Taking action to lose weight: Toward an understanding of individual differences

The problem of obesity has reached epidemic proportions. Currently, roughly two-thirds of all adult Americans are overweight or obese. Of these, 40% are not engaging in weight control. Little is known about these individuals except that they are at high-risk for a variety of medical comorbidities. A greater understanding of these persons is imperative for ultimately encouraging their initiation of weight control practices. Among those who are addressing their obesity, the prominent strategy employed is dieting on one’s own. Previous research has studied overweight people who seek help with weight control versus those who do not. Help-seeking has been associated with higher levels of psychological distress and more severe obesity. This classification however neglects individuals attempting other weight control methods besides seeking outside assistance. The present study proposes a two-dimensional system for understanding varying levels of weight control behavior. A help-seeking dimension is proposed that capres a gradation of help-seeking behaviors. The second dimension aims at classifying individuals on a self-agency dimension. This dimension explores how individuals’ perception of themselves as agents of change influences their weight control. Socioeconomic status (SES) is hypothesized as a potential moderator of both dimensions. The present study aims to demonstrate possible correlates of both dimensions, including psychological distress, disordered eating behavior, obesity-related knowledge, body-image, and comorbid medical risks. By uncovering differences in these variables across the two dimensions, our understanding of what factors contribute to engagement in varying levels of weight control behaviors will be augmented.Ph.D., Clinical Psychology -- Drexel University, 200

Taking action to lose weight: Toward an understanding of individual differences

The problem of obesity has reached epidemic proportions. Currently, roughly two-thirds of all adult Americans are overweight or obese. Of these, 40% are not engaging in weight control. Little is known about these individuals except that they are at high-risk for a variety of medical comorbidities. A greater understanding of these persons is imperative for ultimately encouraging their initiation of weight control practices. Among those who are addressing their obesity, the prominent strategy employed is dieting on one’s own. Previous research has studied overweight people who seek help with weight control versus those who do not. Help-seeking has been associated with higher levels of psychological distress and more severe obesity. This classification however neglects individuals attempting other weight control methods besides seeking outside assistance. The present study proposes a two-dimensional system for understanding varying levels of weight control behavior. A help-seeking dimension is proposed that capres a gradation of help-seeking behaviors. The second dimension aims at classifying individuals on a self-agency dimension. This dimension explores how individuals’ perception of themselves as agents of change influences their weight control. Socioeconomic status (SES) is hypothesized as a potential moderator of both dimensions. The present study aims to demonstrate possible correlates of both dimensions, including psychological distress, disordered eating behavior, obesity-related knowledge, body-image, and comorbid medical risks. By uncovering differences in these variables across the two dimensions, our understanding of what factors contribute to engagement in varying levels of weight control behaviors will be augmented.Ph.D., Clinical Psychology -- Drexel University, 200

Achieving Cultural Congruency in Weight Loss Interventions: Can a Spirituality-Based Program Attract and Retain an Inner-City Community Sample?

Ethnic minorities continue to be disproportionately affected by obesity and are less likely to access healthcare than Caucasians. It is therefore imperative that researchers develop novel methods that will attract these difficult-to-reach groups. The purpose of the present study is to describe characteristics of an urban community sample attracted to a spiritually based, weight loss intervention. Methods. Thirteen participants enrolled in a pilot version of Spiritual Self-Schema Therapy (3S) applied to disordered eating behavior and obesity. Treatment consisted of 12 one-hour sessions in a group therapy format. At baseline, participants were measured for height and weight and completed a battery of self-report measures. Results. The sample was predominantly AfricanAmerican and Hispanic and a large percentage of the sample was male. Mean baseline scores of the EDE-Q, YFAS, and the CES-D revealed clinically meaningful levels of eating disordered pathology and depression, respectively. The overall attrition rate was quite low for interventions targeting obesity. Discussion. This application of a spiritually centered intervention seemed to attract and retain a predominantly African-American and Hispanic sample. By incorporating a culturally congruent focus, this approach may have been acceptable to individuals who are traditionally more difficult to reach

The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study.

INTRODUCTION: In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. METHODS: A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. RESULTS: Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). CONCLUSIONS: This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background: Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.Objective: The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.Methods and Procedures: A total of 103 women lost weight on a meal replacement&ndash;supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.Results: Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.Discussion: Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group\u27s diet, if shown to be sustainable in future studies, could have weight maintenance benefits.<br /

Taking action to lose weight: toward an understanding of individual differences

The purpose of the present study was to understand differences in obese/overweight individuals who do and do not seek ongoing external assistance for weight loss. Help-seeking was examined as a dichotomous and as a continuous variable. Measures of body mass index, comorbid medical conditions, socioeconomic status, psychological distress, disordered eating behavior, body image, and obesity-related knowledge were administered to a community sample of 120 overweight women (age: 22–65 y, BMI: 25–63 kg/m2). Fewer predictors of help-seeking were identified when measuring help-seeking as a dichotomy than when measuring it as a continuum. All predictors were from psychosocial domains, with obesity-related knowledge being the strongest, most consistent predictor. Help-seeking for weight control in a community sample of overweight and obese individuals appears to be motivated by psychological aspects of obesity, rather than obesity\u27s physical or medical burden

Examining the effects of maternal chronic illness on child well-being in single parent families

Objective:Chronicillnessishighlyprevalentamongadultswithchildren.Itisthereforeimportantto understand how parental illness may or may not have an impact on affected families. Findings thus far have suggested that differences between children with and without a sick parent are minimal, but there are individ- ual and familial moderators of outcome. It is unclear whether these results are generalizable to single-parent families. The purpose of the present study was to examine whether maternal chronic illness affects multiple aspects of child functioning in a large, ethnically diverse sample of single-parent families compared to those not affected by illness. Potential moderators of differences, including maternal distress, parenting variables (ag- gravation and warmth), functional impairment related to illness, and demographic characteristics were also tested. Methods: Using data from the Child Development Study (CDS), 812 mother-child pairs were studied. Mothers completed measures of child internalizing, externalizing, and positive behaviors, while children com- pleted a measure of depression. Results: The results indicated that overall there were no differences between children with or without a sick mother on the measures of well-being. Higher symptom levels among both cohorts were associated with maternal distress and aggravation in parenting only. However, children with a sick mother were more likely to have a consultation due to emotional difficulties. Conclusion: Several areas for future work on how illness affects single-parent families were identified such as prospectively studying ill- nesses with a variable course and determining which protective factors promote resiliency for children in this difficult situation

A Comparison of Weight-Control Behaviors in African American and Caucasian Women

Objectives: The purpose of the present study was to examine whether there are overall differences in help-seeking, in specific weight control behaviors used, and in predictors of seeking professional help for weight loss between African American and Caucasian women. Design: Cross-sectional study Setting: Participants were recruited from community sources in Philadelphia. Participants: One hundred twenty female participants were studied. Of these, 58% were African American. Main Outcome Measures: Participants completed a packet of measures assessing weight control behaviors, body mass index, co-morbid medical conditions, socioeconomic status, disordered eating behavior, and body image. Results: Caucasian women were significantly more likely to be classified as high help-seekers than were African American women, χ2=4.27, p=.04. Caucasian women were more likely to use commercial weight loss programs, χ2=4.25, p=.04, while African American women were more likely to try herbal supplements for weight control, χ2=6.21, p=.01. Higher scores on a measure of body image, responsiveness to the food environment, and the disinhibition and hunger subscales of the Three-Factor Eating Questionnaire (TFEQ) predicted seeking professional help for Caucasian women only. Conclusions: The results indicate that African American and Caucasian women differ in overall weight-control efforts as well as in specific behaviors used. Furthermore, interactions were found between some factors associated with help-seeking and ethnicity. A better understanding of how available programs could be augmented to address the needs of African American and other minority groups is necessary