Cleaning the plate: food left by overweight and normal weight persons.

The amount of food left on trays after a clinner meal in a university cafeteria was measured for 146 persons. Half of the subjects were overweight and half were normal weight. Overweight women left significantly less food on their trays than did women of normal weight. Among men, the overweight also left less food but the difference did not reach significance. These findings suggest that food left over must be measured in estimating food intake from food choice, that behavior therapy injunctions to leave food on the plate are justified, and that obesity may be, at least in part, a result of learned patterns of behavior.     

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.     

The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial.

Despite considerable clinical interest, attempts to link perceived self-efficacy with successful weight control have had mixed success. Definitive data on prospective associations between self-efficacy and weight loss are particularly sparse. This study examined relationships between self-efficacy beliefs, weight control behaviors, and weight change among individuals participating in a weight loss trial (N = 349, 87% women). Cross-sectionally, eating and exercise self-efficacy beliefs were strongly associated with corresponding weight loss behaviors. Self-efficacy beliefs prospectively predicted weight control behavior and weight change during active treatment but not during follow-up. Mediational models indicate that people's weight control behaviors mediate the impact of self-efficacy on weight change.     

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.     

Causes and consequences of time perception differences in overweight and normal weight people.

Three experiments considered whether there are differences between overweight and normal weight subjects in time perception which represent the obese subjects' lack of internal responsiveness as well as heightened external reactivity in a noneating setting. In the first study, no time-relevant cues were provided, and overweight subjects were inaccurate in their temporal judgments and showed significantly higher group variability than did normals. In the second study, the effects of differential temporal information generated by interesting and boring cues was considered. The presentation of these time-relevant external cues reduced the judgment variability of the overweight subjects and influenced their perceived passage of time significantly more than normals. The third study examined the influence, on eating behavior, of differences in perceived passage of time as a consequence of manipulating cues for interest or boredom. When bored, overweight subjects perceived time to pass more slowly than did normals and thus ate sooner. Similarly, they delayed eating, judging time to have passed more quickly than it actually had, when they were attending to interesting cues. The implications of a generalized lack of internal sensitivity for a theory about the development and consequences of obesity are discussed.     

Dropping the weight stigma: Nostalgia improves attitudes toward persons who are overweight

Weight stigma, a negative attitude toward persons who are overweight, can lead to emotional detriment (increased vulnerability to depression and anxiety, decreased self-esteem) and discriminatory practices (denial of employment, lower wages, refusal of job promotion or college admission, healthcare deprivation), which have increased dramatically in the United States over the past decade. We report two experiments that implicate nostalgia as a resource or strategy for weight stigma reduction. We hypothesized and found that nostalgia about an encounter with a person who is overweight improves attitudes toward the group “overweight.” Undergraduates who recalled a nostalgic (vs. ordinary) interaction with an overweight person subsequently showed more positive outgroup attitudes. The effect of nostalgia on outgroup attitudes was mediated by greater inclusion of the outgroup in the self and increased outgroup trust (Experiments 1 and 2), as well as reduced intergroup anxiety and greater perceptions of a common ingroup identity (Experiment 2). The findings have interventional potential.     

Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences

Substantial research has compared obese and nonobese persons on body image and psychosocial adjustment. While differences in body satisfaction are often observed, the literature is less clear on other dimensions. Extant differences are typically thought to result from the social stigmatization and maltreatment experienced by obese persons, especially females. The present study of 165 women compared three cohorts who were currently overweight, never overweight, or formerly overweight. Relative to never-overweight women, currently overweight women reported more body dissatisfaction/distress, overweight preoccupation, and dysfunctional appearance investment, as well as more binge eating, lower social self-esteem, and less satisfaction with life. Consistent with the “phantom fat” phenomenon, formerly overweight women were comparable to currently overweight women but worse than never-overweight women on overweight preoccupation and dysfunctional appearance investment. Correlations confirmed that, among overweight but not formerly overweight women, more frequent stigmatizing experiences during childhood, adolescence, and adulthood were significantly associated with currently poorer body image and psychosocial functioning. Scientific and clinical implications of the findings are discussed.     

Overvaluation of shape and weight in binge eating disorder and overweight controls: refinement of a diagnostic construct

Debate continues regarding the nosological status of binge eating disorder (BED) as a diagnosis as opposed to simply reflecting a useful marker for psychopathology. Contention also exists regarding the specific criteria for the BED diagnosis, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by overvaluation of shape/weight. The authors compared features of eating disorders, psychological distress, and weight among overweight BED participants who overvalue their shape/weight (n=92), BED participants with subclinical levels of overvaluation (n=73), and participants in an overweight comparison group without BED (n=45). BED participants categorized with clinical overvaluation reported greater eating-related psychopathology and depression levels than those with subclinical overvaluation. Both BED groups reported greater overall eating pathology and depression levels than the overweight comparison group. Group differences existed despite similar levels of overweight across the 3 groups, as well as when controlling for group differences in depression levels. These findings provide further support for the research diagnostic construct and make a case for the importance of shape/weight overvaluation as a diagnostic specifier.     

Overvaluation of shape and weight among overweight children and adolescents with loss of control eating

Little is known about the phenomenology of pediatric loss of control (LOC) eating. Overvaluation of shape and weight, however, appears to be diagnostically meaningful among binge eating adults. We explored the significance of shape and weight overvaluation among children and adolescents with LOC eating. Participants (n = 526) included 149 overweight youth with LOC eating and 377 overweight controls (CON). Participants were categorized as those reporting at least moderate overvaluation (LOC-Mod, n = 74; CON-Mod, n = 106) or less than moderate overvaluation (LOC-Low, n = 75; CON-Low, n = 271), and compared on measures of eating-related and general psychopathology. LOC-Mod evidenced lower self-esteem than CON-Low, and greater behavioral problems than CON-Mod and CON-Low, but did not differ from LOC-Low in these domains. With the exception of LOC-Low and CON-Mod, all groups differed on global eating-disorder severity, with LOC-Mod scoring the highest. Overvaluation of shape and weight appears to be of questionable importance in defining subtypes of youth with LOC eating. However, as overvaluation and LOC eating each independently predicts eating-disorder onset, their confluence may confer even further risk for eating-disorder development. Longitudinal studies should address this possibility. Developmentally appropriate discussion about body image disturbance may be indicated in interventions targeting pediatric LOC eating and/or obesity.     

Clinician's comment on treatment of childhood overweight meta-analysis.

Given the prevalence and urgency of the childhood overweight problem, pediatric providers are searching for evidence-based management to translate into clinical practice, particularly in primary care. There are numerous challenges to translation and therefore to more widespread adoption of childhood overweight treatment recommendations. In this article, the authors try to bridge this gap between childhood overweight treatment research and clinical care by discussing the current evidence-based recommendations through a clinical case and by examining the challenges of translation. Looking at this issue through the lens of a clinician, the authors consider the broader social context within which childhood overweight exists, and highlight areas for further translational work.     

Differential effects of approach bias and eating style on unhealthy food consumption in overweight and normal weight women

Objective: The current study aimed to examine the effects of approach bias for unhealthy food and trait eating style on consumption of unhealthy food in overweight and normal weight individuals.

Method: Participants were 245 undergraduate women aged 17 – 26 years. They completed an Approach–Avoidance Task, the Dutch Eating Behaviour Questionnaire (to assess restrained, emotional, and external eating), and a taste test to measure consumption of unhealthy food.

Results: An external eating style predicted increased consumption of unhealthy food. Among overweight participants, external and emotional eating style individually moderated the relationship between approach bias for unhealthy food and subsequent consumption. Specifically, approach bias was positively related to consumption in high external and emotional eaters, but negatively related to consumption in low emotional eaters. These interactions were not observed among normal weight participants.

Conclusion: Practically, the results suggest that overweight individuals who are external or emotional eaters may benefit from interventions that aim to modify approach bias towards unhealthy food cues to reduce problematic eating behaviour.     

Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials.

CONTEXT: Evaluating the efficacy of pediatric weight loss treatments is critical. OBJECTIVE: This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls. DATA SOURCES: Medline, PsycINFO, and Cochrane Controlled Trials Register. STUDY SELECTION: Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes. DATA EXTRACTION: Standardized coding was used to extract information on design, participant characteristics, interventions, and results. DATA SYNTHESIS: For trials with no-treatment controls, the mean effect size was 0.75 (k = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (k = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (k = 4, CI = 0.13-0.82) at end of treatment and 0.91 (k = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified. CONCLUSIONS: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. Future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.     

Children's stereotypes of overweight children

The aim of the present study was to assess the content, favourability and generality of perceptions held about overweight children. The research also addressed whether anti‐fat biases change with age and whether they result from a strong association between overweight and bad behaviour, a weak association between overweight and good behaviour or both. Seventy‐three 5‐ to 10‐year‐olds were read aloud a number of short stories containing characters demonstrating high and low athletic, academic, artistic and social abilities. They were then shown eight different pairs of cards; each pair comprised a drawing of an average‐weight and an overweight version of the same child. Participants were then asked to point to the pictures that looked most like the good and bad characters in the stories. The results demonstrated that 5‐ to 8‐year‐olds were significantly less likely to choose an overweight picture to represent the characters with high athletic, academic, artistic and social ability. In contrast, 9‐ to 10‐year‐olds were significantly less likely to choose an overweight figure to represent the characters with high athletic ability, did not differentiate on the basis of weight for the academic and artistic stories, and were significantly more likely to choose an overweight picture as having high social ability.     

Psychometric properties of a scale measuring negative attitudes toward overweight individuals.

This study examined the psychometric properties of the Anti-fat Attitudes Scale (AFAS), a 5-item instrument developed by the authors to measure negative attitudes toward overweight individuals. A total of 4 studies were conducted among Canadian adolescents (n = 1,452) and university students (n = 424). Results suggested that the AFAS possessed a unidimensional factor structure and satisfactory reliability for both men and women. As predicted, men obtained higher scores than women on the AFAS, and antifat attitudes were positively associated with authoritarianism, homonegativity, and political conservatism. Participants who were overweight had lower scores on the AFAS than participants who were thin or average weight. Responses on the AFAS did not appear to be contaminated by social desirability bias.