Validity of the Addiction-like Eating Behavior Scale among Patients with Compulsive Eating.

Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84-0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = -0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS "appetite drive" subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating.

Novel Guided Self-Help for the treatment of Binge Eating Disorder: Feasibility, Acceptability, and Preliminary Efficacy.

Purpose: Binge eating disorder (BED) is a prevalent eating disorder. Many individuals with BED do not receive evidence-based care due to many barriers. This preliminary study evaluated the feasibility, acceptability, and potential efficacy of a manualized guided self-help (GSH) intervention with support in the form of a culturally adapted manual for a French-Canadian population.Method: Twenty-two women with overweight or obesity meeting the BED diagnostic criteria participated in an 8-week open trial. The GSH programme combined a self-help book and weekly support phone calls. Participants were assessed at baseline, at week 4, postintervention, and 12 weeks following its end. Feasibility was measured by attrition rates, participation, and satisfaction. Acceptability was measured by a questionnaire based on the Theoretical Framework of Acceptability. Potential efficacy outcomes were objective binge eating days, eating disorder symptomatology, depressive symptoms, and propensity to eat intuitively.Results: The GSH programme has proven feasible (4.5% attrition, 91% completion, 95.5% satisfaction) and acceptable. Potential efficacy results showed promising improvements on all outcomes (19% abstinence, 70.9% reduction in objective binge eating days).Conclusion: Although preliminary, this programme warrants further study as it may be an efficient and cost-effective way to deliver GSH for BED patients with accessibility barriers.

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

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

Effects of Vertical Sleeve Gastrectomy on Weight Loss, Eating Behaviors, and Weight Concern Eight Months Postsurgery.

OBJECTIVES: Following vertical sleeve gastrectomy (VSG), the role of eating behaviors in weight regain remains unclear. This study aimed to examine the effects of VSG on excess weight loss (EWL) and five eating-related variables (food addiction, disinhibition, susceptibility to hunger, dietary restraint, and weight concern) while exploring their associations before and eight months post-surgery. MATERIALS AND METHODS: A sample of 76 participants who underwent VSG was recruited from a healthcare center in Quebec, Canada. Measurements included body mass index (BMI), the Eating Disorder Examination (weight concern), the Yale Food Addiction Scale (food addiction), and the Three-Factor Eating Questionnaire (disinhibition, susceptibility to hunger, and dietary restraint). T-tests were conducted between pre-surgery (T0) and eight-month post-surgery (T8), and correlations were examined between T0 and T8, within T0, and within T8. RESULTS: The mean EWL was 63.43% ± 13.14 at T8. Comparisons between T0 and T8 showed a significant decrease in food addiction, disinhibition, and susceptibility to hunger (p = 0.001-0.005). No significant differences were observed for dietary restraint and weight concerns. BMI at T0 was negatively correlated with EWL at T8 (r = -0.45). Within T0, a negative correlation was observed between food addiction and dietary restraint (r = -0.42), which changed from negative to positive within T8 (r = 0.35). CONCLUSIONS: This study confirmed that VSG is effective for weight loss and associated with a reduction in maladaptive eating behaviors. Postsurgery, individuals with greater food addiction exhibited more dietary restraint, suggesting a need for restraint among those experiencing a strong drive toward food. However, weight concerns remained high even after significant weight loss, indicating that weight loss alone may not be sufficient for change. A postsurgery medical follow-up focusing on overall well-being and lifestyle adaptation would be a crucial complement.

COVID-19-Related distress, body image, and eating behaviors: a cross-sectional explanatory model.

BACKGROUND: The COVID-19 pandemic has been associated with increased body dissatisfaction and disordered eating behaviors in adolescents. To better understand these associations, this study tested an explanatory model in which appearance-focused social media use, internalization of social media pressure, and mindfulness abilities mediated the relationship between COVID-related distress and body dissatisfaction, which in turn was associated with dietary restraint and binge eating episodes. METHODS: Adolescents (N = 493, Mage= 16.7; 47.5% girls) recruited within high schools completed online measures. We conducted model testing through path analysis in MPlus, using modification indices to derive a well-fitting model. RESULTS: The initially hypothesized model was a poor fit for the data. The final well-adjusted model confirmed several significant paths and supported the parallel mediational roles of social media (specifically, the use of appearance-focused social media and internalization of social media pressure) along with mindfulness, on the relationship between COVID-19-related distress and body satisfaction. Model adjustments involved adding three paths, resulting in two additional significant indirect effects, and suppressing one path. CONCLUSIONS: Findings suggest that mindfulness, media use and the internalization of social media pressure are potential key processes explaining body dissatisfaction and eating disorders among adolescents who experienced higher levels of COVID-related distress.

A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI.

The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.

Recovery Trajectories in Adolescent Girls with Anorexia Nervosa.

Background: This study aimed to document recovery trajectories among adolescents with anorexia nervosa (AN) based on three markers of remission, namely changes in body weight, food restriction, and excessive exercise, and to identify predictors of these trajectories. Methods: One hundred twenty-six adolescent girls (14.7 ± 1.3 years) were recruited during initial assessment visits at specialized eating disorder (ED) programs in five University Health Centers across the province of Quebec, Canada. z-BMI and AN symptom severity (food restriction and excessive exercise) were assessed at initial assessment visits and subsequently reassessed at each quarterly follow-up over a 12-month period to identify recovery trajectories. Results: Considering the three markers of remission, three distinct trajectories emerged: Group 1, rapid responders; Group 2, gradual responders; and Group 3, unstable responders. At initial visits, a difference between groups was found regarding the type of treatment (p = 0.01) and weight suppression (p = 0.02). Group 1 had a higher number of youths hospitalized than Group 2 and Group 3, and a greater weight suppression than Group 3. Furthermore, individuals with atypical AN were more likely to belong to Group 2 than to Group 1 and Group 3 (p < 0.0001). Conclusions: This study contributes to a better understanding of the heterogeneity of recovery trajectories in adolescent girls with AN.

Attitudes and Behaviors towards Food and Weight in Late Pregnancy: A Comparative Approach between Individuals with and without Previous Bariatric Surgery.

The aims of this study were to compare, between pregnant individuals with and without bariatric surgery: (1) eating behaviors, (2) intuitive eating components and, (3) attitudes towards weight gain. This retrospective study included data collected in healthy pregnant individuals with and without previous bariatric surgery who were recruited at the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval. Pregnant individuals who underwent bariatric surgery (biliopancreatic bypass with duodenal switch [n = 14] or sleeve gastrectomy [n = 5]) were individually matched, for age (±0.4 years) and body mass index (BMI) (±0.3 kg/m2), with pregnant individuals who have not received bariatric surgery. In the second trimester, participants completed the Three Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale 2 (IES-2). In the third trimester, participants completed the French version of the Pregnancy Weight Gain Attitude Scale assessing attitudes towards weight gain. Pregnant individuals who have had bariatric surgery had a higher score for flexible restraint and a lower score for situational susceptibility to disinhibition compared to individuals who have not had undergone bariatric surgery (2.89 ± 1.15 vs. 1.95 ± 1.31; p = 0.04 and 1.11 ± 1.29 vs. 2.79 ± 1.44, respectively; p < 0.001). Regarding intuitive eating, pregnant individuals who experienced bariatric surgery had a higher score for reliance on internal hunger and satiety cues and a lower one for unconditional permission to eat compared with those who had not experienced bariatric surgery (3.99 ± 0.81 vs. 3.30 ± 1.03; p = 0.02 and 3.28 ± 0.54 vs. 3.61 ± 0.68, respectively; p = 0.03). No difference in attitudes towards weight gain was observed between groups. Overall, pregnant individuals who had undergone bariatric surgery had different eating behaviors and intuitive eating components compared to pregnant individuals without bariatric surgery. These results need to be confirmed in further studies with larger sample sizes.

Anorexia Nervosa in Adolescence: A Comprehensive Study of Multidimensional Factors Associated with Symptom Severity 1 Year Following the Diagnosis.

The overarching goal of this study was to examine the unique contribution of psychological, familial, and friendship factors in explaining anorexia nervosa (AN) symptom severity 1 year following diagnosis among a sample of adolescent girls. A second objective was to determine whether friendship factors mediated the association between psychological and/or familial factors and AN symptom severity. This study included 143 adolescent girls under the age of 18 diagnosed with AN (M = 14.84, SD = 1.31). Participants were recruited from specialized eating disorder treatment programs. At admission (T1), participants completed a set of self-report questionnaires measuring psychological, familial, and friendship factors. AN symptom severity was assessed 1 year later (T2). Results of hierarchical regression analysis revealed that greater general psychological maladjustment at T1 (b = .26; se = .03; p = .00) was associated with greater AN symptom severity at T2. Greater alienation from friends at T1 (b = 1.20, se = .53, p = .03) also predicted greater AN symptom severity at T2, above and beyond the influence of adolescent girls' general psychological maladjustment. Finally, the mediating role of alienation from friends in the association between general psychological maladjustment at T1 and AN symptom severity at T2 was also identified. AN is a multidimensional disorder with a prognosis that involves both psychological and social factors. The results stemming from the present study shed light on the role of peer as a mechanism through which general psychological maladjustment is linked to AN symptom severity 1 year following diagnosis.

Group therapy to reduce maladaptive eating behaviors in people with overweight or obesity: Does food addiction impact the treatment response?

BACKGROUND: Given that the presence of food addiction worsens the clinical portrait in people with overweight or obesity, it could also impact the treatment response. The objective was to explore the moderating effect of baseline food addiction (FA) on the treatment response. The associations between changes in FA symptoms and other maladaptive eating behaviors were also examined. METHODS: Sixty adults with overweight or obesity were recruited and took part in a 12-session group therapy for compulsive eating. They completed questionnaires on FA and three treatment outcomes (binge eating, grazing, and depressive symptoms). Participants were split into two groups according to their number of baseline FA symptoms (no/mild FA vs. moderate/severe FA) and were compared on all outcomes at four measurement points (baseline, mid-treatment, post-treatment, and 6-month follow-up). Correlations between changes in FA symptoms and all three outcomes from pre- to post-treatment were performed. RESULTS: Group and treatment effects were significant for binge eating and grazing but not for depressive symptoms. Interaction effects were not significant for the three outcomes. The reduction in FA symptoms from pre- to post-treatment was positively associated with the reduction in binge eating (r = 0.49) and grazing (r = 0.55). CONCLUSIONS: People with moderate/severe FA maintained higher maladaptive eating behaviors than people with no/mild FA from the beginning to the end of the treatment. Progression through treatment followed the same pattern for both groups, suggesting that baseline FA did not have a moderating effect. People with moderate/severe FA would likely benefit from a longer treatment.

Associations between mind-body practice engagement and diet quality: Exploring the mediating roles of eating behaviour traits and regulation styles for eating behaviours in the PREDISE study.

While engaging in Mind-Body Practices (MBPs) may be related to better diet quality, its association with eating behaviours is unclear. This cross-sectional study explores whether eating behaviour traits and regulation style of eating behaviours mediate the association between MBP engagement and diet quality. A total of 418 women and 482 men, aged between 18 and 65 years and recruited as part of the PREDISE study cohort, reported whether they currently practice one or more MBP (e.g., yoga or meditation). Canadian Healthy Eating Index (C-HEI) was calculated from three 24h dietary recalls. Intuitive Eating Scale (IES-2), and Regulation of Eating Behaviour Scale were completed online. Mann-Whitney tests were conducted to compare C-HEI scores of individuals who currently engage in MBPs (practitioners) to those who do not (non-practitioners). Multiple regression analyses and bootstrapping were performed to test whether eating behaviours and regulation style of eating behaviours mediate the association between MBPs and diet quality. Overall, 88 women and 43 men were practitioners. They had higher C-HEI scores than non-practitioners (62.9 ± 13.0 vs. 55.6 ± 14.3; p = 0.001). Parallel mediation model showed significant indirect effects of the IES-2 subscale relating to Body-Food Choice Congruence (ß = 1.57, SE = 0.41, 95% CI: 0.86, 2.43), self-determined motivation (ß = 1.51, SE = 0.39, 95% CI:0.81, 2.32) and non-self-determined motivation (ß = 0.39, SE = 0.21, 95% CI: 0.03, 0.85) on the association between practitioner status and C-HEI. These findings suggest that the current practice of MBPs is associated with better diet quality, mainly through practitioners' higher intuitive eating skills and more self-determined regulation of eating behaviours. Further studies should investigate the potential impacts of MBPs on the development and maintenance of positive eating habits.

Determinants of weight gain and body changes during pregnancy: A qualitative study of French-Canadian pregnant people.

OBJECTIVE: More than half of pregnant Canadian people exceed current gestational weight gain recommendations, which has been associated with adverse outcomes for both parent and child. Although the physiological causes of excessive gestational weight gain have been well investigated, few studies have evaluated the context of gestational weight gain and body changes through the perspective of pregnant people. Therefore, we aim to explore factors influencing body changes and weight gain during pregnancy as experienced by pregnant individuals. METHODS: A total of three focus groups and six individual interviews were conducted with pregnant people (n=21) recruited in the 2nd or 3rd trimester. A semi-structured interview guide was developed according to a pre-existing conceptual model by Hill et al., 2013. Focus groups and interviews were recorded, transcribed, and thematically analysed using NVivo software. FINDINGS: Results were categorized into four main themes, based on the conceptual model: (1) parental psychological, social and cognitive factors, (2) outcomes, (3) parental behaviors and (4) health behavior change constructs. Participants identified structural, social, professional, and especially partner support (1), health-related strategies (2), body image (1) and knowledge of gestational weight gain recommendations (3) as influent components of their body changes experience. CONCLUSIONS: In this study, the themes addressed affect both pregnant individuals and their relatives. Enhanced knowledge of gestational weight gain recommendations in this population, support from relatives and quality of follow-up offered by health professionals must therefore be considered as possible avenues of intervention.

A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates.

INTRODUCTION: Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD: Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS: Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION: Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Impact of glycemic variability on cognitive impairment, disordered eating behaviors and self-management skills in patients with type 1 diabetes: study protocol for a cross-sectional online study, the Sugar Swing study.

BACKGROUND: People living with type 1 diabetes (PWT1D) are at increased risk for impairments in brain function, which may impact on daily life. Cognitive impairments in PWT1D might contribute to increasing eating disorders, reducing self-management skills, and deteriorating glycemic control. Glycemic variability may be a key determinant of disordered eating behaviors, as well as of cognitive impairments. The main objective of this study is to better understand the impact of glycemic variability in disordered eating behaviors and cognitive impairment, and its consequences on self-management skills in PWT1D. METHOD: We aim to recruit 150 PWT1D with 50% of men and women in this cross-sectional study. Participants will record their glycemic variability over a 10-day period using a continuous glucose monitoring system (CGMS) and track their dietary intakes using image-assisted food tracking mobile application (2 days). Over four online visits, eating behaviors, diabetes self-management's skills, anxiety disorders, depression disorder, diabetes literacy and numeracy skills, cognitive flexibility, attention deficit, level of interoception, and impulsivity behaviors will be assessed using self-reported questionnaires. Cognitive functions (i.e., attention, executive functions, impulsivity, inhibition and temporal discounting), will be measured. Finally, medical, biological and sociodemographic data will be collected. To further our understanding of the PWT1D experience and factors impacting glycemic self-management, 50 PWT1D will also participate in the qualitative phase of the protocol which consist of individual in-depth face-to-face (virtual) interviews, led by a trained investigator using a semi-structured interview. DISCUSSION: This study will contribute to highlighting the consequences of blood sugar fluctuations (i.e., "sugar swings"), in daily life, especially how they disrupt eating behaviors and brain functioning. A better understanding of the mechanisms involved could eventually allow for early detection and management of these problems. Our study will also seek to understand the patients' point of view, which will allow the design of appropriate and meaningful recommendations. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05487534. Registered 4 August 2022.

Health At Every Size intervention® under real-world conditions: the rights and wrongs of program implementation.

Implementation integrity is known to be critical to the success of interventions. The Health At Every Size® (HAES®) approach is deemed to be a sustainable intervention on weight-related issues. However, no study in the field has yet investigated the effects of implementation on outcomes in a real-world setting. Objective: This study aims to explore to what extent does implementation integrity moderate program outcomes across multiple sites. Methods: One hundred sixty-two women nested in 21 health facilities across the province of Québec (Canada) were part of a HAES® intervention and completed questionnaires at baseline and after the intervention. Participant responsiveness (e.g. home practice completion) along with other implementation dimensions (dosage, adherence, adaptations) and providers' characteristics (n = 45) were assessed using a mix of qualitative and quantitative data analysis. Adaptations to the program curriculum were categorized as either acceptable or unacceptable. Multilevel linear modeling was performed with participant responsiveness and other implementation dimensions predictors. Intervention outcomes were intuitive eating and body esteem. Results: Unacceptable adaptations were significantly associated with providers' self-efficacy (rs (23) = .59, p = .003) and past experience with facilitating the intervention (r(23) = .47, p = .03). Participant responsiveness showed a significant interaction between time and home practice completion (B = .07, p < .05) on intuitive eating scores. Conclusion: Except for participant responsiveness, other implementation dimensions did not moderate outcomes. Implications for future research and practice are discussed.

Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review.

Mindfulness and self-compassion interventions are two strategies helpful in preventing and reducing burnout and work stress. However, professionals with overburdened schedules can experience obstacles in learning and practicing these interventions, originally taught with lengthy programs. The use of digital technologies could make these interventions more accessible to workers, as studied in a recent, growing body of evidence. The evidence available is diverse in terms of interventions, designs, outcomes, and populations. This calls for a review that can take into consideration this diversity while still rigorously synthesize it. Scoping reviews are designed to examine emerging evidence and summarize the evidence on a specific topic of interest. The present scoping review aims to assess the current state of the literature on the use of online programs and mobile applications of self-compassion, mindfulness, and meditation (digital mindfulness-based interventions; dMBIs) by workers. More specifically, information on the type of intervention, population, advantages, and disadvantages, measured outcomes, and advice for future research are gathered. MEDLINE (PubMed; Ovid), PsychInfo (Ovid), and Web of Science (Clarivate) were searched to identify all relevant articles. The screening process resulted in 56 articles being included in this scoping review. Inclusion criteria were (1) participants are workers; (2) the intervention is individual, digital, and mindfulness/self-compassion/meditation-based; and (3) articles were available in French or English language at the time of the review. Interventions used were mostly mindfulness-based, equally categorized under web-based and app-based interventions. Most interventions included information on mindfulness, meditation or self-compassion, meditation exercises, other types of exercises, instructions on how to use, and reminders. dMBIs are often studied in the healthcare population and predominantly in female samples. Although dMBIs present advantages (low cost, accessibility, practicality, feasibility), obstacles can arise in their implementation (low engagement and motivation, concerns about confidentiality). Included articles measured outcomes related to work, mindfulness or self-compassion, and other psychological variables (stress/anxiety, depression, resilience, wellbeing). Articles provided important directions to further research on dMBIs regarding methodological aspects, modality and intervention, and individual and organizational questions. dMBIs are becoming more popular and interventions are diverse. Although not without limitations, this scoping provided a synthesis on different aspects of the use of dMBIs within workers and highlighted pertinent future research directions.

Maladaptive Eating Behaviors and Childhood Trauma: A Focus on Food Addiction.

Background Many studies have highlighted the clinical relevance of food addiction (FA) by showing its association with psychopathological severity and even more when co-occurring with binge eating disorder. It was suggested that the association between FA and greater psychopathological severity could be accounted for by a history of traumatic experiences. The present study examined the relationship between childhood trauma (including peer victimization, abuse, and neglect) and maladaptive eating behaviors (FA, binge eating, and grazing) and explored whether childhood trauma predicts FA when controlling for binge eating, grazing, and other confounding variables. Methods One hundred fourteen adult women seeking psychological help for problems related to eating or weight completed questionnaires measuring FA, binge eating, grazing, depressive symptoms, peer victimization, and childhood abuse and neglect. Results FA showed significantly small to moderate positive correlations with all measures of childhood trauma, except for physical neglect. A hierarchical regression, including binge eating, grazing, depressive symptoms, age, and childhood trauma explained 55% of FA variance, with 7% of variance explained uniquely by childhood trauma. Conclusions This study supports that FA is related to childhood trauma and provides a potential explanation for the association of FA with greater psychopathological severity. From a clinical perspective, FA provides an accurate and quick assessment of psychopathological severity and represents an essential complement to the evaluation of eating disorders related to overweight. Future studies should attempt to estimate the impact of childhood trauma on treatment outcomes.

Childhood sexual abuse and food addiction severity in a clinical sample of individuals with overweight or obesity.

PURPOSE: A higher risk of food addiction (FA) in individuals reporting childhood sexual abuse (CSA) has been well demonstrated with community samples, but studies including clinical samples failed to replicate this relation. This study examined, among individuals presenting eating and weight disorders, the risk of FA for those reporting CSA while considering the severity of CSA and other types of traumas. METHODS: Participants (N = 187) completed a DSM-5 diagnosis assessment and questionnaires on LimeSurvey evaluating FA, interpersonal traumas, depressive level, body esteem, dieting/weight preoccupations, and body mass index (BMI). Logistic regressions were used to calculate the odds ratio (OR) of FA using interpersonal traumas as risk factors, and t tests were used to compare individuals with FA and CSA and those with FA without CSA. RESULTS: Of all interpersonal traumas, CSA was associated with the highest risk of FA, with ORs of 1.73 (p = 0.094) and 2.07 (p = 0.034). The relationship with the abuser, the type of sexual abuse and the number of abuses were significant or marginally significant risk factors, with ORs ranging from 1.26 to 1.50. Finally, no significant difference was found between FA with CSA and FA without CSA. CONCLUSION: Using a clinical sample, this study showed a higher risk of FA in individuals reporting CSA and provided evidence that the relationship with the abuser, the type of sexual abuse, and the number of abuses are relevant factors. Additionally, in individuals with FA, the presence or absence of CSA did not influence depressive level, body esteem, dieting/weight preoccupations, or BMI. LEVEL OF EVIDENCE: Level V, cross-sectional, descriptive study.

Increased Adipose Tissue Indices of Androgen Catabolism and Aromatization in Women With Metabolic Dysfunction.

CONTEXT: Body fat distribution is a risk factor for obesity-associated comorbidities, and adipose tissue dysfunction plays a role in this association. In humans, there is a sex difference in body fat distribution, and steroid hormones are known to regulate several cellular processes within adipose tissue. OBJECTIVE: Our aim was to investigate if intra-adipose steroid concentration and expression or activity of steroidogenic enzymes were associated with features of adipose tissue dysfunction in individuals with severe obesity. METHODS: Samples from 40 bariatric candidates (31 women, 9 men) were included in the study. Visceral (VAT) and subcutaneous adipose tissue (SAT) were collected during surgery. Adipose tissue morphology was measured by a combination of histological staining and semi-automated quantification. Following extraction, intra-adipose and plasma steroid concentrations were determined by liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). Aromatase activity was estimated using product over substrate ratio, while AKR1C2 activity was measured directly by fluorogenic probe. Gene expression was measured by quantitative PCR. RESULTS: VAT aromatase activity was positively associated with VAT adipocyte hypertrophy (P valueadj < 0.01) and negatively with plasma high-density lipoprotein (HDL)-cholesterol (P valueadj < 0.01), while SAT aromatase activity predicted dyslipidemia in women even after adjustment for waist circumference, age, and hormonal contraceptive use. We additionally compared women with high and low visceral adiposity index (VAI) and found that VAT excess is characterized by adipose tissue dysfunction, increased androgen catabolism mirrored by increased AKR1C2 activity, and higher aromatase expression and activity indices. CONCLUSION: In women, increased androgen catabolism or aromatization is associated with visceral adiposity and adipose tissue dysfunction.

Extreme weight control behaviors among adolescent athletes: Links with weight-related maltreatment from parents and coaches and sport ethic norms.

The use of extreme weight-control behaviors is prevalent among adolescent athletes and may result from individual and sport-specific factors. Weight-related maltreatment from coaches and parents, and conformity to sport ethic norms have recently been linked to the use of extreme weight-control behaviors. This study aims to investigate the role of sport ethic norms and weight-related maltreatment from coaches and parents in the use of extreme weight-control behaviors among adolescent athletes. A sample of 999 French-Canadian athletes aged 14-17 years competing in a variety of sports completed an online survey assessing extreme weight-control behaviors, weight-related maltreatment from coaches and parents, and conformity to sport ethic norms. A total of 16.9% of the adolescent athletes reported having adopted extreme weight-control behaviors during their athletic careers. Extreme weight-control behaviors were significantly more prevalent among girls (19.75% vs 9.7% in boys) and weight-class-sport athletes (44%). In addition, 7.4% of the sample experienced at least one type of weight-related maltreatment by coaches or parents. Sex, weight-related neglect by coaches and parents, and weight-related psychological violence by coaches explained 24.4% of extreme weight-control behaviors variance. Indeed, participants who engaged in extreme weight-control behaviors experienced significantly more violence than the other participants did. In contrast, no differences were observed between people who engaged in extreme weight-control behaviors and those who did not due to conformity to sport ethic norms.