Assessing the three types of dieting in the Three-Factor Model of dieting. The Dieting and Weight History Questionnaire

The moderating effect of weight loss intentions on dynamic associations between weight suppression and disordered eating

OBJECTIVE

Weight suppression refers to the difference between one's current and highest previous weight in adulthood and has been associated with development of eating pathology. Previous research has been agnostic as to whether reported weight suppression reflects deliberate weight control behavior, and few studies have assessed whether weight loss that occurs unintentionally (e.g., due to illness) is longitudinally associated with eating pathology.

METHOD

Undergraduates at a Canadian university (N = 661; 81.4 % female) completed three online surveys over six months. Longitudinal multilevel models examined the interaction of within-person fluctuations in weight suppression and between-person differences in weight loss intentions on binge eating, dietary restriction, and body dissatisfaction.

RESULTS

Of participants who reported weight suppression at baseline, 47.6 % indicated that their weight loss was unintentional. Compared to participants endorsing unintentional weight suppression, participants endorsing intentional weight suppression showed greater body dissatisfaction and binge eating across the assessment period (β = 3.64, p ≤ .001 and β = 2.32, p ≤ .001). Significant within-person effects were found only for restriction, indicating that when individuals reported greater weight suppression, they also reported more restrictive eating (β = 0.89, p = .004). Contrary to hypotheses, associations between within-person fluctuations in weight suppression and disordered eating outcomes did not differ by weight loss intentions.

DISCUSSION

Findings suggest that whether weight suppression is intentional may influence mean levels of disordered eating but may have limited influence on within-person fluctuations in weight suppression and disordered eating severity in a non-clinical sample.

Weight History Correlates of Resting Energy Expenditure in Women With Bulimia Nervosa

OBJECTIVE

Among those with bulimia nervosa, weight suppression has been associated with illness severity and treatment prognosis. Although significant weight loss is known to reduce metabolic rate, the relation between weight suppression and resting energy expenditure (REE) in bulimia nervosa has not been examined. This study tested the hypothesis of an inverse relation between weight suppression and REE in a sample of women with bulimia nervosa (N = 84).

METHODS

In primary analyses, linear regressions were conducted between weight suppression and REE, corrected for fat-free mass. In follow-up, exploratory analyses, stepwise linear regressions were conducted to explore the main and interaction effects of weight history and weight suppression on REE.

RESULTS

Neither traditional (TWS) nor developmental weight suppression (DWS) correlated with REE. Results from exploratory analyses, however, revealed a medium-to-large inverse relation between several weight history variables and REE (highest past weight, sr2 = 0.05; lowest postmorbid weight, sr2 = 0.07; current weight, sr2 = 0.05). Additionally, DWS interacted with current (sr2 = 0.08) and highest premorbid (sr2 = 0.05) z-BMI to influence REE with a medium-to-large effect. For individuals low in current and premorbid z-BMIs, higher DWS associated with lower REE levels. However, for individuals at higher premorbid z-BMIs, higher DWS unexpectedly associated with greater REE levels.

DISCUSSION

In this sample of women with bulimia nervosa, reduced REE associated with higher weights across all timepoints. If the interaction effect between DWS and z-BMI history persists in future studies, this may indicate unique challenges faced by individuals low in z-BMI and high in DWS related to weight gain and normalization of eating.

Physiological, body composition, and body mass measures show that a developmental measure of weight suppression is more valid than the traditional measure

OBJECTIVE

The traditional measure of weight suppression (TWS; the difference between an individual's highest past weight at adult height and current weight), has been associated with many psychological, behavioral and biological variables in those with eating disorders. A new measure of weight suppression, called developmental weight suppression (DWS), corrects two major problems in the original measure. Initial research indicates that DWS represents a superior operationalization of the construct weight suppression was originally designed to measure (Lowe [1993, Psychol Bull, 114: 100]). This study is the first to examine the relation between both WS measures and weight history, body composition and a variety of metabolic hormones.

METHODS

Data were collected in 91 women with bulimia nervosa (BN) or BN-spectrum disorders.

RESULTS

Both weight suppression indices were related to multiple hormones. However, multiple regression analyses showed that the independent effects of DWS differed from the independent effects of TWS in that only DWS was negatively related to: (1) current z-BMI, (2) body fat percentage, and (3) insulin, leptin, T3 free, and TSH. This differential pattern also occurred when results were corrected for multiple comparisons.

DISCUSSION

Findings provide stronger biological support for the construct validity of DWS than TWS and suggest that: (1) from the perspective of individuals with BN, high DWS embodies success at food restriction and weight loss, (2) elevated DWS may trap individuals with BN in a powerful biobehavioral bind, and (3) DWS is the preferred measure of weight suppression in future research on eating disorders.

PUBLIC SIGNIFICANCE

Most individuals with bulimia nervosa lose substantial weight in the process of developing their disorder. Such weight suppression is related to many characteristics of those with the eating disorder bulimia nervosa. This study shows why a new measure of weight suppression, based on an individual's growth during development, is more biologically valid than the traditional measure of weight suppression.

The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study

People with overweight and obesity tend to both underreport dietary energy intake and experience weight stigma. This exploratory pilot study aimed to determine the relationship between weight bias and weight stigma and energy intake reporting accuracy. Thirty-nine weight-stable adults with BMI ≥ 25 completed three 24 h dietary recalls; indirect calorimetry to measure resting metabolic rate; a survey measuring weight stigma, psychosocial constructs, and physical activity; and a semi-structured qualitative interview. Multiple linear regression was used to determine if weight bias internalization, weight bias toward others, and experiences of weight stigma were predictive of the accuracy of energy reporting. A thematic analysis was conducted for the qualitative interviews. Weight stigma was reported by 64.1% of the sample. Weight stigma constructs did not predict the accuracy of energy intake reporting. People with obesity underreported by a mean of 477 kcals (p = 0.02). People classified as overweight overreported by a mean of 144 kcals, but this was not significant (p = 0.18). Participants reported a desire to report accurate data despite concerns about reporting socially undesirable foods. Future research should quantify the impact of weight stigma on energy reporting in 24 h recalls using a larger, more diverse sample size and objective measures like doubly labeled water for validation.

The impact of the first COVID-19 lockdown on weight management practices in UK adults: A self-regulation perspective

This study aimed to identify the impact of the first UK COVID-19 lockdown on individuals' weight management attempts (WMA). A self-regulation theoretical framework was used to identify predictors of continuing with a WMA, and weight change during the lockdown. An online retrospective cross-sectional study was conducted after the first UK COVID-19 lockdown. The sample consisted of 166 UK adults (M:31.08, SD:12.15) that were trying to manage their weight before the lockdown started. The survey assessed changes in WMA and practices, and measured perceived stress, flexible/rigid restraint, uncontrolled eating, craving control, and self-compassion. Results showed that 56% of participants reported disruption to their WMA during the lockdown. Participants with lower levels of perceived stress and higher flexible restraint were more likely to continue their WMA. Flexible restraint was a significant predictor of weight change. Interventions that promote flexibility in weight management may be beneficial for at-risk individuals under lockdown conditions.

Identifying weight management clusters and examining differences in eating behaviour and psychological traits: An exploratory study

Previous research has suggested differences in psychological traits and eating behaviours between groups of individuals with varying weight management profiles, for example, differences between individuals who have maintained weight loss compared to those who have not. However, no study has looked at differences in traits across a sample with a broad range of characteristics including variations in bodyweight and its management. Across two studies, we identified and validated weight management profiles using a clustering approach and examined trait differences across groups. Data were collected using online questionnaires (Study 1: secondary data analysis; Study 2: primary data analysis allowing for cluster validation). Cluster analysis was implemented with BMI, diet history, weight suppression (difference between highest and current weight) as primary grouping variables, and age and gender as covariates. Differences in psychological and eating behaviour traits (e.g., restraint) were explored across clusters. In study 1, 423 participants (27.21 ± 9.90 years) were grouped into 5 clusters: 'lean men', 'lean young women', 'lean middle-aged women', 'successful' and 'unsuccessful dieters'. The cluster structure was broadly replicated with two additional groups identified ('lean women without dieting' and 'very successful dieters') in study 2 with 368 participants (34.41 ± 13.63 years). In both studies, unsuccessful dieters had higher restrained and emotional eating scores than lean individuals, and in study 1, they also had higher food addiction scores than successful dieters. Individuals could be grouped in terms of their weight management profiles and differences in psychological and eating behaviour traits were evident across these groups. Considering the differences in traits between the clusters may further improve the effectiveness and adherence of weight management advice.

Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology

OBJECTIVE

Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression [DWS] here).

METHOD

In this exploratory study, we compared the relationships between traditional weight suppression (TWS) and DWS and a variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub-clinical bulimia nervosa.

RESULTS

TWS and DWS were correlated (r = 0.40, p < 0.001). TWS was only significantly related to a measure of physical activity whereas DWS was related to 14 outcomes. DWS showed consistent positive relations with behavioural outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns).

CONCLUSIONS

Findings indicated much more consistent relationships between the novel DWS measure and bulimic characteristics than with the TWS measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.

Polish Adaptation of the Dutch Eating Behaviour Questionnaire (DEBQ): The Role of Eating Style in Explaining Food Intake-A Cross-Sectional Study

Knowledge of associations between emotional, external, and restrained eating with food choices is still limited due to the inconsistent results of the previous research. The aim of the study was to adopt the Dutch Eating Behavior Questionnaire (DEBQ) and then to examine the relationship between emotional, external, and restrained eating styles and dietary patterns distinguished on the basis of intake of fruit and vegetables (fresh and processed separately), fruit and/or vegetable unsweetened juices, sweets and salty snacks, and the adequacy of fruit and vegetable intake. The cross-sectional study was conducted in 2020, in a sample of 1000 Polish adults. The questionnaire consisted of the Dutch Eating Behavior Questionnaire, questions on selected food groups intake, and metrics. DEBQ structure was tested using both exploratory and confirmatory factor analysis (EFA, CFA) and structural equation modelling (SEM), while multi-group analysis was used to test measurement invariance. Logistic regression was applied to investigate the association between eating styles and dietary patterns, identified with the use of K-means cluster analysis. EFA, CFA and SEM revealed a three-factor, 29-item tool with satisfactory psychometric parameters. Restrained eating (ResEat) and external eating (ExtEat) were found to decrease chances of low intake of both favorable (fruit, vegetables, and unsweetened juices) and unfavorable (sweets and salty snacks) foods and increased the chances of their moderate intake. ResEat increased the probability of the high intake of favorable and moderate or high intake of unfavorable foods. ResEat and ExtEat were predisposed to adequate intake of fruit and vegetables while emotional eating had the opposite effect. Gender, education, and BMI were also found to determine food intake. Our results provide evidence that both eating styles and sociodemographic characteristics should be taken into account while explaining food intake as they may favor healthy and unhealthy eating in different ways.

A new, developmentally-sensitive measure of weight suppression

OBJECTIVE

Weight suppression (WS) has demonstrated associations with numerous indices of eating behavior, psychopathology and eating disorder prognosis. However, because WS has traditionally been measured as a simple subtraction of current weight from highest past weight at adult height, this calculation is problematic for most individuals with disordered eating, who usually reach their highest past weight during adolescence. Here we propose a new method for computing WS to address this shortcoming, termed "developmental weight suppression" (DWS), and provide a web-based tool for ease of calculation.

METHOD

DWS is calculated as the difference between one's highest premorbid z-BMI (i.e., BMI z-score), and current z-BMI. z-BMIs were calculated using Cole's lambda-mu-sigma (LMS) approach, in accordance with LMS parameters publicly available from the Center for Disease Control (2010). A web-based user interface is available at https://niuxin.shinyapps.io/devws/, making its computation easier and its adoption by researchers simpler.

DISCUSSION

By using z-BMIs in place of weights, DWS is more sensitive to the developmentally-relevant factors of age, height, and sex. Preliminary findings suggest that DWS is more strongly related to measures of eating pathology and biological reactions to weight loss than traditionally-computed WS, although more research is needed to test this hypothesis.

Compulsive exercise and weight suppression: Associations with eating pathology in distance runners

Some athletes, particularly those who participate in activities that emphasize leanness such as competitive running, are at greater risk for eating disorder (ED) pathology. Compulsive exercise (CE) is linked with ED pathology among female athletes, with evidence that CE for weight control is most strongly correlated with ED thoughts and behaviors. Weight suppression (WS), the discrepancy between highest adult weight and current weight, is also linked with ED symptoms. Taken together, runners with greater WS may be more likely to engage in CE to influence their weight or shape and may subsequently report other associated ED symptoms. As such, the current study investigated associations between CE and ED pathology in a mixed-gender sample of adult distance runners (N = 277, 51% female), and tested the impact of WS on this association. Results indicated that females reported greater CE and ED pathology, whereas males reported greater WS. A significant interaction effect for CE x WS, (p < .05) indicated that the relation between CE and ED scores was stronger among male runners who reported higher WS. In contrast, WS did not impact the association between CE and ED pathology for female runners. Results from the current study have important implications for the assessment and treatment of ED in athletes, specifically runners, and suggest that WS is an important factor to consider when working with male athletes.

Weight suppression uniquely predicts body fat gain in first-year female college students

Identifying predictors of increases in weight (or in fat mass) is important for understanding the genesis of obesity and for the design of prevention programs. We examined the predictive utility of 6 variables that have been predictive of weight gain in past research: depression, disinhibition, family history of overweight, body dissatisfaction, self-reported dieting and weight suppression (the difference between highest past and current weight). Percentage fat gain was evaluated with DEXA. We tested these variables as predictors of fat gain two years later in 294 female first-year students who were selected to have characteristics associated with future weight gain. Participants were categorized as weight stable or weight gainers at the two-year follow-up and logistic regression was used to evaluate the independent predictive ability of the 6 variables. Baseline body fat was entered as a covariate and predicted fat gain, as expected. The only significant predictor of the 6 tested was weight suppression, with those gaining weight showing greater weight suppression at baseline. Previous research has supported weight suppression as a robust predictor of future weight gain mostly among individuals with eating disorders. The current study indicates that weight suppression is a predictor of long-term fat gain among nonclinical female first-year students who were overwhelmingly in a healthy weight range.

Self-monitoring has no adverse effect on disordered eating in adults seeking treatment for obesity

OBJECTIVES

Although monitoring is considered a key component of effective behaviour change, the development of apps has allowed consumers to constantly evaluate their own diet, with little examination of what this might mean for eating behaviour. The aim of this study was to investigate whether self-monitoring of diet using the app MyFitnessPal or daily self-weighing increases the reported occurrence of eating disorders in adults with overweight/obesity following a weight loss programme.

METHODS

Two hundred fifty adults with body mass index ≥ 27 kg/m2 received diet and exercise advice and were randomized to one of four monitoring strategies (daily self-weighing, MyFitnessPal, brief monthly consults or self-monitoring hunger) or control for 12 months. The Eating Disorder Examination Questionnaire 6.0 was used to assess eating disorder symptoms and behaviours for the previous 28 d at 0 and 12 months.

RESULTS

There were no significant differences in the global Eating Disorder Examination Questionnaire score or the subscales between those in the four monitoring groups and the control at 12 months (all p ≥ 0.164), nor were there differences in binge eating, self-induced vomiting, laxative misuse or excessive exercise at 12 months (p ≥ 0.202). The overall prevalence of one or more episodes of binge eating was 53.6% at baseline and 50.6% at 12 months, with no change over time (p = 0.662).

CONCLUSIONS

There was no evidence that self-monitoring, including using diet apps like MyFitnessPal or daily self-weighing, increases the reported occurrence of eating disorder behaviours in adults with overweight/obesity who are trying to lose weight.

Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial

Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to 'hunger training' influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to 'hunger training', chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p < 0.001) more weight than those who completed fewer days. They also had significantly higher intuitive eating scores than those who completed 30 days or less of booklet entry; a difference (95% CI) of 0.73 (0.12, 1.35) in body-food choice congruence and 0.79 (0.06, 1.51) for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of -0.70 (-1.13, -0.27). Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour.

The Effect of Different Types of Monitoring Strategies on Weight Loss: A Randomized Controlled Trial

OBJECTIVE

To determine the effectiveness of various monitoring strategies on weight loss, body composition, blood markers, exercise, and psychosocial indices in adults with overweight and obesity following a 12-month weight loss program.

METHODS

Two hundred fifty adults with BMI ≥ 27 were randomized to brief, monthly, individual consults, daily self-monitoring of weight, self-monitoring of diet using MyFitnessPal, self-monitoring of hunger, or control over 12 months. All groups received diet and exercise advice, and 171 participants (68.4%) remained at 12 months.

RESULTS

No significant differences in weight, body composition, blood markers, exercise, or eating behavior were apparent between those in the four monitoring groups and the control condition at 12 months (all P ≥ 0.053). Weight differences between groups ranged from -1.1 kg (-3.8 to 1.6) to 2.2 kg (-1.0 to 5.3). However, brief support and hunger training groups reported significantly lower scores for depression (difference [95% CI]: -3.16 [-5.70 to -0.62] and -3.05 [-5.61 to -0.50], respectively) and anxiety (-1.84, [-3.67 to -0.02]) scores than control participants.

CONCLUSIONS

Although adding a monitoring strategy to diet and exercise advice did not further increase weight loss, no adverse effects on eating behavior were observed, and some monitoring strategies may even benefit mental health.

Responsiveness to healthy advertisements in adults: An experiment assessing beyond brand snack selection and the impact of restrained eating

The objective of this study was to explore the impact of different advertising messages on adults' snack choice. Eighty participants (18-24 years old) were offered the choice between two snack packs following exposure to one of three advertising conditions. The snack packs contained either healthy or high fat, sugar or salt (HFSS) foods. Participants were exposed to commercials containing either non-food products, healthy food products or HFSS food products and their subsequent choice of snack pack was recorded. The Dutch Eating Behaviour Questionnaire (DEBQ) was used to assess the impact of external, restrained and emotional eating behaviour on snack pack selection following exposure to advertisements. The majority of unrestrained participants preferentially choose the HFSS snack pack irrespective of advertisement condition. In contrast, high restrained individuals exposed to the healthy eating advertisement condition preferentially selected the healthy snack pack while those in other advertisement conditions refused to take either snack pack. The healthy eating message, when distributed through mass media, resonated with restrained eaters only. Exposure to healthy food adverts provoked restrained eaters into choosing a snack pack; while exposure to other messages results in restrained eaters refusing to take any foods.

The relation of hedonic hunger and restrained eating to lateralized frontal activation

Asymmetrical alpha activation in the prefrontal cortex (frontal asymmetry) in electroencephalography (EEG) has been related to eating behavior. Prior studies linked dietary restraint with right frontal asymmetry [1] and disinhibition with left frontal asymmetry [2]. The current study simultaneously assessed restrained eating and hedonic hunger (drive for food reward in the absence of hunger) in relation to frontal asymmetry. Resting-state EEG and measures of restrained eating (Revised Restraint Scale; RRS) and hedonic hunger (Power of Food Scale; PFS) were assessed in 61 non-obese adults. Individually, hedonic hunger predicted left asymmetry. However, PFS and RRS were correlated (r=0.48, p<0.05) and there was a significant interaction between PFS and RRS on frontal asymmetry, p<0.01. Results indicated that those high in hedonic hunger exhibited left asymmetry irrespective of RRS scores; among those low in PFS, only those high in RRS showed right asymmetry. Results were consistent with literature linking avoidant behaviors (restraint) with right-frontal asymmetry and approach behaviors (binge eating) with left-frontal asymmetry. It appears that a strong drive toward palatable foods predominates at a neural level even when restraint is high. Findings suggest that lateralized frontal activity is an indicator of motivation both to consume and to avoid consuming highly palatable foods.

Determining how best to support overweight adults to adhere to lifestyle change: protocol for the SWIFT study

BACKGROUND

Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a "best" diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While brief support is effective, it has on-going cost implications. While self-monitoring (weight, diet, physical activity) is a cornerstone of effective weight management, little formal evaluation of the role that self-monitoring technology can play in enhancing adherence to change has occurred to date. People who eat in response to hunger have improved weight control, yet how best to train individuals to recognise when true physical hunger occurs and to limit consumption to those times, requires further study.

METHODS/DESIGN

SWIFT (Support strategies for Whole-food diets, Intermittent Fasting, and Training) is a two-year randomised controlled trial in 250 overweight (body mass index of 27 or greater) adults that will examine different ways of supporting people to make appropriate changes to diet and exercise habits for long-term weight control. Participants will be randomised to one of five intervention groups: control, brief support (monthly weigh-ins and meeting), app (use of MyFitnessPal with limited support), daily self-weighing (with brief monthly feedback), or hunger training (four-week programme which trains individuals to only eat when physically hungry) for 24 months. Outcome assessments include weight, waist circumference, body composition (dual-energy x-ray absorptiometry), inflammatory markers, blood lipids, adiponectin and ghrelin, blood pressure, diet (3-day diet records), physical activity (accelerometry) and aerobic fitness, and eating behaviour. SWIFT is powered to detect clinically important differences of 4 kg in body weight and 5 cm in waist circumference. Our pragmatic trial also allows participants to choose one of several dietary (Mediterranean, modified Paleo, intermittent fasting) and exercise (current recommendations, high-intensity interval training) approaches before being randomised to a support strategy.

DISCUSSION

SWIFT will compare four different ways of supporting overweight adults to lose weight while following a diet and exercise plan of their choice, an aspect we believe will enhance adherence and thus success with weight management.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry ACTRN12615000010594. Registered 8th January 2015.

A novel classification paradigm for understanding the positive and negative outcomes associated with dieting

There are significant discrepancies regarding use of the term “dieting.” Common definitions of dieting include behavior modifications arguably moderate (e.g., increasing vegetable consumption), those considered more extreme (e.g., fasting), and more ambiguous behaviors (e.g., reducing carbohydrates). Adding to confusion are findings demonstrating that many individuals endorsing dieting do not actually reduce caloric intake. (1) Thus, “dieting” refers to behaviors ranging from moderate to extreme, attempts to reduce intake without objective caloric decrease, and caloric reductions without associated distress. Unfortunately, existing measures collapse together these widely discrepant experiences. As a result, there is poor coordination between the eating disorder and obesity fields in terms of dieting recommendations. Some suggest that dieting contributes to development of disordered eating and obesity; others argue that dieting is necessary for reducing excess weight and health risk. Without clearly defined dieting constructs, neither the eating disorders nor obesity fields can progress towards effective prediction, prevention, or treatment. We propose a novel classification scheme, the “Psycho-behavioral Dieting Paradigm”, which improves upon existing models by differentiating the behavioral and psychological dimensions associated with discrepant dieting experiences and categorizing the interactions between these domains. This model is intended to categorize individuals that endorse dieting, independent of dieting goals. At present, this model is only meant to describe dieting patterns associated with different outcomes, rather than to suggest causal relationships between these patterns and eating disorder and obesity risk. Below we describe this paradigm and provide directions for research.

Personal history of dieting and family history of obesity are unrelated: implications for understanding weight gain proneness

Identifying predictors of future weight gain is important in obesity prevention efforts. Both family history of obesity and personal dieting history have been established as predictors of future weight gain; however, it is unknown if they are independent or overlapping predictors. The purpose of this study was to examine the degree of overlap between these two predictors using cross-sectional data. Baseline data from four studies were examined separately and in combination for a total of 561 female participants, and analyses were conducted to examine parent anthropometric variables by dieting status within and across studies. All participants were female university students between the ages of 17 and 30. For each study, as well as for the entire sample combined, parent anthropometric variables were examined by dieting status using factorial ANOVAs. No meaningful pattern was found when examining parent anthropometric variables by dieting status, which suggests that the two risk factors are largely independent. This suggests that the processes associated with the development of future weight gain by each variable are different; therefore, future research should use a longitudinal study to test the hypothesis that using both variables to predict future weight gain would account for more variance than using either variable alone.

Dieting: proxy or cause of future weight gain?

The relationship between dieting and body mass has a long and controversial history. This paper aims to help resolve this issue by making two key distinctions. The first is between dieting as a cause of weight gain/regain and as a proxy risk factor for identifying non-obese individuals prone to weight gain for reasons other than dieting. The second is between the body mass that is attained following one or more weight loss/regain cycles and the body mass that might have been reached had dieting never been undertaken. Evidence is reviewed on the relation between recent diet-induced weight loss and sustained weight loss (weight suppression), on the one hand, and weight regain, on the other hand. Furthermore, the reason that a history of dieting in non-obese individuals reflects a susceptibility to future weight gain is explained. It is concluded that (i) diet-induced weight loss hastens weight regain but a history of weight loss diets does not cause weight gain beyond that which would occur in the absence of dieting, and (ii) weight loss dieting in non-obese individuals does not cause future weight gain but is simply a proxy risk factor reflecting a personal vulnerability to weight gain and living in an obesogenic environment.