Measuring carbohydrate-deficient transferrin by direct immunoassay: factors affecting diagnostic sensitivity for excessive alcohol intake

BACKGROUND: carbohydrate-deficient transferrin (CDT) is a marker of alcohol intake that is used for detecting or monitoring alcohol-use disorders. The introduction of a new direct immunoassay for CDT justifies reevaluation of test performance and reexamination of factors affecting test diagnostic sensitivity and specificity. METHODS: individuals enrolled in twin/family studies of alcohol use and dependence provided blood samples and information on recent alcohol use. Serum CDT concentration was measured in 2 088 people with the N Latex CDT (Dade Behring) method, and CDT percentage (CDT%) was calculated as the proportion of the total transferrin concentration measured with Roche reagents. RESULTS: diagnostic sensitivity was low, both for comparisons of men who reported an alcohol intake of >28 drinks/week vs those who consumed < or = 28 drinks/week (28% sensitivity) and for women who consumed >14 drinks/week vs those who consumed < or = 14 drinks/week (18% sensitivity), at cutoff values that yielded a 95% specificity. Body mass index, variables associated with metabolic syndrome, and smoking had notable effects on the probability of an abnormal CDT result with excessive alcohol use. Diagnostic sensitivity was greater in men of normal weight (43%) than in obese men (10%) and greater in male smokers (38%) than in male nonsmokers (21%). In women, diagnostic sensitivities were < or = 20%, even for those of normal weight and for smokers. CONCLUSIONS: CDT is a poor marker of excessive alcohol intake in both women and men who are overweight or obese. It is also less useful in nonsmokers than in smokers. The diagnostic performance of the direct immunoassay and the effects of obesity and smoking are similar to those reported with previous anion-exchange immunoassay methods.     

Differential effects of viqualine on alcohol intake and other consummatory behaviors

Viqualine, a serotonin releaser and uptake inhibitor, was studied for its effects on consummatory behaviors (intake of ethanol and nonalcoholic beverages, cigarette smoking, and changes in body weight) in 29 men who were early-stage problem drinkers between 21 to 55 years of age. Subjects were randomly assigned to receive a placebo and either 100 mg/day viqualine (n = 15) or 200 mg/day viqualine (n = 14) orally in a double-blind crossover study. Viqualine administration and ethanol intake were assessed by self-reports and by measurement of drug and ethanol concentrations in body fluids. Compared with placebo, 100 mg/day viqualine did not decrease ethanol intake. However, 200 mg/day viqualine significantly decreased the total number of drinks consumed in a 14-day period (F1,12 = 5.3; p less than 0.05). An increase in the number of abstinent days was significant only for those subjects who received the placebo first (F1,6 = 11.3, p less than 0.02). Subjects reported a decreased interest in and decreased desire for alcohol during viqualine treatment. Patterns of response varied, but 64% of the subjects decreased the number of alcoholic drinks consumed and/or increased the number of days of abstinence by at least 25% during treatment with 200 mg/day viqualine compared with placebo treatment. Neither dose of viqualine had an effect on cigarette smoking or on consumption of nonalcoholic beverages, but subjects showed significant decreases in body weight with both doses. These findings indicate that viqualine both attenuates ethanol intake and reduces body weight in human beings.     

Smoking status, obesity and hypertension in a general population sample: a cross-sectional study

BACKGROUND: In some studies, hypertension is more common in never and former smokers than in current smokers. AIM: To examine the associations between hypertension and smoking status, when divided into subgroups by overweight and obesity. DESIGN: Cross-sectional study. METHODS: We used data from a national health survey with a probability sample of the national population of Germany aged 18 to 79 (n = 6903 with complete data). Smoking status data were collected via questionnaire. Obesity and overweight were assessed by body mass index, hypertension by blood pressure measurement and by participants' statements about antihypertensive treatment. Analyses were adjusted for gender, age, history of coronary artery disease, serum cholesterol levels, alcohol drinking, exercise, and education. RESULTS: Obese former smokers who were abstinent for 3 or more years had an adjusted odds ratio (OR) 3.6 (95% confidence interval, CI 2.3-5.7) for mild hypertension (> or =140 mmHg systolic or > or =90 mmHg diastolic blood pressure) and an adjusted OR 6.5 (95%CI 3.6-11.8) for moderate or severe hypertension (> or =160 mmHg systolic or > or =100 mmHg diastolic). Normal weight never or former smokers did not differ from normal weight current smokers smoking > or =15 cigarettes/day with regard to likelihood of hypertension (normal weight never smokers, OR 1.1, 95%CI 0.8-1.5; normal weight former smokers, abstinent 3 or more years, OR 0.8, 95%CI 0.5-1.3). DISCUSSION: In this nationally representative sample, never or former smoking was unrelated to hypertension among normal weight individuals.     

Questioning of diabetic patients on their knowledge of nutrition and dietetics as well as on their smoking habits]

100 diabetics were asked questions referring to the knowledge of nutrition to smoking habits. Most of the diabetics controlled their body weight regularly and were convinced that overweight may be dangerous to health. Despite this knowledge, more than half of the patients were overweight and did not know their individual ideal weight. Between the quality of dietary consultation and dietary behaviour of the patients a similar discrepancy existed: More than half of the questioned persons - especially males - had to be regarded as dietary failures. Patients with relatively low educational level came off worse. Fortunately, most of the patients were non-smokers. However, the dietary consultation practised at the moment seemed to have had no influence on the number of smokers. Consequently, for the training of the patients the following results: More than ever, the patients must be incited to normalize their body weight and they must be positively motivated in this regard as well as with regard to nicotine abuse. Behaviour therapy would certainly be desirable. Moreover, the patients should have a dietary consultation at least every second year. A dietary filled in for the patient personally must serve as the basis for the observance of the diet. Persons in whom diabetes mellitus was diagnosticated should receive consultation more quickly than up to now. Moreover, it would be useful to free the diet from the odium of an annoying and unimportant supplementation to medicamentous diabetes therapy. The study showed that continuous self-control of the own educational work is indispensable to guarantee a high standard of therapeutic efforts.     

Body weight status, dietary habits, and physical activity levels of middle school-aged children in rural Mississippi

OBJECTIVES: Obesity and cardiovascular diseases are more prevalent in the Southeast as compared with other geographic regions of the United States. However, few investigations have addressed health disparities among children in rural Southeastern areas. The purpose of this investigation was to determine the risk of overweight and obesity in middle school-aged children residing in a racially diverse rural community, and to characterize their dietary and physical activity habits. METHODS: Two hundred and five middle school children from Scott County, Mississippi were enrolled in this investigation. Measurements included height, weight, body mass index, dietary intake using a 24-hour recall, and physical activity level using pedometers. RESULTS: Of the 205 children studied, 54% were "overweight" or "at risk for overweight" according to a body mass index-for-age sex-specific percentile. Intake of saturated fat and sodium exceeded recommended levels, whereas intake of calcium, fruits, and vegetables was inadequate. One third of the sample consumed 12 fluid ounces or more of soda on the day of the recall. Physical activity level was below that previously reported for children in this age range, and knowledge of the importance of diet and physical activity in the prevention of cardiovascular disease was poor, particularly among African-American children. CONCLUSIONS: The children in our sample are at increased risk for overweight and obesity. Factors that may be targeted for intervention include a reduction in dietary intake of fat, saturated fat, sodium, and soft drinks, and an increased intake of fruits and vegetables. Physical activity should be encouraged. Many of these factors could be improved through changes within the school environment.     

Smoking habits of office-based general practitioners and internists in Austria and their smoking cessation efforts

Tobacco smoking is the major cause of lung disease. This study aimed to determine: 1) the prevalence of tobacco smoking among office-based physicians; 2) their readiness to inquire about their patients' smoking habits and, if need be, to motivate them to stop smoking; 3) whether non-smoking doctors advise their patients more frequently to stop smoking than their smoker colleagues do. A self-designed questionnaire on a post card was sent to 7674 office-based general practitioners (GPs) and internists. 1395 (18.2%) questionnaires were returned. Independent telephone interviews with 91 doctors were also carried out to minimize the bias of self-presentation. Just under 11% of doctors were smokers. About 50% of all doctors who responded described themselves as ex-smokers. 38% of the smokers would accept outside help to stop smoking. About 50% of GPs and 90% of internists inquire about the smoking habits of their patients during history taking. Of these, 85% of GPs and 92% of internists recommend their patients to stop smoking. Doctors who themselves are smokers do so less than their non-smoker colleagues. For this reason, a further reduction in the smoking prevalence among doctors would be of special importance. Inquiry about smoking habits in the initial history taking should be stressed more to identify any smoker who can be subsequently encouraged to stop smoking.     

Motor function of the stomach and small intestine and gastric secretory activity in smokers and alcoholic patients with duodenal ulcer

The dependence of the parameters of the electromyogastroenterogram, basal and maximal histamine secretion of HCl and pepsin on alcohol consumption and smoking (separately and in combination) was studied in 248 duodenal ulcer patients. The amplitude parameters of the digestive motor gastric and small intestinal function, HCl secretion in the basal period and in response to maximal histamine stimulation were found to be significantly increased in habitual alcoholics and smokers, while the level of the basal and stimulated pepsin secretion in smokers was also increased. In addition, in 15 males without ulcer a single intake of large doses of alcoholic drinks containing more than 200 g of ethanol caused significant increase in the amplitude parameters of the electromyogastroenterogram which normalized in 48 hours. Since alcohol and smoking significantly enhance hypermotor gastroenteral dyskinesis and gastric hypersecretion in duodenal ulcer patients, prophylaxis and treatment should be aimed at the removal of these factors.     

An analysis of energy-drink toxicity in the National Poison Data System

Context. Small studies have associated energy drinks—beverages that typically contain high concentrations of caffeine and other stimulants—with serious adverse health events. Objective. To assess the incidence and outcomes of toxic exposures to caffeine-containing energy drinks, including caffeinated alcoholic energy drinks, and to evaluate the effect of regulatory actions and educational initiatives on the rates of energy drink exposures. Methods. We analyzed all unique cases of energy drink exposures reported to the US National Poison Data System (NPDS) between October 1, 2010 and September 30, 2011. We analyzed only exposures to caffeine-containing energy drinks consumed as a single product ingestion and categorized them as caffeine-containing non-alcoholic, alcoholic, or “unknown” for those with unknown formulations. Non-alcoholic energy drinks were further classified as those containing caffeine from a single source and those containing multiple stimulant additives, such as guarana or yerba mate. The data were analyzed for the demographics and outcomes of exposures (unknown data were not included in the denominator for percentages). The rates of change of energy drink-related calls to poison centers were analyzed before and after major regulatory events. Results. Of 2.3 million calls to the NPDS, 4854 (0.2%) were energy drink-related. The 3192 (65.8%) cases involving energy drinks with unknown additives were excluded. Of 1480 non-alcoholic energy drink cases, 50.7% were children < 6 years old; 76.7% were unintentional; and 60.8% were males. The incidence of moderate to major adverse effects of energy drink-related toxicity was 15.2% and 39.3% for non-alcoholic and alcoholic energy drinks, respectively. Major adverse effects consisted of three cases of seizure, two of non-ventricular dysrhythmia, one ventricular dysrhythmia, and one tachypnea. Of the 182 caffeinated alcoholic energy drink cases, 68.2% were < 20 years old; 76.7% were referred to a health care facility. Educational and legislative initiatives to enhance understanding of the health consequences of energy drink consumption were significantly associated with a decreased rate of energy drink-related cases (p = 0.036). Conclusions. About half the cases of energy drink-related toxicity involved unintentional exposures by children < 6 years old. Educational campaigns and legal restrictions on the sale of energy drinks were associated with decreasing calls to poison centers for energy drink toxicity and are encouraged.     

Survey of student nurses and midwives: smoking and alcohol use

This article presents findings from a survey of 186 first year nursing and midwifery students that relate to their smoking and alcohol consumption. Of the students sampled, 28% were cigarette smokers. This is higher than the smoking rate of 25% for the adult population in the UK. The majority of the students who smoked said that they would like to stop smoking. Most of the students (86.5%) reported having drunk alcohol on at least one occasion during the previous week, with 26.5% having had a drink on three or four days. The amount consumed over the week ranged from no drinks to 90, with the mean being 13.72.Worryingly, 74% had exceeded the daily benchmarks for low-risk drinking on at least one occasion during the week for which consumption was reported, and 55% were drinking at binge levels. The findings raise concerns for the future health of many of our students and for their roles as health promoters.     

Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers

The effects of fluoxetine, a relatively selective long-acting serotonin uptake inhibitor, on the consumption of alcoholic and nonalcoholic drinks, cigarette smoking, and body weight were assessed in 29 men who were early stage problem drinkers. After a 2-week baseline, subjects were randomly assigned to receive 40 mg/day fluoxetine (n = 8), 60 mg/day fluoxetine (n = 11), or placebo (n = 10) for 4 weeks. Fluoxetine 60 mg/day decreased mean daily alcoholic drinks from (X +/- SEM) 8.3 +/- 0.7 during baseline to 6.9 +/- 0.7 and decreased total drinks per 14 days from 115.8 +/- 9.3 to 96.5 +/- 9.5 (p less than 0.01; 17.3% decrease from baseline), with no significant increase in days of abstinence. Neither 40 mg/day fluoxetine nor placebo had effects on intake of alcohol. Fluoxetine 60 mg/day decreased total and mean daily alcoholic drinks compared with 40 mg/day fluoxetine (ANCOVA, both p less than 0.02), but neither dose of fluoxetine was different from placebo. Compared with placebo, both 40 mg/day fluoxetine and 60 mg/day fluoxetine no differences were detected between treatment groups, 60 mg/day fluoxetine increased mean daily nonalcoholic beverages from baseline (5.0 +/- 0.4 to 5.6 +/- 0.3, p less than 0.01) and increased daily cigarettes smoked (from 25.1 +/- 4.6 to 26.9 +/- 4.5, p less than 0.05), whereas no significant changes from baseline were observed with 40 mg/day fluoxetine or placebo.(ABSTRACT TRUNCATED AT 250 WORDS)     

Perception of daily stress and oral coping behaviors in normal, overweight, and recovering alcoholic women

One method of coping with perceived stress is the use of oral behaviors (e.g., eating, drinking, smoking). This study addressed the influence of perceived daily stress level (day rated as pleasant, neutral, or unpleasant) on oral behaviors in three groups of women, aged 25 to 45. Subjects included 37 female normal alcohol users of normal weight, 23 recovering alcoholics of normal weight, and 37 normal alcohol users who were 25% to 100% overweight. The normals responded to daily stress levels by changing their oral behaviors in predictable and consistent ways. On unpleasant days, the normals and the recovering alcoholic women ate more sweet, starchy, and salty/spicy foods. The overweight women ate more food, especially salty/spicy and sweet foods regardless of the type of day. The alcoholic women desired alcohol and smoked more than the other two groups all the time. Hence, the alcoholics and overweight women desired to or engaged in their habituated oral behaviors regardless of fluctuating daily stress levels.     

Overweight and perceived health in Mexican American children: a pilot study in a central Texas community.

This study assessed actual and perceived health status of overweight Mexican American clients at a central Texas school-based health center in a predominantly Hispanic school district. It also explored the participants' interest in making lifestyle changes to promote a healthy weight. A medical records review indicated that of the Hispanic children between the ages of 7 and 12 years, 38% had a weight status at or above the 85th percentile. Assessments were conducted in a sample of these overweight Mexican American children to learn about their medical history, eating and activity patterns, perceived health and body size, and general health-risk status. Weight-related conditions, such as elevated blood pressure and cholesterol levels, were found in more than half the sample. Few consumed fruits and vegetables, and many engaged in only sedentary activities. The majority perceived themselves as "big," wanted to make changes in their body size, and wanted family members to participate in making changes with them. Although most of the sample were in the 97th body mass index percentile, many perceived themselves to be as healthy as or healthier than others. These findings substantiate the need to design and implement a culturally appropriate weight management and obesity prevention program in this community. However, the perception of being healthy in the presence of multiple indicators of poor health may pose challenges to successful intervention.     

Osteoporosis of the slender smoker revisited by epidemiologic approach

A representative sample of 285 70-year-old Danish women were examined by case history, 125I photon absorptiometry of both forearms (BMC), and lateral X-rays of the spine. Fat mass was calculated from height (H), weight (W) and estimated lean body mass (LBM) as W-LBM/H kg m-1. Seventy-five participants with previous or present disease or treatment known to influence the calcium metabolism were excluded. The remaining 210 women included the final study groups of seventy-seven long-term smokers and 103 non-smokers. Within both groups BMC correlated positively to fat mass, r = 0.447 and 0.560, respectively (P less than 0.001). The slopes of the regression lines and their positions were similar (P greater than 0.05). Hence, for a certain degree of overweight smoking per se does not influence BMC to a significant degree. Although the smokers were less obese (P less than 0.005) and tended to have lower BMC (P less than 0.10) their frequency of non-violent post-menopausal fractures, 40.3%, was the same as for non-smokers, 44.7%. The respective frequencies of definite osteoporotic fractures (i.e., spinal crush and fractures of the hip, proximal humerus and distal forearm) were comparable as well. In conclusion, the influence of smoking on the female skeleton seems mainly to be caused by the associated slenderness.     

Clinical and demographic characteristics of various types of arterial hypertension in elderly patients (based on results of Russian scientific-practical program ARGUS

AIM: It is the fragment of the trial aimed at the study of demographic indices and components of cardiovascular risk in patients over 55 with known and newly diagnosed arterial hypertension (AH) by referral to outpatient clinic depending on AH type. MATERIAL AND METHODS: For a week, 140 therapists from 14 regions of the Russian Federation measured AP in all persons aged 55 and older visiting outpatient clinics. A total of 5582 persons were examined. 3847 of them were already diagnosed to have hypertension. Primary diagnosis of hypertension was made in 5.7 examinees out of 2442. RESULTS: Patients with previous diagnosis of hypertension vs those with primary diagnosis had significantly greater index of body mass, had more often overweight, obesity and diabetes mellitus. Isolated systolic AH was encountered in 56% of all the primary cases. High and very high risk to develop cardiovascular complications was encountered in 59.9% of primary patients and 85.8% of those previously diagnosed. CONCLUSION: Patients aged 55 and older with newly diagnosed isolated systolic AH had the following most common factors of risk of cardiovascular complications: overweight, obesity, smoking, dyslipidemia, diabetes mellitus. In treated patients these risk factors are: overweight, obesity, dyslipidemia, diabetes mellitus, smoking.     

Trial design: blood pressure control and weight gain prevention in prehypertensive and hypertensive smokers: the treatment and prevention study

BACKGROUND: Cigarette smokers with elevated blood pressure (BP) are at substantially higher risk for cardiovascular events compared to normotensive smokers. Although smoking cessation should be a primary treatment goal for these patients, increases in body weight accompanying smoking abstinence may further increase BP. Intervention strategies that facilitate smoking cessation and modify adverse changes in body weight and BP are needed. METHODS: We describe an ongoing multi-site, two-phase, five-year randomized clinical trial. Participants are cigarette smokers with Prehypertension or Stage I Hypertension. In the first phase, participants receive a smoking cessation intervention combining behavioral counseling and nicotine replacement in an open-label fashion. In the second phase, participants who successfully quit smoking are randomly assigned to one of three lifestyle interventions: 1) weight gain prevention, 2) blood pressure control, or 3) usual lifestyle. Participants are followed for one year to assess changes in blood pressure, body weight, dietary intake, and physical activity. CONCLUSIONS: Results from the proposed study will provide important insights into the efficacy of various approaches to lifestyle modification in smokers at increased risk for cardiovascular events.     

Citalopram decreases desirability, liking, and consumption of alcohol in alcohol-dependent drinkers.

In previous studies serotonin uptake inhibitors such as citalopram decreased alcohol consumption in alcoholics. The mechanism of the effect is not fully understood. This study tested the hypothesis that it is mediated by changes in desire to drink and alcohol effects. After a 1-week baseline period, subjects (13 men and three women; aged 26 to 69 years; healthy, nondepressed, alcohol-dependent drinkers [mean, 6.6 drinks per day]) were randomized in a double-blind fashion to receive 40 mg/day citalopram and placebo for 1 week each, separated by a 1-week washout period. Daily standard alcoholic drinks (13.6 gm ethanol), nonalcoholic drinks, and tobacco use were recorded; evening urine samples were taken; and interest, desire, craving, and liking for alcohol were rated. Medical status, depression, and anxiety were assessed weekly, but no other treatment or advice was given. Daily alcoholic drinks significantly decreased during citalopram treatment (mean +/- SEM = 4.6 +/- 0.6) compared with placebo (5.7 +/- 0.8; p = 0.01), and the average decrease was 17.5%. Percentage of days abstinent increased during citalopram administration (27.7% +/- 5.7%) compared with placebo (15.5% +/- 3.7%; p less than 0.01). Citalopram decreased interest, desire, craving, and liking for alcohol (all p less than 0.05). There was clear internal validation of these measures in that variations in each correlated with alcohol consumption (all r greater than 0.5, p less than 0.05). Nonalcoholic drinks, self-reports of cigarettes smoked (daily smokers), and body weight did not change significantly. In experimental bar sessions, after the citalopram and placebo periods, subjects were required to consume as many of 18 minidrinks as possible (equivalent to six standard drinks) at 5-minute intervals. Subjects rated their desire for alcohol, intoxication, and mood. Citalopram had no significant effects on the desirability of alcohol or subjective feelings of intoxication. The findings indicate that serotonin uptake inhibitors may act by decreasing the urge to drink and the reinforcing effects of alcohol. Also, a naturalistic outpatient trial is a sensitive, simple, and economic procedure for detecting these drug effects.     

精神分裂症患者吸烟原因调查与分析

目的减少精神分裂症患者的吸烟行为,以减轻其家庭负担。方法用RUSSELL吸烟原因问卷对195例吸烟的精神分裂症患者进行问卷调查。结果精神分裂症患者的吸烟原因以享乐、口手活动为主。问卷各维度、依赖分、总分与年龄正相关,P<0.05;女吸烟患者、农民、文化程度较低者、已婚患者分值较高,与相应其他组比较,P<0.001。病程、住院天数对吸烟原因的影响无统计学意义。结论加强“吸烟有害健康”为主题的健康教育,合理安排活动,精神分裂症的患者仍然可以减少吸烟;健康知识的教育对象应侧重农村、文化程度低的人群。     

Time response of cytochrome P450 1A2 activity on cessation of heavy smoking

BACKGROUND AND OBJECTIVE: Cytochrome P450 (CYP) 1A2 activity is induced by cigarette smoking. Thus smoking cessation in patients while they are undergoing therapy with a CYP1A2 substrate such as theophylline or clozapine increases its concentrations and may cause adverse effects. Our objective was to determine the time course of CYP1A2 activity changes after smoking cessation in heavy smokers as the basis for dosing adaptation schemes. METHODS: The study was conducted in 8 men and 4 women (all white) who smoked 20 cigarettes or more per day. Sudden smoking cessation was carried out after a 14-day run-in period. Subjects were phenotyped for CYP1A2 activity at 6, 4, and 1 day before smoking cessation and at 0, 1, 2, 3, 6, 8, 10, and 13 days thereafter by use of the paraxanthine-to-caffeine ratio in plasma 6 hours after a 148-mg caffeine test dose. A monoexponential decay of CYP1A2 activity to a residual value was fitted to the data by nonlinear regression analysis. RESULTS: On cessation of smoking, initial caffeine clearance (estimated geometric means and 95% confidence intervals) decreased significantly (P <.01), by 36.1% (30.9%-42.2%), from 2.47 mL. min(-1). kg(-1) body weight (2.03-3.00 mL. min(-1). kg(-1) body weight) to a new steady state of 1.53 mL. min(-1). kg(-1) body weight (1.24-1.89 mL. min(-1). kg(-1) body weight). The apparent half-life of CYP1A2 activity decrease was 38.6 hours (27.4-54.4 hours). CONCLUSION: Doses of CYP1A2 substrates with a narrow therapeutic range should be decreased immediately on cessation of heavy smoking. As a rule of thumb, a stepwise daily dose reduction of approximately 10% until the fourth day after smoking cessation is proposed, which should be accompanied by therapeutic drug monitoring.     

Perceived well-being of persons quitting smoking

The purpose of this study was to examine the perceived well-being of persons who are smokers, nonsmokers, or are quitting smoking. The sample included 74 nonsmokers, 74 smokers, and 92 self-defined quitters. Subjects' well-being was examined controlling for the effects of daily hassles and selected demographic differences. Measures of well-being included general health, morale, physical, and psychological symptoms. Scores for intensity of daily hassles were significantly higher, and well-being scores lower, for persons quitting smoking compared to smokers and nonsmokers. Further, even after controlling for the effects of daily hassles on well-being, persons quitting smoking had significantly lower levels of well-being than did smokers or nonsmokers.     

Being fat versus thinking fat: Relationships with body image,eating behaviors,and well-being

The majority of females and about one-fourth of men who are objectively normal weight perceive themselves to be overweight. The purpose of this investigation was to examine specific psychological differences between persons as a function of their weight self-classifications with actual weight controlled and vice versa. Subjects were sampled from a nationwide survey. Study 1 compared normal-weight subjects self-classified as overweight with age- and weight-matched subjects who were self-classified as normal weight (n's = 198 females and 130 males) on facets of body image, eating/dieting behaviors, and psychosocial well-being. Relative to controls, self-classified overweight subjects of both sexes reported a less adaptive body image in several respects, and more frequent binge eating and dietary restraint to lose weight, as well as poorer well-being. Study 2 included only self-classified overweight subjects and compared those who were actually overweight with normal-weight controls (n's = 112 females and 106 males). Actually being overweight produced only a few group differences, particularly for females, beyond those of the overweight self-classification. Research directions and clinical implications are discussed.The authors gratefully acknowledge the technical assistance of Timothy A. Brown and the helpful contributions of Louis H. Janda, Robin J. Lewis, and Barbara A. Winstead.