Women's body dissatisfaction, physical appearance comparisons, and Instagram use throughout the COVID-19 pandemic: A longitudinal study.

OBJECTIVE: This study aimed to determine the evolution of Instagram use, body dissatisfaction and physical appearance comparisons throughout the coronavirus disease-2019 (COVID-19) pandemic, and to explore whether there was a relationship between the changes in Instagram use throughout the pandemic and body dissatisfaction and physical appearance comparisons. METHOD: A total of 272 Spanish women (16-70 years old) were followed-up across four waves of assessment between November 2019 (before the pandemic started) and July 2021. Body dissatisfaction, social appearance comparisons, and Instagram use were assessed using the Eating Disorders Inventory-3, the Physical Appearance Comparison Scale-Revised, and an ad hoc questionnaire for Instagram use, respectively. RESULTS: No statistically significant changes were found in the frequency of Instagram use, nor on the proportion of women following appearance-focused accounts on Instagram, among the data collection periods. Body dissatisfaction significantly increased from T1 to T4, and physical appearance comparisons significantly increased from T1 to T2, T3, and T4. These increases were not found to be significant for those with eating disorder risk. No significant differences were found in body dissatisfaction and physical appearance comparisons depending on whether participants' frequency of Instagram use had changed or remained the same, or whether they had started/stopped/continued following appearance-focused accounts on Instagram during the pandemic. DISCUSSION: Women's body dissatisfaction and physical appearance comparisons seem to have increased throughout the pandemic. The experiences of individuals with eating disorder risk throughout the pandemic, and the relationship between the pandemic and Instagram use, might be complex and need further research. PUBLIC SIGNIFICANCE: This study suggests that women's body dissatisfaction and physical appearance comparisons have increased throughout the COVID-19 pandemic. However, this increase might not be as clear for those who had eating disorder risk before the pandemic. Instagram frequency of use, and the percentage of women following appearance-focused accounts on Instagram, do not seem to have significantly increased. More research is needed to explore the impact of the pandemic.

The validation of the Barcelona Orthorexia Scale-Spanish version: evidence from the general population.

PURPOSE: To validate the Spanish version of Barcelona Orthorexia Scale (BOS) in general population, analyzing its items and both its internal structure and psychometric properties (internal consistency and temporal stability). In addition, the relationship between ON and external measures of attitudes towards food was assessed. METHOD: The general population sample consisted of 446 women and 104 men, aged between 18.31 and 69.44 years (M = 36.03; SD = 12.46). Of these, 39 participants answered again the questionnaires after one month from the first application. The assessment instruments were a sociodemographic questionnaire, the BOS, the Eating Attitudes Test-26 (EAT-26) and the Dutch Eating Behavior Questionnaire (DEBQ). RESULTS: The final version of the BOS is composed of 35 items. Exploratory factor analysis extracted an internal structure of 5 factors (Behavioral, Concern for healthy food, Attitudes and beliefs about food, Vital achievement and Emotional discomfort). The BOS-35 and the factors presented good internal consistency (α = .80-.90), and an adequate temporal stability (r = .62-.88). The highest association was observed between the Emotional Distress (BOS) and the Diet subscale (EAT-26; r = .51). CONCLUSIONS: This first validation of the BOS has shown adequate psychometric properties, being a valid and reliable instrument to assess ON in the general population. Level of evidence Level II: Evidence obtained from well-designed controlled trials without randomization.

A consensus document on definition and diagnostic criteria for orthorexia nervosa.

PURPOSE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE: Level V: opinions of expert committees.

The behavioral pathway model to overweight and obesity: coping strategies, eating behaviors and body mass index.

PURPOSE: Obese and overweight people deal with more daily problems and stressful situations than normal-weight individuals, for example, discrimination and bias. The aims of the present study were twofold: to identify differences between overweight and normal-weight people in coping strategies and eating behaviors, and to examine the relationship between coping strategies, eating behaviors and BMI. METHODS: Sample of the present study consisted of 473 participants, 76.7% women (mean age = 32.7; SD = 11.4). Participants completed an ad hoc sociodemographic data questionnaire, the Coping Strategies Inventory, and the Dutch Eating Behavior Questionnaire. Welch's t test and X2 comparison analysis were used to identify differences in coping strategies and eating behaviors, according two BMI groups, normal weight and overweight. To analyze the relationship between coping strategies, eating behaviors and BMI, a structural equation modeling was conducted. RESULTS: Overweight participants score significantly higher in passive coping strategies such as self-criticism, wishful thinking and social withdrawal, and unhealthy eating behaviors such as emotional eating and restrained eating. Structural equation modeling included these variables, coping strategies are more likely to conduct to unhealthy eating behaviors and these are more likely to promote and maintain a high BMI. The model showed an adequate data fit. CONCLUSIONS: This research proposes a relationship between the variables analyzed. It has been proved that passive coping strategies predict a high BMI via unhealthy eating behaviors, especially emotional eating. These results are promising to improve the current prevention obesity programs and weight control treatments. LEVEL OF EVIDENCE: Level III, case-control analytic study.

En_Línea. An online treatment to change lifestyle in overweight and obesity: study protocol for a randomized controlled trial.

BACKGROUND: Obesity has become a major public health problem. Innovative treatments are necessary. Internet and new technologies have been reported effective results in weight control programs, especially those with personalized feedback. This paper presents the protocol for a randomized controlled trial to test the effectiveness of an online weight control program, called en_línea, comparing with a standard group therapy and a control group. METHODS: This is a randomized controlled trial with three intervention arms: en_línea, standard group therapy and control group. To perform this study, 305 adults (18-65 years) with overweight type II (27-29.9 kg/m2) or obesity type I (30-34.9 kg/m2) will be invited to participate. Interventions will last 17 weeks with follow-ups 1, 3, 6 and 12 months after the post-treatment appointment. The primary outcome will be post-treatment weight loss and the maintenance during the follow-ups. Secondary outcomes will be adherence rates, drop outs and quality of life. Participants will be assessed before randomization and they will be sign an inform consent. DISCUSSION: The future challenge is to design innovative obesity treatments. Internet could be a useful tool to improve traditional weight control programs. This new intervention format is appropriate for patients who prefer not to share their intimate problems with a group, and for the new generations who feel comfortable using new technologies. Besides, Internet allows reaching a large amount of people at the same time, even if they live far away. TRIAL REGISTRATION: ClinicalTrials.gov NCT04127201. Retrospectively registered 15th October 2019.

The Barcelona Orthorexia Scale (BOS): development process using the Delphi method.

PURPOSE: Orthorexia nervosa is a currently investigated eating disorder proposed by US physician Steve Bratman, defined as pathological fixation on eating healthy food. This study aimed to develop, by consensus of experts, the basic items for a new questionnaire to evaluate some defining psychological features of orthorexia nervosa in English and Spanish language, the so-called Barcelona Orthorexia Scale (BOS). METHODS: The initial item pool was composed of 105 items divided into six different content areas. To analyse the content of the items, a three-round Delphi study was developed, in which participants had to evaluate the representativeness and clarity of each item. Participants were chosen because of their knowledge on orthorexia and/or eating disorders. RESULTS: 58 experts, from 17 different countries, participated in the initial round and 30 in the last round. Items were added, rephrased, changed into another content area, modified or eliminated according to the participants' suggestions, partly due to the group's response, analysed statistically, and partly due to participants' recommendations. CONCLUSIONS: 64 items were obtained, with two versions in Spanish and English. The future BOS aims to provide a possible solution to the shortage of valid instruments to evaluate psychological features of orthorexia and to promote research on this field. Further analysis regarding validity and reliability is necessary to prove the BOS' value on this matter.

Weight discrimination, BMI, or weight bias internalization? Testing the best predictor of psychological distress and body dissatisfaction.

OBJECTIVE: This study aimed: (1) to compare psychological distress (PD) and body dissatisfaction (BD) in terms of BMI, weight bias internalization (WBI), and weight discrimination (current and past); (2) to assess the best predictor of PD and BD and assess the relationships with weight discrimination, BD, and WBI. METHODS: The sample consisted of 1283 participants across all BMI categories, recruited through the internet voluntarily. People with obesity were the most predominant (26.1%). Experiences of weight-based discrimination were reported by participants across all BMI categories, and they were more prevalent in people with obesity. RESULTS: People with obesity, those with WBI, and those who faced current and past weight discrimination reported higher PD and higher BD. However, WBI was the best predictor after controlling for BMI, WBI, and current and past weight discrimination. Mediation analyses revealed that the relationship between weight discrimination and BD through WBI was significant, as was the relationship between weight discrimination and WBI through BD. CONCLUSIONS: These results stressed the importance of WBI in PD and the role of weight discrimination in WBI and BD. Hence, there is a need to better understand how WBI is formed and to design effective interventions to reduce it.

Anti-fat attitudes among Spanish general population: Psychometric properties of the anti-fat attitudes scale.

Weight discrimination is one of the worst forms of prejudice and is deeply rooted in society. The aim of this study was to adapt the anti-fat attitudes scale (AFA) to the Spanish general population. The sample consisted of 1248 participants from the Spanish community population. They were recruited through the internet and participated voluntarily. Women (77.8%) were more predominant than men. Regarding body weight categories, 5.3% were underweight, 43.5% were normal-weight, 24.9% were overweight and 26.3% had obesity. A cross-validation method with an exploratory and confirmatory factor analysis confirmed the three-factor structure of the AFA. The Spanish version of the AFA showed a satisfactory internal consistency for all three factors, as well as adequate test-retest reliability after a 1-month interval. Finally, the Spanish version of the AFA seems to be an adequate tool to assess negative attitudes towards obesity in both clinical and research settings. Men presented more negative attitudes towards obesity and were convinced that obesity is under someone's control. Women presented more fear of gaining weight. Normal-weight people were those who discriminated more. Participants with overweight or obesity suffered more fear of gaining weight. There was no intra-group discrimination between individuals with overweight and obesity.

Validation of the modified weight bias internalization scale in a Spanish adult population.

Weight bias internalization has received considerable attention in recent years and has been associated with serious psychological and physical consequences in Westernized societies. The modified weight bias internalization scale (WBIS-M) is one of the most frequently used instruments for assessing internalized weight stigma across different body weight categories. The aim of this study was to adapt the WBIS-M for use in Spanish adult populations. The sample consisted of 678 participants from the Spanish general population recruited through the internet, 79.6% of whom were women. The scale was translated into Spanish and then backtranslated. To study the internal structure, a cross-validation analysis was carried out including both exploratory and confirmatory factor analyses to assess the scale's psychometric properties. Internal consistency was evaluated using Cronbach's alpha and McDonald's omega and a test-retest was conducted to assess one-month stability. Results confirmed that the Spanish adaptation of the WBIS-M is an 11-item unidimensional scale, like the original version and shows excellent psychometric properties. In conclusion, the Spanish WBIS-M version seems to be a robust psychometric tool for use in clinical and research settings.

The impact of COVID-19 lockdown on social network sites use, body image disturbances and self-esteem among adolescent and young women.

OBJECTIVE: This study aimed to determine the impact of COVID-19 lockdown on social network sites (SNS) use and to explore whether SNS use is associated with body image disturbances and low self-esteem. METHODS: A total of 2601 women living in Spain aged 14-35 years completed questionnaire measures of SNS use, self-esteem, body dissatisfaction and drive for thinness. In the survey, participants were asked about their use of SNS at the moment of answering the survey and before lockdown. RESULTS: A statistically significant increase was found in the frequency of use of all studied SNS (Instagram, YouTube, TikTok, Twitter and Facebook) during lockdown, as well as in the number of women following appearance-focused Instagram accounts. Moreover, significant relationships were found between the frequency of Instagram use and body dissatisfaction, drive for thinness and low self-esteem in the younger age group (14-24), and between the frequency of Instagram use and drive for thinness in the older age group (25-35). Following appearance-focused accounts on Instagram was related to body dissatisfaction and drive for thinness in the younger group, and only to drive for thinness in the older group (25-35). Following appearance-focused accounts on Instagram and a higher frequency of use of Instagram significantly predicted higher levels of drive for thinness. CONCLUSION: These results suggest that lockdown has had an impact on SNS use, and this might be linked to increased drive for thinness and eating disorder risk among adolescent and young women.

Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials.

BACKGROUND: Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). METHOD: From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. RESULTS: Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. CONCLUSIONS: Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

The number of people with overweight and obesity has tripled worldwide since 1975. Obesity has become a serious problem for public health. For that reason, the design of innovative treatments for people with overweight and obesity is an urgent need. This systematic review and network meta-analysis assesses the effectiveness of innovative interventions, concretely web-based programs for overweight and obesity, comparing them with traditional behavioral treatments and wait-list groups. Both web-based and traditional behavioral treatments were classified according to three feedback characteristics: personalization, frequency, and provider (human versus machine). The literature has suggested that a frequent feedback is an indicator of good prognosis in traditional interventions. The results of this study showed that for web-based interventions, an intensive and personalized feedback provided by a healthcare professional was the treatment option that led to a better prognosis. The second and third option were web-based guided self-hep programs and traditional self-help programs. These interventions empowered the participants, providing more sense of self-efficacy. Web-based minimal-contact programs, web-based self-help programs and wait-list were the last options. An accurate ranking of available treatment options only can be provided by a network meta-analysis, the statistic technique used in this study.

Dimensionality of three versions of the Eating Disorder Inventory in adolescent girls.

OBJECTIVES: To analyze the dimensionality of three versions of the Eating Disorder Inventory (EDI) in adolescent girls. METHOD: The sample comprised 738 participants. The Spanish adaptation of the EDI-2 was used. The EDI-2 contains the 64 items of EDI and has the same items as EDI-3. The dimensional structures hypothesized by Garner for the three EDI versions were assessed via a series of Confirmatory Factor Analyses (CFAs). RESULTS: The CFA did not confirm Garner's proposed structure in any of the three versions. Consequently it was decided to perform Exploratory Factor Analyses (EFA) of the EDI-2 and the EDI-3 to try to identify the underlying structure. The best theoretical and empirical fit was provided by a 7-factor structure. DISCUSSION: This article presents a shortened version of the EDI-2 which may prove more suitable for use with adolescent girls in the general population than the original questionnaire. Certain practical suggestions for optimizing the use of the different versions of the EDI are also presented.

[Cross-cultural study of the different components of body dissatisfaction in community samples from Spain and Chile]. / Estudio transcultural de los diferentes componentes de la insatisfacción corporal en muestras comunitarias de España y Chile.

INTRODUCTION: Background: the study of body dissatisfaction has been focused on their perceptual and cognitive-behavioral components, being the affective component the least analyzed, both in Spain and Chile. Until now, it has been observed more presence of body dissatisfaction in overweight women. This fact has been related with the thinness beauty ideal established by society. Objective: to compare the different components of body dissatisfaction (perceptual, cognitive-behavioral and affective) in adults in a community sample of both sexes of Spain and Chile. Method: the sample consisted of 390 participants and has been divided in two samples by country (n = 179 Chileans; n = 211 Spanish). At the same time, these groups were divided in two groups by body mass index (BMI) and also by sex. The different components of body dissatisfaction were evaluated using specific questionnaires for each of them. Results and conclusion: both in Spain and in Chile, people with overweight show more dissatisfaction in the perceptual and affective areas, especially women. However, cognitive-behavioral component is the only one where differences between countries were found, showing overweight Spanish women more dissatisfaction. These results verify a higher presence of body dissatisfaction in women with overweight (t = 4.14, p < 0.001, d = 0.72, IC = 0.22-1.12), related to the greater pressure on appearance in the female population.

INTRODUCCIÓN: Introducción: el estudio de la insatisfacción corporal se ha centrado sobre todo en sus componentes perceptual y cognitivo-conductual, habiendo sido menos analizado el componente afectivo, tanto en España como en Chile. Hasta el momento, se ha observado mayor presencia de insatisfacción corporal en la población femenina y con sobrepeso. Esto se ha relacionado en gran parte con la mujer delgada y definida como ideal de belleza. Objetivo: comparar los diferentes componentes de la insatisfacción corporal (perceptual, cognitivo-conductual y afectivo) en la edad adulta en una muestra comunitaria de ambos sexos de España y de Chile. Método: se utilizó una muestra de 390 participantes, la cual se dividió en dos muestras según el país (n = 179 chilenos; n = 211 españoles). A su vez, los grupos por países se dividieron en dos grupos en función del índice de masa corporal (IMC) y también en función del sexo. Se evaluaron los diferentes componentes de la insatisfacción corporal mediante cuestionarios específicos para cada uno de ellos. Resultados y conclusión: tanto en España como en Chile, las personas con sobrepeso muestran mayor insatisfacción en las áreas perceptual y afectiva, especialmente las mujeres. Sin embargo, el componente cognitivo-conductual es el único en el que se hallaron diferencias entre países, mostrándose las mujeres con sobrepeso españolas más insatisfechas (t = 4,14, p < 0,001, d = 0,72, IC = 0,22-1,12). Estos resultados constatan la mayor presencia de insatisfacción corporal en mujeres con sobrepeso, asociada a la mayor presión sobre la apariencia en la población femenina.

Assessing Motivational Stages and Processes of Change for Weight Management Around Bariatric Surgery: a Multicenter Study.

INTRODUCTION/PURPOSE: The assessment of the patients' motivation as a predictor of behavioral change via five stages (pre-contemplation, contemplation, preparation, action, and maintenance) and four processes (emotional re-evaluation, weight management actions, environmental restructuring, and weight consequences evaluation) of change. MATERIALS/METHODS: A total of 542 participants (251 waiting for bariatric surgery (BS), 90 undergoing BS, and 201 controls) completed the Stages (S-Weight) and Processes (P-Weight) of Change in Overweight and Obese People questionnaires in a multicenter cross-sectional study. RESULTS: A higher percentage of subjects seeking BS (31.7%) were in the action stage (16.7% of post-BS patients, p < 0.001; 14.9% of controls, p < 0.001). The referred body mass index (BMI) reduction was higher in subjects in active stages (3.6 ± 4.4 kg/m2 in maintenance versus 1.4 ± 1.4 kg/m2 in contemplation, p < 0.001). In the P-Weight questionnaire, patients looking for BS scored significant higher in the four processes of change than controls. In addition, a positive and significantly correlation between BMI and the four processes was observed. In the stepwise multivariate analysis, BMI and the S-Weight allocation were constantly associated with the four processes of change. CONCLUSION: Obesity is accompanied by a modifying behavioral stage, suggesting that subjects before BS are seriously thinking about overcoming excess weight. To identify subjects on the waiting list for BS who will be more receptive to weight lost interventions remains a challenge.

Outcome of cognitive-behavioural therapy in training practice with anxiety disorder patients.

OBJECTIVES: This study aims to assess the effectiveness of cognitive-behavioural therapy applied by trainee therapists in patients with anxiety disorders seen in a private university service and to examine whether this effectiveness is comparable to that observed in controlled studies. DESIGN: We compared the effectiveness of cognitive-behavioural therapy at a private centre with that observed in meta-analyses and reviews of controlled studies. METHODS: Out of the 96 initial patients with anxiety disorder, 64 completed the cognitive-behavioural treatment and 59 also answered a series of questionnaires pre- and post-treatment. The effect size of the intervention was calculated, as were the percentages of patients who improved and those who recovered. RESULTS: The pre-post effect size (1.09) was large, although somewhat lower than those observed in a meta-analysis of Spanish studies and in a range of international meta-analyses; moreover, twice as many hours of treatment were administered (M=27.4) and the drop-out rate was higher (33.3%). The percentages of patients who improved (61%) and those who recovered (52.5%) were roughly comparable to those reported in various reviews of studies performed in anxiety disorders. CONCLUSIONS: Cognitive-behavioural therapy applied by trainee therapists in a private university service appears effective, although this efficacy may be somewhat lower than that in controlled studies. Moreover, the duration of treatment and the drop-out rate may be higher.

[DAILY AND ABNORMAL EATING BEHAVIORS IN A COMMUNITY SAMPLE OF CHILEAN ADULTS]. / COMPORTAMIENTOS ALIMENTARIOS COTIDIANOS Y ANÓMALOS EN UNA MUESTRA COMUNITARIA DE ADULTOS CHILENOS.

AIMS: this research aimed to characterize the daily eating behavior in a sample of Chilean adults according to their Body Mass Index (BMI) and gender and to analyze the possible links between these variables and abnormal eating behaviors. METHODS: 657 participants (437 women and 220 men, age range 18-64 years) were evaluated with a battery of self-administered questionnaires. Mean BMI was 25.50 kg/m2 (women 24.96 kg/m2, men 26.58 kg/m2), being significantly higher the mean of BMI in the men group, being the BMI mean of the total sample and that of the male group in the overweight range. RESULTS: participants with overweight (BMI ≥ 25 kg/m2), in contrast with normal-weight group, tended to do more frequently the following behaviors: skip meals, follow a diet, eat less homemade food, eat faster and in greater quantities, in addition to do a greater number of abnormal eating behaviors of various kinds and to rate significantly higher in clinical scales that evaluated eating restraint and overeating. Men showed significantly more eating behaviors linked with overeating, and women performed more behaviors related with eating restraint and emotional eating. DISCUSSION: the results suggest that, besides "what" people eat, "how" people eat, in terms of specific behaviors, may contribute to the rapid increase of overweight in Chilean population.

Objetivos: los objetivos del estudio fueron caracterizar el comportamiento alimentario cotidiano de una muestra de población adulta chilena, en función del Índice de Masa Corporal (IMC) y el género de los participantes, así como analizar la posible relación de estas variables con comportamientos alimentarios anómalos. Métodos: 657 participantes (437 mujeres y 220 hombres de 18 a 64 años) fueron evaluados con una batería de cuestionarios autoadministrados. El IMC promedio fue 25,50 kg/m2 (24,96 kg/m2 mujeres y 26,58 kg/m2 hombres), siendo el IMC promedio de los hombres significativamente mayor y ubicándose el promedio total y el del grupo de hombres en el rango de sobrepeso. Resultados: los participantes con sobrepeso (IMC ≥ 25 kg/m2), en comparación con el grupo de normopeso, tendían a realizar con mayor frecuencia las siguientes conductas: saltarse comidas, seguir dietas, comer menos comida casera, comer rápido y grandes cantidades; además de realizar más conductas alimentarias anómalas de distintos tipos y puntuar más en las escalas clínicas que evaluaban restricción alimentaria y sobreingesta. Los hombres mostraban significativamente más conductas alimentarias vinculadas a la sobreingesta, mientras que las mujeres realizaban más conductas relacionadas con la restricción alimentaria y la ingesta emocional. Discusión: los resultados obtenidos sugieren que, además de "qué" se come, el "cómo" se come, en términos de conductas específicas, puede estar incidiendo en el incremento acelerado del exceso de peso de la población chilena.

Assessment of processes of change for weight management in a UK sample.

OBJECTIVE: The present study aimed to validate the English version of the Processes of Change questionnaire in weight management (P-Weight). METHODS: Participants were 1,087 UK adults, including people enrolled in a behavioural weight management programme, university students and an opportunistic sample. The mean age of the sample was 34.80 (SD = 13.56) years, and 83% were women. BMI ranged from 18.51 to 55.36 (mean = 25.92, SD = 6.26) kg/m(2). Participants completed both the stages and processes questionnaires in weight management (S-Weight and P-Weight), and subscales from the EDI-2 and EAT-40. A refined version of the P-Weight consisting of 32 items was obtained based on the item analysis. RESULTS: The internal structure of the scale fitted a four-factor model, and statistically significant correlations with external measures supported the convergent validity of the scale. CONCLUSION: The adequate psychometric properties of the P-Weight English version suggest that it could be a useful tool to tailor weight management interventions.

External Eating as a Predictor of Cue-reactivity to Food-related Virtual Environments.

The objective of this study was to assess the association between external eating style and food craving experienced during exposure to food cues in virtual reality (VR) environments in both clinical and non-clinical samples. According to the externality theory, people with external eating experience higher reactivity when exposed to food cues, which in turn increases the probability of overeating. Forty patients with eating disorders (23 with bulimia nervosa and 17 with binge eating disorder) and 78 undergraduate students were exposed to 10 different food cues in four VR environments (kitchen, dining room, bedroom, and café). After 30 seconds of exposure to each VR environment, food craving was assessed using a visual analog scale. External, emotional and restrictive eating styles were also assessed using the DEBQ. The results showed a strong association between external eating and cue-elicited food craving. After controlling for the presence of eating disorder diagnosis, external eating was the best predictor of reported food craving. The results lend support to the externality theory but highlight the need for further research in specific patterns of functioning in patients with bulimia nervosa and binge eating disorder.

Trait and State Craving as Indicators of Validity of VR-based Software for Binge Eating Treatment.

The aim of this study was to establish whether virtual reality (VR) exposure to food cues is able to produce craving levels consistent with state-craving and trait-craving as assessed by the Spanish and Italian versions of the State and Trait Food Craving Questionnaires (FCQ-T/S). The results were compared in 40 patients with eating disorders (17 with binge eating disorder, 23 with bulimia nervosa) and 78 healthy control subjects without eating disorders. Controls and patients with higher levels of trait-craving and state-craving both showed a greater desire to eat during VR exposure. Results also showed that trait and state craving assessed by FCQ-T/S were able to predict the total mean craving experienced during exposure to the VR software in both clinical and control samples. These findings present preliminary evidence about the validity of a new virtual reality-based application for cue-exposure treatment in patients with eating disorders.