Do parents engage in weight- and health-focused conversations with their emerging adult children and are there cross-sectional associations with weight and well-being outcomes?

BACKGROUND: Research indicates harmful associations between parental weight-focused conversations and markers of pediatric health and well-being. However, little is known about the prevalence and consequences of parent conversations focused on weight or health behaviors (i.e., physical activity or nutrition) with emerging adult children. METHODS: Data are from the 2018 follow-up survey of the population-based EAT 2010-2018 (Eating and Activity over Time) in cohort from Minneapolis-St. Paul, MN. Participants were emerging adults at follow-up with ages 18-26. Regression models adjusted for sociodemographic characteristics were conducted. RESULTS: Over two-thirds (68%) of mothers and 44% of fathers engaged in weight-focused conversations with their emerging adult children; 25% of both parents reported engaging in conversations focused only on health behaviors; and 8% of mothers and 26% of fathers reported not engaging in either type of conversation. Health-focused conversations by both parents were associated with lower body mass index (BMI) and disordered eating behaviors, higher intake of fruit and vegetables, and psychosocial well-being in emerging adult children. Weight-focused conversations with both parents were associated with higher BMI and disordered eating behaviors in emerging adults. There were gender moderated associations of paternal conversations about weight and health with vegetable intake, binge eating, and depressive symptoms. DISCUSSION: The high prevalence and negative health outcomes associated with weight-focused conversations coupled with the low prevalence and positive health outcomes associated with health-focused conversations by parents suggests the need for public health messaging and intervention development aimed at reducing parental weight talk with emerging adult children.

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.

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.

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.

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.

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.

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.

Relationships between patterns of weight-related self-monitoring and eating disorder symptomology among undergraduate and graduate students.

OBJECTIVE: To characterize patterns of weight-related self-monitoring (WRSM) among US undergraduate and graduate students and examine associations between identified patterns of WRSM and eating disorder symptomology. METHOD: Undergraduate and graduate students from 12 US colleges and universities (N = 10,010) reported the frequency with which they use WRSM, including self-weighing and dietary self-monitoring. Eating disorder symptomology was assessed using the Eating Disorder Examination Questionnaire. Gender-specific patterns of WRSM were identified using latent class analysis, and logistic regressions were used to identify differences in the odds of eating disorder symptomology across patterns of WRSM. RESULTS: Among this sample, 32.7% weighed themselves regularly; 44.1% reported knowing the nutrition facts of the foods they ate; 33.6% reported knowing the caloric content of the foods they ate; and 12.8% counted the calories they ate. Among women, four patterns of WRSM were identified: "no WRSM," "all forms of WRSM," "knowing nutrition/calorie facts," and "self-weigh only." Compared with the "no WRSM" pattern, women in all other patterns experienced increased eating disorder symptomology. Among men, three patterns were identified: "no WRSM," "all forms of WRSM," and "knowing nutrition/calorie facts." Only men in the "all forms WRSM" pattern had increased eating disorder symptomatology compared with those in the "no WRSM" pattern. DISCUSSION: In a large sample of undergraduate and graduate students, engaging in any WRSM was associated with increased eating disorder symptomology among women, particularly for those who engaged in all forms. Among men, engaging in all forms of WRSM was the only pattern associated with higher eating disorder symptomology.

Parental perceptions of actual and ideal body weight in early childhood prospectively predict adolescent perceptions of actual and ideal body weight among a low-income population.

PURPOSE: To examine the longitudinal associations between parental perceptions of their child's actual weight (PPCA = parental perception of child's actual) and ideal weight (PPCI = parental perception of child ideal) in early childhood and the child's own perceptions of their actual weight (APA = adolescent perceived actual) and ideal weight (API = adolescent perceived ideal) during early adolescence among a low-income population. METHODS: Using a longitudinal study design, 136 child/parent pairs were asked to assess the child's actual and ideal weight using figure rating scales. When children were 4-7 years old, parents reported on their perception of their child's weight; when children were 10-12 years old, the child reported on their own weight perceptions. Actual weight, ideal weight, and the difference between ideal and actual weight perception were assessed at the respective timepoints. Regressions were used to examine the relationship between parental weight perceptions (PPCA and PPCI) and later adolescent weight perception (APA and API). RESULTS: On average, PPCI was higher than PPCA, whereas API was lower than APA. We found a positive relationship between PPCI and API (ß = 0.309, p = .029). PPCA was positively associated with API (ß = 0.304, p = .015) and marginally positively associated with the APA (ß = 0.242, p = .077). However, the difference between PPCI and PPCA did not predict either APA or API. CONCLUSIONS: Parental perception of their child's weight may relate to the adolescent's weight perception, particularly ideal weight. However, several null and marginal associations suggest that parental weight perception in early childhood may not be the most salient factor in determining weight perception in early adolescence. LEVEL OF EVIDENCE: Level III, well-designed longitudinal cohort study.

Cross-sectional associations between weight-related health behaviors and weight misperception among U.S. adolescents with overweight/obesity.

BACKGROUND: Weight misperception occurs when there is a discrepancy between one's actual and perceived weight status. Among adolescents with overweight/obesity, many believe that correcting weight misperception is imperative to inspire weight-related behavior change. However, past research has shown that adolescents with overweight/obesity who misperceive their weight status gain less weight over time compared to accurate perceivers. Therefore, our objective was to examine possible mechanisms underlying this relationship. Specifically, we examined the association between weight misperception and engagement in weight-related health behaviors among adolescents with overweight/obesity. METHODS: Self-reported data from the 2015 National Youth Risk Behavior Survey was used in analyses restricted to participants with overweight/obesity (n = 4383). Using multivariate logistic models correcting for sex, race/ethnicity, and grade in school, we examined the cross-sectional associations between weight misperception and engagement in weight-related health behaviors, specifically related to dietary intake, physical activity, and sleep. RESULTS: Adolescents with overweight/obesity who misperceived their weight status were more likely to drink 100% fruit juice two or more times per day (OR = 1.53, 95% CI: 1.20, 1.94), eat vegetables two or more times per day (OR = 1.29, 95% CI: 1.07, 1.57), be physically active for 1 hour or more per day for at least 5 days in the week prior (OR = 1.40, 95% CI: 1.15, 1.72), be on a sports team in the last year (OR = 1.55, 95% CI: 1.21, 1.97), sleep an average of at least 8 hours per school night (OR = 1.40, 95% CI: 1.15, 1.72), and less likely to be trying to lose weight (OR = 0.17, 95% CI: 0.15, 0.20). Misperceivers were more likely to consume breakfast every morning in the week prior and to drink a sports drink at least once per day, though these results were not statistically significant. We observed no difference in fruit intake, soda intake, or TV viewing between weight misperceivers and accurate perceivers. CONCLUSIONS: Overall, weight misperception among adolescents with overweight/obesity was associated with a number of beneficial weight-related health behaviors. Engagement in these healthy weight-related behaviors may explain some of the protective effect of weight misperception on weight gain over time. TRIAL REGISTRATION: Not applicable.

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.

A mixed-methods longitudinal examination of weight-related self-monitoring and disordered eating among a population-based sample of emerging adults.

BACKGROUND: Weight-related self-monitoring (WRSM) apps are used by millions, but the effects of their use remain unclear. This study examined longitudinal relationships between WRSM and disordered eating among a population-based sample of emerging adults. METHODS: Participants (n = 138) were recruited from EAT 2010-2018 (Eating and Activity over Time study) to participate in a mixed-methods (quantitative and qualitative) longitudinal study to understand the impacts of WRSM. In 2018, participants (Mage=21.7 ± 1.9 years) reported motivations for use and types of WRSM apps used. Dependent variables collected in 2022 (Mage=25.7 ± 1.9 years) included past year total number of disordered weight control behaviors, disordered muscle building behaviors, compulsive exercise, and binge eating. Linear and logistic regressions were used adjusting for sociodemographics, body mass index, and baseline disordered eating. Semi-structured interviews (n = 25) were analyzed using inductive thematic analysis. RESULTS: Participants using WRSM apps for weight management demonstrated an increase in disordered weight control behaviors over time (ß = 0.894, p = .012). Using WRSM apps for "healthy" eating was marginally associated with an increase in disordered weight control behaviors. (ß = 0.673, p = .052). Qualitatively, participants reported varied temporality between WRSM and disordered eating, but believed that app use encouraged restriction/binge cycles and normalized disordered eating. CONCLUSIONS: Findings suggest there may be individual variation in the relationships between WRSM and disordered eating, but that using WRSM apps with the motivation of managing eating or weight may increase disordered eating in some. Additionally, WRSM apps may normalize or encourage disordered eating. Therefore, safeguards, including screening and monitoring, are needed to ensure WRSM does not cause or escalate harm among WRSM users.

For some, weight-related self-monitoring apps, like MyFitnessPal and Fitbit, may cause or worsen disordered eating over time among emerging adults. However, it seems as though the motivation for self-monitoring (e.g., for managing eating or weight) may be more important than what they are monitoring when it comes to disordered eating risk.

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.

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.

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.

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.

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.

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.