The association between weight loss behaviors and body weight perception in Chinese adolescents: 2007-2022.

BACKGROUND: Weight misperceptions are common in children and adolescents, which is related to the engagement of weight loss behaviors. The aim of this study was to investigate the association between body weight perception and weight loss behaviors of lower-calorie diets and increased levels of physical activity (PA). METHODS: The Ningbo Youth Risk Behavior Survey was conducted from 2007 to 2022. A multistage, stratified cluster sampling procedure was utilized to draw target adolescents aged 12 to 18 years participating in each survey wave (2007, 2012, 2017, 2022). Data of anthropometry, weight perception, and weight loss behaviors were collected through self-administered questionnaires. A binary generalized linear model was used to examine associations between body weight perception and weight loss behaviors of lower calorie diets and increased levels of PA. RESULTS: The sample sizes for each survey wave were 777, 885, 1588 and 2638. The prevalence of overweight (OW)/obesity (OB), self-perception of OW/OB and overestimated perception increased from 7.6%, 27.0% and 29.1% in 2007 to 16.3%, 39.9% and 41.4% in 2022, respectively. Adolescents that perceived themselves as OW/OB had higher odds of lower-calorie diets (OR: 4.2, 3.3-5.4) and increased level of PA (OR: 3.8, 2.9-5.0), whereas adolescents that perceived themselves as underweight had lower odds of lower-calorie diets (OR: 0.371, 0.253-0.542) and increased levels of PA (OR: 0.381, 0.295-0.559). CONCLUSION: OW, self-perception of OW/OB and overestimated perception were prevalent in Chinese adolescents. Self-perception of OW/OB was positively associated with lower-calorie diets and increased levels of PA. The results can support public health specialists to promote health education of body perception and improve self-esteem in Chinese children and adolescents.

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.

The dynamics of self-control: within-participant modeling of binary food choices and underlying decision processes as a function of restrained eating.

Successful self-control during food choice might require inhibition of impulses to avoid indulging in tempting but calorie-dense foods, and this might particularly apply to individuals restraining their food intake. Adopting a novel within-participant modeling approach, we tested 62 females during a mouse-tracking based binary food choice task. Subsequent ratings of foods on palatability, healthiness, and calorie density were modeled as predictors for both decision outcome (choice) and decision process (measures of self-control conflict) while considering the moderating role of restrained eating. Results revealed that individuals higher on restrained eating were less likely to choose more high-calorie foods and showed less self-control conflict when choosing healthier foods. The latter finding is in contrast with the common assumption of self-control as requiring effortful and conscious inhibition of temptation impulses. Interestingly, restrained eaters rated healthy and low-calorie foods as more palatable than individuals with lower restrained eating scores, both in the main experiment and an independent replication study, hinting at an automatic and rather effortless mechanism of self-control (palatability shift) that obviates effortful inhibition of temptation impulses.

Food at first sight: Visual attention to palatable food cues on TV and subsequent unhealthy food intake in unsuccessful restrained eaters.

BACKGROUND: This study investigated whether unsuccessful dieters show heightened visual attention to food cues in TV content and how visual attention influences subsequent unhealthy food intake. This study adds to prior literature by investigating the influence of visual attention to food cues on food intake with actual media content (i.e., instead of isolated food cues such as pictures or words) and by differentiating between chronic dieters (i.e., restrained eaters) who vary in dieting success (i.e., perceived self-regulatory success [PSRS]). To get a more detailed insight into different processes of visual attention, two measures of attention (i.e., initial orientation and attention duration) were examined. METHODS: Unrestrained (n = 34) and restrained eaters (n = 28) varying in PSRS watched a talk show containing subtly depicted, palatable food cues. While watching, their visual attention to the food cues was measured with an eye-tracker. Unhealthy food intake was assessed afterwards in a taste test. RESULTS: A two-way interaction between eating restraint and PSRS on initial visual orientation was found: unsuccessful restrained eaters' initial orientation to food cues was faster compared to that of successful restrained eaters. There were no significant findings on attention duration. Furthermore, visual attention did not predict unhealthy food intake. DISCUSSION: Unsuccessful restrained eaters' fast initial orientation, but no longer attention duration, suggests that self-regulation may be important at early stages of visual attention. Future research on this topic should continue to differentiate between initial orientation and attention duration, as well as between more and less successful restrained eaters. The lack of findings on unhealthy food intake suggest that food cues embedded in actual media content might have less influence on eating behavior compared to isolated food cues.

Brief non-dieting intervention increases intuitive eating and reduces dieting intention, body image dissatisfaction, and anti-fat attitudes: A randomized controlled trial.

This study developed and examined a brief dissonance-based non-dieting intervention designed to help college women reject unhealthy dieting behaviors, accept their bodies, and increase healthy eating. Participants included 94 female university students (mean age = 20.6 years; mean BMI = 23.8 kg/m2), randomly assigned either to the non-dieting intervention condition or a brochure control condition. The intervention consisted of two 90-120 min interactive group sessions designed to engender the rejection of dieting, increase body acceptance, and develop healthy eating skills. Assessment measures were collected at baseline, post-treatment, and one-month follow-up. The group sessions produced significant improvements in the intervention group compared to the control group on measures of dieting intention, intuitive eating, body image dissatisfaction, eating concerns, and anti-fat attitudes. These effects were sustained at one-month follow-up. There were also overall improvements over time in dietary intake and mental health-related quality of life across conditions. This study extends the research on non-dieting approaches by using a brief, dissonance-based structure and by applying the intervention to a young adult sample that included participants of normal weight. The findings here indicate that a non-dieting approach is acceptable and feasible, and can result in improvements in eating and weight-related behaviors, in young adult women.

Mediation of emotional and external eating between dieting and food intake or BMI gain in women.

OBJECTIVE: Dieting to control body weight is often associated with weight gain, particularly so in women; however, the underlying mechanisms are unclear. In a series of studies on women, we examined whether the relationship between dieting and weight gain can be explained by (serial) mediation of emotional eating (EE) and/or subsequent external eating (EX). METHODS: In a pilot study (116 women), we first assessed this (serial) mediation between dieting or dietary restraint and actual food consumption in the laboratory. In Study 1, a four-year follow up on patients with newly diagnosed type 2 diabetes (51 women), we assessed this (serial) mediation between dietary restraint and change in BMI and intake of energy (Kcal; Food Frequency Questionnaire). In Study 2, a three-year follow up study in a representative Dutch sample (287 women), we assessed this (serial) mediation between dieting and change in BMI. RESULTS: There was consistent support for (serial) mediation: In the pilot study, frequency of dieting and dietary restraint were both indirectly associated with grams of crackers eaten through EE and EX. In study 1, dietary restraint had a significant (95% CI) indirect association with subsequent change in measured BMI and a marginally (90% CI) significant indirect association with intake of energy through EE and EX. In study 2, EE marginally (90% CI) acted as a mediator between frequency of dieting and subsequent self-reported change in BMI. In the subsample of overweight women (n = 146) frequency of dieting was indirectly associated with subsequent self-reported change in BMI through EE and EX. CONCLUSION: The possibility that female dieters may gain weight through EE and/or subsequent EX should be taken into account when treating women with overweight or obesity.

Adolescent stress: A predictor of dieting behaviors in youth with overweight/obesity.

OBJECTIVE: To examine associations between psychological stress and dieting behavior along with the heterogeneity of this association by gender and race in a diverse sample of adolescents with overweight/obesity. METHODS: One hundred and sixty-one adolescents between the ages of 13-19 years of age with overweight/obesity (65% female; 53% non-Hispanic black/47% non-Hispanic white; age: 16.7 ± 1.7 years) were recruited from Southeast MI and included in this analysis. Psychological stress was measured using the Perceived Stress Scale, and dieting behavior was assessed using the dieting subscale from the Eating Attitudes Test (EAT-26) questionnaire. Multivariable linear regression models were conducted to examine the association between psychological stress and dieting behavior by gender and race. RESULTS: Psychological stress was significantly associated with dieting (ß = 0.18 ± 0.06; p < 0.01), with greater stress associated with greater frequency of dieting behavior. This relationship remained significant (ß = 0.15 ± 0.06; p = 0.016), even when controlling for covariates (age, body fat, gender, race, and pubertal development). There were no statistically significant differences in the association of psychological stress and disordered eating indices by gender or race/ethnicity (p's > 0.05). CONCLUSIONS: Increased psychological stress is associated with increased dieting behavior among adolescents with overweight/obesity. These findings suggest that psychological stress equally affects dieting behavior among adolescents with overweight/obesity, regardless of gender and race. Future studies should seek to identify the unique sources of psychological stress that contribute to increased dieting behavior among adolescents with overweight/obesity.

[Body fat percentage in adolescent among eating risk behaviors, home and sex]. / Porcentaje de grasa corporal en adolescentes asociado con conductas alimentarias de riesgo, hogar y sexo.

OBJECTIVE: To determine the association of risky eating behaviors and the home with the percentage of body fat in adolescents, modified by gender. MATERIALS AND METHODS: We analyzed the information of a cohort of 2 388 adolescents from Morelos in Mexico, from 2004 to 2007. Descriptive techniques and multiple linear regression models of mixed effects were performed. RESULTS: The change in body fat percentage (PGC) is -1.4 percentage points, in men -3.1, in women 0.2. The change of the PGC in relation to CAR's and the household is different by sex. The multiple model shows that diet is associated with an increase in PGC (1.25 IC95% 0.68-1.83) in women, in men of 1.74 (95% CI 0.60-2.88). In relation with the family, women show a positive relationship with the increase in the percentage of body fat according to whether they feel that their family does not love them sometimes or never (value p of trend <0.001), men show in the variable "Satisfied with the help your family receives", a marginal association. CONCLUSIONS: Performing a diet without supervision is associated with an increase in the PGC, giving an effect contrary to what is desired. This is associated with family relationships, and is different between sex.

OBJETIVO: Determinar la asociación de las conductas ali- mentarias de riesgo (CAR) y el hogar con el porcentaje de grasa corporal (PGC) en los adolescentes, modificado por sexo. MATERIAL Y MÉTODOS: Se analizó la información de una cohorte de 2 388 adolescentes de Morelos, México, de 2004 a 2007. Se realizaron técnicas descriptivas y modelos de regresión lineal múltiple de efectos mixtos. RESULTADOS: El cambio del PGC es -1.4 puntos porcentuales (EE 0.22), en hombres -3.1 (EE 0.35) y en mujeres 0.2 (EE 0.21). El cambio del PGC en relación con CAR y el hogar es diferente por sexo. El modelo múltiple muestra que realizar dieta se asocia con el incremento del PGC (1.25 IC95% 0.68-1.83) en mu- jeres y en hombres (1.74 IC95% 0.60-2.88). En relación con la familia, las mujeres muestran una relación positiva con el incremento del PGC de acuerdo con que sientan o no que su familia no las quiere a veces o nunca (valor p de tendencia <0.001); los hombres muestran en la variable de "Satisfecho de la ayuda que recibe se su familia" una asociación marginal. CONCLUSIONES: Realizar dieta sin supervisión se asocia con el incremento en el PGC, lo que da un efecto contrario a lo deseado; esto se asocia con relaciones familiares y es diferente entre sexo.

Effects of a Web-Based, Evolutionary Mismatch-Framed Intervention Targeting Physical Activity and Diet: a Randomised Controlled Trial.

BACKGROUND: This study sought to test the effectiveness of a 12-week, novel online intervention (Evolife) aiming to increase physical activity level (PAL) and reduce energy intake (EI) among overweight/obese adults. The intervention used an evolutionary mismatch message to frame health information in an engaging way, incorporating evidence-based behaviour change techniques to promote autonomous motivation, self-efficacy and self-regulatory skills. METHOD: Men and women aged 35-74 years with a BMI of 25-40 kg/m2 were eligible. Participants were randomised to receive either the intervention (comprising a face-to-face introductory session, 12 weeks' access to the Evolife website and a pedometer) or a control condition (face-to-face introductory session and NHS online health resources). PAL was measured objectively and EI was self-reported using 3-day weighed food records. Secondary measures included BMI, waist circumference and blood pressure. RESULTS: Sixty people met inclusion criteria; 59 (30 intervention) completed the trial (mean age = 50; 56% male). Differences between groups' change scores for PAL and EI were of small effect size but did not reach significance (d = 0.32 and d = - 0.49, respectively). Improvements were found in both groups for PAL (int: d = 0.33; control: d = 0.04), EI (int: d = - 0.81; control: d = - 0.16), waist circumference (int: d = - 0.30; control: d = - 0.17) and systolic blood pressure (int: d = - 0.67; control: d = - 0.28). CONCLUSION: The intervention did not lead to significantly greater improvement in PAL or reduction in EI than a minimal intervention control, although the changes in the intervention group were of meaningful effect size and comparable with positive outcomes in larger intervention trials. TRIAL REGISTRATION: This trail was registered on www.clinicaltrials.gov on 16 January 2017 (appeared online 26 January 2017), reference NCT03032731.

Dietary restraint and weight loss in relation to disinhibited eating in obese Veterans following a behavioral weight loss intervention.

Ability to restrain one's dietary intake is a necessary skill for weight loss. However, dietary restraint has been shown to paradoxically increase disinhibited eating in certain populations, thereby negatively impacting weight loss and leading to worse overall health outcomes. The aim of this study was to address gaps in the literature regarding the relationships between separate facets of dietary restraint (intention; behavior) with weight loss and various types of disinhibited eating (binge eating, external eating, emotional eating) in overweight and obese adults who recently completed a weight loss intervention. A sample of mostly male Veterans with overweight and obesity (N = 88) self-reported their dietary restraint intention, restraint behavior, and current disinhibited eating following completion of an 8-week behavioral weight loss treatment. Greater dietary restraint intention was related to greater dietary restraint behavior, p < .05. Greater dietary restraint behavior was significantly related to greater recent weight loss, p < .05, while restraint intention was not, p > .05. Greater dietary restraint intention was related to greater current binge eating and external eating, while greater self-reported restraint behavior was related to less binge eating, p < .05. Thus, dietary restraint behavior appears to be adaptive for this population, whereas rigid dietary restraint intention may increase risk for disinhibited eating. To decrease disinhibited eating and improve weight loss outcomes in Veterans, interventions might specifically address rigid rule-following associated with abandonment of weight loss goals and help Veterans develop specific yet flexible eating plans. Future research should examine whether dietary restraint intention and behavior differentially predict disinhibited eating and weight loss outcomes prospectively.

Exploring the application of the Prototype Willingness Model to weight loss dieting behaviour among UK adults.

Frequent weight loss dieting leads to increased BMI and is associated with eating pathologies. Theoretical models can aid the development of interventions to reduce risk behaviours such as frequent dieting if they are able to adequately account for the target behaviour. The Prototype Willingness Model (PWM) may be able to account for weight loss dieting as this behaviour is often associated with social images. This study explored whether the PWM could predict weight loss dieting status over and above the Theory of Planned Behaviour (TPB). One hundred and ninety-two participants (69% female; mode age 35-44) completed PWM and TPB measures and recorded their height and weight. Males were more likely to be non-dieters than females. Frequent dieters had a higher BMI than non-dieters and rated themselves as more similar to the overweight prototype. Prototype perceptions predicted willingness to eat unhealthy foods alone. Similarity to the overweight prototype predicted weight loss dieting status over and above TPB measures and sex. Further research should explore prototype perceptions in an obese/overweight frequent dieting population as this may be a fruitful direction for developing interventions to reduce weight loss dieting.

Trends and correlates of unhealthy dieting behaviours among adolescents in the United States, 1999-2013.

BACKGROUND: The increase in adiposity problems among United States adolescents has been accompanied by persistently high prevalence of unhealthy dieting behaviours (UDBs) such as fasting, taking diet pills/powders/liquids, and vomiting/taking laxatives. This study aimed to examine the associations of self-perceptions of weight status, weight change intentions (WCIs) and UDBs with sex, age and race, as well as trends of UDBs in American adolescents across the weight spectrum. METHODS: Data come from the biennial cross-sectional, school-based surveys, the Youth Risk Behaviour Surveillance System (1999-2013, n = 113,542). The outcome measures were the self-reported UDBs: fasting for 24 h or more; taking diet pills/powders/liquids; and vomiting/taking laxatives. Sex-stratified logistic regressions assessed relationships between weight status misperceptions across all weight statuses, race and WCIs with UDBs. Differential trends between races were assessed using race*year interaction terms. RESULTS: In males, all non-White races had higher odds of fasting and vomiting/taking laxatives than Whites (except fasting in Hispanic/Latinos), with Adjusted Odds Ratios (AORs) between 1.44 and 2.07. In females, Black/African Americans and Hispanic/Latinos had lower odds of taking diet pills/powders/liquids compared to Whites (AORs 0.50 and 0.78 respectively). Racial disparities persisted throughout the study period. Prevalence of fasting and vomiting/taking laxatives did not change between 1999 and 2013 for all races, while taking diet pills/powders/liquids decreased. Compared to individuals of normal weight who were accurate weight status perceivers, individuals of almost all other combinations of weight status and weight status perception had significantly higher odds of displaying any UDB outcome. Overestimation of weight status was found to be the strongest determinant of UDBs. Compared to individuals endorsing "not wanting to do anything" about their weight, individuals endorsing all other WCIs (including wanting to gain weight) also showed significantly higher odds for every UDB outcome, with wanting to lose weight having AORs of the greatest magnitudes. CONCLUSIONS: Prevalence of UDBs is persistently high, and highest among females across all racial groups. UDBs may elevate undesired weight gain and weight loss in individuals who are obese/overweight and underweight respectively. Further research into weight status perceptions among adolescents may inform efforts to reduce UDBs.

Parent-child health- and weight-focused conversations: Who is saying what and to whom?

The purpose of this study was to examine the prevalence of health-focused (healthy eating, physical activity) and weight-focused (weight, dieting) parent-child conversations, and to understand who is talking and who is listening, by exploring the associations these conversations have with parent and child characteristics. The study population included 546 parents (age 27-36 years) who participated in Project EAT (Eating and Activity in Teens and Young Adults)-IV (2015-2016) and had a child aged 2-17 years. Cross-sectional prevalence ratios were calculated to identify associations between parent and child characteristics and the parent-child conversations. Conversations about healthy eating (82%) and physical activity (75%) were more prevalent than those about the child's weight (30%), and dieting (25%). In adjusted models, parents meeting physical activity recommendations had a higher prevalence of health-focused conversations (healthy eating PR = 1.10, 95% CI = 1.01, 1.20; physical activity PR = 1.12, 95% CI = 1.02, 1.24); whereas, weight-focused conversations were more common among parents who had recently dieted and perceived their child to be overweight. Health-focused and weight-focused conversations were highly common among the oldest children aged 9-17 years (health-focused = 90-93% and weight-focused = 42-53%); though, a substantial prevalence of health- and weight-focused conversations (>50% and ≥10%, respectively) also occurred with the youngest children (2-4 years). Findings suggest that parent-child health- and weight-focused conversations are common and that characteristics, including child's age and parents' physical activity, dieting, and perceptions of child weight, may be useful to consider in public health messaging, interventions, and family education that address parent-child communication.

Deficits in episodic memory are related to uncontrolled eating in a sample of healthy adults.

Despite a substantial amount of animal data linking deficits in memory inhibition to the development of overeating and obesity, few studies have investigated the relevance of memory inhibition to uncontrolled eating in humans. Further, although memory for recent eating has been implicated as an important contributor to satiety and energy intake, the possibility that variations in episodic memory relate to individual differences in food intake control has been largely neglected. To examine these relationships, we recruited ninety-three adult subjects to attend a single lab session where we assessed body composition, dietary intake, memory performance, and eating behaviors (Three Factor Eating Questionnaire). Episodic recall and memory inhibition were assessed using a well-established measure of memory interference (Retrieval Practice Paradigm). Hierarchical regression analyses indicated that memory inhibition was largely unrelated to participants' eating behaviors; however, episodic recall was reliably predicted by restrained vs. uncontrolled eating: recall was positively associated with strategic dieting (ß = 2.45, p = 0.02), avoidance of fatty foods (ß = 3.41, p = 0.004), and cognitive restraint (ß = 1.55, p = 0.04). In contrast, recall was negatively associated with uncontrolled eating (ß = -1.15, p = 0.03) and emotional eating (ß = -2.46, p = 0.04). These findings suggest that episodic memory processing is related to uncontrolled eating in humans. The possibility that deficits in episodic memory may contribute to uncontrolled eating by disrupting memory for recent eating is discussed.

Special diets in modern America: Analysis of the 2012 National Health Interview Survey data.

BACKGROUND: Special diets are frequently used by the public but reasons for use and characteristics of users remain unclear. AIM: To determine prevalence of the use of special diets, the individual characteristics associated with their use and reasons for use. METHODS: The secondary analysis used data from the 2012 National Health Interview Survey (NHIS), a cross-sectional household interview survey of a nationally representative sample of non-hospitalized US adult populations ( n = 34,525). The dependent variables in this secondary analysis were the use of a special diet (vegetarian, macrobiotic, Atkins, Pritikin, and Ornish) ever and during the past 12 months. Independent variables included sociodemographic, clinical and behavioral variables. Prevalence of special diet use and reasons for use were analyzed descriptively. Associations between independent and dependent variables were analyzed using Chi-square tests and logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Lifetime and 12-month prevalence of using special diets were 7.5% (weighted n = 17.7 million) and 2.9% (weighted n = 6.9 million), respectively. Individuals using special diets in the past 12 months were more likely female (OR = 1.45; 95% CI = 1.21-1.74), not married (OR = 0.76; 95% CI = 0.63-0.91), college-educated (OR = 1.98; 95% CI = 1.25-3.11) and depressed (OR = 1.50; 95% CI = 1.14-1.98). They more likely also used herbal products (OR = 2.35; 95%CI = 1.84-2.99), non-vitamin (OR = 1.82; 95% CI = 1.45-2.27) and vitamin supplements (OR = 1.57; 95% CI = 1.24-1.99). Diets were mainly used to improve overall health (76.7%) or for general wellness/prevention (70.4%). CONCLUSIONS: Special diets are mainly used for unspecific health reasons by those who are females, have a college degree or with depression, and commonly used in conjunction with herbs and dietary supplements.

Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls.

PURPOSE: To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model. METHODS: Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership. RESULTS: Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity. CONCLUSION: Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

Orthorexic and restrained eating behaviour in vegans, vegetarians, and individuals on a diet.

PURPOSE: Orthorexic eating behaviour, restrained eating, and veganism/vegetarianism are food selection strategies sharing several characteristics. Since there are no studies investigating their interrelationships, aim of the present study was to analyse orthorexic and restrained eating behaviour in (1) a sample of vegans and vegetarians and (2) a sample of individuals on a diet to lose weight. METHOD: Division of samples according to pre-defined criteria in (1) vegans (n = 114), vegetarians (n = 63), individuals with rare meat consumption (n = 83) and individuals with frequent meat consumption (n = 91) and in (2) participants on a diet with dietary change (n = 104), without dietary change (n = 37) and a control group of individuals not on a diet (n = 258). Orthorexic eating behaviour was assessed with the Düsseldorfer Orthorexie Skala and restrained eating was assessed with the Restraint Eating Scale. RESULTS: Vegans and vegetarians do not differ in orthorexic eating behaviour, but both groups score higher in orthorexic eating behaviour than individuals consuming red meat. There are no differences regarding restrained eating. Individuals on a diet with dietary change score higher in both orthorexic and restrained eating, than individuals without dietary change and individuals not on a diet. CONCLUSIONS: Individuals who restrict their eating behaviour, either predominantly due to ethical reasons or with the intention to lose weight, display more orthorexic eating behaviour than individuals not limiting their food consumption. Further research is needed to investigate whether veganism, vegetarianism, or frequent dieting behaviour serve as risk factors for orthorexia. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Parental correlates of food parenting practices: socioeconomic status, weight, and dieting status.

Little research has considered how parents' socioeconomic indicators, body mass index (BMI), and dieting status relate to their food parenting. The current study used self-report data from parents of young children to examine group differences on three types of food parenting practices (Structure, Coercive Control, and Autonomy Promotion). Few group differences were found for socioeconomic indicators. However, parent dieting status moderated effects of parent BMI on structure and autonomy promotion. Obese, non-dieting parents reported lower scores on both variables. More research is needed to better understand how parents' dieting status moderates the effects of parent's weight.

Does the incorporation of portion-control strategies in a behavioral program improve weight loss in a 1-year randomized controlled trial?

BACKGROUND/OBJECTIVES: Controlling food portion sizes can help reduce energy intake, but the effect of different portion-control methods on weight management is not known. In a 1-year randomized trial, we tested whether the efficacy of a behavioral weight-loss program was improved by incorporating either of the two portion-control strategies instead of standard advice about eating less. SUBJECTS/METHODS: The Portion-Control Strategies Trial included 186 women with obesity (81%) or overweight (19%). Participants were randomly assigned to one of three equally intensive behavioral programs, consisting of 19 individual sessions over 12 months. The Standard Advice Group was instructed to eat less food while making healthy choices, the Portion Selection Group was instructed to choose portions based on the energy density using tools such as food scales and the Pre-portioned Foods Group was instructed to structure meals around pre-portioned foods such as single-serving main dishes, for which some vouchers were provided. In an intention-to-treat analysis, a mixed-effects model compared weight loss trajectories across 23 measurements; at month 12, weight was measured for 151 participants (81%). RESULTS: The trajectories showed that the Pre-portioned Foods Group initially lost weight at a greater rate than the other two groups (P=0.021), but subsequently regained weight at a greater rate (P=0.0005). As a result, weight loss did not differ significantly across groups at month 6 (mean±s.e. 5.2±0.4 kg) or month 12 (4.5±0.5 kg). After 1 year, measured weight loss averaged 6% of baseline weight. The frequency of using portion-control strategies initially differed across groups, then declined over time and converged at months 6 and 12. CONCLUSIONS: Incorporating instruction on portion-control strategies within a 1-year behavioral program did not lead to a greater weight loss than standard advice. Using pre-portioned foods enhanced early weight loss, but this was not sustained over time. Long-term maintenance of behavioral strategies to manage portions remains a challenge.

Acceptability of a very-low-energy diet in Type 2 diabetes: patient experiences and behaviour regulation.

AIMS: To evaluate the acceptability of an 8-week very-low-energy diet for remission of Type 2 diabetes, and to identify barriers and facilitators of adherence and behaviour-regulation strategies used by participants in the Counterbalance study. METHODS: Eighteen of 30 participants in the Counterbalance study (ISRCTN88634530) took part in semi-structured interviews. Of these, 15 participants were interviewed before and after the 8-week very-low-energy diet intervention. Thematic analysis was used to analyse the narratives. RESULTS: The prospect of diabetes remission, considerable weight loss, and long-term health improvement provided participants with substantial initial motivation. This motivation was sustained through the experience of rapid weight loss, improvements in blood glucose levels, social support and increased physical and psychological well-being. Overall, adherence to the very-low-energy diet for 8 weeks was perceived as much easier than anticipated, but required personal effort. Participants addressed challenges by removing food from the environment, planning, avoidance of tempting situations or places, and self-distraction. Weight loss and improvements in blood glucose levels lead to a sense of achievement and improvements in physical and psychological wellbeing. CONCLUSIONS: Dietary treatment for reversal of Type 2 diabetes is acceptable and feasible in motivated participants, and the process is perceived as highly gratifying. Research outside of controlled trial settings is needed to gauge the generalisability of these findings.