A qualitative analysis of college women's experiences with dieting.

OBJECTIVE: Dieting is a known risk factor for disordered eating, yet many college women engage in this behavior. Given the popularity of diets, and the risks associated with dieting, it is important to enhance understanding of dieters' experiences. This study utilized a qualitative approach to investigate college women's experiences of dieting. PARTICIPANTS: Eighty-four woman-identifying undergraduates [42% White, 24% Asian, 20% Black, 14% other; Mage = 19.18 (1.77)] who endorsed dieting were included in the study. METHODS: Participants provided short-answer responses to open-ended questions. Data were analyzed using a thematic analysis approach. RESULTS: The following themes were identified: A complicated relationship, variability of experiences, and social factors. Subthemes highlighted the complexity of college women's dieting behavior. CONCLUSIONS: Results provide important insight into college women's dieting experiences and their consequences. Future qualitative research should aim to understand how to apply these findings to eating disorder prevention efforts.

The burden of overweight/obesity and weight-related behaviors attributable to food addiction in emerging adults.

While food addiction has been positively associated with excess weight and disordered eating behaviors, this has not been examined in representative samples of emerging adults, who are at elevated risk for these outcomes. This study investigated relationships of food addiction with weight outcomes, weight perception, and weight-control behaviors in emerging adults and estimated the population attributable fraction to food addiction. Data from an observational cohort study were collected in seven annual waves from 2010 to 2016. A nationally representative sample of 2785 10th grade students was recruited from schools within each U.S. census region (73% participation) (mean ± SD baseline age = 16.3 ± 0.5years). Wave 7 retention was 81% (n = 2323, 60% female, mean ± SD = 22.6 ± 0.5 years). Outcomes included current BMI, BMI change from baseline - wave 7, increased weight status in wave 7 (increased weight status from baseline-wave 7), perceived overweight, dieting, any weight-control behavior, and extreme weight-control behaviors. Food addiction was measured in wave 7 using the modified Yale Food Addiction Scale. Relative risk of the outcomes associated with food addiction, and population attributable fraction, were estimated using adjusted log-binomial or robust Poisson regression analyses accounting for the complex survey design. Food addiction prevalence was 4.7%. Participants with food addiction were primarily females (91%); food addiction was uncorrelated with other sociodemographics. Food addiction was associated with 48%-167% increased RR for all outcomes, but these were attenuated after adjustment for confounders (31%-64%). The population attributable fraction for food addiction ranged from 2% (high wave 7 BMI) - 5% (extreme weight-control behaviors). Although the population attributable fraction estimates indicate that the public health burden of these outcomes attributable to food addiction may be relatively minor, food addiction may signal the presence of several adverse mental health symptoms.

Associations between dieting practices and eating disorder attitudes and behaviors: Results from the Canadian study of adolescent health behaviors.

This study aimed to describe the frequency of dieting practices among adolescents and young adults in Canada, as well as determine the association between dieting and eating disorder attitudes and behaviors. Data from 2762 Canadian adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Frequencies were used to determine the prevalence of 11 different diets among the sample, and chi-square tests were used to assess gender differences. Multiple modified Poisson and linear regression analyses were conducted to determine the associations between any dieting and eating disorder attitudes and behaviors. Among the sample, 15.7 % of girls and women, 10.4 % of boys and men, and 13.0 % of transgender/gender expansive (TGE) participants reported any dieting in the past 12 months, with the Ketogenic diet being most common among all genders. Results from regression analyses showed that engaging in any dieting in the past 12 months was associated with greater eating disorder psychopathology among girls, women, boys, and men, but not TGE participants. There were varying trends in association between specific types of dieting practices and eating disorder behaviors among girls, women, boys, and men. Dieting is relatively common among a national sample of Canadian adolescents and young adults, and engagement is associated with greater eating disorder psychopathology and behaviors. Healthcare and public health professionals should consider screening for eating disorders among adolescents and young adults who report engaging in dieting practices.

Eating Behaviors and Adiposity Indicators - Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg.

Purpose: To determine the cross-sectional association between eating behavior in terms of the three-factor eating questionnaire (TFEQ) and adiposity measures. Methods: The TFEQ-R21 was administered to 573 women aged 38 and 50 who participated in the population study of women in Gothenburg 2016/17. Three domains, emotional eating (EE), uncontrolled eating (UE), and cognitive restraint (CR) were examined as outcomes as well as predictors of adiposity outcomes. Multiple linear and logistic regression models were adjusted for age, education, lifestyle factors, and dieting behavior. Results: All TFEQ domains were positively associated with dieting. EE and UE were associated with higher consumption of sweets and CR with lower consumption of sweets. Wellbeing was negatively associated with EE and UE. In mutually adjusted models, EE and CR but not UE were positively associated with BMI, waist circumference (WC), waist-to-hip ratio, waist-to-height ratio, and skinfold. One standard deviation higher EE was associated with obesity, BMI ≥ 30 kg/m2, OR = 1.62 (1.26, 2.10), and abdominal fatness, WC > 88 cm, OR = 1.57 (1.26, 1.95). Former and current dieting were positively associated with these outcomes, too, but UE and CR were not associated in mutually adjusted models. Conclusion: This study shows that emotional eating behavior is associated with adiposity in a population of middle-aged women, over a large range of values for body fatness, and independent of dieting behavior. The results imply that treatment of obesity should include psychological support to restrict the risk for emotional eating in response to states of negative mood.

From Restriction to Intuition: Evaluating Intuitive Eating in a Sample of the General Population.

Intuitive eating (IE) is a non-dieting approach that promotes listening to internal cues of hunger and satiety, rather than adhering to external dietary restrictions aimed at weight loss. However, the role of IE in dieting behaviors related to weight-loss approaches is still unclear. To address this issue, the aim of this study was to compare IE levels between dieting and non-dieting individuals, exploring the relationship between IE and dieting-related psychological and physical factors. A sample of 2059 females was recruited via social media and self-reported questionnaires were administered to measure IE, eating psychopathology, self-efficacy, and quality of life. Individuals with a history of dieting exhibited lower IE levels, a higher BMI, and a greater eating psychopathology, as well as a reduced self-efficacy and quality of life, compared to non-dieters. IE showed a protective effect against dieting behaviors, with higher IE levels being associated with a lower likelihood of dieting. Additionally, higher BMI and eating psychopathology were predictors of dieting. Promoting IE could represent a relevant clinical target strategy to address disordered eating and enhance overall well-being, underscoring the need for interventions that foster a healthier relationship with food and bodily internal sensations.

Effects of repeated weight cycling on non-alcoholic steatohepatitis in diet-induced obese mice.

Lifestyle interventions remain the treatment of choice for patients with obesity and metabolic complications, yet are difficult to maintain and often lead to cycles of weight loss and regain (weight cycling). Literature on weight cycling remains controversial and we therefore investigated the association between weight cycling and metabolic complications using preexistent obese mice. Ldlr-/-.Leiden mice received a high-fat diet (HFD) for 20 weeks to induce obesity. Subsequently, weight-cycled mice were switched between the healthy chow diet and HFD for four 2-week periods and compared to mice that received HFD for the total study period. Repeated weight cycling tended to decrease body weight and significantly reduced fat mass, whereas adipose tissue inflammation was similar relative to HFD controls. Weight cycling did not significantly affect blood glucose or plasma insulin levels yet significantly reduced plasma free fatty acid and alanine transaminase/aspartate transaminase levels. Hepatic macrovesicular steatosis was similar and microvesicular steatosis tended to be increased upon weight cycling. Weight cycling resulted in a robust decrease in hepatic inflammation compared to HFD controls while hepatic fibrosis and atherosclerosis development were not affected. These results argue against the postulate that repeated weight cycling leads to unfavorable metabolic effects, when compared to a continuous unhealthy lifestyle, and in fact revealed beneficial effects on hepatic inflammation, an important hallmark of non-alcoholic steatohepatitis.

Youth's energy intake during a laboratory-based loss-of-control eating paradigm: Associations with reported current dieting.

Dieting is theorized as a risk factor for loss-of-control (LOC)-eating (i.e., feeling a sense of lack of control while eating). Support for this association has largely relied on retrospective self-report data, which does not always correlate with objectively assessed eating behavior in youth. We hypothesized that during a laboratory-based LOC-eating paradigm, children and adolescents who reported current (at the time of the visit) dieting would consume meals consistent with LOC-eating (greater caloric intake, and intake of carbohydrates and fats, but less intake of protein). Participants were presented with a buffet-style meal and instructed to "Let yourself go and eat as much as you want." Current dieting (i.e., any deliberate change to the amount or type of food eaten to influence shape or weight, regardless of how effective the changes are) was assessed via interview. General linear models were adjusted for fat mass (%), lean mass (kg), height, sex, protocol, race and ethnicity, pre-meal hunger and minutes since consumption of a breakfast shake. Of 337 participants (Mage 12.8 ± 2.7y; 62.3 % female; 45.7 % non- Hispanic White and 26.1 % non-Hispanic Black; MBMIz 0.78 ± 1.11), only 33 (9.8 %) reported current dieting. Current dieting was not significantly associated with total energy intake (F = 1.63, p = .20, ηp2 = 0.005), or intake from carbohydrates (F = 2.45, p = .12, ηp2 = 0.007), fat (F = 2.65, p = .10, ηp2 = 0.008), or protein (F = 0.39, p = .53, ηp2 = 0.001). Contrary to theories that dieting promotes LOC-eating, current dieting was not associated with youth's eating behavior in a laboratory setting. Experimental approaches for investigating dieting are needed to test theories that implicate dieting in pediatric LOC-eating.

Genetics of Exercise and Diet-Induced Fat Loss Efficiency: A Systematic Review.

Physical exercise and dieting are well-known and effective methods for fat loss and improving cardiovascular health. However, different individuals often react differently to the same exercise regimen or dietary plan. While specific individuals may undergo substantial fat loss, others may observe only limited effects. A wide range of inter-individual variability in weight gain and changes in body composition induced by physical exercises and diets led to an investigation into the genetic factors that may contribute to the individual variations in such responses. This systematic review aimed at identifying the genetic markers associated with fat loss resulting from diet or exercise. A search of the current literature was performed using the PubMed database. Forty-seven articles met the inclusion criteria when assessing genetic markers associated with weight loss efficiency in response to different types of exercises and diets. Overall, we identified 30 genetic markers of fat-loss efficiency in response to different kinds of diets and 24 in response to exercise. Most studies (n = 46) used the candidate gene approach. We should aspire to the customized selection of exercise and dietary plans for each individual to prevent and treat obesity.

Prepregnancy dieting and obstetrical and neonatal outcomes: Findings from a national surveillance project in the United States.

PROBLEM AND BACKGROUND: Women with overweight or obesity are recommended to lose weight before pregnancy. Dieting is one of the most used weight control strategies. However, the health implications of dieting before pregnancy remain unclear. AIM: To evaluate the associations of dieting during the year before pregnancy with obstetrical and neonatal outcomes, including gestational weight gain (GWG), gestational diabetes, low birthweight, macrosomia, small-for-gestational-age infants (SGA), large-for-gestational-age infants (LGA), and preterm birth. METHODS: This study analyzed data from the Pregnancy Risk Assessment Monitoring System (PRAMS), which is a surveillance project in the United States that collects data on maternal health before, during, and after pregnancy. Women who participated in PRAMS phase 7 with a prepregnancy body mass index ≥25 kg/m2 and a singleton birth were eligible. Statistical analyses included logistic regressions and post-hoc mediation analysis (Sobel Test). FINDINGS: A total number of 51,399 women were included in the analysis. Women who self-reported prepregnancy dieting (42.8 %) had lower odds of SGA (adjusted odds ratio [aOR]: 0.87; 95 % CI: 0.79-0.97), and higher odds of excessive GWG vs adequate GWG (aOR: 1.42; 95 % CI: 1.32-1.52), gestational diabetes (aOR: 1.12; 95 % CI: 1.02-1.22), and LGA (aOR: 1.18; 95 % CI: 1.08-1.28). Furthermore, the association between prepregnancy dieting and LGA was mediated by excessive GWG (Sobel Test z-value = 5.72, p < 0.01). DISCUSSION AND CONCLUSION: This analysis revealed that prepregnancy dieting was associated with several adverse consequences, including excessive GWG, gestational diabetes, and LGA infants. Findings contribute to an improved understanding of the perinatal implications of prepregnancy dieting.

Changes in affect longitudinally mediate associations between emotion regulation strategy use and disordered eating.

BACKGROUND: Trait-level emotion regulation (ER) difficulties are associated with eating disorders (EDs) transdiagnostically. However, little research has examined whether within-person fluctuations in ER longitudinally predict ED behaviors in daily life or the mechanisms of ER effects. Investigating daily ER could help us better understand why people experience ED behaviors at a given time. We examined whether day-to-day changes in adaptive (e.g., cognitive reappraisal) and maladaptive (e.g., rumination) ER longitudinally predicted core ED behaviors (binge eating, purging, dieting) and whether changes in affect mediated effects. METHOD: Female participants (N = 688) ages 15-30 from the Michigan State University Twin Registry reported their adaptive and maladaptive ER use, negative affect (NA), positive affect (PA), binge eating, purging, and dieting on 49 consecutive days. Using structural equation modeling, we examined whether within-person fluctuations in ER predicted same- and next-day ED behaviors and whether changes in affect mediated longitudinal ER effects. RESULTS: Greater maladaptive ER predicted increased likelihood of same-day binge eating and next-day binge eating and purging. The association between maladaptive ER and next-day binge eating and purging was mediated by increased next-day NA. In contrast, dieting was more closely related to changes in PA. Adaptive ER did not predict reduced likelihood of any ED behavior. CONCLUSIONS: Maladaptive ER may longitudinally increase risk for binge eating and purging by amplifying NA. Interventions focused on decreasing maladaptive ER and subsequent NA might help disrupt binge eating-purging cycles. Conversely, results add to evidence that PA fluctuations may play a unique role in maintaining restrictive behaviors. PUBLIC SIGNIFICANCE: Little is known about how daily changes in emotion regulation may impact disordered eating. We found that maladaptive emotion regulation (e.g., rumination) was associated with a higher likelihood of binge eating and purging on the next day because it predicted increased next-day negative affect. In contrast, dieting was more closely tied to fluctuations in positive affect. Targeting daily emotion regulation and affective processes may help disrupt cycles of disordered eating.

Effects of intermittent dieting with break periods on body composition and metabolic adaptation: a systematic review and meta-analysis.

CONTEXT: Intermittent dieting incorporated with break periods (INT-B) has recently been promoted as an alternative dietary approach for optimal weight management. OBJECTIVE: This study assessed the effectiveness of INT-B compared with that of conventional continuous energy restriction (CER) for improving body composition and attenuating metabolic adaptation. DATA SOURCES: A systematic search was conducted on 6 databases using all available records until July 2023. DATA EXTRACTION: The extracted data included the lead author, year of publication, population characteristics, intervention protocols, duration, and adherence. DATA ANALYSIS: Random-effects meta-analyses were conducted for within-group and between-group comparisons of anthropometric and metabolic outcomes. Subgroup moderator analysis was performed for the types of INT-B, intervention duration, and population characteristics. RESULTS: Of the 1469 records, 12 randomized trials (with 881 participants) were included. Within-group analyses demonstrated significant improvements in body mass, fat mass, body mass index, body fat percentage, and waist circumference following both INT-B and CER, with no significant group differences. However, resting metabolic rate (RMR) was significantly reduced following CER only. The compensatory reduction in RMR was significantly smaller following INT-B compared with CER, suggesting a lesser degree of metabolic adaptation. INT-B had a more significant effect on RMR retention in individuals with overweight/obesity compared with resistance-trained individuals. CONCLUSION: This review provides up-to-date evidence for INT-B as a viable dietary strategy to improve body composition and attenuate metabolic adaptation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023448959.

Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study.

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.

The Physiological Effects of Weight-Cycling: A Review of Current Evidence.

PURPOSE OF REVIEW: There is a common perception among the public that yo-yo dieting, defined as repeated cycles of weight loss followed by weight regain, results in accumulation of fat in the body and lower metabolic rate, thus hindering subsequent attempts to lose weight. We evaluated the effects of weight-cycling on body weight and body mass index (BMI), body composition including fat mass (FM) and lean body mass (LBM), and resting metabolic rate (RMR), by systematically reviewing existing scientific literature. RECENT FINDINGS: Twenty-three cross-sectional and cohort studies (including subjects with a history of weight-cycling compared to those without such history) and interventional studies (evaluating physiological effects during one or more cycles of weight loss and regain) were identified, conducted in generally healthy adults across various age groups, races, and both genders, who had normal weight, overweight, or obesity. Eighteen studies investigated the association between weight-cycling and body weight or BMI, and thirteen of them found no significant association. Fifteen out of twenty studies also found no increase in FM, and none of eighteen studies found a decrease in LBM. Twelve out of fourteen studies reported no adverse changes in RMR either. The overwhelming majority of evidence suggests that weight-cycling (yo-yo effect) is not associated with any adverse effects in body weight, body composition, and metabolic rate. Accordingly, healthy individuals who struggle with overweight or obesity should not be discouraged from repeated attempts to lose the excess weight.

A Qualitative Model of Weight Cycling.

Weight cycling is a likely consequence of striving to lose weight after internalizing body image ideals, making upward social comparisons, and experiencing weight stigma. Despite weight cycling's potential physical and psychological consequences, the interplay of weight cycling, social pressures, and experienced and internalized stigma have not been qualitatively explored. Thus, through in-depth interviews of 36 weight-cycling adults, this study sought to understand how people negotiate weight cycling. Interviews informed the development of a qualitative model of weight cycling, which was derived from a theory-neutral inductive analysis. The model's stages included entering the cycle, undergoing the cycle, and challenging the cycle. Participants were triggered to enter the cycle due to weight stigma caused by social pressures. Within the cycle, interviewees internalized weight stigma and engaged in disordered weight management behaviors. Some participants challenged the cycle by becoming more self-aware and mitigating their toxic dieting behaviors. However, it was very difficult, if not impossible, for many to fully exit weight cycling and the restraints of previous weight management thinking and patterns. Our investigation underscores the seriousness of weight cycling and suggests ways to combat weight cycling on both macro and individual levels. It may also be useful to consider weight cycling as disordered eating in hopes of shifting society's dangerous focus on rapid weight loss.

My Diet Study: protocol for a two-part observational, longitudinal, psycho-biological study of dieting in Australian youth.

Introduction: Self-directed dieting (i.e., unsupervised) is very common among adolescents and young adults but has had almost no direct research. This paper describes the protocol for the My Diet Study, a two-arm observational investigation of the natural progression of dieting among young people over a period of 6-months. The study aims to examine the links between self-directed dieting, general physiological and psychological metrics of wellbeing (e.g., depressive symptoms) and biomarkers of gut-brain axis functions (e.g., microbiome and hormones) that are predicted to influence diet adherence through appetite, mood and metabolism regulation. Methods: Young people aged 16-25, intending to start a diet will be invited to participate in this observational study. For Part 1 (psychological arm), participants will be asked to complete a set of questionnaires and diaries at the beginning of every month for 6 months, to assess overall mental (e.g., psychological distress, disordered eating) and physical (e.g., weight) health, perceived diet success, food intake and gastrointestinal movements. For Part 2 (biological arm), a subsample of 50 participants will be asked to provide feces, blood and saliva for bio-sampling each month for the first 3-months of their participation in Part 1. Discussion: The My Diet Study will be the first longitudinal, observational study of dieting in young people combining in-depth psychological and biological data. It is anticipated that the findings will yield psychological & biological information about the impacts and effectiveness of self-directed dieting in young people, inform a framework for advice on safety in dieting among young people and help to establish the potential for biomarkers for risk management and improvement of diet-based lifestyle interventions.

Dieting alleviates hyperuricemia and organ injuries in uricase-deficient rats via down-regulating cell cycle pathway.

Dieting is a basic treatment for lowering hyperuricemia. Here, we aimed to determine the optimal amount of dietary food that lowers serum uric acid (SUA) without modifying the dietary ingredients in rats. Increased SUA was found in food-deprived 45-day-old uricase-deficient rats (Kunming-DY rats), and the optimal amount of dietary food (75% dietary intake) to lower SUA was established by controlling the amount of food given daily from 25% to 100% for 2 weeks. In addition to lowering SUA by approximately 22.5 ± 20.5%, the optimal amount of dietary food given for 2 weeks inhibited urine uric acid excretion, lowered the uric acid content in multiple organs, improved renal function, lowered serum triglyceride, alleviated organ injuries (e.g., liver, kidney and intestinal tract) at the histological level, and down-regulated the Kyoto Encyclopedia of Genes and Genome (KEGG) pathway of the cell cycle (ko04110). Taken together, these results demonstrate that 75% dietary food effectively lowers the SUA level without modifying dietary ingredients and alleviates the injuries resulting from uricase deficiency or hyperuricemia, the mechanism of which is associated with the down-regulation of the cell cycle pathway.

Perfectionism or Perfectionisms in Orthorexia Nervosa.

Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa.

The role of dieting, happiness with appearance, self-esteem, and bullying in the relationship between mental health and body-mass index among UK adolescents: a longitudinal analysis of the Millennium Cohort Study.

Background: Mental illness and obesity are among the biggest challenges to population health, they are linked, and may be modifiable during adolescence. We aimed to determine intervening pathways between mental health and BMI z-score symptoms across adolescence. Methods: In this longitudinal cohort study, we used path models to examine self-reported dieting, happiness with appearance, self-esteem and bullying at 14 years as potential mediators of the cross-lagged relationship between mental health (via the Strengths and Difficulties Questionnaire) and Body Mass Index (BMI) z-score at 11 and 17 years by sex in the UK Millennium Cohort Study, a prospective cohort study of 18,818 children born in the UK between September 1st, 2000, and January 31st, 2002. Full, incomplete data on all singleton children still participating in the study by age 11 years were analysed in GSEM via maximum likelihood estimation (N = 12,450). Findings: We found happiness with appearance and self-esteem, but not dieting or bullying, mediated the relationship between BMI age 11 and mental health age 17. Each increase in BMI z-score at 11 years was associated with 0.12 increase for boys and a 0.19 increase for girls in scores of unhappiness with appearance (boys: b 0.12, 95% C.I.; girls b 0.19, C.I. 0.14 to 0.23) and a 16% increase for boys and a 22% increase for girls in odds of low self-esteem (boys OR 1.16, 95% C.I. 1.07 to 1.26; girls: OR 1.22, 95% C.I. 1.15 to 1.30) at 14 years. In turn, for both boys and girls, being unhappy with appearance and low self-esteem at 14 years were associated with a greater likelihood of emotional and externalizing symptoms at 17 years. Interpretation: Early prevention strategies to encourage healthy physical and mental development of children need to focus on the promotion of positive body-mage and self-esteem. Funding: The National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR).

Patients' Pre and Post-Bariatric Surgery Experience of Dieting Behaviours: Implications for Early Intervention.

PURPOSE: Bariatric surgery works, in part, by surgically changing signals of hunger and satiety to achieve weight loss. Not all patients experience optimal outcomes. One potential explanation is that post-surgery dieting may subvert the ability to identify physiological cues of hunger and fullness. Dieting behaviours (e.g. restriction/cognitive restraint) are correlated with disordered eating, and disordered eating implicated in poor outcomes. This study examines the experience of dieting after bariatric surgery. METHOD: Seventeen adult participants who had undertaken bariatric surgery and residing in Australia participated in semi-structured interviews. Surgeries occurred in 2021 (n = 8), 2020 (n = 4), 2019 (n = 2), and one participant each had surgery in 2014, 2009, and 2004. Thematic analysis elicited themes related to post-operative dieting. RESULTS: All participants reported chronic pre-surgery dieting. Lifestyle change was the overarching post-surgical theme comprising (i) flexibility (e.g. allowing food, intuitive eating), and (ii) control, comprising surgery control (e.g. set portions, surgery instilled control) and dieting control (e.g. discipline, restriction/restraint). Descriptions of lifestyle change often mirrored pre-surgery descriptions of dieting. CONCLUSION: Post-surgery lifestyle change appears to encompass a tension between flexible/adaptive approaches to eating and the need to maintain control. Control may emerge as practices that mirror pre-surgery dieting with the potential to interfere with adaptive eating behaviours or promote disordered eating. Dieting behaviours may be a precursor to the development of disordered eating. Health care practitioners should regularly assess dieting behaviour post-surgery to enable early intervention where warranted. Future research should consider how post-surgery re-emerging dieting may be identified and measured to aid in intervention.

A Slim Majority: The Influence of Sex Ratio on Women's Body Dissatisfaction and Weight Loss Motivations.

The current investigation examined whether women's perceptions of the sex ratio (ratio of women to men) in the local population influence their body dissatisfaction and weight loss motivations. A higher ratio of women to men in a given population signifies a relative abundance of same-sex mating competitors, intensifying female intrasexual competition. Five studies (N = 1,776) tested the hypotheses that women's perceptions of a female-skewed sex ratio would correspond to increased feelings of intrasexual competitiveness and perceptions of unfavorable mating prospects, which would, in turn, be associated with heightened body dissatisfaction and weight loss motivations. Among university and community women (Studies 1and 2), perceptions of a female-skewed sex ratio corresponded to greater intrasexual competitiveness, increased body dissatisfaction, and increased dieting inclinations. Among single women, assessments of a female-skewed sex ratio corresponded to perceptions of unfavorable mating prospects, increased romantic pressure to alter their appearance, and higher body dissatisfaction (Study 3). Studies 4 and 5 experimentally manipulated perceived sex ratio. Women in the female-skewed condition felt less satisfied with their weights and shapes, but only if they believed the manipulation (Study 4). In Study 5, using a within-subjects design, women who evaluated a male-skewed (vs. female-skewed) dating profile array subsequently desired to lose less weight. Findings suggest women's perceptions of their social environments may contribute to body image and dieting motivations.