Timing and sequence of the onset of overweight, dieting, and binge eating in overweight patients with binge eating disorder

OBJECTIVE: To examine the self-reported sequence and timing of onset of overweight, binge eating, and dieting in adult patients diagnosed with binge eating disorder (BED). METHOD: Participants were 284 treatment-seeking adults (73 men and 211 women) who met DSM-IV research criteria for BED. Patients were interviewed with structured diagnostic interviews and were queried regarding history of overweight, dieting, and binge eating behaviors. Questionnaires were also administered to assess current eating disturbances, body dissatisfaction, and general functioning. Participants were classified as Overweight First, Binge First, or Diet First, and the three groups were compared on developmental sequence and using the battery of measures. RESULTS: Sixty-three percent of the 284 participants reported becoming overweight prior to the onset of dieting or binge eating. Participants who reported they were overweight first had significantly greater BMI at the time of assessment. The 16% of the participants who reported binge eating first were significantly younger at the onset of BED diagnosis and reported significantly less dietary restraint. Onset order differed significantly by gender; proportionally more women (25%) than men (11%) reported that dieting preceded overweight or binge eating. CONCLUSION: Weight problems preceded dieting and binge eating behaviors for a majority of treatment-seeking overweight participants diagnosed with BED.     

Weight loss expectations in obese patients seeking treatment at medical centers

OBJECTIVE: To investigate weight loss expectations (expected 1-year BMI loss, dream BMI, and maximum acceptable BMI) in obese patients seeking treatment and to examine whether expectations differ by sex, weight, diet and weight history, age, psychological factors, and primary motivations for weight loss. RESEARCH METHODS AND PROCEDURES: 1891 obese patients seeking treatment in 25 Italian medical centers (1473 women; age, 44.7 +/- 11.0 years; BMI, 38.2 +/- 6.5 kg/m2) were evaluated. Diet and weight history, weight loss expectations, and primary motivation for seeking treatment (health or improving appearance) were systematically recorded. Psychiatric distress, binge eating, and body image dissatisfaction were tested by self-administered questionnaires (Symptom CheckList-90, Binge Eating Scale, and Body Uneasiness Test). RESULTS: In 1011 cases (53.4%), 1-year expected BMI loss was > or = 9 kg/m2, dream BMI was 26.0 +/- 3.4 kg/m2 (corresponding to a 32% loss), and maximum acceptable BMI was 29.3 +/- 4.4 kg/m2 (-23%). BMI and age were the strongest predictors of weight goals. Weight loss necessary to reach the desired targets was largely in excess of weight loss observed during previous dieting. Psychiatric distress, body dissatisfaction, and binge eating did not predict weight loss expectations. The primary motivation for weight loss was concern for future or present health; women seeking treatment to improve appearance had a lower grade of obesity, were younger, and had first attempted weight loss at a younger age. DISCUSSION: Obese Italian patients had unrealistic weight loss expectations. There were significant disparities between patients' perceptions and physicians' weight loss recommendations of desirable treatment outcome.     

Why does dieting predict weight gain in adolescents? Findings from project EAT-II: a 5-year longitudinal study

OBJECTIVE: Dieting has been found to predict weight gain in adolescents, but reasons for this association remain unclear. This study aimed to explore potential mechanisms by which dieting predicts weight gain over time in adolescents. DESIGN: Population-based, 5-year longitudinal study. PARTICIPANTS: Adolescents (n=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2). MAIN OUTCOME MEASURE: Body mass index (BMI) change over 5 years. STATISTICAL ANALYSIS: Multiple regressions were used to examine associations between Time 1 dieting and Time 2 binge eating, breakfast consumption, fruit and vegetable intake, and physical activity. Associations were then examined between these behaviors and BMI change. Finally, to test for mediating effects, associations between dieting and BMI change were examined with and without the inclusion of these behaviors, and regression coefficients were compared. RESULTS: In female adolescents, dieting predicted increased binge eating (P<0.001) and decreased breakfast consumption (P=0.030). In male adolescents, dieting predicted increased binge eating (P<0.001), decreased physical activity (P=0.006), and a trend toward decreased breakfast consumption (P=0.064). These behaviors were also associated with increases in BMI. The association between dieting and BMI increase was weakened, but still remained significant, after binge eating, breakfast consumption, fruit/vegetable intake, and physical activity were included in the model being tested. Thus, the longitudinal association between dieting and BMI increase was partially mediated by these behaviors. CONCLUSIONS: In part, dieting may lead to weight gain via the long-term adoption of behavioral patterns that are counterproductive to weight management.     

Dietary energy density and successful weight loss maintenance

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27-45kg/m(2)), normal weight adults (NW: BMI=19-24.9 kg/m(2)), and weight loss maintainers (WLM: current BMI=19-24.9kg/m(2) [lost≥10% of maximum body weight and maintained loss for ≥5years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45kcal/g; NW=1.60±0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials.     

Longitudinal changes in BMI in older adults are associated with meat consumption differentially, by type of meat consumed

Hypotheses regarding the role of meat consumption in body weight modulation are contradictory. Prospective studies on an association between meat consumption and BMI change are limited. We assessed the association between meat consumption and change in BMI over time in 3902 men and women aged 55-69 y from the Netherlands Cohort Study. Dietary intake was estimated at baseline using a FFQ. BMI was ascertained through baseline self-reported height (1986) and weight (1986, 1992, and 2000). Analyses were based on sex-specific categories of daily total fresh meat, red meat, beef, pork, minced meat, chicken, processed meat, and fish consumption at baseline. Linear mixed effect modeling adjusted for confounders was used to assess longitudinal associations. Significant cross-sectional differences in BMI between quintiles of total meat intake were observed (P-trend < 0.01; both sexes). No association between total fresh meat consumption and prospective BMI change was observed in men (BMI change highest vs. lowest quintile after 14 y: -0.06 kg/m2; P = 0.75) and women (BMI change: 0.26 kg/m2; P = 0.20). Men with the highest intake of beef experienced a significantly lower increase in BMI after 6 and 14 y than those with the lowest intake (BMI change after 14 y 0.60 kg/m2). After 14 y, a significantly higher increase in BMI was associated with higher intakes of pork in women (BMI change highest vs. lowest quintile: 0.47 kg/m2) and chicken in both sexes (BMI change highest vs. lowest category in both men and women: 0.36 kg/m2). The results remained similar when stratifying on median baseline BMI, and age-stratified analyses yielded mixed results. Differential BMI change effects were observed for several subtypes of meat. However, total meat consumption, or factors directly related to total meat intake, was not strongly associated with weight change during the 14-y prospective follow-up in this elderly population.     

Food insecurity,food choices,and body mass index in adults: nutrition transition in Trinidad and Tobago

BACKGROUND: This study evaluated whether food insecurity and obesity were associated in a population sample in Trinidad. METHODS: A sample was drawn of 15 clusters of households, in north central Trinidad. Resident adults were enumerated. A questionnaire was administered including the short form Household Food Security Scale (HFSS). Heights and weights were measured. Analyses were adjusted for age, sex, and ethnic group. RESULTS: Data were analysed for 531/631 (84%) of eligible respondents including 241 men and 290 women with a mean age of 47 (range 24-89) years. Overall, 134 (25%) of subjects were classified as food insecure. Food insecurity was associated with lower household incomes and physical disability. Food insecure subjects were less likely to eat fruit (food insecure 40%, food secure 55%; adjusted odds ratio [OR] = 0.60, 95% CI: 0.36-0.99, P = 0.045) or green vegetables or salads (food insecure 28%, food secure 51%; adjusted OR = 0.46, 95% CI: 0.27-0.79, P = 0.005) on >/=5-6 days per week. Body mass index (BMI) was available for 467 (74%) subjects of whom 41 (9%) had BMI <20 kg/m(2), 157 (34%) had BMI 25-29 kg/m(2), and 120 (26%) had BMI >/=30 kg/m(2). Underweight (OR = 3.21, 95% CI: 1.17-8.81) was associated with food insecurity, but obesity was not (OR = 1.08, 95% CI: 0.55-2.12). CONCLUSIONS: Food insecurity was frequent at all levels of BMI and was associated with lower consumption of fruit and vegetables. Food insecurity was associated with underweight but not with present obesity.     

Childhood maltreatment in extremely obese male and female bariatric surgery candidates

OBJECTIVE: To examine rates of self-reported childhood maltreatment in extremely obese bariatric surgery candidates and to explore associations with sex, eating disorder features, and psychological functioning. RESEARCH METHODS AND PROCEDURES: Three hundred forty (58 men and 282 women) extremely obese consecutive candidates for gastric bypass surgery completed a questionnaire battery. The Childhood Trauma Questionnaire was given to assess childhood maltreatment. RESULTS: Overall, 69% of patients self-reported childhood maltreatment: 46% reported emotional abuse, 29% reported physical abuse, 32% reported sexual abuse, 49% reported emotional neglect, and 32% reported physical neglect. Except for higher rates of emotional abuse reported by women, different forms of maltreatment did not differ significantly by sex. Different forms of maltreatment were generally not associated with binge eating, current BMI, or eating disorder features. At the Bonferonni-corrected significance level, emotional abuse was associated with higher eating concerns and body dissatisfaction, and emotional neglect was associated with higher eating concerns. In terms of psychological functioning, at the Bonferonni-corrected level, emotional abuse and emotional neglect were associated with higher depression and lower self-esteem, and physical abuse was associated with higher depression. DISCUSSION: Extremely obese bariatric surgery candidates reported rates of maltreatment comparable with those reported by clinical groups and roughly two to three times higher than normative community samples. Reported experiences of maltreatment differed little by sex and were generally not significantly associated with current BMI, binge eating, or eating disorder features. In contrast, maltreatment-notably emotional abuse and neglect-were significantly associated with higher depression and lower self-esteem.     

Influence of dietary pattern on the development of overweight in a Chinese population

OBJECTIVE: To examine dietary factors predisposing to overweight and obesity, taking into account age, gender, education level and physical activity.Design:Longitudinal population study. SETTING: Community living subjects in Hong Kong. SUBJECTS: One thousand and ten Chinese subjects participating in a territory wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 5-9 years. MEASUREMENTS: Body mass index (BMI) was measured. Information was collected on factors predisposing to development of overweight and obesity (age, gender, education level, physical activity, macronutrient intake, Mediterranean diet score and food variety), and the predisposing dietary factors examined, adjusted for other confounding factors, using logistic regression. RESULTS: The 5-9-year incidence of overweight is 22.6% (BMI > or =23 kg/m2, 95% confidence interval (CI)=15.0-30.1%) or 11.5% (BMI > or =25 kg/m2, 95% CI=7.3-15.7%), and for obesity (BMI >/=30 kg/m2) is 0.6% (95% CI=-0.2-1.4%). The corresponding figures for women were 14.1% (95% CI=8.8-19.5%), 9.7% (95% CI=6.0-13.4%) and 3% (95% CI=1.3-4.8%). After adjusting for confounding factors (age, sex, education and physical activity), increased variety of snack consumption was associated with increased risk of developing overweight (BMI > or =23 kg/m2) in the Hong Kong Chinese population over a 5-9-year period. CONCLUSION: Increased variety of snack consumption may predispose to weight gain over a 5-9-year period.     

Rigid vs. flexible dieting: association with eating disorder symptoms in nonobese women

The correlates of rigid and flexible dieting were examined in a sample of 188 nonobese women recruited from the community and from a university. The primary aim of the study was to test the hypothesis that women who utilize rigid versus flexible dieting strategies to prevent weight gain report more eating disorder symptoms and higher body mass index (BMI) in comparison to women who utilize flexible dieting strategies. The study sample included women who were underweight (29%), normal weight (52%), and overweight (19%). None of the women were obese, as defined by BMI>30. Participants were administered a questionnaire that measures Rigid Control and Flexible Control of eating. Body weight and height were measured and measures of eating disorder symptoms and mood disturbances were administered. Our results indicated that BMI was significantly correlated with rigid dieting and flexible dieting. BMI was controlled statistically in other analyses. The study found that individuals who engage in rigid dieting strategies reported symptoms of an eating disorder, mood disturbances, and excessive concern with body size/shape. In contrast, flexible dieting strategies were not highly associated with BMI, eating disorder symptoms, mood disturbances, or concerns with body size. Since this was a cross sectional study, causality of eating disorder symptoms could not be addressed. These findings replicate and extend the findings of earlier studies. These findings suggest that rigid dieting strategies, but not flexible dieting strategies, are associated with eating disorder symptoms and higher BMI in nonobese women.     

Individual weight change is associated with household food security status

This study examined the relation between household food security status and current measured weight and change in self-reported weight over 12 mo using data from the 1999-2000 and 2001-2002 National Health and Nutrition Examination Surveys. Current measured BMI categories were as follows: underweight (<18.5 kg/m(2)), overweight (> or =25 kg/m(2)), and obese (> or =30 kg/m(2)). Change in self-reported weight used 2 cut-off points, i.e., a gain/loss of at least 2.27 kg (5 lb) and at least 4.54 kg (10 lb). Household food security categories were as follows: fully secure, marginally secure, insecure without hunger, and insecure with hunger. Multivariate analyses were adjusted for race/ethnicity, household income, education level, and current health status. Compared with women in households that were fully food secure, women in households that were marginally food secure [odds ratio (OR) 1.58] and food insecure without hunger (OR 1.76) were significantly more likely to be obese. Compared with women in households that were fully food secure, those in households that were marginally food secure were significantly more likely to gain at least 4.54 kg (OR 1.68). Compared with men in households that were fully food secure, men in households that were marginally food secure were more likely to be obese and to gain at least 4.54 kg, but these effects were smaller in magnitude than those for women and insignificant in some specifications. This study corroborates previous cross-sectional associations between intermediate levels of food insecurity and obesity for women, and it finds an association between intermediate levels of food insecurity and 12-mo weight gain for women.     

Chocolate craving among children: implications for disordered eating patterns

The aim was to test the validity of a multidimensional model of chocolate craving among children, and to examine if the dimensions underlying the model predict consumption and eating disordered symptoms. Participants were 602 children (53% female) aged 11, 12, and 13 from 11 schools in Western Australia. Measures included the Orientation to Chocolate Questionnaire (OCQ) designed to assess three components of chocolate craving (approach, avoidance, and guilt), questions assessing body image dissatisfaction and dieting, and body mass index (BMI). Using structural equation modeling, results confirmed that chocolate craving among children is best conceptualized as a three-factor model (approach, avoidance, guilt). The underlying dimensions were differentially associated with self-reported chocolate consumption and indicators of disordered eating patterns. After controlling for BMI and gender, chocolate-related guilt was strongly associated with greater body dissatisfaction and dieting, and avoidance inclinations were also associated with dieting. Chocolate-related guilt was higher in girls than in boys. Results suggest that children experience chocolate craving as a multidimensional phenomenon reflecting some ambivalence. A gender difference in chocolate-related guilt appears to emerge in childhood, potentially contributing to a greater risk for girls to develop exaggerated concerns about body shape and weight.     

Pathological dieting and alcohol use in college women--a continuum of behaviors

The relationship between dieting and bingeing severity and alcohol use was studied in a sample of women in their first year of college (n = 1384). The study was designed to replicate and extend earlier findings of a graded positive relationship between the dieting and bingeing severity and the frequency, intensity, and negative consequences of alcohol use in young women, while adjusting for known predictors of alcohol use. Prevalence of past month alcohol use, drinking enough to get high on half or more drinking occasions, and heavy drinking (>or= five drinks in a row) in these women were positively associated with dieting and bingeing severity in a graded manner across the entire range of these behaviors. Dieting and bingeing severity was also more closely associated with the frequency and intensity of alcohol use than measures of depression, parents' drinking level, and early age of first drink. Finally, dieting and bingeing severity was positively associated with the prevalence of negative consequences of alcohol use, such as blackouts and unintended sexual activity. These results suggest that the dysfunctional eating behaviors often associated with dieting could also be associated with dysfunctional alcohol use.     

Frequency of eating occasions reported by young New Zealand Polynesian and European women

The frequency of eating occasions reported by young New Zealand Polynesian and European women was examined. The timing and content of meals and snacks were analysed from 80 self-reported seven-day food diaries from a previous study of 80 young women (39 New Zealand Polynesian and 41 European) aged between 18 and 27 years. Nineteen Polynesian and 20 European women had a body mass index (BMI) greater than 30 kg.m-2 and were classified as obese. Breakfast was eaten more often by the European women than the Polynesian (median 4 versus 3 times.week-1, P = 0.012). Eleven (28%) of the Polynesian women skipped breakfast every day of the study week compared to only three (7%) of the Europeans (P = 0.019). Dinner was eaten more frequently by the European women (P = 0.020) who also ate significantly more meals during the week than the Polynesian (P = 0.039). Non-obese Europeans ate breakfast more frequently than their obese counterparts (P = 0.002) while no significant difference was observed between non-obese and obese Polynesians. The obese European and Polynesian groups reported similar patterns of breakfast consumption which differed significantly from the non-obese Europeans (P = 0.008). The young women in this study did not eat breakfast every day with the young Polynesian women eating fewer meals than the Europeans. There was an association between ethnic origin, body size and eating patterns in the women. These findings in comparison with previous studies in other countries indicate that the frequency of eating breakfast may be declining with time.     

Familial and individual variables as predictors of dieting concerns and binge eating in college females

OBJECTIVE: The current study explored family and individual variables associated with dieting and binge eating. METHOD: 581 college females completed questionnaires exploring the amount of criticism and preoccupation with weight and food they experienced in their families, their current levels of depression, external attributions, and body esteem, and their degree of focus on dieting and binge eating. RESULTS: A structural equation model incorporating previous research and theoretical considerations was evaluated. The data were consistent with a model in which family variables were mediated by individual variables of depression, external attributions, and negative body esteem to predict dieting and bingeing. Dieting was influenced by all three individual variables, and in turn, dieting and depression were associated with binge eating. DISCUSSION: These results are consistent with an internalization model of family issues. Family dysfunction and values lead to depressive symptoms, external attributions, and negative body esteem. Dieting may be a "solution" that leads to additional eating problems such as binge eating when depression is present.     

Why do slim women consider themselves too heavy? A characterization of adult women considering their body weight as too heavy

OBJECTIVE: The purpose of this study was to characterize women who, in spite of a low body mass index (BMI), considered themselves too heavy. METHOD: Of 11,905 women (27-38 years of age), we focused on 2,443 nonpregnant women with a low BMI (18.5-21.0 kg/m(2)), who considered their weight acceptable or too heavy. Participants completed a comprehensive questionnaire. By multiple logistic regression we examined associations between lifestyle and health variables and the risk of considering own body weight too heavy. RESULTS: Approximately 10 % considered their body weight too heavy. Risk factors included early severe life events, young age at start of risky lifestyle behaviors, weight fluctuation, self-reported lifetime history of eating disorders, perception of too heavy workload, and poor physical form and self-rated health. Body dissatisfaction decreased with increasing age. DISCUSSION: Our results indicate that body dissatisfaction is established in childhood and adolescence. It is unknown if this body dissatisfaction influences the life of the women, but it might influence the values they pass on to their children.     

Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women

BACKGROUND: Uterine leiomyomata are a major source of morbidity in black women. We prospectively investigated the risk of self-reported uterine leiomyomata in relation to body mass index (BMI), weight change, height, waist and hip circumferences, and waist-to-hip ratio in a large cohort of U.S black women. METHODS: Data were derived from the Black Women's Health Study, a U.S. prospective cohort study of black women who complete biannual mailed health questionnaires. From 1997 through 2001, we followed 21,506 premenopausal women with intact uteri and no prior diagnosis of uterine leiomyomata. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: After 70,345 person-years of follow up, 2146 new cases of uterine leiomyomata confirmed by ultrasound (n = 1885) or hysterectomy (n = 261) were self-reported. Compared with the thinnest women (BMI <20.0 kg/m), the multivariate IRRs for women with BMIs of 20.0-22.4, 22.5-24.9, 25.0-27.4, 27.5-29.9, 30.0-32.4, and 32.5+ kg/m were 1.34 (95% CI = 1.02-1.75), 1.39 (1.07-1.81), 1.45 (1.12-1.89), 1.47 (1.11-1.93), 1.36 (1.02-1.80), and 1.21 (0.93-1.58), respectively. IRRs were larger among parous women. Weight gain since age 18 was positively associated with risk, but only among parous women. No other anthropometric measures were associated with risk. CONCLUSIONS: BMI and weight gain exhibited a complex relation with risk of uterine leiomyomata in the Black Women's Health Study. The BMI association was inverse J-shaped and findings were stronger in parous women. Weight gain was positively associated with risk among parous women only.     

Dietary patterns and their associations with obesity in the Brazilian city of Rio de Janeiro

OBJECTIVE: To evaluate the dietary patterns of adults living in the city of Rio de Janeiro, Brazil and their associations with body mass index (BMI). RESEARCH METHODS AND PROCEDURES: A survey was conducted in 1996 in a probabilistic sample of 2040 households. Weight and height were measured and food intake was based on an 80-item semi-quantitative food frequency questionnaire. Dietary patterns were identified through factor analysis. RESULTS: More than one-third of the adult population (20 to 60 years old) was overweight (BMI = 25 to 29.9 kg/m(2)), and 12% were obese (BMI >or= 30 kg/m(2)). Three major dietary patterns were identified: mixed pattern when all food groups and items had about the same factor loading, except for rice and beans; one pattern that relies mainly on rice and beans, which was called a traditional diet; and a third pattern, termed a Western diet, where fat (butter and margarine) and added sugar (sodas) showed the highest positive loading and rice and beans were strong negative components. Among men, the Western diet also included deep-fried snacks and milk products with high positive values. The traditional diet was associated with lower risk of overweight/obesity in logistic models adjusted for dieting, age, leisure physical activity, and occupation (13% reduction in men and 14% reduction in women comparing the traditional and Western diets). DISCUSSION: Factors contributing to the effects of the Brazilian traditional diet may include low-energy density, high-dietary fiber content, incorporation of low glycemic index foods such as beans, or a relatively low food variety.     

Dieting and food craving. A descriptive, quasi-prospective study

Evidence linking food restriction and food craving is equivocal. This study investigated whether dieting was associated with a greater frequency of food craving. Dieting to lose weight was distinguished from watching so as not to gain weight. Participants were 129 women (mean age=41 yrs): 52 were currently dieting to lose weight, 40 were watching their weight, and 37 were non-dieters. They completed a food craving record after every food craving, a food diary, and a daily mood assessment over 7-days. Of the 393 craving incidents recorded, dieters experienced significantly more food cravings than non-dieters, with watchers intermediate. Chocolate was the most craved food (37% of cravings) but neither the types of food, the proportion of cravings leading to eating (～70%), the situations in which cravings occurred, nor the time since the last eating episode differed between groups. Compared with non-dieters, dieters experienced stronger cravings that were more difficult to resist, and for foods they were restricting eating. Watchers showed similarities in experience both to dieters (low hunger) and non-dieters (lower craving intensity). These results support an association between dieting and food craving, the usefulness of distinguishing dieting to lose weight and watching, and suggest a need for further experimental investigation of actual food restriction on food craving experiences.     

Body Composition Correlates of Weight Dissatisfaction and Dietary Restraint in Young Women

Previous research found that when Body Mass Index (BMI) was statistically controlled in a multiple regression model, the percentage of body fat accounted for no additional variance in dietary restraint scores among women although, on its own, it was a significant predictor of this variable. These results imply that anatomical factors, besides fatness, influence dieting behaviour. The present study was designed to compare the relative influence on dietary restraint and weight dissatisfaction, of three body composition measures, each of which contributes in a different way to subjective impressions of body size (viz. BMI, body fat content, and skeletal frame size). Measures of emotional reactivity ('neuroticism'), body dissatisfaction, and body focus were also included in the regression model. Results indicated that these psychological variables were strongly and positively related to restraint. Frame size was also a significant predictor of restraint and weight dissatisfaction. In fact, when frame size was controlled in the regression model, neither percentage of body fat nor BMI were able to explain any additional variance in restraint scores. These findings indicate that weight concerns and dieting behaviour are influenced, at least among young women, more by the size of their skeletal structure than their degree of adiposity. The irony of these findings is obvious and disheartening. An anatomical feature which is essentially resistant to change by dieting or exercise appears to be a primary influence in women's weight dissatisfaction and their tendency to diet. It is acknowledged, however, that this relationship may not obtain among very obese women.     

Never too old for eating disorders or body dissatisfaction: a community study of elderly women

OBJECTIVE: The aim of the study is to examine eating behavior and body attitude in elderly women. METHOD: A randomly selected nonclinical sample of 1,000 women, aged 60-70 years, was contacted for our questionnaire survey covering current eating behavior, weight history, weight control, body attitude, and disordered eating (DSM-IV). RESULTS: The 475 (48%) women included in our analyses had a mean BMI of 25.1 but desired a mean BMI of 23.3. More than 80% controlled their weight and over 60% stated body dissatisfaction. Eighteen women (3.8%; 95% confidence interval: 2.3-5.9%) met criteria for eating disorders (ED; N = 1 anorexia nervosa, N = 2 bulimia nervosa, and N = 15 EDNOS) and 21 (4.4%) reported single symptoms of an ED. CONCLUSION: Although EDs and body dissatisfaction are typical for young women, they do occur in female elderly and therefore should be included in the differential diagnosis of elderly presenting with weight loss, weight phobia, and/or vomiting.