Health materials and strategies for the prevention of immigrants' weight-related problems.

Existing health education materials dealing with healthy eating, active living, and body image were examined by immigrant parents of elementary school children to determine their relevance, cultural competence, and accessibility. A total of 13 immigrant mothers from Sri Lanka and China participated in a series of three focus groups. Study findings indicate that the present health education materials intended to help prevent weight-related problems could be improved to better meet the needs of new immigrant families. Immigrant mothers who participated in the study expressed their preferences for health education materials and prevention interventions undertaken in a culturally relevant/competent, knowledge-sharing, participatory manner. Acting on these suggestions could help practitioners and public health agencies develop more effective strategies that meet the requirements of ethno-cultural immigrant communities.

A controlled evaluation of web-based training for teachers and public health practitioners on the prevention of eating disorders.

The effectiveness of a web-based prevention program designed for elementary school teachers was examined in 78 elementary school teachers and 89 local public health practitioners (who provide support to schools). Participants were assigned to either the intervention (n = 95) or comparison (n = 72) study groups. All participants completed self-report online measures prior to, and following, the 60-day study period assessing knowledge about various factors that influence body image in children and efficacy to fight weight bias in the school. Information was also solicited on the feasibility of, and on the perceived benefit of the web-based program as a knowledge translation tool, in terms of layout and content. The Student Body program was found to be successful in improving knowledge concerning facts about dieting among the teacher participants, and in increasing efficacy to fight weight bias among the public health participants. Overall, the feedback was very positive concerning the layout and content of the Student Body. Participants reported an overall improvement in their awareness about how weight bias can be present in their teaching practices, and how this can trigger body image concerns among their students. Findings have implications for using the web to engage teachers in the prevention of disordered eating among school age children.

Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program.

This study was a controlled evaluation of a comprehensive school-based universal prevention program involving male and female students, parents, teachers, school administrators and local public health professionals. A total of 982 male and female Grades 6 and 7 middle school students (and 91 teachers/school administrators) completed self-report surveys at baseline on measures of body satisfaction, internalization of media ideals, size acceptance, disordered eating, weight-based teasing, weight loss and muscle-gaining behaviours, and perceptions of school climate (teachers only). Eighty-four percent of the students repeated the surveys immediately following the 8-month school-wide intervention and 71% again 6 months later. Repeated measures ANCOVAs revealed that participation in the Healthy Schools-Healthy Kids (HS-HK) program had a positive influence by reducing the internalization of media ideals among male and female students and by reducing disordered eating among female students. The program was also associated with reductions in weight-loss behaviours among the students, although this effect was lost by the 6-month follow-up. When the intervention students were sub-divided into low versus high-risk groups, the high-risk group appeared to benefit most from the intervention with significant reductions in internalization of media ideals, greater body satisfaction, and reduced disordered eating over time. There were no intervention effects for teachers. Challenges of engaging teachers in prevention are discussed.

Psychological factors associated with ratings of portion size: relevance to the risk profile for obesity.

The ability to assess accurately the relative size of food portions is highly variable in the population. This study was designed to identify salient individual differences that correlate with this variation since estimation errors are seen as a barrier to the control of food intake and a detriment to many obesity treatment strategies. Healthy weight and obese adult women were assessed on a self-report measure of food amount ratings. We predicted that a high sensitivity to reward, symptoms of binge eating, and a preference for fat foods would relate positive to scores on this rating scale, and that weight status might moderate these relationships. As expected, a preference for high-fat food was associated with the tendency to under-estimate portion sizes. A significant interaction between weight status and reward sensitivity indicated that high values on the latter were correlated with ratings reflecting under-estimation of food amounts--but only among obese individuals. This study identified important factors that may influence estimation biases in food amount ratings-information of direct relevance to research and treatment protocols that use food diaries and focus on efforts to normalize eating behaviours.

Psychosocial profiles of young adolescent females seeking treatment for an eating disorder.

PURPOSE: Children as young as 12 years of age are presenting for treatment of an eating disorder (ED), underscoring the need to understand the psychological and social make-up of this age group. Early adolescent females seeking treatment for an eating disorder were compared with healthy age-matched controls on psychosocial variables relevant to this stage of development. METHODS: Self-report measures of individual (e.g., competence and importance ratings across five domains of self-concept, self-oriented and socially prescribed perfectionism) and contextual factors (e.g., conditional support from mother, father, and peer, and negative peer, family, and school events) were administered to adolescents with EDs (n = 25) and a comparison group comprised of age-matched females from the general population (n = 25 in a low-risk and n = 25 in a high-risk group). RESULTS: Compared with the control sample, the ED group had significantly lower ratings of competence in physical appearance and higher ratings on the importance of physical appearance and self-oriented perfectionism. There were no group differences on the parental or peer support variables, or on negative life event variables. CONCLUSION: This study has implications for early identification and early intervention.

From motivation to behaviour: a model of reward sensitivity, overeating, and food preferences in the risk profile for obesity.

The reinforcing effects of addictive drugs and palatable foods are regulated, at least in part, by a common biological mechanism. The reactivity or sensitivity of these brain reward regions have been found to correlate significantly with the risk for a variety of drug addictions. Sensitivity to Reward (STR) is conceptualised as a psycho-biological personality trait rooted firmly in the availability of dopamine in the mesocorticolimbic ('common reward') pathways, and as such is a good candidate for studying motivational factors and eating behaviours. The purpose of the present study was to examine whether STR was related to behaviours that contribute to excess body weight. Structural equation modelling procedures were used with a sample of healthy adult women (n=151). We hypothesised that STR would positively predict overeating and a preference for foods high in fat and sugar; and that these two behaviour would, in turn, predict a higher Body Mass Index. Results provided an excellent fit of the model to our data confirming our view that a personality trait like STR can only influence a physical condition like body weight indirectly by the way it co-varies with behaviours that contribute directly to variation in the outcome variable.

Associations among overeating, overweight, and attention deficit/hyperactivity disorder: a structural equation modelling approach.

BACKGROUND: Some recent studies have reported strong links between obesity and ADHD in adults; however, to date, little work has focussed on possible behavioural mechanisms that could account for this association. METHOD: This study used structural equation modelling (SEM) in a sample of healthy adult women to test the predictions that ADHD symptoms predict aspects of overeating, including binge eating and emotionally-induced eating, which in turn are positively correlated with Body Mass Index. RESULTS: The SEM produced a non-significant chi-square and both the measurement model and the structural model fit the data very well. CONCLUSIONS: Plausible mechanisms are discussed to help explain how the symptomatology of ADHD could foster different forms of overeating.

Correlates of weight loss and muscle-gaining behavior in 10- to 14-year-old males and females.

BACKGROUND: This study examined the influence of appearance and social acceptance esteem, awareness and internalization of media stereotypes, body size acceptance, and teasing on the weight loss and muscle-gaining behaviors of 10- to 14-year-old boys and girls. METHODS: Male (n = 670) and female (n = 788) students were drawn from one of four public senior middle schools (grades 6-8) in Southern Ontario as part of a longitudinal outcome-based study. Students' baseline self-report questionnaires, measuring the above variables, were analyzed for the purposes of this study. RESULTS: A higher percentage of girls reported engaging in weight loss behaviors, whereas a higher percentage of boys admitted to muscle gaining and the use of specific weight control methods such as laxative use and vomiting. Regression analyses revealed that internalization of media messages and body size acceptance were equally predictive of boys' weight loss and muscle-gaining behaviors, while teasing was found to also predict their muscle-gaining behavior. Among the girls, appearance esteem, internalization of media stereotypes, and body size acceptance were predictive of weight loss behaviors. None of the study variables were predictive of girls' muscle-gaining behavior. CONCLUSIONS: Weight loss and muscle-gaining behaviors appear to have their onset in children as young as 10 years. The findings support the need for prevention programs that focus on media literacy and ways to decrease weight-based teasing in the school setting.

Evaluation of a school-based program designed to improve body image satisfaction, global self-esteem, and eating attitudes and behaviors: a replication study.

OBJECTIVE: The purpose of the current study was to evaluate the effectiveness of a life-skills promotion program designed to improve body image satisfaction and global self-esteem, while reducing negative eating attitudes and behaviors and feelings of perfectionism, all of which have been identified as predisposing factors to disordered eating. METHOD: A total of 258 girls with a mean age of 11.8 years (intervention group = 182 and control group = 76) completed questionnaires before, and 1 week after, the six-session school-based program, and again 6 and 12 months later. RESULTS: The intervention was successful in improving body image satisfaction and global self-esteem and in reducing dieting attitude scores at post intervention only. The gains were not maintained at the 12-month follow-up. DISCUSSION: The need to assess the influence of health promotion programs on predisposing risk factors, compared with problem-based outcome measures, is discussed.

Dieting among preadolescent and young adolescent females.

We examined the prevalence of dieting and negative eating attitudes among 2279 females (aged 10-14 years) in southern Ontario. Self-report questionnaires revealed that 29.3% of the girls were currently trying to lose weight and 10.5% had scores greater than the clinical threshold for disordered eating (Children's version of the Eating Attitudes Test [ChEAT] score > or = 20). Those with elevated ChEAT scores were more likely than those with lower scores to be engaged in dieting and other extreme weight control methods.

Replication of a peer support program designed to prevent disordered eating: is a life skills approach sufficient for all middle school students?

The evaluation of a school-based peer support group previously shown to improve body esteem and global self-esteem and reduce dieting in young adolescent girls was replicated in the present study. A total of 282 girls in grades 7 and 8, 196 of whom were in the control group, completed self-report questionnaires immediately before and after the life skills intervention, and 3 months later. Contrary to the findings reported in the original study, participation in the 10-session peer support group did not lead to improvements in body esteem or eating attitudes and behaviors beyond what was experienced by the control group. Interestingly, participants of the current intervention group exhibited higher disordered eating scores at baseline than those participants in the original study. Implications for matching prevention curriculum with the developmental and symptom levels of students are discussed.