Social media use and weight bias internalization: association moderated by age and weight perception.

BACKGROUND: The current study examined whether weight perception or age moderated associations between time spent on image-based social media and weight bias internalization (WBI). METHODS: Data come from the baseline visit of the Tracking Our Lives Study, a randomized control trial of college women (n = 200). Participants completed questionnaires assessing time spent on social media (continuous, overall and individual platforms Instagram, Facebook, and Snapchat), WBI (continuous), weight perception (perceive their weight as "overweight" vs. do not perceive their weight as "overweight"), age (continuous, 18-49 years), and confounders (race/ethnicity, parent education, sexual orientation, and BMI). Adjusted zero-inflated Poisson regressions were performed to determine if weight perception and age moderated associations between time spent on image-based social media and WBI. RESULTS: As expected, we found a positive association between overall time spent on image-based social media and WBI (ß = 0.826, p < 0.001). In moderation analyses, the strength of the association was weakened among women who perceived their weight as "overweight" (ß=-0.018, p = 0.006). Associations also weakened with age (ß=-0.001, p < 0.001). The association between time spent on Instagram and WBI was also weakened with age (ß=-0.014, p = 0.018), which was the only significant moderation found for individual social media platforms. CONCLUSIONS: Our results suggest that image-based social media use is more strongly associated with increases in WBI among younger women.

There is research reporting that college women who spend an increased amount of time on image-based social media apply more negative-based weight stereotypes to oneself, leading to weight-based self-degradation. This is known as weight bias internalization. However, there may be things that make social media more or less harmful for college women. The goal of this study was to see if a woman's age or their perception of their weight changed the relationship between the amount of time spent on image-based social media and weight bias internalization. Data come from 200 college women who completed questionnaires to determine time spent on social media, their level of weight bias internalization, how they perceived their weight, age, and other demographics. Results showed that women who perceive their weight as "overweight" had a weaker association between time spent on all image-based social media and weight bias internalization, as did older women. Our results suggest that younger women may be more susceptible to influences on social media that increase their weight bias internalization. These results can be used to identify those who may benefit from interventions aimed at reducing weight bias internalization and prevent later health consequences as a result of having more weight bias internalization.

Identifying methods used to manage weight and shape by first year university students: A qualitative analysis.

OBJECTIVE: To identify current strategies used by first-year university students to lose weight, maintain weight, or change their body shape. METHODS: First-year university students (n = 661) completed an open-ended, web-based survey. Cross-sectional data were analyzed qualitatively using a reflexive thematic approach to identify strategies used to lose weight, maintain weight, or alter body shape/composition. Thematic maps were constructed for each weight- and shape-related goal. RESULTS: Four main types of strategies were used to achieve all three weight or shape-related goals among first-year college students: changes in diet, changes in exercise, self-monitoring, and disordered eating. One behavioral strategy observed across all weight-related goals was prioritizing protein consumption, including protein gained from supplementation. However, there were also differences in strategies by weight- or shape-related goal. For example, only participants aiming to lose or maintain weight reported mindful strategies for monitoring diet. Individuals aiming to alter body composition reported heterogeneity in goal-related intentions, targeting specific body parts through exercise, and extensive supplement use. CONCLUSIONS: First-year college students use a variety of strategies to manage their weight and shape. Some strategies were observed across goals, whereas others are specific to the weight- or shape-related goal. More research is needed to understand the impacts, both positive and negative, of using the strategies identified in the present study.

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time.

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.

A longitudinal test of problematic alcohol use and binge eating among college women: The moderating role of shame.

Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time. OBJECTIVE: Examine (1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and (2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating. METHOD: In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to investigate our objectives. RESULTS: Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support (1) problematic alcohol use as a prospective risk factor for binge eating, (2) shame as an additive predictor of binge eating, and (3) shame as a positive moderator of prediction from problem drinking. CONCLUSION: Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women.

Intermittent fasting: consider the risks of disordered eating for your patient.

This is a commentary on "Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians" by Albosta et al. While this article adequately summarized the biochemical clinical advantages and limitations, we feel it failed to mention a few drawbacks, primarily the risk for disordered eating and eating disorders. Here we delve into the emerging data on intermittent fasting or time-restricted feeding in patient populations and urge clinicians to consider these risks prior to encouragement of intermittent fasting.

Is intuitive eating a privileged approach? Cross-sectional and longitudinal associations between food insecurity and intuitive eating.

OBJECTIVE: To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood. DESIGN: Longitudinal population-based study. Young people reported IE and FI (two items from the US Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item US Household Food Security Module in adolescence. SETTING: Adolescents (Mage = 14·3 ± 2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009-2010 and again in 2017-2018 as emerging adults (Mage = 22·1 ± 2 years). PARTICIPANTS: The analytic sample (n 1372; 53·1 % female, 46·9 % male) was diverse across race/ethnicity (19·8 % Asian, 28·5 % Black, 16·6 % Latinx, 14·7 % Multiracial/Other and 19·9 % White) and socio-economic status (58·6 % low/lower middle, 16·8 % middle and 21·0 % upper middle/high). RESULTS: In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (P = 0·02) and emerging adulthood (P < 0·001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (P = 0·01). Those who remained food-insecure (P = 0·05) or became food-insecure (P = 0·02) had lower IE in emerging adulthood than those remaining food-secure. All effect sizes were small. CONCLUSIONS: Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE.

Do Weight Perception Transitions in Adolescence Predict Concurrent and Long-Term Disordered Eating Behaviors?

PURPOSE: Perceiving one's weight as "overweight" is associated with disordered eating in adolescence. Yet, it is unknown whether weight perceptions change during adolescence, or whether these weight perception transitions predict disordered eating. This study aims to: (1) characterize weight perception transitions from early to late adolescence among a population-based sample and (2) examine whether weight perception transitions in adolescence predict concurrent and future disordered eating into young adulthood. METHODS: Eating and Activity in Teens and Young Adults (N = 1,414) survey data were used to examine correlates of weight perception transitions from early (Mage = 14.9 ± 1.6 years) to late adolescence (Mage = 19.4 ± 1.6 years). Adjusted generalized estimating equations were used to determine whether weight perception transitions in adolescence predicted concurrent and future disordered eating in emerging adulthood (Mage = 25.2 ± 1.6 years) and young adulthood (Mage = 31.0 ± 1.6 years). RESULTS: Weight perceptions were stable from early to late adolescence for 77.2% of adolescents, whereas 15.5% transitioned to perceiving their weight as "overweight" and 7.3% stopped perceiving "overweight" in late adolescence. Perceived "overweight", especially in late adolescence, was associated with higher concurrent and long-term disordered eating up to 10 years later. For example, the predicted prevalence of binge eating in young adulthood among individuals who perceived their weight as "overweight" throughout adolescence was 20.1% compared to 6.6% for those who never perceived their weight as "overweight" in adolescence. DISCUSSION: Adolescent weight perception was relatively stable in this population-based sample. However, weight perception transitions that involved perceiving "overweight", particularly in late adolescence, were associated with long-term higher risk of disordered eating.

Eating disorder risk in rural US adolescents: What do we know and where do we go?

Adolescence is a vulnerable period for the development of eating disorders, but there are disparities in eating disorder risk among adolescents. One population that may be at increased risk but is vastly understudied, is adolescents residing in rural regions within the United States. Rural communities face many mental and physical health disparities; however, the literature on rural adolescent eating disorder risk is nearly nonexistent. In this paper we summarize the scant literature on disordered eating and eating disorder risk and prevalence among rural US adolescents. We also detail eating disorder risk factors that may have unique influence in this population, including socioeconomic status, food insecurity, healthcare access, body image, and weight stigma. Given the presence of numerous eating disorder risk factors, we speculate that rural adolescents may be a particularly vulnerable population for eating disorders and we propose critical next steps in research for understanding eating disorder risk among the understudied population of rural adolescents. PUBLIC SIGNIFICANCE: Rural adolescents may be at increased risk for eating disorders due to disproportionate burden of known risk factors, though this relationship remains understudied. We present a summary of the literature on prevalence and unique risk factors, proposing that this may be a high-risk population. We detail next steps for research to understand eating disorder risk in this population to inform future prevention, identification, and treatment efforts needed in this community.

Helicopter Parenting Among Socio-Economically and Ethnically/Racially Diverse Emerging Adults: Associations with Weight-Related Behaviors.

Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-economic families, with little research examining weight-related health or with emerging adult children. The current study examined associations with emerging adult diet, physical activity, and body mass index (BMI) among a diverse population-based sample of parent and emerging adult dyads (n = 919). Helicopter parenting was highest among lower socioeconomic households and those identifying as Black, Indigenous, or people of color. Helicopter parenting was associated with both healthy and less healthy dietary behaviors across ethnic/racial groups, but was not associated with physical activity or BMI. Greater consideration of the cultural context related to helicopter parenting is needed before making conclusions about its benefits or harms.

Like parent, like child? Intuitive eating among emerging adults and their parents.

Intuitive eating (IE) emphasizes relying on hunger and satiety cues to guide eating, and is associated with positive mental health and health-promoting behaviors. Although parents' own eating patterns often shape those of their children, no known research has explored familial associations of IE. The purpose of this cross-sectional, population-based study was to examine IE concordance between emerging adults and their parents, and whether concordance differed across sociodemographic characteristics and weight perceptions. The analytic sample included 891 emerging adults (M age = 22.0) and their primary parent (M age = 50.4) who participated in the population-based, longitudinal EAT and F-EAT 2010-2018 studies. Parents and emerging adults were grouped into dyads based on IE concordance: (1) neither are intuitive eaters; (2) only the emerging adult is an intuitive eater; (3) only the parent is an intuitive eater; (4) both are intuitive eaters. Dyads differed across socioeconomic status (SES), race/ethnicity, and weight perceptions. Concordant dyads who ate intuitively were more likely to be at higher SES and perceive their weight as "about right" than concordant dyads who did not eat intuitively. Asian emerging adults were most likely to belong to concordant non-intuitive eater dyads. Emerging adults who shared their parent's perception their weight was "overweight" were less likely to be intuitive eaters (even if their parents were). In this sample, sociodemographic characteristics and weight perceptions were related to IE concordance among emerging adults and their parents. Lower SES might be an intergenerational barrier to IE disproportionately impacting communities of color, though longitudinal data are needed. Results also suggest rather than motivating healthful eating, perceiving one's weight as "overweight" could hinder IE. Differences across sociodemographic variables likely intersect in meaningful ways, which is an important future research direction.

Using apps to self-monitor diet and physical activity is linked to greater use of disordered eating behaviors among emerging adults.

Use of weight-related self-monitoring (WRSM) apps is common among emerging adults, as are weight and shape concerns. The present study aimed to examine (1) whether emerging adult use of dietary-focused (e.g., MyFitnessPal) and physical activity-focused (e.g., Fitbit) WRSM apps was associated with weight-control and muscle-building behaviors, including commonly recommended/conventional behaviors and disordered behaviors and (2) whether prior use of weight-control and muscle-building behaviors in adolescence might explain such relationships. Data were collected as part of the EAT (Eating and Activity over Time) 2010-2018 study (n = 1446) and analyzed using gender-stratified logistic regression models adjusted for demographic characteristics and body mass index. Among women and men, physical activity- and dietary-focused app use were associated with greater adjusted prevalence of disordered weight-control behaviors (e.g., fasting, purging), and disordered muscle-building behaviors (e.g., using steroids). Physical activity- and dietary-focused app use were also associated with a higher adjusted prevalence of commonly recommended weight-control and conventional muscle-building behaviors (e.g., exercising, changing eating habits), but only among those who were also engaging in disordered behaviors. The observed associations remained statistically significant in models that further adjusted for adolescent use of the respective behaviors. Findings suggest that emerging adults who use physical activity- and dietary-focused WRSM apps are more likely to engage in disordered weight-control and muscle-building behaviors and that associations are not explained by engagement in these behaviors during adolescence. Future research is needed to examine if there are aspects of WRSM apps that could be modified to reduce potential harm.

Correlates of weight-related self-monitoring application use during emerging adulthood in a population-based sample.

PURPOSE: This study was designed to examine (1) the types of technologies or other applications (apps) emerging adults use to track their eating, physical activity, or weight; (2) who uses these apps and (3) whether eating and weight-related concerns during adolescence predict app use in emerging adulthood. METHODS: Longitudinal survey data were obtained from EAT 2010-2018 (Eating and Activity over Time study, N = 1428), a population-based sample of ethnically/racially and socioeconomically diverse adolescents (mean age: 14.5 ± 2.0 years), who were followed into emerging adulthood (mean age: 22.0 ± 2.0 years). Data were used to examine sociodemographic correlates of physical activity- and dietary-focused app use. Adjusted, gender-stratified logistic regressions were used to investigate longitudinal relationships between eating and weight-related concerns in adolescence and app use in emerging adulthood. RESULTS: Compared to men, women were more likely to use physical activity- (23.2 versus 12.5%, p < 0.001) and dietary-focused apps (16.1 versus 5.5%, p < 0.001). Among women, eating and weight-related concerns in adolescence, particularly unhealthy muscle-building behaviors (OR = 1.73, 95% CI 1.03-2.92), were associated with later dietary-focused app use. Among men, use of other muscle-building behaviors and body dissatisfaction in adolescence predicted use of physical activity- (ORother muscle-building = 1.60, 95% CI 1.03-2.49 and ORbody dissatisfaction = 1.67, 95% CI 1.06-2.65) and dietary-focused (ORother muscle-building = 2.18, 95% CI 1.07-4.47 and ORbody dissatisfaction = 2.35, 95% CI 1.12-4.92) apps 8 years later. CONCLUSIONS: Eating and weight-related concerns may predict later use of physical activity- and dietary-focused apps; future research is needed to understand whether use of such apps further increases eating and weight-related concerns. LEVEL OF EVIDENCE: III, well-designed longitudinal cohort study.

Dietary self-monitoring is associated with increased likelihood of problematic alcohol use among college students.

Objective: To assess the relationship between dietary self-monitoring and problematic alcohol use including binge drinking, increased body confidence while drinking, and restricting food intake to compensate for alcohol consumption, among college students. Participants: Undergraduate and graduate students from 12 US colleges participating in the Healthy Bodies Study in 2013-2014 and 2014-2015 school years (n = 10,133). Methods: Weighted prevalence was calculated for dietary self-monitoring and problematic alcohol use. Gender-stratified logistic regressions were used to assess relationships. Results: Knowing nutrition facts was associated with restricting to compensate for alcohol consumption among women (OR = 2.42, p < .0001) and men (OR = 1.64, p = .002). Among women, knowing and counting calories predicted all problematic alcohol use behaviors. Among men, knowing calories was associated with restricting to compensate (OR = 2.69, p < .0001) and counting calories was associated with restricting to compensate (OR = 5.10, p < .0001) and increased body confidence while drinking (OR = 2.25, p < .0001). Conclusions: Dietary self-monitoring predicts problematic alcohol use among college students, particularly women.

Digital technology use and muscle-building behaviors in young adults.

OBJECTIVE: Digital technology use and muscle-building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle-building behaviors remain unknown and this study aimed to address this gap. METHOD: Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population-based Eating and Activity over Time 2018 study. Gender-stratified-modified Poisson regression models were used to determine cross-sectional associations between three types of digital technology use (screen time, social media, weight-related self-monitoring apps) and five types of muscle-building behaviors (changing eating, exercise, protein powders/shakes, pre-workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. RESULTS: Screen time and social media were either not found to be associated with muscle-building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre-workout drinks in men). In contrast, the use of weight-related self-monitoring apps was positively associated with all muscle-building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13-2.97) and women (PR = 4.43; 95% CI: 1.68-11.68). DISCUSSION: While most recreational screen time may represent sedentary behaviors not related to muscle-building behaviors, weight-related self-monitoring apps are highly associated with more muscle-building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle-building substances.

Stay-at-Home Orders during COVID-19: The Influence on Physical Activity and Recreational Screen Time Change among Diverse Emerging Adults and Future Implications for Health Promotion and the Prevention of Widening Health Disparities.

BACKGROUND: The purpose of this study was to examine changes in physical activity (PA) and recreational screen time (RST) behaviors from pre-COVID-19 in 2018 to Spring 2020 during the mandatory stay-at-home order in an ethnically/racially, socioeconomically diverse sample of emerging adults. METHODS: Longitudinal data were analyzed from 218 participants (Mage = 24.6 ± 2.0 years) who completed two surveys: EAT 2018 (Eating and Activity over Time) and C-EAT in 2020 (during COVID-19). Repeated ANCOVAs and multiple linear regression models were conducted. RESULTS: Moderate-to-vigorous and total PA decreased (4.7 ± 0.3 to 3.5 ± 0.3 h/week [p < 0.001] and 7.9 ± 0.4 to 5.8 ± 0.4 h/week [p < 0.001], respectively), and RST increased from 26.5 ± 0.9 to 29.4 ± 0.8 h/week (p = 0.003). Perceived lack of neighborhood safety, ethnic/racial minoritized identities, and low socioeconomic status were significant predictors of lower PA and higher RST during COVID-19. For example, low SES was associated with 4.04 fewer hours of total PA compared to high SES (p < 0.001). CONCLUSIONS: Stay-at-home policies may have significantly influenced PA and RST levels in emerging adults with pre-existing disparities exacerbated during this mandatory period of sheltering-in-place. This suggests that the pandemic may have played a role in introducing or magnifying these disparities. Post-pandemic interventions will be needed to reverse trends in PA and RST, with a focus on improving neighborhood safety and meeting the needs of low socioeconomic and ethnic/racial minoritized groups.

Are there protective associations between family/shared meal routines during COVID-19 and dietary health and emotional well-being in diverse young adults?

BACKGROUND: This study examined who is engaging in family/shared meals and associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being among young adults during the COVID-19 pandemic. METHODS: A rapid-response online survey was sent to participants in a ten-year longitudinal study (Eating and Activity over Time: EAT 2010-2018). A total of 585 young adults (mean age = 24.7 ± 2.0 years, 63.3% female) living with at least one family member completed the COVID-EAT (C-EAT) survey during the U.S. outbreak of COVID-19. Items assessed changes in family/shared meal frequency, eating behaviors, and emotional well-being. Regression models adjusting for sociodemographic characteristics examined associations between family/shared meal frequency and home food availability, dietary consumption, and emotional well-being. RESULTS: Participants reported an average of 4.6 ± 3.4 family/shared meals per week during COVID-19, a 0.5 meal/week increase from prior to the pandemic (p = .002). Family/shared meal frequency during COVID-19 differed by race/ethnicity, with Asian American participants being most likely to report only 1-2 family/shared meals per week. Family/shared meals during COVID-19 were associated with higher vegetable intake, greater availability of fruits, vegetables, and whole wheat bread in the home, lower levels of depressive symptoms and perceived stress, and greater perceived ability to manage stress in young adults. CONCLUSIONS: Results suggest that engaging in a regular routine, such as family/shared meals, during COVID-19 may have protective associations with dietary health and emotional well-being for young adults. Results may inform practices/routines to offer protective benefits during public health crises such as the current pandemic.

Impacts of dietary self-monitoring via MyFitnessPal to undergraduate women: A qualitative study.

The present study explored college women's perceptions of how dietary self-monitoring alters eating and body image-related cognitions and behaviors. The sample consisted of undergraduate women (N = 20), aged ≥ 18 (mean = 21.9 ±â€¯6.6 years) from a cross-sectional qualitative study using semi-structured interviews conducted upon participants' completion of a randomized controlled trial testing the effects of dietary self-monitoring via the smartphone app, MyFitnessPal. Inductive content analysis was utilized to identify participants' perceptions of how engaging in dietary self-monitoring for one month impacted them. Participants' experiences dietary self-monitoring was highly variable, with some participants reporting increased negative feelings (n = 9), positive feelings (n = 7), or both (n = 2). Other notable findings included increases in weight and/or shape concerns (n = 10) and a number of changes in dietary intake and other behaviors. Participants indicated that dietary self-monitoring may be helpful when trying to lose weight but harmful if the behavior becomes obsessive or if the user has poor body image. Individual experiences with dietary self-monitoring varies widely, and while dietary self-monitoring may be a useful tool for some college women, use should be monitored to avoid possible harmful side effects.

Introducing Dietary Self-Monitoring to Undergraduate Women via a Calorie Counting App Has No Effect on Mental Health or Health Behaviors: Results From a Randomized Controlled Trial.

BACKGROUND: Strong positive relationships between dietary self-monitoring and eating disorder risk are seen in population-based, observational studies. However, current evidence cannot establish causality. Furthermore, little is known about other mental and behavioral health consequences of dietary self-monitoring among college women, a population vulnerable to eating disorders. OBJECTIVE: To determine if introducing dietary self-monitoring via a popular smartphone app to undergraduate women impacts eating disorder risk, other aspects of mental health, or health behaviors including dietary intake and physical activity. DESIGN: Randomized controlled trial. PARTICIPANTS/SETTING: Undergraduate women who had not engaged in dietary self-monitoring in the past year and who were at low-risk for an eating disorder participated between May and October 2019 (n = 200). INTERVENTION: Participants were randomly assigned to engage in dietary self-monitoring via MyFitnessPal for approximately 1 month or to receive no intervention. MAIN OUTCOME MEASURES: Self-report data on eating disorder risk, other mental health outcomes, and health behaviors were collected at baseline and post-intervention. STATISTICAL ANALYSES PERFORMED: Linear and logistic regressions were utilized to test hypotheses. RESULTS: Adherence to the intervention was high, with participants recording their dietary intake via MyFitnessPal on average 89.1% of days between baseline and post-intervention. Assignment to the intervention was not associated with changes in eating disorder risk, anxiety, depressive symptoms, body satisfaction, quality of life, nutritional intake, physical activity, screen time, or other forms of weight-related self-monitoring (all P > .05). CONCLUSIONS: Among dietary self-monitoring naive undergraduate women with low-risk of an eating disorder, dietary self-monitoring via MyFitnessPal for 1 month did not increase eating disorder risk, impact other aspects of mental health, or alter health behaviors including dietary intake. The null results in our study may be due to the selection of a low-risk sample; future research should explore whether there are populations for whom dietary self-monitoring is contraindicated.

Relationships between patterns of technology-based weight-related self-monitoring and eating disorder behaviors among first year university students.

OBJECTIVE: To identify patterns of technology-based weight-related self-monitoring (WRSM) and assess associations between identified patterns and eating disorder behaviors among first year university students. METHODS: First year university students (n = 647) completed a web-based survey to assess their use of technology-based WRSM and eating disorder behaviors. The cross-sectional data were analyzed using gender-stratified latent class analysis to identify patterns of WRSM, followed by logistic regression to calculate the predicted probability of eating disorder behaviors for each pattern of WRSM. RESULTS: Technology-based WRSM is common among first year university students, with patterns of WRSM differing by student gender. Further, unique patterns of WRSM were associated with differing probability of engaging in eating disorder behaviors. For example, compared to the 67.0% of females who did not use technology-based WRSM, females engaging in high amounts of technology-based WRSM (33.0%) were more likely to report fasting, skipping meals, excessively exercising, and using supplements. Among males, those who reported all forms of WRSM (9.5%) were more likely to report fasting, skipping meals, purging, and using supplements but those who only used exercise self-monitoring (11.9%) did not have increased likelihood of eating disorder behaviors. CONCLUSIONS: Using multiple forms of technology-based WRSM is associated with increased likelihood of engaging in eating disorder behaviors among both female and male, first year university students. Assessing technology-based WRSM may be a simple method to screen for elevated eating disorder risk among first year students.