Weight loss expectations and body dissatisfaction in young women attempting to lose weight

The relationship between weight history and psychological health-Differences related to gender and weight loss patterns

BACKGROUND

The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities.

METHOD

The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics.

RESULTS

According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a "weight maintainer" was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a "weight maintainer" was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past.

CONCLUSION

Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.

Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? A systematic review and meta-analysis

International guidelines recommend women with an overweight or obese body mass index (BMI) aim to reduce their body weight prior to conception to minimize the risk of adverse perinatal outcomes. Recent systematic reviews have demonstrated that interpregnancy weight gain increases women's risk of developing adverse pregnancy outcomes in their subsequent pregnancy. Interpregnancy weight change studies exclude nulliparous women. This systematic review and meta-analysis was conducted following MOOSE guidelines and summarizes the evidence of the impact of preconception and interpregnancy weight change on perinatal outcomes for women regardless of parity. Sixty one studies met the inclusion criteria for this review and reported 34 different outcomes. We identified a significantly increased risk of gestational diabetes (OR 1.88, 95% CI 1.66, 2.14, I²  = 87.8%), hypertensive disorders (OR 1.46 95% CI 1.12, 1.91, I²  = 94.9%), preeclampsia (OR 1.92 95% CI 1.55, 2.37, I²  = 93.6%), and large-for-gestational-age (OR 1.36, 95% CI 1.25, 1.49, I²  = 92.2%) with preconception and interpregnancy weight gain. Interpregnancy weight loss only was significantly associated with increased risk for small-for-gestational-age (OR 1.29 95% CI 1.11, 1.50, I²  = 89.9%) and preterm birth (OR 1.06 95% CI 1.00, 1.13, I²  = 22.4%). Our findings illustrate the need for effective preconception and interpregnancy weight management support to improve pregnancy outcomes in subsequent pregnancies.

"Better If They Laugh with Me than at Me": The Role of Humor in Coping with Obesity-Related Stigma in Women

This study investigated the role of perceived stigmatization in the relationship between humor styles and coping with stress among young women suffering from stigma due to obesity. In the 21st century, obesity is an increasing global health issue with many physical and mental consequences for obese women. As a chronic stigmatizing disease, it requires that the affected individuals cope with social consequences; women with obesity are more prone to such consequences than men. Humor fosters the breaking of stereotypes and alleviating the consequences of stigmatization. A total of 127 young adult women (age M = 25.74, SD = 2.73) participated in the study (n = 54 with overfat and n = 73 with healthy fat). Participants filled out the Humor Styles Questionnaire, Perceived Stigmatization Questionnaire, and the Brief COPE Scale. Anthropometric data were gathered using a body composition analyzer. Results indicate that, when perceiving hostile behaviors toward themselves and using humor as a coping strategy, women with overfat select maladaptive styles of humor (i.e., self-defeating and aggressive styles). Women with overfat were also more likely to use humor as a coping strategy in difficult situations. Furthermore, none of the participants were satisfied with their body mass. At the same time, among women without obesity, a lack of compliments was not treated as a problem, even if they had high body fat.

Prediction factors of weight control intention in Chinese young adults

BACKGROUND

Weight control is a widespread phenomenon among young adults, especially in women.

AIM

This study aimed to determine the prediction factors of weight control intention in a young Chinese sample.

METHODS

A cross-sectional study was conducted with 963 (276 male and 687 female; mean age 21.8 ± 4.4 years) adult students from a university in Taiwan. The data were collected from October 2016 to January 2017. Body mass index (BMI), the Chinese version of the Weight Self-Stigma Questionnaire, the Body Areas Satisfaction Scale and the Media Influence Questionnaire were used as data collection instruments.

RESULTS

The participants with weight control intention had higher BMI, weight self-stigma and media influence scores and lower body satisfaction scores than those without the intention. Female sex, BMI, weight self-stigma, body satisfaction and media influence were significant predictors of weight control intention for all participants.

CONCLUSION

Before conducting weight loss programmes, the perception of weight self-stigma and the influence of social media on body image should be confirmed, particularly in women with intention to lose weight.

Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis

The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.

Perceived cardiovascular risk and attitude towards lifestyle change

BACKGROUND

Cardiovascular diseases are prominent cause of death. Lifestyle change is effective in decreasing mortality. Perception of patients' cardiovascular risk by physicians is a drive for following preventive recommendations. Whether the hazard perceived by patients influences their attitude towards lifestyle is uncertain.

OBJECTIVE

We hypothesized that high perceived risk would be associated with a stronger determination for lifestyle change, while incorrectly optimistic patients would be less motivated.

METHODS

Two hundred patients visiting their family physicians were asked to fill out a questionnaire about demographic, clinical and lifestyle characteristics, about their attitude towards lifestyle change and their estimation of their cardiovascular risk. Actual risk was estimated by family physicians based on the national guideline.

RESULTS

Questionnaires were completed by 80.5% (161/200) of patients approached. Patients underestimated their risk (P < 0.001), mainly because high-/very high-risk patients classified themselves into lower risk categories. The majority of patients were planning a lifestyle change, losing weight being the most popular goal. It was the priority even for some normal weight subjects and for smokers, too. Perceived risk played a marginal role as a determinant of lifestyle change. Underestimation of perceived risk had no effect on patients' motivation. Self-rated obesity was the predictor of three out of five means of change (weight loss, diet, physical activity).

CONCLUSION

Perceived cardiovascular risk and incorrect optimism about this hazard have minimal, if any, influence on attitude towards lifestyle change. Patients' motivation seems not to be primarily health related.

Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less

AIM

Currently, health care professionals plead for stabilization of weight and improving health conditions rather than focusing on weight loss only. Individuals with obesity have been shown to report weight loss goals that are much higher than what has been suggested by guidelines. The aim was to determine whether weight discrimination and body dissatisfaction have an impact on how much weight an individual with obesity wants to lose.

METHODS

In this representative telephone survey, 878 participants with obesity were asked about their experiences with weight stigma, their body image concerns, and about the amount of weight they would like to weigh using random digital dialing and Kish selection grid to ensure random selection of participants.

RESULTS

Regression analysis reveals that being female, having a higher BMI, being younger, and trying to lose weight was related to a greater discrepancy between current weight and desired weight. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma and body image concerns.

CONCLUSION

Independent on the weight loss method, treating obesity should include realistic weight loss goals without being affected by social pressure or weight stigma, especially since stigma can result in further weight gain and decline health issues related to obesity and overweight.

Longitudinal changes in desired body weight compared to changes in body weight: evidence of adaptation to weight gain?

Background

Overweight individuals desire a lower weight than they actually have. Little is known on the extent to which this discrepancy is reduced over time due to adaptation or resignation. The aim of this study is to describe cross-sectional relationships and longitudinal changes in desired body weight and differences between actual and desired body weight according to gender, age and category of body mass index in a large, adult cohort in Tromsø, Norway.

Methods

Cross-sectional analyses of 8960 men and 9992 women aged 25–69 participating in Tromsø 4 (during 1994–1995), and longitudinal analyses of 3210 men and 3689 women participating in both Tromsø 4 (during 1994–1995) and Tromsø 6 (during 2007–2008). Simple descriptive statistics and linear regression was used to describe actual and desired weight, the difference between them, and how gender and age are related to the changes in actual and desired weight over this 13-year period.

Results

The difference between actual and desired body weight was largest for the obese and higher among the overweight than the normal weight for both genders. While normal weight men were quite satisfied with their body weight, normal weight women were not. Actual weight increased more than desired weight for all age groups and both genders except the oldest women. The difference between change in actual body weight and change in desired body weight during the 13-year follow-up was significantly larger among men (2.0 kg) than women (1.5 kg) (p < 0.001), and larger among young than older adults (p < 0.001). Adjusting for level of education had no impact on this relationship. Furthermore, the association between age and the difference between change in actual body weight during the 13 years and change in desired body weight in the same period did not differ between men and women and, in gender specific analyses, between subjects with normal weight and those who were overweight or obese at start of follow-up.

Conclusion

Older people adapt more to weight gain than younger age groups, with clear gender differences. Further studies of longitudinal changes in desired weight are warranted.

Electronic supplementary material

The online version of this article (doi:10.1186/s40608-016-0120-6) contains supplementary material, which is available to authorized users.

Validity of silhouette showcards as a measure of body size and obesity in a population in the African region: A practical research tool for general-purpose surveys

Background

The purpose of this study is to validate the Pulvers silhouette showcard as a measure of weight status in a population in the African region. This tool is particularly beneficial when scarce resources do not allow for direct anthropometric measurements due to limited survey time or lack of measurement technology in face-to-face general-purpose surveys or in mailed, online, or mobile device-based surveys.

Methods

A cross-sectional study was conducted in the Republic of Seychelles with a sample of 1240 adults. We compared self-reported body sizes measured by Pulvers’ silhouette showcards to four measurements of body size and adiposity: body mass index (BMI), body fat percent measured, waist circumference, and waist to height ratio. The accuracy of silhouettes as an obesity indicator was examined using sex-specific receiver operator curve (ROC) analysis and the reliability of this tool to detect socioeconomic gradients in obesity was compared to BMI-based measurements.

Results

Our study supports silhouette body size showcards as a valid and reliable survey tool to measure self-reported body size and adiposity in an African population. The mean correlation coefficients of self-reported silhouettes with measured BMI were 0.80 in men and 0.81 in women (P < 0.001). The silhouette showcards also showed high accuracy for detecting obesity as per a BMI ≥ 30 (Area under curve, AUC: 0.91/0.89, SE: 0.01), which was comparable to other measured adiposity indicators: fat percent (AUC: 0.94/0.94, SE: 0.01), waist circumference (AUC: 0.95/0.94, SE: 0.01), and waist to height ratio (AUC: 0.95/0.94, SE: 0.01) amongst men and women, respectively. The use of silhouettes in detecting obesity differences among different socioeconomic groups resulted in similar magnitude, direction, and significance of association between obesity and socioeconomic status as when using measured BMI.

Conclusions

This study highlights the validity and reliability of silhouettes as a survey tool for measuring obesity in a population in the African region. The ease of use and cost-effectiveness of this tool makes it an attractive alternative to measured BMI in the design of non-face-to-face online- or mobile device-based surveys as well as in-person general-purpose surveys of obesity in social sciences, where limited resources do not allow for direct anthropometric measurements.

Lower weight loss expectations and healthier eating attitudes in older overweight and obese women attempting weight loss

Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross-sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty-six younger (18-38 years) and 33 older (60-78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure-choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (-14.5 kg vs. -22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (-18.5 kg), whereas younger women derived their greatest WLEs from mass media (-28.5 kg). Both older and younger groups perceived that their families would be supportive of the smallest amount of weight loss (-8.4 and -17.6 kg, respectively). The groups did not differ on body dissatisfaction, but younger women's disordered eating attitudes were significantly higher (p < .001). Older overweight and obese women have lower WLEs than younger women but experience similar levels of body dissatisfaction and healthier eating attitudes. The attitudinal constructs underlying these differences may be useful in clinical practice to tailor age-specific weight loss interventions.

Weight expectations, motivations for weight change and perceived factors influencing weight management in young Australian women: a cross-sectional study

OBJECTIVE

To examine young Australian women's weight expectations, motivations for weight change and perceived factors influencing weight management, and to determine if these factors differ by age, BMI, marital status, education or income.

DESIGN

Cross-sectional study. An online survey captured respondents' weight, height, ideal weight, main reasons for wanting to change their weight and challenges to managing their weight.

SETTING

Online survey in Australia.

SUBJECTS

Six hundred and twenty women aged 18-30 years currently living in Australia who completed the survey between 31 July and 30 September 2012.

RESULTS

Approximately half of participants (53·1 %) were a healthy weight, 25·2 % overweight and 19·0 % obese. Women unhappy at their current weight (78·1 %) reported a median ideal weight -12·3 % less than their current weight. The key motivators for weight change were to improve health (24·4 %, ranked 1), feel better in oneself (22·3 %) and improve self-confidence (21·5 %). Lack of motivation, time constraints because of job commitments and cost were the most commonly reported factors influencing weight management. Age, BMI, marital status, education and income were found to influence weight expectations, motivations for weight change and/or factors perceived to influence weight management.

CONCLUSIONS

The findings suggest potential implications for weight management interventions and public health messaging targeting young women, to improve long-term health outcomes. Strategies that promote the health benefits of physical activity and healthy eating, feeling better about oneself and improved self-confidence, and address the main factors influencing weight management including lack of motivation, time constraints and cost, may be used to engage this target group.

The Hurt of Judgment in Excessive Weight Women: A Hermeneutic Study

Excess weight is one of the increasing problems of the present society and one of the threatening health conditions around the world. Despite many efforts for prevention and treatment or even surgery, the process of excess weight is not decreased in the world. While most of the studies conducted on excess weight concentrated on the issues why people get excess weight or how the prevention and treatment of excess weight must be performed, there is lake of knowledge about what excessive weight people really experience in their daily life. Understanding the lived experience of excess weight in women is linked with their health and society's health while it indirectly develops the nursing knowledge to improve the quality and access to holistic health care in excessive weight women. The aim of study was to describe with a deeper understanding, the lived experience of excess weight in women. Using a hermeneutic phenomenological approach and a van-manen analysis methods, in depth semi- structured interviews were conducted with twelve women who had lived experience of excess weight. The hurt of Judgment was the main theme that emerged in the process of data analysis. This theme was derived from three sub-themes including social judgment, being different and being seen. These findings can prove helpful in promoting the nursing knowledge concerning a holistic approach in communicating to excessive weight people.