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Crossland A, Kirk E, Preston C. Interoceptive sensibility and body satisfaction in pregnant and non-pregnant women with and without children. Sci Rep 2022; 12:16138. [PMID: 36168024 PMCID: PMC9515153 DOI: 10.1038/s41598-022-20181-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/09/2022] [Indexed: 11/24/2022] Open
Abstract
Pregnancy is a time of great physical and psychological change. As well as prominent changes in the external appearance of the body, such as the baby bump, there are also substantial changes taking place within the body. Our awareness of, and attention towards, internal bodily signals (interoception) is thought to have a direct impact on how we feel about our bodies. Therefore, understanding how our experience of these interoceptive signals might change during pregnancy may have important implications for maternal wellbeing. This study examined body satisfaction and interoceptive sensibility (subjective experience of interoception) in pregnant and non-pregnant women with and without children. Feelings towards pregnancy-specific changes in body satisfaction and interoceptive sensibility were also examined in women in their first pregnancy (primigravida) and subsequent pregnancies (multigravida). It was found that pregnancy did not directly impact levels of body satisfaction, instead pregnant and non-pregnant women with children reported less satisfaction with their bodies compared to those without children. Primigravida women were more satisfied with the appearance of pregnancy specific bodily changes compared to multigravida women. Interestingly, these differences in body satisfaction in those with children (pregnant and non-pregnant) were mediated by the extent to which women trusted their bodies (measure of interoceptive sensibility). All other pregnancy related changes in interoceptive sensibility and body satisfaction were either non-significant or had small effect sizes. These results may suggest body trust as an important factor to support during the transition to parenthood in order to improve body satisfaction in mothers.
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Lee H, Kim MH, Jin SC, Choi LY, Nam YK, Yang WM. LIPOSA pharmacopuncture, a new herbal formula, affects localized adiposity by regulating lipid metabolism in vivo. Exp Ther Med 2021; 22:1290. [PMID: 34630645 PMCID: PMC8461519 DOI: 10.3892/etm.2021.10725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/03/2020] [Indexed: 12/01/2022] Open
Abstract
Localized adiposity is a serious aesthetic problem and a well-known health risk factor. There is a growing interest in minimally invasive treatment options for excessive fat accumulation, such as pharmacopuncture. LIPOSA is a newly developed pharmacopuncture formula from three natural herbs: The tuber of Pinellia ternata (Thunb.) Breitenb., the whole plant of Taraxacum platycarpum Dahlst. and the root of Astragalus membranaceus Bunge. The present study investigated the effects of pharmacopuncture treatment with LIPOSA on localized adiposity. Male C57BL/6J mice were fed high fat diet for 8 weeks to induce obesity. Then, 100 µl LIPOSA was injected into the left-side inguinal fat pad at various concentrations, including 13.35, 26.7 and 53.4 mg/ml. Normal saline was injected into the right-side inguinal fat pad of each mouse as a control. The treatment was performed three times per week for 2 weeks. The weight and histological changes were analyzed in the inguinal fat pad of the obese mice. The expression levels of adipose triglyceride lipase (ATGL), hormone-sensitive lipase (HSL), autophagy-related gene (ATG)5, ATG7 and LC3-II, as lipophagy-related factors, were evaluated to confirm the lipid-catabolic effects of LIPOSA. LIPOSA pharmacopuncture markedly decreased the weight of the fat tissue and the size of the adipocytes in the inguinal region of the mouse models of obesity in a dose-dependent manner. The expression levels of ATGL, HSL, ATG5, ATG7 and LC3-II were significantly increased by the LIPOSA treatments. In addition, LIPOSA pharmacopuncture was found to decrease the expression levels of ACC, PPAR-γ and PEPCK. The results indicated that subcutaneous injection of LIPOSA can degrade local fat and induce lipophagic and lipase activation effects. In addition, lipid metabolism related to fat accumulation was regulated by the LIPOSA treatment. The present study suggests that LIPOSA pharmacopuncture can be a non-surgical alternative in the treatment of localized adiposity.
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Affiliation(s)
- Haesu Lee
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.,Boin Bio Convergence Co., Ltd., Seoul 02455, Republic of Korea
| | - Mi Hye Kim
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Seong Chul Jin
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - La Yoon Choi
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yeon Kyung Nam
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.,Boin Bio Convergence Co., Ltd., Seoul 02455, Republic of Korea
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Björkman S, Wallengren O, Laurenius A, Eliasson B, Larsson I. Nocturnal eating but not binge eating disorder is related to less 12 months' weight loss in men and women with severe obesity: A retrospective cohort study. Clin Obes 2020; 10:e12408. [PMID: 32851796 PMCID: PMC7685102 DOI: 10.1111/cob.12408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022]
Abstract
There is a paucity of studies on the frequency of binge-eating disorder (BED) and nocturnal eating (NE) and their potential role as barriers in non-surgical weight loss treatment in subjects with severe obesity (body mass index [BMI] ≥35 kg m2 ). The aim was to identify BED and NE, and their effect on weight loss treatment. In total, 1132 (727 women, 405 men), BMI ~41 kg/m2 were patients in a 12-month weight loss programme at a specialist clinic. The questionnaire for eating and weight patterns-revised was completed by the patients before start of treatment. BED was diagnosed in 5.1% of men and 12.4% of women. NE prevalence was 13.5% and 12.7%, respectively. Mean (±SEM) 12-month weight loss was less in patients with NE compared to those without (-11.0 ± 1.5 vs -14.6 ± 0.7 kg, P = .008) but did not differ in patients with and without BED, (-12.3 ± 1.9 vs -14.2 ± 0.6 kg, P = .24). Factors associated with dropout were BED (odds ratio, OR 1.57, 95% confidence interval (CI) 1.14-2.17; P = .006) and previous weight loss attempts (OR 1.35, 95% CI 1.0-1.7; P = .02). BED did not seem to hinder weight loss whereas NE resulted in less weight loss in patients with severe obesity who completed a 12-month treatment programme. Previous weight loss attempts affect both dropout and ability to lose weight.
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Affiliation(s)
- Sofia Björkman
- Department of Gastroenterology and Hepatology, Unit of Clinical Nutrition and the Regional Obesity CenterSahlgrenska University HospitalGothenburgSweden
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Ola Wallengren
- Department of Gastroenterology and Hepatology, Unit of Clinical NutritionSahlgrenska University HospitalGothenburgSweden
| | - Anna Laurenius
- Department of Gastroenterology and Hepatology, Unit of Clinical NutritionSahlgrenska University HospitalGothenburgSweden
- Department of Surgery, Institute of Clinical SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Björn Eliasson
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Ingrid Larsson
- Department of Gastroenterology and Hepatology, Unit of Clinical Nutrition and the Regional Obesity CenterSahlgrenska University HospitalGothenburgSweden
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
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Oldham M, Robinson E. Visual body size norms and the under-detection of overweight and obesity. Obes Sci Pract 2018; 4:29-40. [PMID: 29479462 PMCID: PMC5818735 DOI: 10.1002/osp4.143] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 02/01/2023] Open
Abstract
Objectives The weight status of men with overweight and obesity tends to be visually underestimated, but visual recognition of female overweight and obesity has not been formally examined. The aims of the present studies were to test whether people can accurately recognize both male and female overweight and obesity and to examine a visual norm-based explanation for why weight status is underestimated. Methods The present studies examine whether both male and female overweight and obesity are visually underestimated (Study 1), whether body size norms predict when underestimation of weight status occurs (Study 2) and whether visual exposure to heavier body weights adjusts visual body size norms and results in underestimation of weight status (Study 3). Results The weight status of men and women with overweight and obesity was consistently visually underestimated (Study 1). Body size norms predicted underestimation of weight status (Study 2) and in part explained why visual exposure to heavier body weights caused underestimation of overweight (Study 3). Conclusions The under-detection of overweight and obesity may have been in part caused by exposure to larger body sizes resulting in an upwards shift in the range of body sizes that are perceived as being visually 'normal'.
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Affiliation(s)
- M. Oldham
- Psychological SciencesUniversity of LiverpoolLiverpoolUK
| | - E. Robinson
- Psychological SciencesUniversity of LiverpoolLiverpoolUK
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Weinberger NA, Kersting A, Riedel-Heller SG, Luck-Sikorski C. The Relationship between Weight Status and Depressive Symptoms in a Population Sample with Obesity: The Mediating Role of Appearance Evaluation. Obes Facts 2018; 11:514-523. [PMID: 30554212 PMCID: PMC6341343 DOI: 10.1159/000492000] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 07/10/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Identifying the underlying pathways between obesity and depression and which individuals with obesity are at risk for developing depressive symptoms is important for improving prevention and treatment efforts. The current study investigated appearance evaluation as a potential mediator of the relationship between obesity and depression. METHODS A total of 1,000 participants with a self-reported BMI greater than 30 kg/m2 were interviewed about their experiences with an elevated body weight and completed measures on appearance evaluation and depression. RESULTS A negative relationship between satisfaction with appearance and BMI and a negative association between satisfaction with appearance and depression was found in men and women. Men reported less depressive symptoms and higher satisfaction with appearance compared to women. While no mediation effect could be determined in women, satisfaction with appearance mediated the obesity-depression relationship in men. CONCLUSIONS Efforts to reduce adverse effects of either obesity or depression need to take the reciprocal relationship between the two conditions into account. The current findings underscore the importance of appearance evaluation for treatment efforts in individuals with obesity. Interventions addressing body image might improve both, psychological distress and weight management efforts in general.
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Affiliation(s)
- Natascha-Alexandra Weinberger
- Integrated Research and Treatment Center (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany,
- University of Applied Health Sciences SRH Gera, Gera, Germany,
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University Hospital Leipzig, Leipzig, Germany
| | - Claudia Luck-Sikorski
- Integrated Research and Treatment Center (IFB) AdiposityDiseases, University Hospital Leipzig, Leipzig, Germany
- University of Applied Health Sciences SRH Gera, Gera, Germany
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Wimmelmann CL, Hegelund ER, Folker AP, Just-Østergaard E, Osler M, Mortensen EL, Flensborg-Madsen T. Prospective Associations of the Short Form Health Survey Vitality Scale and Changes in Body Mass Index and Obesity Status. J Obes 2018; 2018:3671953. [PMID: 30155289 PMCID: PMC6092999 DOI: 10.1155/2018/3671953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 07/12/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objectives of the current study were to prospectively investigate the predictive value of the vitality scale of the Short Form Health Survey for changes in body mass index and development of obesity. METHODS The study population comprised 2864 (81.5%) men and 648 (18.5%) women from the Metropolit Project and the Danish Longitudinal Study on Work, Unemployment and Health, who participated in a follow-up examination in 2009-2011 corresponding to a follow-up period of 3-7 years. Associations of vitality with body mass index and obesity were investigated separately for men and women in linear and logistic regression models adjusting for age, baseline body mass index, education, physical activity, smoking, and obesity-related diseases. RESULTS Vitality was significantly associated with change in body mass index among men (p < 0.001) and women (p < 0.05) gaining weight after adjusting for age, baseline body mass index, education, physical activity, smoking, and obesity-related diseases. No significant associations of vitality with BMI change were observed among individuals maintaining or losing weight during the follow-up period. Furthermore, vitality significantly predicted development of obesity among women. CONCLUSION The study indicates that vitality is of predictive value for increases in BMI over time among individuals gaining weight and may further predict the development of obesity among women. This identification of poor vitality as a potential risk indicator for weight gain and development of obesity may be beneficial in clinical practice.
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Affiliation(s)
- Cathrine Lawaetz Wimmelmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emilie Rune Hegelund
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
| | - Emilie Just-Østergaard
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Research Center for Prevention and Health, Glostrup Hospital, Glostrup, Denmark
- Danish Aging Research Center, University of Aarhus, Aarhus, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, University of Copenhagen, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
| | - Erik Lykke Mortensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Trine Flensborg-Madsen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models. CNS Spectr 2017; 22:51-60. [PMID: 27899165 PMCID: PMC5322826 DOI: 10.1017/s1092852916000468] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education. RESULTS In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, and greater omission and commission errors on the emotional processing task. CONCLUSION Despite the modest sample size, our results showed that individuals with BDD performed poorly compared to healthy controls on tests of cognitive flexibility, reward and motor impulsivity, and affective processing. Results from separate studies in OCD patients suggest similar cognitive dysfunction. Therefore, these findings are consistent with the reclassification of BDD alongside OCD. These data also hint at additional areas of decision-making abnormalities that might contribute specifically to the psychopathology of BDD.
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Bond DS, Pavlović JM, Lipton RB, Graham Thomas J, Digre KB, Roth J, Rathier L, O'Leary KC, Evans EW, Wing RR. Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity. Headache 2016; 57:417-427. [PMID: 28028805 DOI: 10.1111/head.13019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVE Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: (1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine and (2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders. METHODS Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n = 37) and nonmigraine controls (n = 37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m2 ), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n = 105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety. RESULTS On average, participants and matched controls had severe obesity (BMI = 42.4 ± 3.8 kg/m2 ; range = 35-49.9) and were 37.3 ± 7.2 years of age (range = 22-50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, P = .82). In the larger sample of participants with migraine and overweight/obesity (38.2 ± 7.8 years of age; BMI = 34.8 ± 6.4 [range = 25-50 kg/m2 ]; 8.0 ± 4.3 migraine days/month, maximum pain intensity = 5.9 ± 1.4 on 0-10 scale; average attack duration = 18.3 ± 9.7 hours), FSD was not associated with attack frequency (P = .31), pain intensity (P = .92), or attack duration (P = .35) but was associated with more severe anxiety symptoms (Ps < .017). CONCLUSIONS Rates of sexual dysfunction did not differ in severely obese women with and without migraine. Moreover, indices of migraine severity were not associated with increased risk of FSD in women with overweight/obesity. Replication of present findings in wider populations of women with migraine and of both normal-weight and overweight/obese status are warranted.
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Affiliation(s)
- Dale S Bond
- Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jelena M Pavlović
- Albert Einstein College of Medicine/Montefiore Medical Center, Montefiore Headache Center, Bronx, NY, USA
| | - Richard B Lipton
- Albert Einstein College of Medicine/Montefiore Medical Center, Montefiore Headache Center, Bronx, NY, USA
| | - J Graham Thomas
- Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Kathleen B Digre
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Julie Roth
- Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Lucille Rathier
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Kevin C O'Leary
- Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - E Whitney Evans
- Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Rena R Wing
- Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
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Manzoni GM, Cesa GL, Bacchetta M, Castelnuovo G, Conti S, Gaggioli A, Mantovani F, Molinari E, Cárdenas-López G, Riva G. Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 19:134-40. [PMID: 26430819 DOI: 10.1089/cyber.2015.0208] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.
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Affiliation(s)
- Gian Mauro Manzoni
- 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .,2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Gian Luca Cesa
- 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy .,4 Centro Obesità e Nutrizione Clinica (CONC) , Ospedale Privato Accreditato Villa Igea, Forlì (FC), Italy
| | - Monica Bacchetta
- 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy
| | - Gianluca Castelnuovo
- 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .,2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Sara Conti
- 3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy
| | - Andrea Gaggioli
- 2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .,3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy
| | - Fabrizia Mantovani
- 5 CESCOM-Centre for Research in Communication Sciences, University of Milan-Bicocca , Milan, Italy
| | - Enrico Molinari
- 1 Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano , Verbania, Italy .,2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Georgina Cárdenas-López
- 6 Laboratorio de Enseñanza Virtual y Ciberpsicología, Facultad de Psicología, Universidad Nacional Autónoma de México , México, Mexico
| | - Giuseppe Riva
- 2 Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy .,3 Applied Technology for Neuro Psychology Lab, Istituto Auxologico Italiano , Verbania, Italy
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Abstract
BACKGROUND Individuals with severe obesity commonly report poor body image. Improvement in body image has been found after conservative weight reduction programs as well as after bariatric surgery (gastric bypass, biliopancreatic diversion, or gastric banding). However, no studies investigating body image after laparoscopic sleeve gastrectomy (LSG) are available. METHODS Of 70 consecutive patients who planned to undergo LSG at a comprehensive obesity center, 62 patients were included in the study and evaluated before surgery. Their mean body mass index (BMI) was 51.3 kg/m(2) and the patients' mean age before surgery was 43.8 years. One-year follow-up data were obtained for 51 patients (82.3 %). Body image was assessed using the body image questionnaire (BIQ-20), and depression was assessed using the Patient Health Questionnaire (PHQ-9). RESULTS Patients reported poor body image before surgery. One year after LSG, negative evaluations of the body and perceptions of body dynamics and vitality had markedly improved, without reaching healthy levels. No correlations between body image and weight-related parameters (BMI, percentage of excess weight loss) or mood after 1 year were found. CONCLUSIONS Body image improves after LSG. This improvement might reflect changes to patients' attitudes, beliefs, and thoughts rather than real weight lost. Further studies should investigate the factors that mediate improvement of body image after bariatric surgery.
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Ratcliff MB, Eshleman KE, Reiter-Purtill J, Zeller MH. Prospective changes in body image dissatisfaction among adolescent bariatric patients: the importance of body size estimation. Surg Obes Relat Dis 2011; 8:470-5. [PMID: 22154271 DOI: 10.1016/j.soard.2011.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 10/10/2011] [Accepted: 10/19/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Body image dissatisfaction (BID) is pervasive among patients presenting for bariatric surgery but improves significantly postoperatively. These findings have been determined primarily from studies of adults. The objective of the present study was to examine the changes in BID among adolescents with extreme obesity from baseline/preoperatively to 6 and 12 months after receiving bariatric surgery at a pediatric medical center using body size estimation. METHODS BID was prospectively assessed among 16 adolescent bariatric patients (mean age 16.3 ± 1.2 years, mean body mass index [BMI] 66.2 ± 12.0, 67% female) using a standard visual/perceptual measure (i.e., Stunkard Figure Rating Scale). Participants identified their current and ideal body size, with a discrepancy score (current minus ideal) indicating BID. The body size estimation ratings were compared with attitudinal (i.e., Impact of Weight on Quality Of Life-Kids: Body Esteem and Self-Perception Profile for Adolescents: Physical Appearance) body image scores, BMI, and total weight-related quality of life. RESULTS A significant reduction occurred in the current body size (from 7.9 to 6.4, P <.001) from baseline to 6 months but not from 6 to 12 months. The current body size was related to BMI and percentage of excess weight loss but not attitudinal body image at each follow-up point. A smaller discrepancy (current minus ideal) was associated with greater total weight-related quality of life (r = -.68), with a trend toward significance for body esteem (r = -.65) at 12 months. CONCLUSION Adolescents undergoing bariatric surgery experience a significantly decreased BID within the first 12 months after surgery, with the most substantial change occurring from baseline to 6 months. The postoperative weight-related quality of life is more closely associated with the body size discrepancy than with the current body size.
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Affiliation(s)
- Megan B Ratcliff
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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Carraça EV, Silva MN, Markland D, Vieira PN, Minderico CS, Sardinha LB, Teixeira PJ. Body image change and improved eating self-regulation in a weight management intervention in women. Int J Behav Nutr Phys Act 2011; 8:75. [PMID: 21767360 PMCID: PMC3150233 DOI: 10.1186/1479-5868-8-75] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 07/18/2011] [Indexed: 11/29/2022] Open
Abstract
Background Successful weight management involves the regulation of eating behavior. However, the specific mechanisms underlying its successful regulation remain unclear. This study examined one potential mechanism by testing a model in which improved body image mediated the effects of obesity treatment on eating self-regulation. Further, this study explored the role of different body image components. Methods Participants were 239 overweight women (age: 37.6 ± 7.1 yr; BMI: 31.5 ± 4.1 kg/m2) engaged in a 12-month behavioral weight management program, which included a body image module. Self-reported measures were used to assess evaluative and investment body image, and eating behavior. Measurements occurred at baseline and at 12 months. Baseline-residualized scores were calculated to report change in the dependent variables. The model was tested using partial least squares analysis. Results The model explained 18-44% of the variance in the dependent variables. Treatment significantly improved both body image components, particularly by decreasing its investment component (f2 = .32 vs. f2 = .22). Eating behavior was positively predicted by investment body image change (p < .001) and to a lesser extent by evaluative body image (p < .05). Treatment had significant effects on 12-month eating behavior change, which were fully mediated by investment and partially mediated by evaluative body image (effect ratios: .68 and .22, respectively). Conclusions Results suggest that improving body image, particularly by reducing its salience in one's personal life, might play a role in enhancing eating self-regulation during weight control. Accordingly, future weight loss interventions could benefit from proactively addressing body image-related issues as part of their protocols.
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Affiliation(s)
- Eliana V Carraça
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688 Cruz Quebrada, Portugal
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Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis 2010; 6:608-14. [PMID: 20947446 PMCID: PMC3031862 DOI: 10.1016/j.soard.2010.07.015] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 06/16/2010] [Accepted: 07/27/2010] [Indexed: 01/14/2023]
Abstract
BACKGROUND Improvements in psychosocial status are an important aspect of successful outcomes after bariatric surgery. Relatively few studies have investigated the changes in psychosocial functioning at a number of points in the first few postoperative years. The present study was undertaken to assess the changes in quality of life and body image after gastric bypass surgery. The present study was performed at an academic medical center. METHODS A total of 200 men and women were enrolled in the study and completed psychometric measures of quality of life and body image before surgery and again 20, 40, and 92 weeks postoperatively. RESULTS The participants reported significant improvements in several domains of health- and weight-related quality of life, as well as changes in body image, after surgery. These changes were correlated with the percentage of weight loss. CONCLUSION Those who undergo gastric bypass surgery experienced significant improvements in quality of life and body image within the first few months after surgery. These changes were, with few exceptions, maintained into the second postoperative year.
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Affiliation(s)
- David B Sarwer
- Department of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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Meyer AH, Weissen-Schelling S, Munsch S, Margraf J. Initial development and reliability of a motivation for weight loss scale. Obes Facts 2010; 3:205-11. [PMID: 20616611 PMCID: PMC6452138 DOI: 10.1159/000315048] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed at developing and evaluating a questionnaire assessing health and appearance as the two main reasons for weight loss in overweight and obese individuals. METHODS Using data from two representative telephone surveys in Switzerland, the factorial structure of this questionnaire was analyzed by exploratory and confirmatory factor analysis. The model obtained was cross-validated with data from a second representative Swiss survey and multigroup analyses according to sex, age, BMI and regional language subgroups were performed. RESULTS This lead to a 24-item, 3-factor solution, with factors labeled 'health', 'appearance in relation to others', and 'appearance in relation to oneself'. Internal consistency and test-retest reliability were good. CONCLUSIONS To the best of our knowledge, this is the first validated questionnaire assessing overweight and obese individuals' reasons for weight loss. It should be further tested whether using this questionnaire as a pretreatment assessment device will help in tailoring treatments to individuals, thereby increasing treatment adherence and success.
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Affiliation(s)
- Andrea H Meyer
- Division of Applied Statistics in Life Sciences, University of Basel, Switzerland.
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Ogden J, Clementi C. The experience of being obese and the many consequences of stigma. J Obes 2010; 2010:429098. [PMID: 20721360 PMCID: PMC2915811 DOI: 10.1155/2010/429098] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 02/23/2010] [Accepted: 03/03/2010] [Indexed: 11/17/2022] Open
Abstract
The present qualitative study aimed to explore how people experience their obesity and to explore the impact of this on their motivations to lose weight. Participants (n = 46) were either currently obese or had been obese and were interviewed about their experiences. Participants described the impact of obesity on aspects of their self-identity and used language such as "ugly", "freak", "hate", "blob", and "disgust" which reflected the pervasively negative impact of their weight. They highlighted a complex and often contradictory relationship with food and described how such negative experiences were created out of the dynamic between their obesity and a stigmatising social context. Some, however, suggested that such stigma could also have positive consequences by promoting and encouraging behaviour change. Many obese people, therefore, experience their weight in profoundly negative ways as a result of existing within a social context which stigmatises their condition. The results are discussed in terms of the costs and benefits of stigma and a balance between support, tolerance, and collusion in promoting weight loss.
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Affiliation(s)
- Jane Ogden
- Department of Psychology, University of Surrey, Guildford Surrey GU2 7XH, UK
- *Jane Ogden:
| | - Cecelia Clementi
- Department of Psychology, University of Surrey, Guildford Surrey GU2 7XH, UK
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Johnstone AM, Stewart AD, Benson PJ, Kalafati M, Rectenwald L, Horgan G. Assessment of body image in obesity using a digital morphing technique. J Hum Nutr Diet 2008; 21:256-67. [PMID: 18477181 DOI: 10.1111/j.1365-277x.2008.00862.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Historically, body image research has relied on generic, whole body outlines, which may not be suited to obese individuals. The development of computer generated, individualized digital images to represent body image may be more effective. METHODS Sixty volunteers participated, with three categories of subject: lean, obese and lean regular exercisers. Body image was assessed using a digital morphing technique in comparison to two standard paper questionnaires. RESULTS Using the novel digital morphing tool, obese subjects displayed poorer body awareness (perception) than their lean counterparts (P = 0.03), significantly over-estimating their actual body size. Both genders overestimated body size to a similar degree. For body satisfaction, females wished to be smaller and males to be larger, identifying gender-specific body regions (P < 0.001). Obese subjects showed greatest dissatisfaction (P < 0.001) with body image. There was significant correlation for body image dissatisfaction (P < 0.05) between the digital technique and the questionnaires, which was highest for the figural stimuli questionnaire (r = 0.80, P < 0.001). CONCLUSIONS This method represents a novel and alternative approach to rating body image perception (IP) and satisfaction in obese subjects, particularly providing data on specific regional areas. Body image dissatisfaction appears to be both due to poor body IP compounded with the desire to be smaller.
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Markowitz S, Friedman MA, Arent SM. Understanding the relation between obesity and depression: Causal mechanisms and implications for treatment. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1468-2850.2008.00106.x] [Citation(s) in RCA: 155] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cena H, Toselli A, Tedeschi S. Body uneasiness in overweight and obese Italian women seeking weight-loss treatment. Eat Weight Disord 2003; 8:321-5. [PMID: 15018384 DOI: 10.1007/bf03325034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE It is known that the psychopathology of eating disorders is associated with body image disturbances, but little is known concerning the body image of obese subjects. The aim of this study was to assess body uneasiness in overweight and obese women in relation to their age, degree of obesity, the percentage and distribution of body fat mass, and eating disordered behaviours. METHOD The study population consisted of 99 overweight and obese women with a mean age of 34.3 +/- 10.1 years and a mean body mass index (BMI) of 31.3 +/- 5.4 kg/m2, who completed two self-report questionnaires: the Bulimic Investigation Test Edinburgh (BITE) to assess disordered eating behaviours and the Body Uneasiness Test (BUT) to assess body image uneasiness. Pearson correlations were used to determine the associations between the BUT scores and age, anthropometric measures (BMI, waist and hip circumferences, waist/hip ratio, percentage of body fat mass) and the BITE scores. The most significant determinants of the BUT scores were also determined using a multiple linear regression model. RESULTS Disordered eating behaviours were found in 7.1% of the patients. Neither BUT nor BITE scores correlated with age, but BITE scores correlated with BMI and hip circumference (p < 0.05). The overall BUT score increased with increasing BITE scores and higher indices of all of the anthropometric measures (p < 0.001) except for the percentage of body fat mass. Multiple linear regression analyses showed that, among the considered parameters, the only significant determinants of body uneasiness were disordered eating behaviours. CONCLUSIONS Our results confirm that body uneasiness in an obese clinical population is closely associated with disordered eating behaviours, and suggest that it is not dependent on age, the degree of obesity, or the percentage or distribution of body fat mass.
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Affiliation(s)
- H Cena
- Department of Applied Health Sciences, Section of Human Nutrition, University of Pavia, Italy.
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