There is a correlation between nutritional status, Self-Rated Health and Life Satisfaction? Evidence from 2018 Health Behaviour in School-aged Children cross sectional study in a sample of Italian adolescents living in Tuscany Region.

Background: Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them. Methods: A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese). Results: The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females. Conclusions: Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.

Interactions between physical activity and psychological factors in the association with the risk of lean type 2 diabetes mellitus.

Background: The extent to which physical activity and psychological factors may affect the risk of diabetes mellitus among lean individuals remains unclear.Purpose: This study aimed to investigate the associations of total physical activity (TPA) and psychological factors with lean type 2 diabetes mellitus (T2DM) risk.Research Design: A prospective cohort study.Study Sample: The study population included 1,945 Korean adults who maintained a body mass index <23 kg/m2.Data Collection and Analysis: Baseline data on TPA and psychological factors were collected and T2DM incidence was assessed for 10 years. For analysis, a multivariable Cox proportional hazards regression model was used.Results: TPA was inversely associated with T2DM risk and this association was more pronounced in participants who were depressed or distressed; the top TPA quartile exhibited significant reductions in T2DM risk of 66% (95% confidence interval [CI]: 0.15, 0.78) and 65% (95% CI: 0.14, 0.88) among participants who reported depressed mood and those who perceived high distress, respectively, compared with the bottom TPA quartile.Conclusions: The current study demonstrated the preventive effects of physical activity on T2DM in lean adults through its interaction with psychological factors.

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis.

Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors. We therefore aimed to assess parent perceptions of child weight, and parent reports of child appetite using the Baby Eating Behavior Questionnaire (BEBQ), in a sample of infants and toddlers with CF, compared with a community sample. We additionally assessed relationships of parent perceptions of child weight with parent feeding behaviors in the sample with CF. Anthropometric and questionnaire data were collected for 32 infants and toddlers with CF, as well as 193 infants and toddlers drawn from RESONANCE, a community cohort study. Parents perceived children with CF to be lower in weight than their actual weight, to a greater extent than was evident in the community sample. Parents who perceived their children with CF to be underweight vs. right weight reported greater slowness in eating on the BEBQ. Parents perceived children with CF to have greater slowness in eating and lower enjoyment of food, compared to parents of children in the community sample, independent of sample differences in child weight, age, and sex. Our results demonstrate the potential utility of the BEBQ in a clinical sample and suggest it may be helpful for clinicians to assess parents' perceptions of their child's weight and appetite to promote a fuller understanding of the child's nutritional status, facilitate appropriate feeding behaviors and alleviate unnecessary concerns.

Conditioned overconsumption is dependent on reinforcer type in lean, but not obese, mice.

Associative learning can drive many different types of behaviors, including food consumption. Previous studies have shown that cues paired with food delivery while mice are hungry will lead to increased consumption in the presence of those cues at later times. We previously showed that overconsumption can be driven in male mice by contextual cues, using chow pellets. Here we extended our findings by examining other parameters that may influence the outcome of context-conditioned overconsumption training. We found that the task worked equally well in males and females, and that palatable substances such as high-fat diet and Ensure chocolate milkshake supported learning and induced overconsumption. Surprisingly, mice did not overconsume when sucrose was used as the reinforcer during training, suggesting that nutritional content is a critical factor. Interestingly, we also observed that diet-induced obese mice did not learn the task. Overall, we find that context-conditioned overconsumption can be studied in lean male and female mice, and with multiple reinforcer types.

The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis.

AIM: To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions. MATERIALS AND METHODS: The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling. RESULTS: The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification. CONCLUSIONS: Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.

The "Young Athlete Body Project"-A pilot study evaluating the acceptability of and results from an eating disorder prevention program for adolescent athletes.

BACKGROUND: The high frequency of eating disorders (EDs) in sports speaks of a need for early-stage preventive measures. OBJECTIVES: This study evaluated the acceptability of an age, sex, and sports adapted version of the "Body Project" and changes in mental health symptoms. METHODS: This noncontrolled pilot study included a class of athletes from 18 sports (N = 73, 13-14 years) at a sport-specialized junior high school in six small-group workshops. We interviewed 34 athletes on program acceptability, and all athletes responded to questionnaires at pretest, posttest, and 6-month follow-up including the Body Appreciation Scale 2-Children, Social Attitudes towards Appearance Questionnaire-4 revised, Eating Disorder Examination Questionnaire Short form-12 modified, and questions about body appearance pressure (BAP). RESULTS: Athletes found the program acceptable and beneficial, but some missed physically oriented activities or did not identify with the focus, particularly boys. There were acceptable levels in mental health constructs before the workshops. There were temporary changes in the percentage of boys experiencing "BAP in society" by -14.8% points (95% CI: -.6 to .0, p = .04), % in total group experiencing "BAP at school" by +11% points (95% CI: .0-.2, p = .05), thinness idealization by girls (g = .6, p = .002) and total group (g = .4, p = .006), and muscularity idealization by boys (g = .3, p = .05) and total group (g = .23, p = .04). DISCUSSION: Athletes experienced benefits from the Young Athlete Body Project. Seeing stabilization in outcomes may mean a dampening of the otherwise expected worsening in body appreciation and ED symptoms over time. PUBLIC SIGNIFICANCE: Adolescent athletes are at risk for developing EDs. Due to lack of prevention programs for this group, we adapted and evaluated a well-documented effective program, the Body Project, to fit male and female athletes <15 years. The athletes accepted the program and experienced participation benefits, with stronger acceptance among girls. Our promising findings encourage larger scaled randomized controlled trials to further evaluate a refined version this program among very young athletes.

Being underweight, academic performance and cognitive control in undergraduate women.

The prevalence of underweight among young women is a serious international health issue. However, the evidence on how being underweight negatively affects brain health and cognition is still unclear. This study investigated the association between underweight status, academic performance, and neurocognitive control in young Japanese women using a cross-sectional design. We analyzed the academic performance of female undergraduates, comparing underweight and healthy-weight groups (n = 43; age 18-23 years, M = 21.1, SD = 1.3) based on their grade point average (GPA). We also analyzed their error-related negativity (ERN), an electrophysiological measure that potentially reflects academic performance, during an arrowhead version of the flanker task to assess cognitive control of action monitoring. Participants with a low body mass index were found to have lower GPAs. Furthermore, the underweight students exhibited smaller ERN amplitudes, which indicates decreased cognitive control in action monitoring. These findings suggest that a healthy weight status is essential for effective cognitive functioning and academic success in young adult women, among whom being underweight is a serious health problem.

The female athletic ideal - Friend or foe? Fit, thin, and athletic body ideals and their associations with women's body image.

The internalization of body ideals is a critical predictor of body image and health behaviors. Thin and athletic ideal internalization in women need to be elucidated. The aims of the current study included: (i) describing the endorsement of thin and athletic body ideals among women and (ii) examining group differences in negative and positive self-conscious emotions and body image. Participants (N = 392 women; Mage = 25.6, SD = 5.3 years) were assigned to Fit Ideal (n = 110), Thin Ideal (n = 83), Athletic Ideal (n = 55), and Low Internalization (n = 144) groups based on scores for thin and athletic internalization. Three multivariate analyses of variance were conducted to examine Body Ideal group differences on negative appearance and fitness self-conscious emotions, and positive self-conscious emotions and body image. The Athletic Ideal and Low Internalization groups generally scored lower on negative self-conscious emotions and higher on positive self-conscious emotions and body image in comparison to the Fit and Thin Ideal groups (Cohen's d =.35 to 1.15). Results suggest that differing levels of thin and athletic internalization may intersect uniquely with women's body-related self-conscious emotions and positive body image and thus may have distinct effects on women's health and behavior.

A Close Association between Body Weight, Health-Related Quality of Life, and Risk Behaviors in a Sample of Italian High School Students.

INTRODUCTION: Adolescents experience rapid physical, cognitive, and psychosocial growth with different factors contributing to health and well-being. In this view, an important role is played by body weight and related perceptions. The purpose was to determine, in a sample of Italian high school students, whether health-related quality of life (HRQoL) is associated with the different weight status categories (underweight, normal weight, overweight, obese), even considering sex differences. MATERIAL AND METHODS: Data were collected from 1826 adolescents (n = 735 males). HRQOL was analyzed using the Italian version of KIDSCREEN-52. RESULTS: Overweight adolescents showed reductions in psychological well-being (p < 0.05) and self-perception (p < 0.05) compared with individuals in other BMI categories. Subjects with obesity reported increased bullying victimization (p < 0.05) and reductions in self-perception and eating disorders (p < 0.001), while underweight individuals were characterized by altered adherence to the Mediterranean diet (p < 0.001), eating disorders (p < 0.001), and problematic use of social media (p < 0.05). No sex differences were found, except for socio-economic status perceptions, where underweight girls reported higher economic well-being than boys (p < 0.05). CONCLUSIONS: Our findings may suggest that there is an association between weight status categories and HRQoL that is more pronounced in underweight and overweight adolescents. The association between BMI categories and psychosocial dimensions opens the need to define specific domains on which such preventive interventions should focus, always through a personalized perspective.

Cohort profile: the longitudinal National Growth and Health Study (NGHS) of black and white girls from Northern California tracking how behavioural and psychosocial risk factors predict cardiovascular risk and biological ageing in midlife and in offspring.

PURPOSE: The National Heart, Lung and Blood Institute Growth and Health Study (NGHS) prospectively collected anthropometric, biospecimens, clinical, health behaviour and psychosocial measures associated with cardiovascular disease from childhood to young adulthood. The aim of the current study was to assess the impact of stress, dysregulated eating and social genomic biomarkers on cardiometabolic risk factors among the original participants now in midlife and their children. PARTICIPANTS: Beginning in 1987-1988, NGHS recruited black and white girls (age 9-10 years) from socioeconomically diverse backgrounds from from three sites: Cincinnati, Ohio; Washington, DC; and Western Contra Costa County, California (N=2379) and followed them for 10 years. The study maintained an 89% retention rate. The current study is 30 years after the start of the original study and focused on the participants of California (n=887) and their children aged 2-17 years. We re-enrolled 624 of 852 eligible participants (73%): 49.2% black and 50.8% white. The mean age was 39.5 years. Among the 645 eligible biological children, 553 were enrolled; 49% black and 51% white, with 51.5% girls and 48.5% boys. The mean age was 9.3 years. FINDINGS TO DATE: Longitudinal analysis of adolescent drive for thinness predicted higher scores for drive for thinness during midlife, which was indirectly associated with greater adult body mass index through adult drive for thinness. Latent trajectory modelling of adolescent growth over 10 years found that women with persistently high weight trajectory had twice the odds of having children who met the definition for obesity compared with the persistently normal group, adjusting for adult weight. FUTURE PLANS: New studies on neighbourhood socioeconomic status, food insecurity and additional biomarkers of chronic stress, microbiome and accelerated ageing (ie, telomere length and epigenetic clock) are underway. We are developing a 10-year follow-up to understand changes in ageing biomarkers of the participants and their children. TRIAL REGISTRATION NUMBER: NCT00005132.

Predicting long-term outcome in anorexia nervosa: a machine learning analysis of brain structure at different stages of weight recovery.

BACKGROUND: Anorexia nervosa (AN) is characterized by sizable, widespread gray matter (GM) reductions in the acutely underweight state. However, evidence for persistent alterations after weight-restoration has been surprisingly scarce despite high relapse rates, frequent transitions to other psychiatric disorders, and generally unfavorable outcome. While most studies investigated brain regions separately (univariate analysis), psychiatric disorders can be conceptualized as brain network disorders characterized by multivariate alterations with only subtle local effects. We tested for persistent multivariate structural brain alterations in weight-restored individuals with a history of AN, investigated their putative biological substrate and relation with 1-year treatment outcome. METHODS: We trained machine learning models on regional GM measures to classify healthy controls (HC) (N = 289) from individuals at three stages of AN: underweight patients starting intensive treatment (N = 165, used as baseline), patients after partial weight-restoration (N = 115), and former patients after stable and full weight-restoration (N = 89). Alterations after weight-restoration were related to treatment outcome and characterized both anatomically and functionally. RESULTS: Patients could be classified from HC when underweight (ROC-AUC = 0.90) but also after partial weight-restoration (ROC-AUC = 0.64). Alterations after partial weight-restoration were more pronounced in patients with worse outcome and were not detected in long-term weight-recovered individuals, i.e. those with favorable outcome. These alterations were more pronounced in regions with greater functional connectivity, not merely explained by body mass index, and even increases in cortical thickness were observed (insula, lateral orbitofrontal, temporal pole). CONCLUSIONS: Analyzing persistent multivariate brain structural alterations after weight-restoration might help to develop personalized interventions after discharge from inpatient treatment.

Association of Social Networking Sites Use with Actual and Ideal Body Shapes, and Eating Behaviors in Healthy Young Japanese Women.

Recent reports have associated the use of social networking sites (SNS) with the drive for thinness in young women; however, its influence on their actual body shape and eating behaviors (EB) remains unclear. We aimed to examine the effect of SNS use on body mass index (BMI), body image (BI), and EB in young women. Participants included 196 healthy women (20-29 years) who answered questions about their SNS use, height, weight, BI and EB via a web-based survey. First, the correlation between time spent on SNS and each variable was determined. Participants were then divided into quartiles according to the duration of daily SNS use as long (≥3 h, n = 52) and short (<1 h, n = 54), and the data were then compared between the groups. Correlation analysis showed that the longer the duration of daily SNS use, the significantly lower the BMI, the use of nutrition labels, and the frequency of consumption of milk and dairy products. The long group had significantly lower BMI and ideal BI than the short group. The results suggest that spending more time on SNS in young women may be associated with thinner actual and ideal body shapes and poorer access to health information and healthy foods.

Secular trends in body image dissatisfaction and associated factors among adolescents (2007-2017/2018).

OBJECTIVE: To assess secular trends in body image dissatisfaction and associated factors among adolescents over a 10-year period (2007-2017/2018). METHODS: The sample included 1,479 (2007, n = 531; 2017/2018, n = 948) high school adolescents of both sexes, aged 14 to 18 years, of schools in a city in southern Brazil, in 2007 and 2017/2018. Data were collected on sex, age, physical activity (IPAQ, short form), anthropometric measurements (body weight, height, and triceps and subscapular skinfolds), and body image dissatisfaction (figure rating scale). The variables were compared with Independent samples t-test and Mann-Whitney U-test. The associations between sex and other variables were examined with chi-square test, and the factors associated with body image were identified with multinomial logistic regression. RESULTS: Most adolescents were dissatisfied with their body image in 2007 (65,2%) and 2017/2018 (71,1%). The prevalence of body dissatisfaction increased by 9.2% over the 10-year period, particularly dissatisfaction with thinness (21.3%). After stratification by sex, in 2017/2018 sample, dissatisfaction with overweight was 46.1% greater in boys, and dissatisfaction with thinness was 66.9% greater in girls. Factors found to be significantly associated with body image dissatisfaction were physical activity level, and body adiposity. CONCLUSIONS: There was a secular trend toward increased body image dissatisfaction in both sexes. Future efforts should go beyond scientific production, in public and private environments aimed at increasing awareness of health issues related to body care in the physical, psychological, and environmental domains.

The independent contribution of muscularity-oriented disordered eating to functional impairment and emotional distress in adult men and women.

Muscularity-oriented disordered eating (MODE) refers to a broad cluster of pathological eating patterns driven by the pursuit of muscularity and leanness. Although increasing attention has been devoted towards understanding these symptoms in men, little work has been conducted to understand MODE in women. It is also unclear whether MODE contributes unique variance to functional impairment and emotional distress beyond thinness-oriented disordered eating symptoms. We addressed these gaps in a sample of 1,321 community-based adult women (n = 1136) and men (n = 185). Hierarchical multiple regressions revealed that MODE explained a significant proportion of unique variance in functional impairment in both men and women, even after controlling for traditional thinness-oriented disordered eating symptoms. MODE also contributed unique variance in symptoms of depression and anxiety in women, but not for men. Findings highlight the possible significance of these unique symptoms patterns geared towards the pursuit of muscularity and leanness. MODE symptoms may be a viable target in eating disorder intervention or prevention programs, although further longitudinal research is needed.

Relationships between body image and mental health in white, cisgender college students.

PURPOSE: Previous studies have suggested that drive for leanness (DL) may be less maladaptive than drive for thinness (DT) or drive for muscularity (DM). However, no studies have examined whether there might be gender differences in the relationships between these three drives and mental health variables. The purpose of this study was twofold. First, we wanted to examine DL in the context of mental health and to see if it is less maladaptive than DT and DM. Second, we wanted to examine gender differences in the relationships between body dissatisfaction (DT, DM, DL) and mental health in a sample of college students. METHODS: A sample of 988 White, heterosexual, cisgender college students (76.8% female) completed an omnibus survey measuring body image (DL, DT, DM) and mental health (generalized anxiety, social physique anxiety, self-esteem) variables. Regression analyses evaluated associations between these drives and mental health variables. RESULTS: DT predicted all three mental health outcomes in both men and women. DM predicted generalized and social physique anxiety in women but only generalized anxiety in men. DL predicted social physique anxiety only in women. CONCLUSION: Because we found gender differences in body image and relationships between body image and mental health, future studies should take gender into account when exploring body image and related variables. LEVEL OF EVIDENCE: V Cross-sectional descriptive study.

A qualitative investigation of the phenomenology of muscle dysmorphia: Part 1.

Muscle dysmorphia (MD) is a psychological disorder defined by preoccupation with one's perceived lack of muscularity and/or leanness, causing significant functional impairment. Studies of individuals with diagnosed MD are rare and no large-scale qualitative studies of the disorder exist. We conducted a qualitative study exploring the lived experiences of 29 individuals with diagnosed MD. Using reflexive thematic analysis, we generated five themes capturing the core features of MD. We identified two distinct phenotypes of MD: a "muscular/lean phenotype" focused on both gaining muscle and remaining lean, and a "muscular phenotype" with a sole preoccupation of increasing muscle mass. Participants also described their physique goals as never-obtained "moving goalposts", differed in their desire for muscularity versus leanness, and experienced fluctuations in body dissatisfaction during "cutting" versus "bulking" phases, and pre- versus post-workout. Almost all participants reported avoiding public body exposure and compulsively mirror-checking. Most were rigorous dieters who meticulously tracked their caloric and macronutrient intake, and were obsessive about meeting protein targets. Disruptions to dieting and training were often minimised by compromising their social lives. Low self-esteem appeared a predisposing factor for MD, while social comparison, body image distortion, and integration of MD into one's self-identity may represent maintaining factors. Additional clinically valuable insights into MD's phenomenology are discussed in detail.

The effects of exposure to social media images of thin and average size women on body satisfaction among young women: Emotion regulation and self-efficacy as modulating factors.

Although appearance comparison has emerged as an important mechanism underlying the detrimental effects of exposure to idealized social media images on body image among young women, little is known regarding the role of the direction of these comparisons. In addition, to date, little attention has been paid to the role of self-regulation processes in these effects. A sample of 260 female students (Mage = 19.6) from a University in Paris completed an online survey where they were randomly assigned to view thin-ideal or average size social media images of women. Participants reported on state body satisfaction before and after exposure, as well as state appearance comparison and direction of appearance comparison, and trait emotion regulation difficulties and self-efficacy. Findings revealed no main effect of condition. However, among participants who engaged in upwards appearance comparison the thin-ideal condition was associated with greater decreases in body satisfaction. In addition, three-way interactions revealed that emotional regulation difficulties and self-efficacy both further moderated these effects. These findings suggest that self-regulation processes may be important to account for in the effects of exposure to social media images on body satisfaction among young women.

Testing the interaction of thinness/restriction and negative affect reduction expectancies on disordered eating behavior.

OBJECTIVE: Thinness/restriction expectancies (i.e., perceived rewards from thinness/dietary restriction) and negative affect reduction expectancies (i.e., beliefs that eating will reduce negative emotions) are associated with disordered eating, but have largely been studied in isolation despite evidence that individuals can endorse these expectancies simultaneously. Guided by the goal conflict model, we hypothesized that for individuals reporting high levels of one type of expectancy, stronger endorsement of the second expectancy category would be associated with more dietary restriction, binge eating, and compensatory behaviors. A secondary aim included testing an adapted goal conflict model. DESIGN: Interaction effects were tested using multiple linear and negative binomial regressions. Exploratory indirect effect models tested the adapted goal conflict model. Given gender differences, hypotheses were tested separately by gender. MEASURES: Participants (N = 406, 54.2% female, non-Hispanic White = 68.8%, Mage = 20.99, MBMI = 25.05) completed measures of thinness/restriction expectancies, negative affect expectancies, dietary restriction, binge eating, and compensatory behaviors (e.g., purging, laxative/diuretic use, compensatory exercise). RESULTS: No statistically significant interaction of thinness/restriction and negative affect expectancies on disordered eating was observed for either the male or female sample. Main effects models revealed consistent findings across subsamples. Greater thinness/restriction expectancies were associated with more dietary restriction, binge eating, and compensatory behaviors. Greater negative affect reduction expectancies were associated with more binge eating. Exploratory indirect effect models yielded significant effects of each expectancy category on disordered eating. CONCLUSION: Expectancies may be independent risk factors for disordered eating. Disordered eating prevention and intervention efforts may benefit from explicitly targeting thinness/restriction and negative affect expectancies.

Associations between Schizotypal Facets and Symptoms of Disordered Eating in Women.

Research has suggested that schizotypy-a personality organisation representing latent vulnerability for schizophrenia-spectrum disorders-may be elevated in women with symptoms of disordered eating. However, studies have not fully considered associations between symptoms of disordered eating and multidimensional schizotypy. To overcome this limitation, we asked an online sample of 235 women from the United States to complete measures of symptoms of disordered eating (drive for thinness, body dissatisfaction, and bulimic symptoms) and multidimensional schizotypy. Correlational analyses indicated significant associations between drive for thinness and bulimic symptoms, respectively, and most schizotypal facets. Body dissatisfaction was significantly associated with only two schizotypal facets. Overall, the strength of correlations was weak-to-moderate. Regression results indicated that only the schizotypal feature of excessive social anxiety was significantly associated with all risk for disordered eating factors. These results are consistent with aetiological models of disordered eating that highlight socio-affective difficulties as risk factors for symptoms of disordered eating.

Examining relationships among thin-ideal internalization, eating pathology, and motivational reactions to high- and low-calorie food.

Motivational responses to food stimuli are relevant for eating disorders (EDs). Research examining reactions to food in EDs has been mixed, with some studies reporting enhanced appetitive responses, and others observing defensive responses, to food. Thin-ideal internalization, a socio-cognitive factor implicated in EDs, may relate to these mixed findings, as individuals with eating pathology may experience food as a threat to internalized ideals of thinness, despite its inherently appetitive qualities. In the present study, physiological reflexes measuring defensive (startle blink reflex) and appetitive (postauricular reflex) responding as well as self-report ratings were recorded while 88 women with and without eating pathology viewed images of high- and low-calorie food. Greater global eating pathology, but not thin-ideal internalization, was associated with negative self-report valence ratings and lower craving ratings of high-calorie food. In contrast, greater thin-ideal internalization and eating pathology both related to more positive self-report valence ratings of low-calorie food, with thin-ideal internalization accounting for some of the shared variance between low-calorie food ratings and eating pathology. Overall, thin-ideal internalization may represent a higher-order factor that may contribute to the relationship between conscious reactions to food and disordered eating.