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Davis HA, Rush M, Smith GT. Reciprocal relations between body dissatisfaction and excessive exercise in college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1473-1479. [PMID: 35728008 DOI: 10.1080/07448481.2022.2080508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
Objective: Body dissatisfaction elevates the risk for disordered eating behaviors. Excessive exercise is prevalent among college women and associated with harm. Risk theory posits a bidirectional relationship between risk factors for disordered eating behaviors and the behaviors themselves. This study investigated the longitudinal, reciprocal relationship between body dissatisfaction and excessive exercise. Participants and methods: College women (n = 302) assessed in August (baseline) and November (follow-up). Results: Baseline body dissatisfaction significantly predicted increases in excessive exercise endorsement at follow-up, controlling for baseline excessive exercise endorsement and body mass index (BMI). Baseline excessive exercise endorsement predicted increases in body dissatisfaction at follow-up, controlling for baseline body dissatisfaction and BMI. Conclusions: Findings support the presence of a positive feedback loop between body dissatisfaction and excessive exercise; both predict increases in risk for the other, regardless of weight status. Future research should test whether this process is ongoing and predicts further distress.
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Affiliation(s)
- Heather A Davis
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Molly Rush
- Barnes-Jewish Hospital System in St. Louis, St. Louis, Missouri, USA
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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2
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Philip SR, Fields SA, Van Ryn M, Phelan SM. Comparisons of Explicit Weight Bias Across Common Clinical Specialties of US Resident Physicians. J Gen Intern Med 2024; 39:511-518. [PMID: 37794262 PMCID: PMC10973280 DOI: 10.1007/s11606-023-08433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Patients with high body weight are persistently stigmatized in medical settings, with studies demonstrating that providers endorse negative stereotypes of, and have lower regard for, higher-weight patients. Very little is known about how this weight bias varies across specialties. OBJECTIVE The purpose of this study is to examine how explicit weight bias varies between resident providers among sixteen of the largest residency specialties in the USA. The identification of these differences will guide the prioritization and targeting of interventions. DESIGN The current study utilized cross-sectional, observational data. PARTICIPANTS Forty-nine allopathic medical schools were recruited to participate in this national, longitudinal study. The current study utilized data from 3267 trainees in Year 2 of Residency among those who specialized in one of the most common sixteen residency programs in 2016. MAIN MEASURES Participants reported demographic information and residency specialties and completed three sets of measures pertaining to explicit weight bias. KEY RESULTS A significant minority (13-48%) of residents reported slight-to-strong agreement with each anti-fat statement. There was a significant relationship between residency specialty and anti-fat blame (F(15, 3189 = 12.87, p < .001), η2 = .06), anti-fat dislike (F(15, 3189 = 7.01, p < .001), η2 = .03), and attitudes towards obese patients (F(15, 3208 = 17.78, p < .001), η2 = .08). Primary care residents (e.g., family medicine, pediatrics) consistently reported lower levels of weight bias than those in specialty programs (e.g., orthopedic surgery, anesthesiology). CONCLUSIONS This study is the first to report on weight bias in a large, heterogeneous sample of US resident physicians. Problematic levels of weight bias were found in all specialties, with residents in specialty programs generally reporting more bias than those in primary care residencies. Future research should examine which factors contribute to these differences to guide intervention.
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Affiliation(s)
- Samantha R Philip
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Sherecce A Fields
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | | | - Sean M Phelan
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, NY, USA
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Adams V, Gladden A, Craddock J. Perceptions of Health Among Black Women in Emerging Adulthood: Alignment With a Health at Every Size Perspective. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:916-924. [PMID: 36055946 PMCID: PMC9561025 DOI: 10.1016/j.jneb.2022.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore the health perceptions of Black women in emerging adulthood and the degree to which perceptions align with core Health at Every Size (HAES) principles. DESIGN Semistructured interviews with Black women in emerging adulthood. Data were collected between June and July 2018 as part of a larger, mixed-methods study. SETTING Southern California. PARTICIPANTS Forty-one Black women aged 18-24 years were recruited via a combination of convenience and respondent-drive sampling. PHENOMENON OF INTEREST Health perceptions of young Black women and alignment with core HAES principles. ANALYSIS Data were analyzed using principles of inductive thematic analysis. Following analysis, data were further interpreted within the HAES framework. RESULTS Participants' insights resulted in 3 main themes: (1) health is multidimensional, (2) good health means taking care of yourself, and (3) systemic and environmental disparities affect Black women's health. These themes reflect 3 HAES principles of health enhancement, weight inclusivity, and eating for well-being. CONCLUSIONS AND IMPLICATIONS Findings provide preliminary support for aligning HAES principles and perceptions and health for Black women in emerging adulthood. Prioritizing holistic well-being, attention to individualized health needs and access to needed information and resources in efforts to improve health outcomes among members of this demographic may be promising.
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Affiliation(s)
- Vashti Adams
- School of Social Work, University of Maryland, Baltimore, MD.
| | - Aliya Gladden
- Department of Family Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Jaih Craddock
- Department of Family Medicine, School of Medicine, University of California Irvine, Irvine, CA
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Berman MI, Park J, Kragenbrink ME, Hegel MT. Accept Yourself! A Pilot Randomized Controlled Trial of a Self-Acceptance-Based Treatment for Large-Bodied Women With Depression. Behav Ther 2022; 53:913-926. [PMID: 35987548 DOI: 10.1016/j.beth.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 03/04/2022] [Accepted: 03/16/2022] [Indexed: 11/15/2022]
Abstract
A pilot parallel randomized controlled trial compared a self-acceptance, non-weight-loss intervention, Accept Yourself! (AY), to a weight loss program, Weight Watchers (WW), in order to provide preliminary safety, feasibility, and efficacy data in preparation for a definitive RCT of AY as an intervention to enhance the mental and physical health of larger-bodied women with Major Depressive Disorder (MDD). Adult women with MDD and a Body Mass Index ≥30 were eligible. Nineteen women were randomized by random number table into AY (n = 9) or WW (n = 10). Intake, pretreatment, posttreatment, 3-, 6-, 9-, and 12-month follow-up assessments occurred at a rural academic medical center. Primary outcomes included depression severity and cardiovascular fitness. Chi-square and t-tests assessed attrition and participant preferences for treatment; other analyses used intention-to-treat, linear mixed-effects models for repeated measures, including all participants' available data. Both groups improved in self-reported, F(5, 43.81) = 7.45, p < .001, partial η2 = .38, and blinded-clinician-rated depression, F(6, 62.03) = 10.41, p < .001, partial η2 = .5. AY was superior to WW in self-reported depression, F(5, 43.81) = 2.72, p = .03, partial η2 = .11. Neither group improved in fitness. Eating disorder symptoms and weight gain worsened in WW. AY appeared safe, feasible, and offered initial evidence of efficacy for depression; it should be investigated in a definitive RCT, with modifications to increase potency. WW may not be suitable as a comparator intervention for AY because of risk to participants.
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Affiliation(s)
| | - John Park
- Geisel School of Medicine at Dartmouth
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Ward A, Mann T. Control Yourself: Broad Implications of Narrowed Attention. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:1692-1703. [PMID: 35830521 DOI: 10.1177/17456916221077093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Attention represents a key element of self-control, and multiple theoretical accounts have highlighted the role played by abundant attentional capacity in effecting successful self-regulation. What, then, are the consequences of living in today's world, in which attention can become so easily divided by a multitude of stimuli? In this article, we consider the implications of divided attention for self-control and show that although the end result is typically disinhibited behavior, under specified conditions, attentional limitation, or what we term attentional myopia, can be associated with enhanced restraint.
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Affiliation(s)
- Andrew Ward
- Department of Psychology, Swarthmore College
| | - Traci Mann
- Department of Psychology, University of Minnesota
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Zafir S, Jovanovski N. The weight of words: Discursive constructions of health in weight-neutral peer-reviewed journal articles. Body Image 2022; 40:358-369. [PMID: 35149443 DOI: 10.1016/j.bodyim.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
Weight-neutral approaches to health, like the Health at Every Size® (HAES®) approach arose in response to emerging evidence showing the negative health consequences of weight-focused approaches through the effects of stigma and marginalization in many settings, including healthcare. While the discourses of dominant 'weight-normative' approaches are well-researched and described, little is known about how language and discourse is creating certain 'truths' about weight-neutral approaches. The aim of this study was to explore how academic discourses create truths about weight-neutral approaches to health. A discourse analysis of 63 academic journal articles was conducted. We found that the language used in academic literature is creating confusing and contradictory messages about weight and weight-neutral approaches to health (like the HAES® approach) through: (i) the continued use of stigmatising and normative labels like 'overweight' and 'obese', (ii) paradoxical language like 'flexible restraint', and (iii) a focus on individual responsibility and blame for health and weight without acknowledgement of broader societal and systemic factors. More research is needed to characterize weight-neutral approaches and develop a clearer framework for researchers wishing to engage with the weight-neutral paradigm of health.
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Affiliation(s)
- Shoa Zafir
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Natalie Jovanovski
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
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First do no harm: reconsidering our approach to weight in primary care. Br J Gen Pract 2022; 72:102-103. [PMID: 35210233 PMCID: PMC8884442 DOI: 10.3399/bjgp22x718565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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8
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Standen EC, Mann T. Calorie deprivation impairs the self-control of eating, but not of other behaviors. Psychol Health 2021; 37:1185-1199. [PMID: 34139896 DOI: 10.1080/08870446.2021.1934469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Sustained weight loss is difficult to achieve, and weight regain is common due to biological and psychological changes caused by calorie deprivation. These changes are thought to undermine weight loss efforts by making self-control more difficult. However, there is a lack of evidence showing a causal relationship between calorie deprivation and behavioral self-control. DESIGN In this longitudinal field experiment, we tested whether a ten-day period of calorie deprivation leads to the impairment of behavioral self-control. Participants were randomly assigned to either restrict their calorie intake or to continue eating normally for the study period. MAIN OUTCOME MEASURES Participants were given a box of food and non-food 'treats' (i.e., chocolates and lottery tickets) that they were asked to resist until the end of the study. On the last day, researchers recorded the number of treats that remained for each participant. RESULTS Nonparametric permutation tests revealed that calorie-deprived participants ate significantly more chocolates than control participants did (p = 0.036), but that participants did not differ in the number of lottery tickets 'scratched' by condition (p = 0.332). CONCLUSION This pattern of findings suggests that calorie deprivation impairs food-related self-control, but that this self-control deficit may not generalize beyond food-related tasks.
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Affiliation(s)
- Erin C Standen
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Traci Mann
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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Barnett MA, Jones TL, Schmitt KA, Cordas KC, Harrod S. Adults' attitudes toward children, adolescents, and adults who are obese and tax-funded programs to combat obesity. The Journal of Social Psychology 2021; 161:379-393. [PMID: 33198607 DOI: 10.1080/00224545.2020.1845114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The goals of the present study were to assess (1) adults' patterns of beliefs about and attitudes toward children, adolescents, and adults who are obese and (2) their attitudes toward hypothetical tax-funded programs designed to combat obesity in children, adolescents, and adults. A total of 267 participants, ranging in age from 19 to 88 years old, were recruited through Amazon's Mechanical Turk (MTurk) to participate online in the present study. The participants rated adults who are obese less favorably, and as less malleable, than children or adolescents who are obese. Furthermore, they were less supportive of tax-funded programs designed to combat obesity in adults than children or adolescents. In general, the participants' relatively unfavorable response to adults who are obese appears to be associated with the beliefs that older individuals who are obese are relatively unchangeable and have heightened personal fault for their plight.
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Affiliation(s)
- Mark A Barnett
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Tucker L Jones
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Kennedy A Schmitt
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Kyla C Cordas
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Sarah Harrod
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
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Manokaran R, Pausé C, Roßmöller M, Vilhjálmsdóttir TM. ‘Nothing about us without us’: Fat people speak. QUALITATIVE RESEARCH IN PSYCHOLOGY 2020. [DOI: 10.1080/14780887.2020.1780355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
| | - Cat Pausé
- Massey University, Palmerston North, New Zealand
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11
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Changes in body mass index and risk of adolescent psychopathology: a longitudinal cohort study. Ir J Psychol Med 2020:1-9. [PMID: 32475379 DOI: 10.1017/ipm.2020.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND. Abnormal body mass index (BMI) has been associated with development of psychopathology. This association in children is well documented, for both overweight and underweight children. However, the association between change in BMI and the development of psychopathology has been less investigated. AIM. To investigate the association between change in BMI between childhood and adolescence and psychopathology in adolescence. METHODS. Data from the Growing Up in Ireland cohort were used. We investigated the '98 cohort (also known as the child cohort) at age 9/13. BMI, defined using internationally recognised definitions as underweight, healthy or overweight, was used as the exposure, and abnormal Strength and Difficulties Questionnaire scores were used as the outcome. Logistic regression was undertaken for the analysis. All analyses were adjusted for confounders. RESULTS. A change to overweight from healthy BMI was significantly associated with increased risk of psychopathology (adjusted OR 1.66; 95% CI 1.19-2.32). Both change from underweight to healthy (adjusted OR 0.12; 95% CI 0.03-0.43) or from overweight to healthy (adjusted OR 0.47; 95% CI 0.79-0.8) was associated with a significantly reduced risk of developing psychopathology. DISCUSSION. As a child's BMI returns to within the healthy range, their risk of adolescent psychopathology is reduced. Interventions to restore healthy BMI, in both underweight and overweight, children may reduce their risk of adolescent psychopathology.
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Brochu PM. Testing the effectiveness of a weight bias educational intervention among clinical psychology trainees. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/jasp.12653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Paula M. Brochu
- Department of Clinical and School Psychology Nova Southeastern University Fort Lauderdale FL USA
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