bulimia nervosa (BN) engage in both maladaptive (i.e., compulsive and/or compensatory) and adaptive exercise (e.g., for enjoyment). No research has examined whether those who engage in adaptive, compulsive, and/or compensatory exercise exhibit differences in BN pathology or treatment outcome compared to those not engaging in exercise, limiting intervention efficacy. METHOD: We examined associations of baseline exercise engagement with baseline and posttreatment BN pathology among 106 treatment-seeking adults (Mage = 37.4, SDage = 12.95, 87.74% female, 68.87% White) enrolled across four clinical trials of outpatient enhanced cognitive behavioral therapy for BN (range: 12-16 sessions). Analysis of covariances examined associations between baseline exercise type and baseline/posttreatment global eating pathology, dietary restraint, loss-of-control (LOC) eating, and purging frequency. RESULTS: Those engaging in only adaptive exercise reported lower global eating pathology compared to those engaging in compulsive-only exercise (Est = -1.493, p = .014, Mdiff = -.97) while those engaging in baseline compulsive exercise reported less LOC eating compared to those not engaging in exercise (Est = -22.42, p = .012, Mdiff = -12.50). Baseline engagement in compulsive-only exercise was associated with lower posttreatment global eating pathology compared to baseline engagement in no exercise (Est = -.856, p = .023, Mdiff = -.64) and both compulsive and compensatory exercise (Est = .895, p = .026, Mdiff = -1.08). DISCUSSION: Those engaging in compulsive, compensatory, adaptive, and no exercise exhibit different patterns and severity of BN pathology. Future research is needed to position treatments to intervene on maladaptive, while still promoting adaptive, exercise. PUBLIC SIGNIFICANCE STATEMENT: No research to date has examined whether those who engage in adaptive, compulsive, and/or compensatory exercise exhibit differences in BN pathology or treatment outcome compared to those not engaging in exercise, limiting targeted intervention efforts. We found that those engaging in compulsive, compensatory, and adaptive exercise exhibit different patterns of BN pathology and that adaptive exercise engagement was related to lower cognitive eating disorder symptoms at baseline.

Exploring longitudinal relationships between fitness tracking and disordered eating outcomes in college-aged women.

OBJECTIVE: A growing body of research, primarily cross-sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness-tracking smartphone applications ("apps") or wearable devices ("wearables") and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college-aged women, as well as to determine whether the individual-level risk factors of pre-existing eating concerns, perfectionism, and rumination about food moderated the relationship. METHOD: N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self-report measures. RESULTS: At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next-day levels for any of the outcome measures. Within-day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time. DISCUSSION: These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted.

Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study.

OBJECTIVE: Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. METHOD: Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. RESULTS: Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. DISCUSSION: Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. PUBLIC SIGNIFICANCE: Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.

Differences in dietary acceptability, restraint, disinhibition, and hunger among African American participants randomized to either a vegan or omnivorous soul food diet.

The Nutritious Eating with Soul study was a 24-month, randomized behavioral nutrition intervention among African American adults. This present study, which is a secondary analysis of the NEW Soul study, examined changes in dietary acceptability, restraint, disinhibition, and hunger. Participants (n = 159; 79% female, 74% with ≥ college degree, mean age 48.4 y) were randomized to either a soul food vegan (n = 77) or soul food omnivorous (n = 82) diet and participated in a two-year behavioral nutrition intervention. Questionnaires assessing dietary acceptability (Food Acceptability Questionnaire; FAQ) and dietary restraint, disinhibition, and hunger (Three-Factor Eating Questionnaire; TFEQ) were completed at baseline, 3, 6, 12, and 24 months. Mixed models were specified with main effects (group and time) and interaction effects (group by time) to estimate mean differences in FAQ and TFEQ scores using intent-to-treat analysis. After adjusting for employment, education, food security status, sex, and age, there were no differences in any of the FAQ items, total FAQ score, dietary restraint, disinhibition, and hunger at any timepoint except for one item of the FAQ at 12 months. Participants in the vegan group reported a greater increase in satisfaction after eating a meal than the omnivorous group (mean difference 0.80 ± 0.32, 95% CI 0.18, 1.42; P = 0.01). This is one of the first studies to examine differences in dietary acceptability, hunger, and other eating factors among African American adults randomized to either a vegan or omnivorous soul food diet. The findings highlight that plant-based eating styles are equally acceptable to omnivorous eating patterns and have similar changes in hunger, restraint, and disinhibition. These results suggest that plant-based eating styles can be an acceptable dietary pattern to recommend for cardiovascular disease prevention and may result in greater post-meal satisfaction.

Uncontrolled eating is associated with higher impulsiveness, risk taking and novelty-seeking.

Previous studies suggest that trait disinhibition as measured by the Three Factor eating Questionnaire (TFEQ) is related to selected measures of impulsivity and risk taking. However, the factor validity of the original trait disinhibition measure has been questioned, and a revised scale of uncontrolled eating consequently developed. To date few studies have revisited the relationship between impulsivity and the uncontrolled and emotional eating scales of the revised TFEQ. In the present study, 283 participants (208 women) completed the revised TFEQ alongside a battery of measures of impulsivity and risk taking in an online study. The total and all subscale scores on the Barratt Impulsiveness Scale were significantly associated with scores on the uncontrolled, but not emotional or restrained, TFEQ scale. Likewise, risky behaviour indexed by the average number of pumps per trial on the Balloon Analogue Risk Task were also associated with uncontrolled, but not emotional or restrained, eating, and the same pattern of associations were also found for the novelty, but not intensity, subscales of the Arnetts Inventory of Sensation Seeking. Overall these data suggest that uncontrolled eating is related to wider personality traits of risky decision making, novelty seeking and wider cognitive impulsivity, which may in turn increase of future weight gain.

It is a matter of perspective: Attentional focus rather than dietary restraint drives brain responses to food stimuli.

Brain responses to food are thought to reflect food's rewarding value and to fluctuate with dietary restraint. We propose that brain responses to food are dynamic and depend on attentional focus. Food pictures (high-caloric/low-caloric, palatable/unpalatable) were presented during fMRI-scanning, while attentional focus (hedonic/health/neutral) was induced in 52 female participants varying in dietary restraint. The level of brain activity was hardly different between palatable versus unpalatable foods or high-caloric versus low-caloric foods. Activity in several brain regions was higher in hedonic than in health or neutral attentional focus (p < .05, FWE-corrected). Palatability and calorie content could be decoded from multi-voxel activity patterns (p < .05, FDR-corrected). Dietary restraint did not significantly influence brain responses to food. So, level of brain activity in response to food stimuli depends on attentional focus, and may reflect salience, not reward value. Palatability and calorie content are reflected in patterns of brain activity.

Evaluating dietary restriction as a maintaining factor in binge-eating disorder.

OBJECTIVE: Prominent theories of binge-eating (BE) maintenance highlight dietary restriction as a key precipitant of BE episodes. Consequently, treatment approaches for eating disorders (including binge-eating disorder; BED) seek to reduce dietary restriction in order to improve BE symptoms. The present study tested the hypothesis that dietary restriction promotes BE among 112 individuals with BED. METHODS: Participants completed a 7-day ecological momentary assessment (EMA) protocol before and after completing 17 weeks of either Integrative Cognitive-Affective Therapy or guided self-help cognitive behavioral therapy. Analyses examined whether dietary restriction on 1 day of the baseline EMA protocol predicted risk for BE later that same day, and on the following day. Changes in dietary restriction over the course of treatment were also evaluated as a predictor of change in BE from pre-treatment to post-treatment. Baseline dietary restraint was examined as a moderator of the above associations. RESULTS: Dietary restriction did not predict BE later the same day, and changes in restriction were not related to changes in BE across treatment, regardless of baseline dietary restraint levels. Restriction on 1 day did predict increased BE risk on the following day for individuals with higher levels of dietary restraint, but not those with lower levels. DISCUSSION: These findings challenge the assumption that dietary restriction maintains BE among all individuals with BED. Rather, results suggest that dietary restriction may be largely unrelated to BE maintenance in this population, and that reducing dietary restriction generally does not have the intended effect on BE frequency.

Differentiating types of dietary restraint and their momentary relations with loss-of-control eating.

OBJECTIVE: Despite evidence supporting the link between dietary restraint (i.e., attempts at dietary restriction) and loss of control (LOC) eating among individuals with binge-spectrum eating disorders (EDs), some research suggests that dietary restraint may not be linked to LOC eating in all contexts. It is currently unknown how often dietary restraint results in successful dietary restriction, or which types of restraint/restriction confer highest risk for LOC eating. Furthermore, little research has evaluated momentary, temporal associations between dietary restraint and LOC eating. Thus, the present study aimed to (1) characterize dietary restraint and restriction, among individuals with LOC eating, and (2) examine temporal relationships between restraint/restriction and LOC eating within- and between-subjects. METHOD: The current study recruited adults with binge spectrum EDs (n = 96, 80.4% female) to complete a 7-14-day ecological momentary assessment protocol assessing ED symptoms. Multilevel models and linear regression evaluated within- and between-subjects associations between momentary restraint/restriction and LOC eating, respectively. RESULTS: Attempted avoidance of enjoyable foods, limiting the amount eaten, and any restraint predicted greater likelihood of LOC eating at the next survey. Attempts to delay eating predicted reduced likelihood of LOC eating at the next survey, though this effect was no longer statistically significant after correcting for multiple comparisons. Diagnostic presentation moderated the association between attempted avoidance of enjoyable foods and LOC eating such that this association was significantly stronger for those on the BN-spectrum. DISCUSSION: Dietary restraint seems to be more predictive of LOC eating than dietary restriction both within- and between-subjects. Future treatments should target dietary restraint to reduce LOC eating. PUBLIC SIGNIFICANCE: Some research suggests that dietary restriction (i.e., reduced calorie intake) and restraint (i.e., attempted restriction) may not be linked to LOC eating in all contexts. We found that dietary restraint is more predictive of LOC eating than dietary restriction both within and between individuals. Future treatments should target dietary restraint to reduce LOC eating.

Responses to bright light exposure in individuals with binge-spectrum eating disorders characterized by high dietary restraint and negative affect.

OBJECTIVE: Circadian rhythm disruptions are associated with binge eating, can be causal of negative mood, and may be corrected with bright light exposure. A subtype of individuals with binge-spectrum eating disorders are characterized by combined high dietary restraint and negative affect. These individuals have higher eating disorder psychopathology and poorer treatment response. We aimed to test the targeted effects of morning bright light exposure on individuals with binge-spectrum eating disorders, hypothesizing significant reductions in binge eating for those characterized by high dietary restraint and negative affect. METHODS: Participants (N = 34 females with binge-eating disorder and bulimia nervosa) used a morning bright light and normal light for 10 consecutive days each, in randomized order. They completed the Change in Eating Disorder Symptoms (CHEDS) scale at baseline, day 12 (when they switched lamps), and day 22. We conducted moderation analyses, clustering data by person, controlling for order, and examining the effect of light condition on binge eating according to baseline restraint and negative affect. RESULTS: At high levels of combined dietary restraint and negative affect, participants experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. There were no changes in restrictive eating, body preoccupation, body dissatisfaction, or body checking following exposure to morning bright light for these individuals. DISCUSSION: These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult to treat restraint/negative affect subtype. PUBLIC SIGNIFICANCE: At high levels of combined dietary restraint and negative affect, participants with binge-spectrum eating disorders experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult-to-treat restraint/negative affect subtype.

Disconnect between sympathetically-induced hunger suppression and consumption among highly restrained eaters following stress.

Despite emphasis on findings suggesting restrained eaters increase food consumption under stress, unrestrained eaters' reduction in intake is more robust. Early proposals asserted unrestrained eaters significantly reduced intake after certain threats due to the hunger-inhibiting effects of autonomic influences, presuming unrestrained eaters are more responsive to these effects and restrained eaters rely less on physiological cues for eating. However, scant empirical evidence has substantiated these claims. This study examined whether a sequence exists whereby stress elicits autonomic activation, autonomic activation impacts hunger, and hunger then impacts eating, with dietary restraint altering the hunger-intake link. It was hypothesized that sympathetic nervous system activation would be greatest when ongoing safety from stress was uncertain, sympathetic activation would be linked to reduced hunger, and lower hunger would be associated with attenuated intake. Restraint, conceptualized via Hagan et al.'s (2017) latent restraint factors, was hypothesized to reduce the association between hunger and intake. Female participants (n = 147) were randomized to a stress + certain safety, stress + uncertain safety, or control condition. Sympathetic nervous system activity was recorded prior to a bogus taste test, which quantified ad libitum consumption of highly-palatable snack foods post-stress. Only the stress + uncertain safety condition exhibited greater sympathetic nervous system activity than the control condition. A significant index of moderated serial mediation emerged for Preoccupation with Dieting and Weight-Focused Restraint in the stress + uncertain safety condition. Though sympathetic activation decreased hunger similarly regardless of dietary restraint, only less restrained individuals significantly decreased intake. More restrained individuals ate more despite experiencing lower hunger. The disconnect between hunger and intake in more restrained eaters suggests that focus on enhancing attunement to hunger may yield greater benefit than enhancing restraint. 281 words.

Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression.

The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.

Associations of maternal food addiction, dietary restraint, and pre-pregnancy BMI with infant eating behaviors and risk for overweight.

Maternal food addiction, dietary restraint, and pre-pregnancy body mass index (BMI) are associated with high-risk eating behaviors and weight characteristics in children and adolescents. However, little is known about how these maternal factors are associated with individual differences in eating behaviors and risk for overweight in infancy. In a sample of 204 infant-mother dyads, maternal food addiction, dietary restraint and pre-pregnancy BMI were assessed using maternal self-report measures. Infant eating behaviors (as measured by maternal report), objectively measured hedonic response to sucrose, and anthropometry were measured at 4 months of age. Separate linear regression analyses were used to test for associations between maternal risk factors and infant eating behaviors and risk for overweight. Maternal food addiction was associated with increased risk for infant overweight based on World Health Organization criteria. Maternal dietary restraint was negatively associated with maternal report of infant appetite, but positively associated with objectively measured infant hedonic response to sucrose. Maternal pre-pregnancy BMI was positively associated with maternal report of infant appetite. Maternal food addiction, dietary restraint, and pre-pregnancy BMI are each associated with distinct eating behaviors and risk for overweight in early infancy. Additional research is needed to identify the mechanistic pathways driving these distinct associations between maternal factors and infant eating behaviors and risk for overweight. Further, it will be important to investigate whether these infant characteristics predict the development of future high-risk eating behaviors or excessive weight gain later in life.

A review of sex differences in the mechanisms and drivers of overeating.

Disordered eating is often associated with marked psychological and emotional distress, and severe adverse impact on quality of life. Several factors can influence eating behavior and drive food consumption in excess of energy requirements for homeostasis. It is well established that stress and negative affect contribute to the aetiology of eating disorders and weight gain, and there is substantial evidence suggesting sex differences in sub-clinical and clinical types of overeating. This review will examine how negative affect and stress shape eating behaviors, and how the relationship between the physiological, endocrine, and neural responses to stress and eating behaviors differs between men and women. We will examine several drivers of overeating and explore possible mechanisms underlying sex differences in eating behavior.

Latent profiles of dietary restraint among individuals with binge-spectrum eating disorders: Associations with eating disorder symptom severity.

OBJECTIVE: The relationship of dietary restraint in increasing risk for binge eating among individuals with binge-spectrum eating disorders (B-EDs) is well established. However, previous research has not yet identified whether these individuals exhibit heterogeneous profiles of dietary restraint and whether these profiles are associated with differences in eating pathology. METHODS: Individuals with B-EDs (N = 290) completed the Eating Disorder Examination. Latent profile analysis was conducted on dietary restraint frequency data, including restriction of overall amount of food consumed, avoidance of eating, desire for an empty stomach, food avoidance, and dietary rules. Identified latent profiles were compared on binge eating frequency, compensatory behaviors frequency, and ED pathology using the three-step procedure. RESULTS: A four-class model of dietary restraint best fit the data. Classes significantly differed in frequency of compensatory behaviors (F[3, 286] = 31.01, p < .001), EDE Eating Concern (F[3, 286] = 14.36, p < .001), EDE Shape Concern (F[3, 286] = 7.06, p < .001), EDE Weight Concern (F[3, 286] = 6.83, p < .001), and ED Pathology (F[3, 286] = 12.86, p < .001), but did not differ in frequency of objective (F[3, 286] = 2.45, p = .06) or subjective binge episodes (F[3, 286] = 1.87, p = .14). DISCUSSION: Individuals with B-EDs exhibit distinct profiles of dietary restraint, which are associated with frequency of compensatory behaviors and severity of ED pathology. PUBLIC SIGNIFICANCE STATEMENT: Individuals with binge-spectrum eating disorders have different patterns of restrictive eating symptoms. These profiles of restrictive eating behaviors are associated with differences in severity of compensatory behaviors and cognitive eating disorder symptoms, like shape and weight dissatisfaction. Understanding the relationships between profiles of restrictive eating behaviors and other eating disorder symptoms may allow for personalization of treatment and improvements in treatment efficacy.

Motivation for dietary restraint, and disordered eating among adults experiencing food insecurity in the United States.

OBJECTIVE: Does engaging in dietary restraint due to weight/shape concerns versus economic hardship differentially relate to disordered eating? METHOD: The sample consisted of 582 adults experiencing food insecurity (FI) who completed online measures assessing severity of FI, disordered eating, loss of control over eating, and dietary restraint. Participants reported their motivation for dietary restraint with options consisting of weight/shape concerns, economic hardship (i.e., insufficient funds and prioritizing others' needs), mixed reasons, and other/I do not know. RESULTS: In the sample, 18% reported engaging in dietary restraint primarily due to weight/shape concerns, 33% due to economic hardship, 18% other/do not know, and 30% due to a mix of reasons. There were positive correlations between FI, economic hardship, dietary restraint, disordered eating, and loss of control over eating. Regression analyses revealed the association between dietary restraint and disordered eating does not differ across individuals who endorse economic hardship as a motivator for dietary restraint. Findings replicated with loss of control. However, the association between dietary restraint and disordered eating grew stronger as more dietary restraint due to weight/shape concerns was endorsed. No significant association emerged with loss of control. DISCUSSION: Research is needed to replicate findings and examine how patterns of food scarcity impacts disordered eating in food insecure populations with and without weight/shape concerns. Findings suggest that motivation for dietary restraint may influence associations with dietary restraint and the cognitive components of disordered eating, but not the behavioral components of disordered eating. PUBLIC SIGNIFICANCE STATEMENT: Disordered eating due to dietary restraint is most commonly associated with weight and shape concerns; however, even when dietary restraint is due to economic reasons, it can still be associated with disordered eating.

Comparison of ad libitum snack consumption and acquisition between adolescents living with food security and food insecurity: A stage 1 registered report.

OBJECTIVE: Approximately 11% of the U.S. population experiences food insecurity (FI; insufficient access to healthy food due to financial constraints). FI is associated with detrimental health outcomes, including the development of eating disorders (EDs). However, additional studies are needed, particularly in adolescence when EDs are likely to emerge. The current study will utilize an experimental ad libitum snack paradigm to investigate snack consumption, acquisition (i.e., taking snacks home), and associated disordered eating behaviors among racially, ethnically, and financially diverse adolescents living with FI and food security (FS). METHOD: Sixty-four adolescents will be recruited and randomized into one of two conditions: prior knowledge condition (i.e., participants will know prior to snacking that they can take any remaining food home) and no prior knowledge condition (i.e., participants will not know ahead of time that they can take snacks home). RESULTS: We expect youth with FI to show increased eating and acquisition behaviors compared to youth with FS across both conditions. DISCUSSION: This study, utilizing a novel experimental design, is an important step in understanding how FI impacts adolescent eating behaviors among youth from marginalized backgrounds, who have historically been excluded from research.

The effect of item placement on snack food choices from physical and online menus.

Previous attempts to promote healthy eating using explicit techniques have not been consistently successful. We therefore investigated an implicit strategy (item placement techniques) to encourage healthy food choices in the context of snack menus. Two experimental studies compared presentation of healthy items in the top, middle, and bottom sections of a snack menu. Study 1 compared these presentations in a physical paper-based menu, while Study 2 used an online menu. Menus consisted of 8 unhealthy and 4 healthy items, arranged in three rows of four in Study 1, and one column of 12 in Study 2. In each study, participants selected one food item from one of the three experimental menus, before completing the Revised Restraint Scale (to determine dietary restraint status). In Study 1 (n = 172), item placement condition did not predict healthiness of food choice. In Study 2 (n = 182), healthy items were most popular from the first section of the menu, in comparison to the middle or last sections. Dietary restraint did not moderate the effect of item placement condition on food choice. In line with nudging principles, our results suggest that item placement techniques could be a potentially powerful tool in promoting healthy choices from online snack menus.

The associations of socioeconomic status and financial strain with restrained and emotional eating among 42-year-old women and men.

The current study investigated how different aspects of socioeconomic status (SES) and experiencing financial strain are associated with restrained and emotional eating among 42-year-old Finnish women and men. Lower SES is shown to be associated with diets of poorer nutritional quality and obesity. Nevertheless, little research has been done on the association between SES, financial strain and psychological dimensions of eating behaviour. The study was based on questionnaire data from 734 women and 600 men aged 42 years who were participants in a Finnish cohort study. SES was measured through three different dimensions: education, occupation and household income. Data were analyzed using binary logistic regression models. Results showed that restrained eating was associated with higher household income level in women and with higher occupational position in men. Emotional eating was associated with higher financial strain among women. Also, women with lower college education had higher odds for emotional eating compared to women with vocational education or less. Among men, emotional eating was not statistically significantly associated with any of the SES variables nor with financial strain, which may also be due to the very low level of emotional eating reported by men. In conclusion, our findings indicate that restrained eating would be associated with higher status brought by belonging to a higher income or occupational group. Emotional eating, in turn, would be related to experiencing financial strain, rather than to traditional SES dimensions, in women. These results are relevant when health-related interventions are targeted to different SES groups.

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.

The effects of puberty on associations between mood/personality factors and disordered eating symptoms in girls.

OBJECTIVE: Negative and positive urgency, anxiety, and depressive symptoms are significant factors of disordered eating (DE) symptoms in early adolescence through young adulthood. However, it is unclear how puberty-a critical developmental milestone that is associated with increased risk for DE symptoms-affects the relationship between these factors and DE symptoms, given that the role of pubertal status has rarely been considered in relation to these associations. Thus, the present study examined whether puberty moderates associations between mood/personality factors and DE in pre-adolescent and adolescent girls. METHOD: Participants included 981 girls (aged 8-16 years) from the Michigan State University Twin Registry. Mood/personality factors, pubertal status, and DE were assessed with self-report questionnaires. RESULTS: Puberty significantly moderated associations between several factors (negative urgency, positive urgency, trait anxiety, depressive symptoms) and the cognitive symptoms of DE (e.g., shape/weight concerns, body dissatisfaction). Associations between mood/personality factors and cognitive DE were stronger in girls with more advanced pubertal status. By contrast, no significant moderation effects were detected for mood/personality-dysregulated eating (e.g., binge eating, emotional eating) associations. DISCUSSION: Findings identify pubertal development as an important moderator of mood/personality-DE symptom associations, especially for cognitive DE symptoms that are known to predict the later onset of clinical pathology.