Measurement invariance of two measures of positive body image among Hispanic/Latina undergraduate women.

Although positive body image is associated with mental and physical health benefits, there is a relative dearth of research investigating the psychometric properties of commonly used measures of positive body image among Hispanic/Latina women in the United States. The current study explored the psychometric properties of the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) and the Functionality Appreciation Scale (FAS; Alleva et al., 2017) in undergraduate women. Altogether 565 undergraduates (n = 386 Hispanic/Latina; n = 179 non-Hispanic White [NHW]) completed the BAS-2, FAS, and demographic questionnaires. Confirmatory factor analysis (CFA) and measurement invariance testing across ethnicity was conducted on each measure. The CFA confirmed the 1-factor, 10-item model of the BAS-2 among Hispanic/Latina women but indicated a less than adequate model fit for the FAS which improved after correlating the residuals of items 6 and 7. Measurement invariance testing revealed evidence of partial scalar invariance of the BAS-2 and full invariance of the FAS across ethnicity. There were no significant mean differences between groups on the measures. These analyses indicate acceptable psychometric properties of the BAS-2 and FAS among Hispanic/Latina women. Nonetheless, they did suggest potentially meaningful group differences in how these items behaved, which warrant further exploration.

Examination of ecological validity of intuitive eating.

BACKGROUND: Intuitive eating, which involves following internal cues of hunger and satiety to guide eating choices, would be better understood if studied at the individual momentary level instead of globally or cross-sectionally. The current study employed ecological momentary assessment (EMA) to examine the ecological validity of a popular intuitive eating measure, the Intuitive Eating Scale (IES-2). METHOD: College males and females completed a baseline assessment of trait levels of intuitive eating as measured by the IES-2. Participants then followed a seven-day EMA protocol where they completed brief smart phone assessments about intuitive eating and related constructs while in their natural daily environments. Participants were asked to complete recordings before and after eating about their state level of intuitive eating at that moment. RESULTS: Among 104 participants, 87.5% were female, mean age was 24.3, and mean BMI was 26.3. Baseline trait level intuitive eating was significantly correlated with state level intuitive eating reported across EMA recordings, with some evidence suggesting that correlations were stronger before eating compared to after eating. Intuitive eating generally was related to less negative affect, fewer eating restrictions, and more anticipated taste enjoyment before eating, as well as less guilt and regret after eating. DISCUSSION: Individuals who reported high trait levels of intuitive eating also reported following their internal cues for hunger and satiety and had less guilt, regret, and negative affect surrounding eating in their naturalistic environments, thereby supporting the ecological validity of the IES-2.

A qualitative exploration of perceived barriers and facilitators to following an intuitive eating style.

BACKGROUND: Intuitive eating involves following internal cues of hunger and satiety to guide eating choices as opposed to responding to external signals, strong emotions, or dietary rules. This style of eating has consistently been shown to be related to better physical and psychological health indicators, and more interventions are being designed and studied to promote this eating style. The current study aimed to identify anticipated facilitators and barriers to following this style of eating among a group of college students enrolled in a larger study of intuitive eating. METHOD: Following a week of tracking their current eating as part of a larger study, college students read a description of intuitive eating. They then answered three open-ended questions about following intuitive eating including facilitators, barriers, and perceived ability to follow long term. Responses were coded using thematic analysis to identify themes across responses. RESULTS: Among 100 participants, 86 % were female, 46 % were Hispanic (41 % non-Hispanic White, 13 % other race/ethnicity), mean age was 24.3 years, and mean body mass index was 26.2. The most commonly anticipated participant-reported facilitators of intuitive eating were being in touch with the body's needs and hunger cues, positive perceptions of intuitive eating, and health considerations. The most commonly anticipated barriers were logistical constraints (e.g., busyness and mealtimes), difficulty with hunger cues and reactions to food, and negative perceptions of intuitive eating. The majority of participants (64 %) would consider following this style of eating long term. DISCUSSION: This study provides information that can be used to improve efforts aimed at promoting intuitive eating to college students, including marketing intuitive eating interventions, and clarifying misunderstandings of its key tenets that might serve as barriers.

Examining the individual and relational impacts of varying responses to negative body talk within college women's female friendships.

Many college women make self-disparaging comments about their appearance to others. This "fat talk" (negative body talk) is a causal risk factor for body image disturbance, which in turn predicts eating disorders and depression. Research is needed to identify effective responses to negative body talk; namely, those that reduce negative body talk without shaming its initiator or damaging the relationship. The current study examined the impact of different responses to negative body talk on the likelihood of future negative body talk and on individual and relationship factors. College women (N = 160) recalled a situation using negative body talk with a female friend. Participants listened to audio recordings of four responses (Deny/Reassure, Challenge, Empathize/Reciprocate, Ignore) and rated appearance satisfaction, shame, friendship support, and likelihood of future negative body talk after each. Linear mixed models indicated that the Deny/Reassure response followed closely by the Challenge response were most beneficial for individual and relationship factors; however, participants reported being least likely to use future negative body talk after the Ignore response. Recommendations for developing promising responses to negative body talk include combining responses to balance validation (Deny/Reassure) and change (Challenge), and studying the contribution of other relationships and varying body dissatisfaction levels.

Assessing hedonic hunger among Chinese adults using the Power of Food Scale: Psychometric properties and cross-cultural invariance between China and the US.

Hedonic hunger refers to food consumption for pleasure without biological energy deficits. The Power of Food Scale (PFS) is a well-developed self-report instrument assessing hedonic hunger. The present study aimed to translate and validate the PFS into simplified Chinese (C-PFS) and examine its psychometric properties among Chinese adults. A total of 773 participants (51.1 % men, M age = 24.98 years, SD = 6.10) were recruited in the present study from college and community populations. Consistent with the previous studies, confirmatory factor analysis showed that the C-PFS had three factors: food present, food available, and food tasted. In addition, a Cronbach's alpha of 0.92 and an ICC of 0.86 suggested that the C-PFS has good internal consistency and test-retest reliability. In terms of convergent validity, the scores of C-PFS correlated significantly with disordered eating symptomatology and loss of control over eating. Measurement invariance tests showed that the C-PFS was invariant across gender and sample source groups in the Chinese sample. In addition, a U.S. sample of 490 college students (26.6 % men, M age = 21.41 years, SD = 5.45) was used to test the measurement invariance across countries, and results suggested a partial invariance across college students from China and those from the U.S. In conclusion, the C-PFS can be a useful tool for measuring hedonic hunger among adults in China, and there may be cultural differences in the measurement of the PFS in college students across China and the U.S.

Using Exploratory Structural Equation Modeling (ESEM) To Examine the Factor Structure and Measurement Invariance of the Farsi Version of the Children's Eating Attitudes Test (F-ChEAT) among Iranian Preadolescents Across Gender and Age.

Despite considerable examination of the Children's Eating Attitudes Test (ChEAT) in Western societies, there is no study about the ChEAT in Iran. The purpose of the current study was to translate and examine the factor structure and measurement invariance of the Farsi version of the ChEAT (F-ChEAT) among Iranian preadolescents. Iranian preadolescents (N = 717) completed the F-ChEAT and demographic information. Exploratory structural equation modeling (ESEM) was used to examine the factor structure and measurement invariance across gender and age. A 5-factor, 15-item ESEM model showed an excellent fit of the data. Tests of measurement invariance suggested that scores on the latent means could be meaningfully compared across gender and age. Girls had higher latent means on the Food Preoccupation and Caloric Awareness and Control factors, and older preadolescents had higher latent means on all the F-ChEAT factors, except for the Dieting factor. Findings suggest that a 5-factor, 15-item ESEM model of the F-ChEAT was a useful assessment tool to understand disordered eating symptoms in Iranian preadolescents.

What Is Healthy Eating? Exploring Profiles of Intuitive Eating and Nutritionally Healthy Eating in College Women.

PURPOSE: Research suggests that food's nutritional content and the feelings and behaviors associated with eating contribute to overall health, yet these constructs are rarely considered simultaneously. The current cross-sectional study investigated healthy eating profiles in college women that included both nutritional quality and intuitive eating (IE), with IE being an eating style that prioritizes physiological hunger/satiety cues and minimizes dieting and emotional eating. DESIGN/SETTING/SUBJECTS: Undergraduate women (n = 352) completed an online assessment and daily diaries (80% retention). MEASURES: Nutritionally healthy eating, IE, dieting, body dissatisfaction, disordered eating, and psychological health were examined. ANALYSIS: Latent profile analysis explored patterns of nutritionally healthy eating and IE, and determined how these patterns related to psychological and disordered eating outcomes. RESULTS: A four-profile solution emerged: 1) Dieting (high nutritionally healthy eating + intermediate IE), 2) Unhealthy Eating (low nutritionally healthy eating + low IE), 3) Intuitive Eating (moderately high nutritionally healthy eating + high IE), and 4) Non-Dieting (low nutritionally healthy eating + intermediate IE). These profiles significantly differed from one another, such that the Intuitive Eating and Non-Dieting profiles reported lower psychological distress, body mass index, and disordered eating compared to other profiles, while the Dieting and Unhealthy Eating profiles showed the healthiest and poorest nutritional eating, respectively. CONCLUSION: These findings suggest that IE and nutritionally healthy eating are distinct factors in conceptualizing the eating patterns of college women, and both should be considered when developing interventions. Future research should replicate these findings in larger/more diverse samples and examine eating profiles longitudinally.

Factor analytic support for the EDE-Q7 among American Indian/Alaska Native undergraduate women.

OBJECTIVE: American Indian/Alaska Native (AI/AN) people have historically been excluded from eating disorder research. Consequently, not much is known about the validity of eating disorder assessment measures in this group. The purpose of the current study was to examine the factor structure of a short measure for eating pathology, the seven-item Eating Disorder Examination Questionnaire (EDE-Q7), in AI/AN undergraduate women. Exploratory analyses examined the measurement invariance of the EDE-Q7 across AI/AN, White, and Latinx undergraduates. METHODS: A sample of 150 AI/AN undergraduate women completed the full EDE-Q (28 items) as part of two larger studies. The seven items comprising the EDE-Q7 were selected from the full measure to test the factor structure. Random samples of White and Latinx women of equal sample size were chosen from the larger studies to test measurement invariance. RESULTS: Confirmatory factor analyses found support for the EDE-Q7 factor structure in AI/AN undergraduate women, and scores were strongly positively correlated with the original EDE-Q global scale and disordered eating behaviors. Exploratory analyses found support for the measurement invariance of the EDE-Q7 across AI/AN, White, and Latinx women. One-way ANOVAs showed no significant racial and ethnic differences on the EDE-Q7. DISCUSSION: The current study found psychometric support for the EDE-Q7 in AI/AN undergraduate women and provided preliminary evidence that the EDE-Q7 can be meaningfully compared across AI/AN, White, and Latinx undergraduate women. Further research should continue to investigate the EDE-Q7 and other eating disorder measures in AI/AN and other historically excluded groups. LEVEL OF EVIDENCE: V, cross-sectional descriptive study.

Development and psychometric evaluation of an empirically-derived daily checklist of weight control: Consumption-reduction strategies and health-focused strategies in college students.

Objective: Many college women report engaging in weight control strategies, yet little is known about which strategies are used and how often. The current study's goal was to evaluate the factor structure of a comprehensive list of weight control behaviors used in the previous 24-hours. Participants: Undergraduate women (N = 286) were recruited from a southwestern university. Methods: Participants reported their weight control strategies for the previous 24 hours on a checklist compiled from previous studies. Results: Exploratory and confirmatory factor analyses indicated that a 14-item, 2-factor ("Consumption-reduction", "Health-focused" Strategies) structure was a good fit of the data. Tests of longitudinal measurement invariance found support for using the checklist to make meaningful comparisons across time. Conclusions: This study developed a checklist of past 24-hour weight-control strategy usage, thereby providing a step toward developing an instrument that may be used for weight control or early intervention for disordered eating.

A factor analytic approach to understanding health risk behaviors and resilience among multi-racial/ethnic adolescents in New Mexico.

OBJECTIVE: This study examined the factor validity of health risk behaviors and resilience indicators and their covariation across a large racially/ethnically diverse adolescent population. DESIGN: The study subsample (47% Hispanic, 31% White Non-Hispanic, 17% American Indian) was derived from the 2013 New Mexico Youth Risk Resilience Survey (YRRS; N-19,033). We conducted a confirmatory factor analysis on the 6 health risk domains identified by the CDC as contributing most to adolescent morbidity/mortality: (1) cigarette use, (2) alcohol and other illicit drug use, (3) marijuana use, (4) sexual activity, (5) nutrition habits, and (6) physical activity. RESULTS: A 4-factor CFA model of adolescent health risk behaviors was replicated, and a hypothesized 6-factor structure based on behaviors that contribute most to adolescent morbidity/mortality was confirmed. The pattern of covarying risk behaviors differed by Hispanic, Native American, and Non-Hispanic White groups. We also confirmed a single external resilience-interference factor (decreased parental support, low school/community engagement, negative peer associations) that positively correlated with all six risk behaviors. CONCLUSION: This study described the structure of adolescent health risk behaviors within a context of psychosocial resilience for American Indian and Hispanic adolescents in contrast to Non-Hispanic White adolescents. Our findings provided evidence for the construct validity of six health-risk behavior dimensions within a large racially/ethnically diverse adolescent sample, which reveal different patterns of loadings, degrees of model fit, and factor inter-correlations across the three racial/ethnic groups. Patterns of covarying risk behaviors differed in strength and direction by racial/ethnic group. Results suggest that interventions should target multiple behaviors and be tailored for different racial/ethnic groups. Targeting health risk and resilience indicators supports the use of multi-level health interventions at the individual, school, family, and community level by identifying individuals based on external resilience scores.

The Bulimia Test-Revised (BULIT-R): Psychometric properties in a non-clinical sample of White and Latina college women.

The Bulimia Test-Revised (BULIT-R) is a measure of bulimia nervosa and binge eating disorder symptoms. While this measure can serve as a useful screening tool, the validity of the BULIT-R in White and Latina samples is uncertain. Previous research has proposed several different BULIT-R factor structures, but has yet to find consistent support for a measurement model or to test measurement invariance. To address this gap, the current study attempted to examine the factor structure and measurement invariance of the BULIT-R among 699 non-clinical White (40.9%) and Latina (59.1%) undergraduate women. Analyses indicated that none of the previously published factor structures in adult samples of the BULIT-R were an acceptable fit in either Latina or White undergraduates. These findings further underscore difficulties in replicating the BULIT-R factor structure, even when using similar sample characteristics to those in the literature. Given the lack of an adequate fitting measurement model, tests of measurement invariance were not conducted. In the absence of measurement invariance of the BULIT-R, there is uncertainty regarding group comparisons, such as whether group differences reflect true differences or are artifacts of measurement error. This study highlights the need for additional psychometric investigation of the BULIT-R. The focus should be on diverse groups as well as non-clinical samples, with the latter being less likely to endorse extreme eating behaviors. Special consideration should be given to the number of items included in the measurement model and the number of indicators per latent factor. Caution should be exercised when interpreting scores on this instrument.

Culturally tailored evidence-based substance use disorder treatments are efficacious with an American Indian Southwest tribe: an open-label pilot-feasibility randomized controlled trial.

BACKGROUND AND AIMS: Many evidence-based treatments (EBTs) for substance use disorder (SUD) exist, yet few are tailored to Indigenous patients. This trial tested the efficacy of a culturally tailored EBT that combined Motivational Interviewing and the Community Reinforcement Approach (MICRA) versus treatment as usual (TAU). DESIGN: A mixed efficacy/effectiveness randomized controlled trial of MICRA (n = 38) and TAU (n = 41) using a parallel design with follow-up assessments at 4-, 8-, and 12- months post baseline. SETTING: United States, reservation-based outpatient, addiction specialty care treatment program. PARTICIPANTS: 79 (68% male) American Indian and Alaska Native (AI/AN) Tribal members meeting criteria for SUD and seeking SUD treatment. INTERVENTIONS: MICRA (individual therapy sessions beginning with MI for 2-3 sessions) compared with TAU (individual and group counseling sessions in a didactic style with Twelve-Step philosophy and elements of relapse prevention). MEASURES: Demographics, percent days abstinent (PDA; the primary outcome at 12months assessed by Form 90D), Inventory of Drug Use Consequences, Alcohol and Drug Use Self-Efficacy Scale, Native American Spirituality Scale, and SCID-DSM-IV-TR. FINDINGS: There was no evidence for the benefit of MICRA over TAU (MICRA PDA = 72.63%, TAU = 73.62%, treatment effect: B = -4.04 (SE = 5.47); 95% CI = -14.941, 6.866; BF = 3.44) in the primary outcome. Both groups showed improvements in PDA, SUD severity, and negative consequences from baseline to the 12-month follow-up. Neither self-efficacy nor spirituality were significant mediators of MICRA. CONCLUSIONS: There were no treatment group differences between culturally tailored evidence-based treatments for substance use disorder and treatment as usual in this randomized controlled trial with American Indian and Alaska Native participants. Nonetheless, participants improved over time on several substance-related outcomes.

Evaluation of the relationships between dietary restraint, emotional eating, and intuitive eating moderated by sex.

Intuitive eating involves attention to feelings putatively related to hunger and satiety to guide eating choices. This adaptive eating style has been linked to a number of positive physical and psychological outcomes. Interestingly, women tend to report lower levels of intuitive eating compared to men. It has been hypothesized that sociocultural pressures or dieting could be contributing factors to this sex discrepancy. The current study aimed to explore whether sex moderates the relationship between either dietary restraint and intuitive eating, or between emotional eating and intuitive eating. Assessments were administered to a sample of college males and females (N = 478) as part of a larger study of eating behaviors. Moderation analyses indicated that higher dietary restraint was more strongly associated with lower levels of intuitive eating in women than in men. Emotional eating also had a stronger negative association with intuitive eating in women compared to men. Additionally, relationships between dietary restraint/emotional eating and a component of intuitive eating, "eating for physical rather than emotional reasons", was stronger for women compared to men. These findings suggest that dietary restraint and emotional eating may serve as barriers in the implementation of an intuitive eating style, especially for women. Prevention and intervention efforts should target those high in dietary restraint and emotional eating.

Body dissatisfaction and disordered eating in Native American, Hispanic, and White College Women.

PURPOSE: The sociocultural model of eating disorders asserts that societies which emphasize the thin-ideal have higher rates of body dissatisfaction and disordered eating. Recent research questions the related presumption that non-White cultures value a larger ideal female and thus have lower rates of body dissatisfaction and disordered eating. The limited research on these constructs in racial/ethnic minorities primarily has used non-validated instruments. The current study investigated rates of body dissatisfaction and disordered eating with validated, widely used measures. METHODS: Measures of body dissatisfaction and disordered eating were completed by 896 college women in the United States: 473 Hispanics, 341 non-Hispanic whites, and 82 Native Americans. RESULTS: Although Native Americans and Hispanics had higher body mass indices (and larger ideal shapes) than White women, the groups had similar body dissatisfaction scores. Native Americans reported somewhat less restricted eating compared to White women. When controlling for body mass index and age, group differences on body dissatisfaction emerged and the group differences in eating disorder symptoms became more pronounced, with White women showing more pathology. Reliability and validity across groups were good. CONCLUSIONS: This study offers some support for the sociocultural model of eating disorders and provides mean scores for Native American and Hispanic females on widely-used eating disorder measures. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Psychometric evaluation of the power of food scale in a diverse college sample: Measurement invariance across gender, ethnicity, and weight status.

The Power of Food Scale (PFS) is an instrument designed to examine individual differences in the drive to eat for pleasure (as opposed to in response to physiological hunger) and the effect of living in an obesogenic environment. Previous research supports the validity and reliability of the PFS, however, it had yet to be validated in an ethnically diverse college sample. The purpose of the current study was to test the factor structure and measurement invariance of the PFS across gender, ethnicity, and weight status. A sample of 432 college students completed the PFS (males=113, females = 319; non-Hispanic white=181, Hispanic=251; non-overweight=302, overweight=130). Confirmatory factor analysis was used to test a second-order, 3-factor (food available, food present, food tasted) structure of the PFS in each group separately (males, females, Hispanic, non-Hispanic white, non-overweight, and overweight) and tests of measurement invariance were conducted to test the equivalency of the measure across gender, ethnicity, and weight status. Results supported the measure's original factor structure (second-order, 3-factor model) and indicated that the measure is equivalent across each of these groups, respectively. Although the small, unbalanced groups may impact the stability of the findings, the results nonetheless suggest that the PFS is a psychometrically valid measure in a diverse college sample, and that mean comparisons on this measure are meaningful across gender, ethnicity, and weight status. Given the measurement invariance of the PFS, there is support for use of the PFS among diverse college students in future work.

Treatment Retention and Outcomes with the Adolescent Community Reinforcement Approach in Emerging Adults with Opioid Use.

Treatment retention and engagement of emerging adults with opioid use disorders can be particularly challenging. This study compares treatment outcomes of young adults with primary opioid use (OU) to those with primary marijuana or alcohol use (MAU), who received the Adolescent Community Reinforcement Approach (A-CRA), an evidence-based therapy for the treatment of substance use. The MAU and OU groups were comprised of an outcome sample of 419 young adults ages 18-25. Groups were compared on intake demographics, clinical characteristics, and measures of treatment retention and other associated factors, including treatment initiation and engagement. Outcome measures were administered at A-CRA intake and at 3, 6, and 12 months post-intake. Both groups were similar in treatment retention, initiation, and engagement. Both groups showed a similar decrease in alcohol (p < .001) and marijuana use (p < .001). The OU group had significantly less opioid use at 3 months (p < .001) and maintained this decrease, but did not improve to the level observed in the MAU group at the 12-month follow-up. The Adolescent Community Reinforcement Approach merits further study as a behavioral treatment for young adults with opioid use.

Confirmatory factor analysis and measurement invariance of the Eating Disorder Examination Questionnaire (EDE-Q) in a non-clinical sample of non-Hispanic White and Hispanic women.

OBJECTIVE: Body dissatisfaction and eating disorder rates have increased in racial and ethnic minority groups, yet the validity of various commonly-used eating disorder instruments has not been established in these populations. One way to establish validity is to test for measurement invariance; namely, that the same constructs are being measured across groups. This study tested the measurement invariance of the Eating Disorder Examination Questionnaire (EDE-Q) across non-Hispanic White and Hispanic women. METHOD: Female undergraduates (n = 561) were recruited from a southwestern U.S. university. Confirmatory factor analysis (CFA) and measurement invariance of the EDE-Q were tested in non-Hispanic White and Hispanic samples. RESULTS: CFA analyses revealed that the original four-factor structure did not fit the data in either group. Only a modified 7-item, three-factor structure of the EDE-Q provided an acceptable fit in both non-Hispanic White and Hispanic women. Thus, this modified EDE-Q factor structure was used to test the equivalence of the measure between groups. Results found that the factor structure was similar across groups, but the factor loadings and intercepts differed across non-Hispanic White and Hispanic women. DISCUSSION: A modified 7-item, three-factor structure of the EDE-Q provided an acceptable fit of the data, which is supported by previous research. However, the lack of measurement invariance suggests that researchers should be cautious when using this modified EDE-Q to make explicit comparisons between non-Hispanic White and Hispanic women. Future research should further examine the psychometric properties of the EDE-Q in ethnically diverse groups, specifically the role of dietary restraint among Hispanic women.

Obligatory exercise and coping in treatment-seeking women with poor body image.

PURPOSE: Obligatory exercise is characterized by continued exercise despite negative consequences, and intense negative affect when unable to exercise. Research suggests psychosocial differences between individuals that exercise in an obligatory manner and those that do not. It also has been speculated that obligatory exercise may serve coping and affect regulation functions, yet these factors have not been routinely examined in community women with poor body image. The purpose of the current study was to investigate psychosocial differences between obligatory and non-obligatory exercisers, and to examine the use of obligatory exercise as an avoidant coping strategy in a sample of women with poor body image. METHODS: Women (n = 70) seeking treatment for body dissatisfaction were divided into obligatory and non-obligatory exercise groups based on their scores on the Obligatory Exercise Questionnaire. Participants then completed an assessment battery about eating pathology, body image, reasons for exercise, coping strategies, and negative affect. RESULTS: Independent t test analyses indicated that obligatory exercisers had significantly greater eating disorder symptomatology, avoidant coping, and appearance- and mood-related reasons for exercise than non-obligatory exercisers. Multiple regression analyses revealed that eating disorder symptomatology and avoidant coping were significant predictors of obligatory exercise. CONCLUSIONS: There are distinct psychosocial differences between women with poor body image who exercise in an obligatory fashion and those who do not. The current study suggests that obligatory exercise may serve as an avoidant coping strategy for women with poor body image. Enhancing healthy coping strategies may be an important addition to body image improvement programs. LEVEL OF EVIDENCE: V, cross-sectional descriptive study.

What does self-reported "dieting" mean? Evidence from a daily diary study of behavior.

Dieting is often recommended as a means of weight loss, yet research consistently shows that self-reported dieting does not result in weight loss. Toward resolving this discrepancy, this study assessed the daily dietary intake and weight control strategies of people who self-identified as dieting. College women (N = 266) provided a report of their eating pattern (dieting, "watching what I eat," and/or "eating healthy") followed by three daily diaries (24-hour recalls of dietary intake and weight control strategies) elicited on randomly selected days during a one-month period. Dieters were expected to report fewer daily calories, more daily exercise, and more daily weight control strategies than non-dieters. At baseline, 122 participants (45.9%) endorsed both "watching" and "eating healthy" ("Concerned Eaters") while 55 (20.7%) endorsed current dieting along with "watching" and "eating healthy" ("Dieters"). Just 3 (1.1%) endorsed dieting only, and 31 (11.7%) endorsed no eating pattern ("Unconcerned Eaters"). Dieters' mean BMI was in the overweight range; the mean BMIs of other groups were in the normal weight range. Dieters did not consistently endorse dieting across diaries. Nevertheless, Dieters reported fewer daily calories, and more overall weight control strategies, including more healthy weight control strategies, than Concerned Eaters. Across groups, participants' weights did not change significantly during the study. Dieters appear to engage in weight control strategies which could result in weight loss; however, their reports of whether they are dieting vary across days, suggesting a need for more consistent behavior. These results have clinical and research implications in the area of weight loss.

Body dissatisfaction predicts poor behavioral weight loss treatment adherence in overweight Mexican American women.

Poor adherence poses a major barrier to the success of behavioral weight loss (BWL) programs, particularly for overweight Mexican American women. Given the high prevalence and costs of overweight/obesity, factors that contribute to attendance and adherence problems should be identified, especially in ethnic minority populations. The current study examined the role of pre-treatment body dissatisfaction and depression in predicting attendance and adherence in a BWL intervention. Ninety-nine overweight/obese Mexican American women enrolled in the intervention and completed baseline measures. Eighty-one of the women attended at least one treatment session and provided measures of dietary and physical activity adherence. Simultaneous linear regression analyses suggested that although higher levels of body dissatisfaction and depression each played unique roles in predicting poorer attendance, only body dissatisfaction predicted adherence. Specifically, higher body dissatisfaction predicted poorer treatment adherence. Findings highlight the importance of addressing body dissatisfaction early in BWL treatment to increase attendance and adherence.