The positive eating scale: relationship with objective health parameters and validity in Germany,the USA and India

Objective: The prevailing focus regarding eating behaviour is on restriction, concern, worry and pathology. In contrast, the purpose of the present studies was to focus on a positive relationship with eating in non-clinical samples from Germany, the USA and India.

Design: In Study 1, the Positive Eating Scale (PES) was tested and validated in a large longitudinal sample (T1: N = 772; T2: N = 510). In Study 2, the PES was tested in online samples from the USA, India and Germany (total N = 749).

Main Outcome Measures: Health risk status was measured in Study 1 with objective health parameters (fasting serum glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, waist circumference, BMI).

Results: Study 1 revealed acceptable psychometric properties of the PES, internal consistency (α = .87), as well as test–retest reliability after six months (r = .67). Importantly, a positive relationship with eating was associated with decreased health risk factors six months later. In Study 2, the structure of the PES was confirmed for German, Indian and US-American adults, suggesting validity across remarkably different eating environments.

Conclusion: A positive relationship with eating might be a fruitful starting point for prevention and intervention programmes promoting physical and psychological health.     

Relationship Between Rate of Eating and Degree of Satiation

ABSTRACT

Behavioral psychologists have developed effective methods of treatment for overeating and weight control, including mealtime regulation, avoidance of taboo foods, and removal of identified precursors to the bingeing behavior. The current study sought to examine the relationship between speed of eating and levels of satiation in weight conscious individuals. Ten participants were instructed to eat at a fast and a slow rate in a within-subjects reversal design. Consuming food at a slow rate helped participants achieve satiation quicker with comparable amounts of food intake. Slow eaters were also less likely to overeat. These results suggest that slow eating may prevent excessive food consumption in weight conscious individuals, constituting an effective means of weight management.     

Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: implications for eating disorder prevention

Third-wave behavioural interventions are increasingly popular for treating and preventing mental health conditions. Recently, researchers have begun testing whether these interventions can effectively targeting eating disorder risk factors (disordered eating, body image concerns). This meta-analysis examined whether third-wave behavioural interventions (acceptance and commitment therapy; dialectical behaviour therapy; mindfulness-based interventions; compassion-focused therapy) show potential for being effective eating disorder prevention programs, by testing their effects on eating disorder risk factors in samples without an eating disorder. Twenty-four studies (13 randomized trials) were included. Most studies delivered selective prevention programs (i.e. participants who reported elevated risk factor). Third-wave interventions led to significant pre–post (g = 0.59; 95% CI = 0.43, 0.75) and follow-up (g = 0.83; 95% CI = 0.38, 1.28) improvements in disordered eating, and significant pre–post improvements in body image (g = 0.35; 95% CI = 0.13, 0.56). DBT-based interventions were associated with the largest effects. Third-wave interventions were also significantly more efficacious than wait-lists (g = 0.39; 95% CI = 0.09, 0.69) in reducing disordered eating, but did not differ to other interventions (g = 0.25; 95% CI = –0.06, 0.57). Preliminary evidence suggests that third-wave interventions may have a beneficial effect in ameliorating eating disorder risk.     

Can we link emotional eating with the emotion regulation skills of adolescents?

Objective: A recent cross-sectional study showed that maternal rejection is associated with emotional eating of obese youngsters seeking treatment, and that this relation is mediated by maladaptive emotion regulation (ER) of the youngsters. We wanted to build on this study and investigate the relation between parental rejection, maladaptive ER and emotional eating in a community sample using longitudinal data.

Design: Participants were 81 youngsters between the ages of 10 and 16 years. Participants completed questionnaires assessing maternal and paternal rejection, ER strategies and emotional eating, at two time moments (M = 71 days between time moments). Latent change models were used to estimate level and change of each variable.

Results: Results showed that the levels of maternal rejection, maladaptive ER and emotional eating were related. The indirect effect of the level of maternal rejection on the level of emotional eating through the level of maladaptive ER was marginally significant. On average, maternal rejection showed no change over time, whereas the other variables decreased. The changes in the variables were not related.

Conclusion: The findings highlight the importance of assessing the emotional bond between mother and youngster and the ER of youngsters with an emotional eating style.     

The relationship between neuroticism and night eating: exploring the mediating roles of psychological distress and maladaptive coping

Night Eating Syndrome has been shown to be associated with various negative physical and psychological consequences. This study explored the relationship between neuroticism and night eating, which had not been studied before. We also examined the possible mediating roles of psychological distress and maladaptive coping for the relationship between neuroticism and night eating. A sample of 578 Chinese college students were assessed on several measures: The Revised Eysenck Personality Questionnaire Short Scale, the Night Eating Questionnaire, the Depression Anxiety Stress Scales, and the Simplified Coping Style Questionnaire. Results indicated that neuroticism was significantly and positively related to night eating (r = .38, p < .01), and the relationship between neuroticism and night eating was partially mediated by psychological distress, but not by maladaptive coping. The results not only revealed a medium-sized relationship between neuroticism and night eating, but also pointed out the importance of psychological distress as related to the relationship between neuroticism and night eating. Unlike neuroticism, which is a personality trait, psychological distress is an emotional state, and it is much more malleable through appropriate intervention. The treatment and intervention for night eating may benefit from our attention to the psychological distress.     

Double trouble: restrained eaters do not eat less and feel worse

Objective: While high levels of dietary restraint do not appear to reflect actual caloric restraint, it has been found to be a risk factor for a wide array of maladaptive eating patterns. These findings raise the question what, if not caloric restriction, dietary restraint entails. We propose that the very finding that restrained eaters do not eat less than they intend to do can provide an answer. Based on this disparity between the intention to restrain oneself and actual behaviour, we therefore hypothesised that high levels of restraint are associated with eating-related guilt.

Method: Three studies (N?=?148) using unobtrusive measures of food intake; different restraint scales; and different measures of guilt tested whether restraint is related to eating-related guilt.

Results: Results indicated that restraint was not associated with food intake, but instead was associated with increased levels of guilt after eating. Guilt was explicitly related to food intake. Moreover, the observed guilt could not be attributed to a general increase in negative affect.

Conclusion: The results of these studies suggest that restraint is not an indicator of actual restricted food intake, but rather a reflection concerns about food and eating manifested in eating-related guilt.     

Understanding the Role of Gender and Ethnic Oppression when Treating Mexican American Women for Eating Disorders

Gender, ethnicity, and weight issues are often the basis for internalized oppression. Mexican American women with eating disorders are subject to such internalization, complicated by cultural and family factors. Mexican American women (n = 136) were assessed. The resulting culturally discrepant gender identity theory describes the complicated set of relationships between weight, cultural weightism, gender identity, assimilation to U.S. culture, family factors, and eating disorder symptoms. Therapists treating eating disorders should consider ethnic and gender identity in addressing the conflicts between family, culture, and gender expectations; and demonstrate sensitivity to the complex inter-generational relationships in Mexican American families.     

Eating behaviors and emotional distress are predicted by treatment and adverse outcome in patients with type 2 diabetes

Depression and anxiety are hightly prevalent among patients with Type 2 Diabetes (T2D), however not commonly related to outcomes, treatment and comorbidities. Eating behaviors could also have an implication. To evaluate the relation between mood and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D we conducted this exploratory cross sectional study in a population from Mexico. Hospital Anxiety and Depression Scale and the Three Factor Eating Questionnaire Revised 21 (TFEQ-R21) were correlated with age, gender, blood pressure, treatment and comorbidities (nephropathy, neuropathy, retinopathy and cardiopathy). Multi-linear regression models and 2^k factorial analyses were conducted. Sixty-one patients (31 male) 55 years old (SD 13) with at least 5 years of T2D were included. Anxiety correlated with depression (r = 0.25, p < 0.05). Gender (women) (std B 0.026, p < 0.001), insulin therapy (std B 0.3, p = 0.11), systolic blood pressure (std B 0.263, p = 0.02) and cardiovascular disease (std B 0.232, p = 0.035) predicted depression. Insulin therapy had a positive effect in cognitive restraint. (std B 0.32, p = 0.001). Age (std B 0.37, p = 0.003) and systolic blood pressure (std B 0.237, p = 0.048) predicted positively emotional eating (not previously published). 2^k factorial analyses proved additive interaction between complications and insulin therapy with depression. This study supports the relation between mood disorders and eating behaviors with demographic, physical, treatment, biochemical profiles and chronic comorbidities in T2D and the additive interaction between factors and mood disorders.     

Media influence on drive for thinness,body satisfaction,and eating attitudes among young women in Hong Kong and China

The present study examined the impact of thin-ideal media exposure on Chinese women’s drive for thinness, attitudes towards body shape, and eating attitude. Women were assigned to one of two video conditions, which portrayed the thin-ideal (experimental) or was neutral (control group), in terms of content. A total of 83 young women from Hong Kong (N = 38) and Shanghai (N = 45), aged between 18 and 25 years (M_age = 22.7) participated in the study. A significant interaction was observed between the experimental video condition and location. Hong Kong women in the experimental group experienced greater levels of body dissatisfaction than Shanghai women exposed to the same condition. Exposure to thin-ideal media produced an increase in drive for thinness, body dissatisfaction and problematic eating attitudes regardless of location, with a greater immediate impact shown in Hong Kong women.     

Eating styles in the morbidly obese: Restraint eating,but not emotional and external eating,predicts dietary behaviour

Objectives : The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population.

Design : A sample of 57 obese participants (BMI: M?=?51.84, SD?=?8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily.

Main outcome measures : A dietician-scored food pyramid analysis of intake.

Results : Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states.

Conclusion : The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people’s ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.     

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.     

Why does asking questions change health behaviours? The mediating role of attitude accessibility

Objective: The question-behaviour effect (QBE) refers to the finding that measuring behavioural intentions increases performance of the relevant behaviour. This effect has been used to change health behaviours. The present research asks why the QBE occurs and evaluates one possible mediator – attitude accessibility.

Design: University staff and students (N = 151) were randomly assigned to an intention measurement condition where they reported their intentions to eat healthy foods, or to one of two control conditions.

Main outcome measures: Participants completed a response latency measure of attitude accessibility, before healthy eating behaviour was assessed unobtrusively using an objective measure of snacking.

Results: Intention measurement participants exhibited more accessible attitudes towards healthy foods, and were more likely to choose a healthy snack, relative to control participants. Furthermore, attitude accessibility mediated the relationship between intention measurement and behaviour.

Conclusion: This research demonstrates that increased attitude accessibility may explain the QBE, extending the findings of previous research to the domain of health behaviour.     

Feeling bad about progress does not lead people want to change their health behaviour

Objective: When do people decide to do something about problematic health behaviours? Theoretical models and pragmatic considerations suggest that people should take action when they feel bad about their progress – in other words, when they experience negative progress-related affect. However, the impact of progress-related affect on goal striving has rarely been investigated.

Design and Methods: Study 1 (N = 744) adopted a cross-sectional design and examined the extent to which measures of progress-related affect were correlated with intentions to take action. Study 2 (N = 409) investigated the impact of manipulating progress-related affect on intentions and behaviour in an experimental design.

Results: Study 1 found that, while engaging in health behaviours had the expected affective consequences (e.g. people felt bad when they were not eating healthily, exercising regularly or limiting their alcohol consumption), it was feeling good rather than bad about progress that was associated with stronger intentions. Study 2 replicated these findings. Participants induced to feel good about their eating behaviour had marginally stronger intentions to eat healthily than participants led to feel bad about their eating behaviour.

Conclusion: The findings have implications for interventions designed to promote changes in health behaviour, as well as theoretical frameworks for understanding self-regulation.     

‘I think a little bit of a kick is sometimes what you need’: Women’s accounts of whole-body scanning and likely impact on health-related behaviours

Objective: This study was designed to investigate whether whole-body scanning might promote healthy eating and physical activity in women, and to explore the effects of scanning on body image.

Design: Fourteen women aged 22–45 years without histories of eating disorders or whole-body scanning took part in semi-structured interviews before and after scanning. Data were analysed using inductive thematic analysis.

Results: Scans did not look as expected, and participants expressed ‘surprise’ and ‘shock’. Participants focused on perceived negative aspects of their bodies as revealed in scan images, and agreed that women with body concerns would find scans too ‘real’ and ‘raw’. Eleven women who met UK Government physical activity and healthy eating guidelines reported that the scan provided additional motivation to maintain, and in nine cases to increase, those behaviours. Two women who neither exercised nor ate healthily would not increase physical activity or change their diets significantly following scanning.

Conclusion: Whole-body scanning may enable maintenance or even acceleration of physical activity and healthy eating, but is unlikely to be useful in promoting initiation of these behaviours. Participants engaged in unhelpful body critique when viewing scans; scanning needs to be confined to contexts where support is provided, to avoid increasing body-related concerns.     

The association between dispositional self-control and longitudinal changes in eating behaviors,diet quality,and BMI

In a random sample from the general population (N = 2781, 46% males), a longitudinal survey was conducted. The association between dispositional self-control and changes in eating behaviours and diet quality was analysed between the first wave (2010) and the last wave (2014). Results show that the higher the dispositional self-control, the lower the increase in overeating behaviours (emotional eating, external eating, ambivalence towards palatable food and overeating), and BMI and the larger the improvement in healthy diet over time. Self-control was not associated with changes in dietary restraint. This is one of the first studies suggesting that dispositional self-control is associated with changes in eating behaviours and healthy food intake over time.     

The benefits of self-forgiveness on mental health: Evidence from correlational and experimental research

Previous research on self-forgiveness is mixed. Some argue self-forgiveness may have a salutary influence on mental health problems following an offense, whereas others suggest it may provide an excuse to reoffend. In two studies, we provide correlational and experimental evidence for the salutary effects of self-forgiveness following an offense. In Study 1 (N = 100), self-forgiveness was associated with lower levels of disordered eating behavior. In Study 2 (N = 462), participants recalled a drinking-related transgression, and were randomly assigned to a self-forgiveness or neutral priming condition. Results revealed that participants in the self-forgiveness condition reported significantly more self-forgiving beliefs and fewer feelings of remorse and self-condemnation than participants in the neutral priming condition to the degree that participants believed their drinking was the cause of the offense. These findings highlight the salutary effects of self-forgiveness.     

Perceived control,depressive symptomatology,and professional burnout: A review of the evidence

This article examines the extent to which self-reported emotional eating is a predictor of unhealthy snack consumption or, alternatively, an expression of beliefs about the relation between emotions and eating derived from concerns about eating behaviour. Three studies were conducted. Study 1 (N = 151) and Study 2 (N = 184) investigated the predictive validity of emotional eating compared to habit strength in snack consumption, employing 7-day snack diaries. Both studies demonstrated that snack consumption was not predicted by emotional eating but depended on the habit of unhealthy snacking and on restraint eating. As emotional eating was not a significant predictor of snack intake, Study 3 addressed the alternative hypothesis of emotional eating being an expression of concerns about eating behaviour. Results from this cross-sectional survey (N = 134) showed that emotional eating was significantly associated with several concerns. Together, these studies show that snack intake is better predicted by habit strength and restraint eating than by emotional eating. Additionally, the results suggest that in normal-weight women the concept of emotional eating may not capture the tendency to eat under emotional conditions, but rather reflects beliefs about the relation between emotions and eating.     

Defining features of unhealthy exercise associated with disordered eating and eating disorder diagnoses

ObjectivesThe current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution.DesignCross-sectional epidemiological study.MethodsA community-based sample of men (n = 592) and women (n = 1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms.ResultsCompulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women.ConclusionsIncluding the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.