Low eating self-efficacy is associated with unfavorable eating behavior tendencies among individuals with overweight and obesity.

Success in long-term weight management depends partly on psychological and behavioral aspects. Understanding the links between psychological factors and eating behavior tendencies is needed to develop more effective weight management methods. This population-based cross-sectional study examined whether eating self-efficacy (ESE) is associated with cognitive restraint (CR), uncontrolled eating (UE), emotional eating (EE), and binge eating (BE). The hypothesis was that individuals with low ESE have more unfavorable eating behavior tendencies than individuals with high ESE. Participants were classified as low ESE and high ESE by the Weight-Related Self-Efficacy questionnaire (WEL) median cut-off point. Eating behavior tendencies were assessed with Three Factor Eating Questionnaire R-18 and Binge Eating Scale, and additionally, by the number of difficulties in weight management. The difficulties were low CR, high UE, high EE, and moderate or severe BE. Five hundred and thirty-two volunteers with overweight and obesity were included in the study. Participants with low ESE had lower CR (p < 0.03) and higher UE, EE, and BE (p < 0.001) than participants with high ESE. Thirty-nine percent of men with low ESE had at least two difficulties in successful weight control while this percentage was only 8% in men with high ESE. In women, the corresponding figures were 56% and 10%. The risk of low ESE was increased by high UE [OR 5.37 (95% CI 1.99-14.51)], high EE [OR 6.05 (95% CI 2.07-17.66)], or moderate or severe BE [OR 12.31 (95% CI 1.52-99.84)] in men, and by low CR [OR 5.19 (95% CI 2.22-12.18)], high UE [OR 7.20 (95% CI 2.41-19.22)], or high EE [OR 23.66 (95% CI 4.79-116.77)] in women. Low ESE was associated with unfavorable eating behavior tendencies and multiple concomitant difficulties in successful weight loss promotion. These eating behavior tendencies should be considered when counseling patients with overweight and obesity.

Polycystic ovary syndrome is associated with weight-loss attempts and perception of overweight independent of BMI: a population-based cohort study.

OBJECTIVE: Up to 70% of women with polycystic ovary syndrome (PCOS) have pre-obesity or obesity. The aim of this study was to investigate whether women with PCOS have more weight-loss attempts than women without PCOS, regardless of BMI. Moreover, women's weight perceptions in relation to previous weight-loss attempts were evaluated. METHODS: A population-based birth cohort study included women with (n = 278) and without PCOS (control individuals, n = 1560) who were examined at ages 31 and 46 years with questionnaires and clinical examinations. RESULTS: Women with PCOS had more weight-loss attempts compared with control individuals at age 31 (47% vs. 34%, p < 0.001) and 46 years (63% vs. 47%, p < 0.001). At age 46 years, PCOS was associated with multiple weight-loss attempts in the adjusted model (odds ratio: 1.43 [95% CI: 1.00-2.03], p = 0.05). The perception of having overweight was more prevalent in those with PCOS, even among participants with normal weight, at age 31 (PCOS 47% vs. control 34%, p = 0.014) and 46 years (PCOS 60% vs. control 39%, p = 0.001). CONCLUSIONS: Women with PCOS were more likely to have experienced multiple weight-loss attempts and a perception of having overweight compared with control individuals, regardless of obesity status.

The Individual-Level Productivity Costs of Physical Inactivity.

PURPOSE: This study estimated the long-term individual-level productivity costs of physical inactivity. METHODS: The data were drawn from the Northern Finland Birth Cohort 1966, to which the productivity cost variables (sick leaves and disability pensions) from Finnish registries were linked. Individuals ( N = 6261) were categorized into physical activity groups based on their level of physical activity, which was measured in three ways: 1) self-reported leisure-time moderate- to vigorous-intensity physical activity (MVPA) at 46 yr old, 2) longitudinal self-reported leisure-time MVPA at 31-46 yr old, and 3) accelerometer-measured overall MVPA at 46 yr old. The human capital approach was applied to calculate the observed costs (years 2012-2020) and the expected costs (years 2012-2031). RESULTS: The results showed that the average individual-level productivity costs were higher among physically inactive compared with the costs among physically active. The results were consistent regardless of the measurement type of physical activity or the period used. On average, the observed long-term productivity costs among physically inactive individuals were €1900 higher based on self-reported MVPA, €1800 higher based on longitudinal MVPA, and €4300 higher based on accelerometer-measured MVPA compared with the corresponding productivity costs among physically active individuals. The corresponding difference in the expected costs was €2800, €1200, and €8700, respectively. CONCLUSIONS: The results provide evidence that productivity costs differ according to an individual's level of physical activity. Therefore, investments in physical activity may decrease not only the direct healthcare costs but also the indirect productivity costs paid by the employee, the employer, and the government.

Factors associated with body size perception among adolescent goal-oriented sports participants and non-participants: a cross-sectional Finnish study.

BACKGROUND: Regardless of competitive athletes' body image pressures, only few studies have focused on adolescent sport participants' body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents' body size perception has not been studied. We examined the factors associated with adolescents' competitive goals in sports and body size perception, and the associations between adolescents' competitive goals in sports and body size perception. METHODS: The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14-16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations. RESULTS: Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p < 0.001 in girls; 74% vs 61%, p < 0.001 in boys). More than one-fourth of girls with competitive goals in sports perceived themselves as overweight, although only 7% of them were overweight. Adolescents with appearance/weight motives to exercise and poor perceived physical fitness had higher odds of perceived fatness. Additionally, BMI was positively associated with perceived fatness and negatively with perceived thinness. Having competitive goals in sports was not independently associated with perceived fatness or perceived thinness. CONCLUSIONS: Adolescents' BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports.

Health behaviours associated with video gaming in adolescent men: a cross-sectional population-based MOPO study.

BACKGROUND: Playing video games, a form of sedentary behaviour, is associated with poor well-being and increased risk of morbidity due to chronic disease. However, the association between health behaviours and video gaming is poorly understood. The purpose of this population-based study was to reveal the differences in dietary habits and physical activity for adolescent men with high amount of video games on weekdays, as compared to their peers who play less often. METHODS: Seven hundred ninety-six adolescent men (age: mean = 17.8, SD = 0.6) attended compulsory conscription for military service in 2013 and completed a questionnaire regarding the amount and frequency of their video gaming. They also participated in a medical examination and underwent physiological measurements. The participants who played video games more than 3 h/d on weekdays were compared with those who played 3h/d or less. The association between health behaviours and the amount of playing video gaming was analysed using multivariable logistic regression analysis. RESULTS: 24.1% (n = 192) of the participants reported video gaming in excess of 3 h/d. This group had higher incidence of having low physical fitness, having poor eating habits, and being obese. No differences were found in smoking or alcohol drinking habits. Other factors, including low leisure-time physical activity (OR = 1.94; 95% CI, 1.29-2.91), low consumption of vegetables and fruits (OR = 0.83; 95% CI, 0.72-0.97), high consumption of sweetened soft drinks (OR = 1.28; 95% CI, 1.06-1.55) and high amount of sitting time (OR = 1.40; 95% CI, 1.28-1.52), explained one-fourth of the difference. CONCLUSION: In this population-based study, adolescent men who played video games a lot on weekdays had lower physical fitness, were more often obese, and had poorer dietary habits, as compared to their peers who played less often. Because playing video games typically adds to a person's total sedentary time, this activity may be associated with adverse health outcomes at a very young age- especially in combination with poor health behaviours. The results of this study can be utilized to promote health interventions targeted at adolescent men so as to raise their awareness of the disadvantages of excessive video gaming.

Eating Behavior Traits, Weight Loss Attempts, and Vertebral Dimensions Among the General Northern Finnish Population.

STUDY DESIGN: A population-based birth cohort study. OBJECTIVE: To evaluate the associations of eating behavior traits and weight loss attempts with vertebral size among the general Northern Finnish population. SUMMARY OF BACKGROUND DATA: Vertebral fragility fractures are a typical manifestation of osteoporosis, and small vertebral dimensions are a well-established risk factor for vertebral fracturing. Previous studies have associated cognitive eating restraint and diet-induced weight loss with deteriorated bone quality at various skeletal sites, but data on vertebral geometry are lacking. METHODS: This study of 1338 middle-aged Northern Finns evaluated the associations of eating behavior traits (flexible and rigid cognitive restraint of eating, uncontrolled eating, emotional eating; assessed by the Three-Factor Eating Questionnaire-18) and weight loss attempts (assessed by a separate questionnaire item) with magnetic resonance imaging-derived vertebral cross-sectional area (CSA). Sex-stratified linear regression models were used to analyze the data, taking body mass index, leisure-time physical activity, general diet, smoking, and socioeconomic status as potential confounders. RESULTS: Women with rigid or rigid-and-flexible cognitive eating restraints had 3.2% to 3.4% smaller vertebral CSA than those with no cognitive restraint (P ≤ 0.05). Similarly, the women who reported multiple weight loss attempts in adulthood and midlife had 3.5% smaller vertebral size than those who did not (P = 0.03). Other consistent findings were not obtained from either sex. CONCLUSION: Rigid cognitive eating restraint and multiple weight loss attempts predict small vertebral size and thus decreased spinal health among middle-aged women, but not among men. Future longitudinal studies should confirm these findings. LEVEL OF EVIDENCE: 3.

The Association of Body Size, Shape and Composition with Vertebral Size in Midlife - The Northern Finland Birth Cohort 1966 Study.

Small vertebral size increases the risk of osteoporotic vertebral fractures. Obese individuals have larger vertebral size and potentially lower fracture risk than lean individuals, but scarce data exist on the association between vertebral size and anthropometric measures beyond height, weight, and body mass index (BMI). Here, we evaluated several anthropometric measures (height, weight, BMI, waist circumference, hip circumference, waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], fat mass [FM], lean body mass [LBM], percentage FM [%FM], percentage LBM [%LBM]) as predictors of vertebral cross-sectional area (CSA). We used a representative sample from the Northern Finland Birth Cohort 1966 (n = 1087), with anthropometric measurements from the ages of 31 and 46, bioimpedance analysis from the age of 46, and lumbar magnetic resonance imaging from the age of 46 years. In our data, height and LBM correlated most strongly with vertebral CSA among both sexes (0.469 ≤ r ≤ 0.514), while WHR, WHtR, %FM, and %LBM had the weakest correlations with vertebral CSA (|r| ≤ 0.114). We conclude that height and LBM have the highest, yet only moderate correlations with vertebral size. High absolute LBM, rather than FM or abdominal mass accumulation, correlates with large vertebral size and thus potentially also with lower osteoporotic vertebral fracture risk.

Disordered eating behavior in boys of draft age - the population-based MOPO study.

BACKGROUND: Eating disorders in boys are poorly detected in health care. MATERIAL AND METHODS: Among 922 boys attending evaluation for military service in Oulu, In 2013, disordered eating behavior was assessed by the SCOFF and Eating Disorder Inventory questionnaires (Drive fir thinness and Bulimia). RESULTS: Disordered eating behavior was present in 129 (14%) boys, of whom 57 (44%) were overweight. Every fourth overweight by had symptoms of eating disorders, typically constant thoughts of weight loss. CONCLUSIONS: Screening of eating disorders should be included in medical examinations, especially in overweight boys.

Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study.

BACKGROUND: Being overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior. METHODS: The population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7) attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression. RESULTS: Altogether, 6.9 % (n = 145) of the men had symptoms of disordered eating, i.e., 5.4 % had a drive for thinness (n = 114) and 3.7 % had bulimic behavior (n = 77). Drive for thinness was associated with a perception of being overweight (OR 3.7; 95 % CI 2.2-6.1), poor self-rated health (2.3; 1.2-4.4), more leisure sitting time (1.1; 1.0-1.2), and body-related exercise motives (body acceptance: 3.0; 1.7-5.2; weight loss: 2.5; 1.4-4.4). Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1-5.8) and several motives to exercise, i.e., due to another person's suggestion (2.8; 1.6-4.8), competitive sports (2.1; 1.2-3.7), body acceptance (2.1; 1.1-3.9), and weight loss (1.9; 1.1-3.3), but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1-0.5; muscular strength or physical performance: 0.5; 0.2-0.9). CONCLUSIONS: In young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial.

Lifestyle intervention has a beneficial effect on eating behavior and long-term weight loss in obese adults.

OBJECTIVE: To investigate the change in eating behavior and the factors related with the change among successful dieters (maintained a weight loss of ≥5% of original weight). METHODS: Obese adult subjects (21 male, 55 female) were randomized into three-year lifestyle intervention (n=59) and control groups (n=17). Eating behavior (cognitive restraint of eating, uncontrolled eating and emotional eating) was evaluated by the TFEQ-18 and motivation to lose weight and tolerance to problems by a separate questionnaire. Weight, height and body mass index were measured. RESULTS: Weight decreased more in the intervention group than in the control group (5.0% vs 0.6%, p=0.027). Cognitive restraint increased twice as much in the intervention group compared to the control group (16.0 vs. 7.0, p=0.044). The increment in cognitive restraint was positively associated with weight loss and high baseline motivation and tolerance to problems. Cognitive restraint increased in both successful (n=27) and unsuccessful dieters (n=32), but only the successful dieters were able to decrease uncontrolled eating in the long term. CONCLUSIONS: Our results showed that intensive lifestyle counseling improved cognitive restraint which was associated with enhanced weight loss among obese adults. Successful dieters also showed a long-term improvement of uncontrolled eating. Eating behavior should be evaluated and followed before and during lifestyle interventions in order to support the change, e.g. by finding methods to control eating at risk situations and strengthening motivation and tolerance to problems.