Contributions of weight perceptions to weight loss attempts: Differences by body mass index and gender

Previous studies have consistently observed that women are more likely to perceive themselves as overweight compared to men. Similarly, women are more likely than men to report trying to lose weight. Less is known about the impact that self-perceived weight has on weight loss behaviors of adults and whether this association differs by gender. We conducted a cross-sectional analysis among an employee sample (n = 899) to determine the association of self-perceived weight on evidence-based weight loss behaviors across genders, accounting for body mass index (BMI) and demographic characteristics. Women were more likely than men to consider themselves to be overweight across each BMI category, and were more likely to report attempting to lose weight. However, perceiving oneself to be overweight was a strong correlate for weight loss attempts across both genders. The effect of targeting accuracy of self-perceived weight status in weight loss interventions deserves research attention.     

Body Image: A Study in a Tri-Ethnic Sample of Low Income Women

This study was designed to examine the evaluative, affective, and behavioral components of body image among 1,217 low-income European American, African American, and Latina women. Participants completed a multidimensional body image questionnaire while awaiting an outpatient clinic appointment. Body mass index (BMI) was determined by medical chart review. Nearly all normal weight and a number of overweight and obese African Americans characterized their weight as normal. In contrast, nearly all overweight and obese European Americans and Latinas regarded themselves as overweight as did over 30% of those of normal weight. European Americans and Latinas with higher BMIs reported more appearance shame than their lower BMI peers did; this pattern was not observed among African Americans. Among Latinas, body image was influenced by length of residency in the U.S. Dr. Berenson is supported by Grant Number K24HD043659, a Midcareer Investigator Award in Patient-Oriented Research, from the National Institute of Child Health and Human Development. Heather Littleton is now at Sam Houston State University.     

Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women.

OBJECTIVE: The trial investigates the effects of augmenting an established weight-reduction intervention with implementation intention prompts. DESIGN: Fifty-five overweight or obese women (ages 18 to 76 years; body mass index from 25.28 to 48.33) enrolled in a commercial weight reduction program were randomly assigned to either an implementation intention prompt or a control condition. Data were collected twice, with a time gap of 2 months. MAIN OUTCOME MEASURES: The primary outcome was participants' change in weight and body mass index from preintervention to follow-up. RESULTS: Repeated measures analysis of variance revealed a significant Time = Condition interaction: On average, implementation intention prompt participants lost 4.2 kg (95% confidence interval = 3.19, 5.07), whereas control participants lost 2.1 kg (95% confidence interval = 1.11, 3.09). The change in frequency of planning mediated the effects of the intervention on weight and body mass index change. CONCLUSION: Among obese or overweight women participating in a commercial weight loss program, those who learn to form implementation intentions can achieve greater weight reduction. Planning facilitation is a key mechanism explaining enhanced weight loss generated by implementation intention formation.     

Lästererfahrungen, Körperbild und Körpergewicht bei jungen Erwachsenen

Background

Negative comments (teasing) on weight and body image in adolescence might predict body dissatisfaction, overweight and eating disorders in adulthood. This study investigated 134 nursing students for a relationship between a history of teasing, body image and weight.

Materials and methods

Subjects with a body mass index (BMI)>?25 kg/m² reported more teasing compared with normal subjects whereas those with a BMI<?20 kg/m² showed lower values compared with normal or overweight subjects. Teasing questionnaire values correlated with aspects of negative body image. The BMI was predicted by factors age (p?=?0.001), sex (p?=?0.016) and teasing subscale weight (p?=?0.001).

Conclusions

It is remarkable that low teasing experience was associated with low weight, which might point to underweight as protective factor against teasing; however, the cross-sectional design of this study precludes direct causal inferences.     

Racial/ethnic differences in Body Mass Index: the roles of beliefs about thinness and dietary restriction

The greater BMI of African American relative to Caucasian women is implicated in racial/ethnic disparities in health outcomes. The principal aim of the current study was to evaluate a theoretical account of racial/ethnic differences in BMI. Thin-ideal internalization, the perceived romantic appeal of thinness, dietary restriction, weight, and height were assessed via self-report measures on a sample of female undergraduates of African American (n = 140) and Caucasian (n = 676) race/ethnicity. Using structural equation modeling, support was obtained for the primary hypothesis that racial/ethnic differences in BMI are explained by Caucasian women's greater thin-ideal internalization and perceived romantic appeal of thinness, thereby resulting in greater levels of dietary restriction. Current findings illustrate the potential for racial/ethnic differences in sociocultural standards of appearance to influence racial/ethnic disparities in physical health, of which BMI is a marker, via effects on weight control behavior.     

Path analysis of exercise treatment-induced changes in psychological factors leading to weight loss

Physical activity may affect weight loss largely through psychological pathways associated with eating changes, especially in obese individuals whose caloric expenditure through exercise is typically small. Direct testing of this is, however, lacking. Previously sedentary adults (N?=?114; 77% female; M _age?=?43.3 years), with a minimum body mass index (BMI) of 35?kg/m² (M _BMI?=?42.0?kg/m²), participated in a 24-week treatment of cognitive-behavioural exercise support and nutrition information. A path model based on tenets of social cognitive and self-efficacy theory was constructed. It was expected that improvements in self-efficacy, physical self-concept, body satisfaction and mood associated with the exercise treatment would predict changes in self-regulation and increased physical activity. It was also hypothesised that improvements in self-efficacy and self-regulation for appropriate eating would transfer from these relationships and predict weight loss. After three theoretically viable paths were added based on modification indices, structural equation modelling indicated a good fit with the data, χ ²(16)?=?20.53, p?=?0.20; RMSEA?=?0.05; SRMR?=?0.06; CFI?=?0.97; TLI?=?0.95. Associations of psychological effects linked to exercise programme participation with predictors of appropriate eating and weight loss were found, and may inform theory, research and treatments.     

Weight ratings of others: The effects of multiple target and rater features

The present study investigated factors that affect the subjective analysis of the weight of other individuals. Three hundred and thirty-three participants viewed figures varying in muscularity, adiposity, gender, and race. For each of the eighteen figures (targets), a 2 (rater gender: male, female) × 3 (rater race/ethnicity: Caucasian, African American, Hispanic) × 3 (target race/ethnicity: Caucasian, African American, Hispanic) repeated measures ANCOVA was conducted (BMI was covaried). Overall, there were few significant effects, however, for some of the figural stimuli, African American raters assigned lower weight ratings than did Caucasian and Hispanic raters. The findings offer support for further investigation of ethnic differences in weight ratings as a potential factor that might inform ethnic differences in overweight and obesity prevalence.     

Body Size Beliefs and Weight Concerns Among Mothers and Their Adolescent Children

African American and White mother/adolescent pairs were examined for familial associations in body size and weight concerns. Mothers' and adolescents' estimates of adolescents' body mass index (BMI) were significantly correlated. Compared to boys, girls had greater body dissatisfaction, higher weight concerns, and perceived higher family/friend weight concerns. By race, White adolescents had more body dissatisfaction and greater concern about weight than African American adolescents. Four items explained 70.4% of the variance in adolescents' weight concern scores: adolescents' weight management practices, mothers' reports of adolescents' saying they were too fat, adolescents' perceptions of family/friends' weight concerns, and adolescents' body dissatisfaction. Our study suggests White girls are more concerned about their weight and perceive greater weight and dieting concerns among family/friends than African American girls.     

Self-Esteem, Teasing and Quality of Life: African American Adolescent Girls Participating in a Family-Based Pediatric Overweight Intervention

Two studies investigated overweight in African American girls. First, African American adolescent girls (BMI was ≥ 85th percentile) and their mothers participated in focus groups addressing weight and eating. Although mothers and daughters shared some similar views on these issues, there were important discrepancies, with mothers expressing greater doubt about the potential success of a healthy weight program. The second study evaluated baseline data from 39 African American girls participating in a weight management program; mothers' reports were also analyzed. In both studies, adolescents reported significant teasing, and in the second study, teasing was inversely associated with social quality of life (β=.55, t=3.01, p=.007). Motivation to participate was positively associated with teasing (r=.50, p < .01). Self-esteem was inversely related to positive health habits (all p < .05). Mothers who viewed their daughters as having higher self-esteem were less concerned about their daughters' weight. Differences in mothers' and daughters' perceptions highlight the importance of a family approach in pediatric overweight interventions. Results provide evidence that overweight African American girls face significant weight stigmatization and suggest areas to target regarding intervention implementation.

Dysfunctional body investment versus body dissatisfaction: Relations with well-being and controlled motivations for obesity treatment

In this study, we investigated the associations between body image and psychological well-being, exploring the mediating role of controlled regulation for entering obesity treatment. In addition, we analyzed whether investment body image was more strongly associated with controlled regulation (and subsequent well-being) compared to evaluative body image. These analyses were performed controlling for baseline BMI effects. Participants were 139 overweight women (age: 38.0 ± 6.7 year; BMI: 32.0 ± 4.1 kg/m²) entering treatment. Evaluative and investment body image, controlled regulation, and psychological well-being were assessed. Body image investment was positively associated with controlled regulation; evaluative body image was not. Controlled regulation was negatively associated with self-esteem and psychological functioning. Controlled regulation partially mediated the effects of body image investment on self-esteem, but did not mediate its effects on psychological functioning. Results suggest that dysfunctional body image investment might undermine well-being within overweight women, partly by increasing controlled regulation for entering obesity treatment. Discussion focuses on the importance of enhancing body image and autonomy during treatment to improve well-being and weight outcomes.     

Pilot Trial of Acceptance-Based Behavioral Weight Loss and Neurocognition Among American Indians

Acceptance-based behavioral therapies (ABTs) for obesity may be superior to standard behavioral therapies but have not been adequately tested with American Indians (AIs). Neurocognitive function is also unexamined in relation to behavioral weight loss among AIs despite findings that neurocognition predicts outcomes in general samples, may help explain some of the benefits of ABTs, and may be relevant to marginalized groups. The primary objective of this pilot was to examine the feasibility/acceptability of ABT in an AI sample. Exploratory analyses examined the relationship between neurocognition and weight loss. Forty-eight AI adults with overweight/obesity (ages 43.3 ± 10.3 years, 85% female; baseline body mass index = 36.8 ± 4.4 kg/m²) enrolled in a 6-month open ABT weight loss trial. Feasibility indices, including screening/enrollment, session attendance, retention rates for posttreatment assessments, and program acceptability were examined. Percent weight loss (%WL) was assessed as well as fluid and crystalized neurocognition (National Institutes of Health Toolbox Cognition Battery [NIHTB-CB]). We enrolled 79% of the eligible sample and retained 75% (N = 36) at posttreatment assessments. Program completers lost an average of 5.2 ± 4.9% of initial body weight (d_z = 1.14), whereas intent-to-treat analyses show a mean loss of 4.1 ± 4.7%. Participants reported high satisfaction, effectiveness, and cultural appropriateness. Exploratory analyses of neurocognitive domains suggested that crystalized cognition was higher among completers, and higher baseline cognitive flexibility predicted greater %WL (β = .34, p = .05). ABT resulted in clinically significant weight loss in an AI sample. A controlled trial of ABT in a larger, more diverse sample is warranted to determine whether (a) the findings are robust, generalizable, and/or superior to other treatments and (b) neurocognitive factors moderate outcomes.     

Les effets de variables psychosociales sur l'intention d'adolescents obèses de changer leurs comportements

We investigate whether psychosocial factors affect intentions from French obese adolescents to change their habits related to nutrition and physical activities. 32 overweight adolescents (age: 10-14y, BMI: M = 27 kg/m²) participating to a program prevention of obesity, answered to pre-test and post-test measures of psychosocial factors (outcome expectancies for self and for other, perceived control, self-efficacy, intention behavior) and of factors related to obesity (BMI, nutrition knowledge, nibbling and television activities). Outcome expectancies and perceived control are positively predictive of intention to change behavior. Conversely, BMI and self-efficacy are negatively predictive of intention to change habits related to nutrition and physical activities. These results are related to difficulties from the subjects to implement their intention with concrete goals.     

Internalized weight stigma mediates and moderates physical activity outcomes during a healthy living program for women with high body mass index

ObjectivesTo investigate the influence of internalized weight stigma (IWS) on physical activity (PA) outcomes among women with body mass index (BMI) over 30 kg/m².Design and methodData were drawn from an RCT that included 80 primarily inactive women (94% non-Hispanic/Latina white; mean age = 39.6, SD = 4.1, range = 30.0 to 45.0; mean BMI = 38.0 kg/m², SD = 3.9, range = 30.2–44.8 kg/m². Participants completed a 6 month weight-neutral, health-at-every-size or weight-loss-focused group-based healthy living program. PA enjoyment and engagement in moderate-intensity PA (MI-PA) (at least 30 minutes most days of the week) were assessed at baseline and immediately post-intervention. We used intention-to-treat linear mixed-effects modeling to test IWS as a moderator of changes in MI-PA engagement. We also tested a model whereby the positive effects of participating in the program on engagement in MI-PA would be serially mediated by a reduction in IWS and a concomitant increase in MI-PA enjoyment.ResultsThe weight-neutral and weight-loss-focused data were combined for all analyses. The moderation hypothesis was supported with a significant interaction between IWS and time. Participants had significant gains overall in MI-PA engagement from baseline to post-intervention; however, those with high IWS had an attenuated response. The serial mediation model was also supported. The positive effect of the program on engagement in MI-PA occurred through decreased IWS and increased MI-PA enjoyment.ConclusionsSelf-directed stigma and holding negative attitudes about one's weight interferes with positive changes in PA outcomes. Healthy living programs may be less effective for those most vulnerable unless we aim to reduce IWS.     

The Quadratic Relationship Between Body Mass Index and Suicide Ideation: A Nonlinear Analysis of Indirect Effects

A nonlinear indirect effects framework was used to investigate potential interpersonal indirect effects (i.e., perceived burden and thwarted belonging) accounting for the nonlinear relationship between body mass index (BMI) and suicide ideation. Using a sample of 338 undergraduates, results revealed a significant quadratic effect of BMI on suicide ideation via perceived burden only, which became significant as BMI fell below 18.00 kg/m² and above 28.00 kg/m². Our results provide novel information relevant for suicide risk screening in the context of weight‐ and health‐related interventions and provide justification for future longitudinal trials assessing suicide risk across the BMI spectrum.     

Examining the Association Between Body Mass Index and Weight Related Quality of Life in Black and White Women

Obesity not only increases risk for morbidity/mortality, but also impacts the quality of life of obese individuals. In the United States, black women have the highest prevalence of obesity of any other group with approximately 80% of black women over age 20 having a body mass index (BMI)????25?kg/m². We aimed to examine the association between BMI and quality of life in this high risk population compared to this association in white women, using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. Data from 172 black women (mean BMI?=?35.7; age?=?40.5) and 171 white women (mean BMI?=?35.5; age?=?40.4) were collected between 2000 and 2010 analyzed in 2010. The mean IWQOL-Lite total score was 81.6 for black women compared to 66.9 for white women, a statistically significant difference. Hierarchical linear regression models revealed a significant BMI-by-race interaction indicating that the relationship between BMI and IWQOL-Lite score was moderated by race. Our findings suggest notable differences in weight-related quality of life in black and white women. At similar BMIs, black women consistently reported better quality of life than white women on all IWQOL-Lite subscales. The greatest difference in IWQOL-Lite scores between black and white women was seen in the self-esteem subscale. Additional research is needed to understand how to incorporate the weight perspectives of black women into weight management messages and interventions.     

Body size dissatisfaction and avoidance behavior: How gender,age, ethnicity,and relative clothing size predict what some won’t try

Sixty-eight percent of U.S. adults are overweight/obese, and this epidemic has physical, psychosocial, and behavioral consequences. An internet sample of adults (N = 2997) perceiving themselves as larger than ideal in clothing size reported their body mass index (BMI), relative clothing size (RS; discrepancy between current and ideal size), and avoidance behaviors. Exploratory factor analysis of 10 avoidance items produced social avoidance and body display avoidance factors. A relative importance analysis revealed RS as a better predictor than BMI for avoidance. A hierarchical multivariate analysis of covariance found RS to predict both avoidance constructs. The relationship between RS and both avoidance constructs was stronger for women than men, and for younger as compared to older participants. Caucasians reported more body display avoidance than African Americans. This suggests that personal dissatisfaction with body size may deter involvement in varied life events and that women are especially avoidant of activities that entail displaying their bodies.     

An acceptance-based behavioral intervention for weight loss: a pilot study

On average, participants in behavioral weight-loss interventions lose 8 kilograms (kg) at 6 months, but there is marked variability in outcomes with some participants losing little or no weight. Individuals with difficulties with internal disinhibition (i.e., eating in response to emotions or thoughts) typically lose less weight in such programs and may require an innovative, specialized approach. This pilot study examined the preliminary acceptability and efficacy of a 24-week acceptance-based behavioral intervention for weight loss among overweight and obese adults reporting difficulty with eating in response to emotions and thoughts. Participants were 21 overweight or obese men and women (mean age=52.2±7.6 years; baseline mean body mass index=32.8±3.4). Eighty-six percent completed the 6-month program and a 3-month follow-up assessment. Ratings of program satisfaction averaged 4.9 on a five-point scale. Multilevel modeling analyses indicated participants lost an average of 12.0 kg (SE=1.4) after 6 months of treatment and 12.1 kg (SE=1.9) at 3-month follow-up, thus exceeding the weight losses typically seen in behavioral treatment programs. Decreases in internal disinhibition and weight-related experiential avoidance were found at 6- and 3-months follow-up. Greater decreases in weight-related experiential avoidance were associated with greater weight loss at the end of the program (r=.64, p=.002), suggesting a potential mechanism of action. Although there have been a few preliminary studies using acceptance-based approaches for obesity, this is the first study to specifically target emotional overeaters, a subgroup that might be particularly responsive to this new approach. Our findings provide initial support for the feasibility, efficacy, and acceptability of this approach for this subgroup of participants. Further study with longer follow-up, a more diverse sample, and comparison to a standard behavioral program is clearly warranted.     

Body weight and weight perception among African and Caribbean university students: Correlation with depression symptoms

The aim of the study was to investigate the association between body weight, weight perception, and depressive symptoms in African and Caribbean university students. In a cross-sectional survey the total sample included 4 964 undergraduate university students (mean age 21.8, SD = 3.4, age range = 18-30 years) from five African and three Caribbean countries. Data on the students’ actual and perceived body weight, as well as depression symptoms, were collected. In logistic regression, perceived rather than measured overweight predicted depressive symptoms in male students with normal weight. For female students, perceived overweight predicted depression symptoms regardless of actual body weight. Male students who overestimated their body weight were at greater risk of depressive symptoms. Body weight self-perceptions appear to influence experience of mood disorder among African and Caribbean country students.     

Change in body image and psychological well-being during behavioral obesity treatment: Associations with weight loss and maintenance

This study reports on outcomes from a behavioral obesity treatment program, evaluating if treatment-related changes in body image and psychological well-being are predictors of weight change during treatment and after follow-up. Participants were 142 overweight/obese women (BMI = 30.2 ± 3.7 kg/m²; age = 38.3 ± 5.8 years) participants in a behavioral treatment program consisting of a 4-month treatment period and a 12-month follow-up. Psychosocial variables improved during treatment and these changes were correlated with 4-month weight reduction. Short-term changes in body size dissatisfaction (p = .002) and mood (p = .003) predicted long-term weight loss. Additional results suggest that there might be a predictive role of short-term changes in body size dissatisfaction and self-esteem on long-term weight loss after accounting for initial weight change (p < .028). We conclude that, along with weight changes, cognitive and affect-related processes influenced during obesity treatment may be related long-term success, in some cases independently of initial weight loss.     

Changing eating behaviour vs. losing weight: the role of goal focus for weight loss in overweight women

A 6-week longitudinal study with N?=?126 overweight women participating in a weight-loss programme investigated the hypothesis that focusing on the process (dietary behaviours) rather than on the outcome of dieting (weight loss) is associated with more successful goal pursuit and achievement. As expected, process focus was related positively to subjective daily success in dieting as well as to actual weight loss, and negatively to deviations from the diet. In contrast, outcome focus had a negative impact on successful dieting: focusing on weight loss was marginally negatively related to actual weight loss and was associated with more disinhibition after lapses. Confirming hypotheses, self-regulation failure (i.e. deviations from the diet, disinhibition) was negatively related to daily affective well-being. Contrary to hypotheses, however, goal focus was not directly associated with affective well-being but only indirectly through self-regulation. Focusing on the process rather than on the outcome of dieting, then, might help achieving difficult health-related goals and support self-regulation but does not contribute directly to affective well-being.