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Objectives This study aimed to understand barriers to engagement in healthy lifestyle behaviors among adolescents with comorbid Type 1 diabetes (T1D) and overweight/obesity (n  =   12), their caregivers (n  =   12), and pediatric endocrinologists (n  =   9). Methods Participants (n  =   33) completed individual, semi-structured interviews. Interviews were transcribed verbatim, and applied thematic analysis was used to analyze the interview data. Results Results from adolescents, caregivers, and pediatric endocrinologists revealed three thematic barriers to healthy lifestyle behaviors for adolescents with T1D and overweight/obesity: (1) discomfort with aspects of T1D that draw attention to the self; (2) T1D as a barrier to engagement in healthy lifestyle behaviors; and (3) physiological dysregulation due to T1D impacting health behaviors. Conclusions Results identify perceived limitations to engaging in recommended healthy lifestyle behaviors and diabetes management concurrently. Results may assist research and clinical care in identifying supports and guidance needed to support adolescents in meeting behavioral recommendations for their health. [ABSTRACT FROM AUTHOR]

Background: Emerging adults are underrepresented in standard behavioral weight loss interventions (BWLIs). Offering BWLIs in college health centers may help to address obesity in emerging adulthood by reducing student barriers associated with participation; however, implementation barriers and facilitators for health centers are unknown. Methods: Health services center administrators and providers (n = 14) and students eligible to participate in a BWLI (n = 9, average BMI = 29.8 ± 4.2 kg/m2) participated in semi‐structured interviews. Interviews focused on the need for and appropriateness of BWLIs in health centers and perceived barriers and facilitators to their implementation. Results: Participants generally believed that BWLIs delivered through a health center were appropriate and indicated that BWLIs would be a beneficial offering on‐campus. Facilitators of health center implementation included availability of trained health professionals, intradepartmental relationships, supportive infrastructure and resources, and in‐house planning and execution. Barriers included limited student use and knowledge of health center offerings, narrow referral/recruitment pathways related to stigma concerns, and challenges related to infrastructure, resources, and competing demands. Conclusions: College health centers are a feasible and appropriate setting to offer BWLIs, though barriers to implementation exist. It will be important to construct a plan for implementation to address unique barriers in health centers prior to BWLI implementation. [ABSTRACT FROM AUTHOR]

Pediatric obesity is an ongoing health concern within the United States, with one third of children being classified as overweight or obese (Ogden et al., 2016). Previous research has shown [...], Introduction: Although families face many barriers to obtaining and maintaining a healthy weight status for children, there remains a lack of psychometrically sound tools to assess perceived barriers. The Barriers to Child Weight Management (BCWM) scale quantitatively assesses parents' perceptions of barriers to engaging in positive weight-related behaviors but has not been validated within a clinical sample. The present study sought to validate the BCWM scale among parents of children presenting to a tertiary pediatric weight management clinic. Method: Participants included 258 parents of children aged 6-18 years presenting to a tertiary care behavioral weight management program. Parents completed the BCWM prior to the initial clinic visit. Confirmatory factor analysis was conducted to test the previously identified 4-factor structure within a clinical sample. Results: Overall model fit was good with the addition of 2 theoretically appropriate model respecifications, [chi square](144) = 278.60, p < .001, comparative fit index = .90, root mean square error of approximation = .05, standardized root mean square residual = .06. Discussion: The BCWM is a promising tool to assess parental perceptions of barriers to healthy weight-related behaviors among youth presenting for clinical weight management intervention. Incorporation of this measure into pediatric weight-management appointments may aid in quickly identifying points of intervention. Keywords: pediatric obesity, health behaviors, barriers, weight management

Childhood obesity is a significant health problem associated with negative physical and mental health outcomes. Although evidence-based family healthy weight programs (FHWPs), such as JOIN for ME , have been developed, there is a significant lag before these are disseminated more broadly. This study outlines the process of participating in the Sp eeding R esearch-tested Int erventions (SPRINT) program, highlighting lessons learned, to increase the reach of a previously tested and efficacious FHWP, JOIN for ME. Qualitative interviews were conducted with policymakers, benefits providers, employers, philanthropists, community stakeholders, and medical providers to iteratively test the developed JOIN for ME business model and identify themes regarding effective scaling and sustainability of an evidence-based FHWP. Rapid qualitative analysis of 45 interviews identified four key themes regarding scaling of an FHWP. These were (i) virtual program delivery, (ii) focus on equity, (iii) return on investment, and (iv) tie-in to local community. The process of engaging stakeholders from multiple backgrounds is critical to refining an efficacious program to ensure scalability and sustainment. The SPRINT process allows researchers to understand the marketplace for evidence-based interventions and develop adaptations for sustaining and scaling research tested programs. [ABSTRACT FROM AUTHOR]

Aims: The Diabetes Eating Problems Survey – Revised (DEPS‐R) is commonly used to assess disordered eating behaviour (DEB) in individuals with type 1 diabetes and has advantages compared to other measures not specifically tailored to diabetes. A score ≥20 on the DEPS‐R is used to indicate clinically significant DEB; however, it does not distinguish between eating disorder (ED) phenotypes necessary to guide treatment decisions, limiting clinical utility. Methods: The current study used latent class analysis to identify distinct person‐centred profiles of DEB in adults with type 1 diabetes using the DEPS‐R. Analysis of Variance with Games Howell post‐hoc comparisons was then conducted to examine the correspondence between the profiles and binge eating, insulin restriction and glycaemic control (HbA1c, mean blood glucose, and percent time spent in hyperglycaemia) during 3 days of assessment in a real‐life setting. Results: Latent class analysis indicated a 4‐class solution, with patterns of item endorsement suggesting the following profiles: Bulimia, Binge Eating, Overeating and Low Pathology. Differences in binge eating, insulin restriction and glycaemic control were observed between profiles during 3 days of at‐home assessment. The Bulimia profile was associated with highest HbA1c and 3‐day mean blood glucose. Conclusions: There are common patterns of responses on the DEPS‐R that appear to reflect different ED phenotypes. Profiles based on the DEPS‐R corresponded with behaviour in the real‐life setting as expected and were associated with different glycaemic outcomes. Results may have implications for the use of the DEPS‐R in research and clinical settings. [ABSTRACT FROM AUTHOR]

Adolescence is a vulnerable time for the development of obesity, likely because of poor diet, decreased physical activity, and increased stress during this sensitive developmental period (Jasik & Lustig, 2008). [...], Introduction: Stress has been consistently related to obesity-promoting eating patterns (i.e., emotional, external, and restrained eating) throughout the life span, including during adolescence. One particularly salient source of stress within adolescence is parent-adolescent conflict. The current study sought to examine whether parent-adolescent conflict is a significant predictor of adolescent obesity-promoting eating patterns, beyond general adolescent stress. Methods: A sample of adolescents (N = 51; 39.2% overweight or obese) completed a study examining stress and eating behaviors. As part of the larger study, adolescents completed measures related to parent-adolescent conflict, general adolescent stress, and obesity-promoting eating patterns. Adolescent height and weight were measured objectively and used to calculate adolescent body mass index (BMI) percentile for age and gender. Results: General adolescent stress predicted all three obesity-promoting eating patterns, emotional, external, and restrained eating, controlling for adolescent BMI percentile. Higher levels of parent-adolescent conflict significantly predicted greater restrained eating, controlling for adolescent BMI percentile and general adolescent stress. Conflict did not predict emotional or external eating patterns. Discussion: Adolescents&apos; perceptions of parent-adolescent conflict appear to present a unique source of stress, above and beyond general perceived stress, that is, particularly relevant to the experience of restrained eating patterns. These findings provide support for the potential integration of assessment and intervention for parent-adolescent conflict within previously established behavioral weight control interventions to decrease restrained eating behaviors. Keywords: pediatric obesity, obesity-promoting eating patterns, family conflict, stress

Author(s): Amy J. Fahrenkamp [sup.1] , Katherine E. Darling [sup.1] , Elizabeth B. Ruzicka [sup.1] , Amy F. Sato [sup.1] Author Affiliations: (Aff1) 0000 0001 0656 9343, grid.258518.3, Clinical Psychology, [...], Introduction The prevalence of pediatric obesity is an issue in the United States, in which approximately one-third of children and adolescents are overweight or obese. Youth living in low socioeconomic (SES) households are at an increased risk for developing obesity; yet, research is needed to understand the mechanisms that might better explain the relationship between SES and obesity risk. Maternal depression presents a potential mechanism by which SES might predict a later risk for obesity in pediatric populations. Methods The present study used a national dataset from the National Institute of Child Health and Human Development-Study of Early Child Care and Youth Development (NICHD-SECCYD) to examine whether maternal depressive symptoms (at an age of 9 years) mediated the association between early SES (the income-to-needs ratio measured at an age of 1 month) and adolescent weight outcomes [Body Mass Index z-scores (zBMI) for age and sex, at an age of 15 years]. Results The results suggested that greater maternal depressive symptoms helped to explain a significant amount of the variance of lower SES predicting poorer weight outcomes in adolescents. Discussion These findings illustrate the role of maternal depressive symptoms in explaining how SES predicts adolescent weight outcomes. Implications are discussed, and future research is needed to identify women from lower SES households who are experiencing depressive symptoms to provide support and initiate points of early intervention to address relevant health outcomes in youths.

Body talk among adolescent females has been associated with negative outcomes, including depressed mood, disordered eating, and body dissatisfaction. Yet, little work has investigated the manifestation of body talk in actual conversations between adolescent females or explored pathways through which body talk is spread (e.g., co-rumination). The present study examined body talk among adolescent female dyads (N = 23 dyads) ages 13 to 17 (M age = 15.12) using an observational design. Reciprocally nominated dyads were recruited from a high school in the southeastern United States. Conversations between dyads were qualitatively coded using an applied thematic analysis approach. Identified themes were related to weight, appearance, and personality. Results provide insight into the social context in which sociocultural norms of weight stigma, body dissatisfaction, and eating-related psychopathology may be reinforced. Findings have implications for informing the development of interventions to reduce co-rumination of negative weight- and appearance-related body talk and to promote positive body image and healthy weight among adolescent girls. [ABSTRACT FROM AUTHOR]

Objective: This study sought to (1) examine perceived stress and resources to cope with stress as predictors of emotional eating during the transition to college and (2) determine whether body mass index (BMI) moderated the emotional eating-stress relationship. Participants: Participants were 97 college freshmen (73% female; BMI: M = 25.3 kg/m[superscript 2], SD = 5.7 kg/m[superscript 2]). Research was conducted in September 2012. Methods: Participants completed the Perceived Stress Scale, Emotional Eating Scale, and Eating and Appraisal Due to Emotions and Stress Questionnaire during the first month of college. Height and weight were measured objectively. Results: BMI moderated the relationship between perceived stress and emotional eating. Higher stress predicted greater emotional eating for the lower BMI groups, but not the highest group. Greater resources to cope with stress predicted lower emotional eating. Conclusions: Greater perceived stress and poorer resources to cope with stress may contribute to emotional eating during the transition to college. The relationship between perceived stress and emotional eating may vary by BMI.

A range of barriers may negatively impact adolescents' ability to successfully alter or sustain healthy weight-related behaviors. However, there is a lack of validated measures to empirically assess these barriers. This study developed a measure of adolescent-reported barriers to healthy weight-related behaviors by adapting the previously validated parent-report Barriers to Child Weight Management. Adolescents (N = 154) ages 11–17 presenting to a tertiary weight management program completed Barriers to Weight Management in Adolescence (BWMA). This measure assessed adolescents' perspectives of barriers to healthy weight-related behaviors. Confirmatory factor analysis was used to examine model fit, with four hypothesized subscales—Parental Disengagement, Cost, Lack of Family Support, and Adolescent Disengagement. Overall, good model fit was model demonstrated, χ2 (98) = 130.44, p =.02, CFI =.92, RMSEA =.05, SRMR =.06, supporting a four-factor structure. A final 16-item measure demonstrated good initial psychometric properties. As hypothesized, BWMA was significantly associated with general healthy habits [ r = −.25, 95% CI(-.46, −.12)] and parent-reported barriers [ r =.40, 95% CI (.264,.586)]. This study adapted and tested preliminary validation of a quantitative measure of adolescent-reported barriers to weight-related behaviors. Identification of barriers may prompt providers to adequately assess, and in turn address, factors impeding adolescents' success in modifying eating and physical activity patterns. [ABSTRACT FROM AUTHOR]

National estimates suggest that more than 35% of American children, ages 2–19 years, are overweight or obese, which increases their risk for weight‐related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost‐effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6–12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity. Although such programs are effective in reducing weight status, there are many barriers to completing these programs. A novel consideration for both the prevention and treatment of childhood obesity is the recognition that the timing of intervention, both duration and time of the year, can impact family engagement and intervention effectiveness. This paper discusses the potential of targeting high‐risk periods for weight gain and offering brief behavioral intervention, in hopes of inspiring research on novel approaches to the prevention and treatment of childhood obesity. [ABSTRACT FROM AUTHOR]

Objective Current guidelines for treatment of obesity in adolescence include screening and referring youth with obesity to appropriate weight management (WM) care. However, prior work has not explored the referral process to adolescent WM programs, especially for youth from lower-income backgrounds, who are at increased risk of obesity and related negative health outcomes. This qualitative study sought to understand pediatricians' current practices regarding referrals to adolescent WM interventions with a focus on adolescents from lower-income backgrounds. Methods Individual interviews were conducted with 11 medical providers that had referred at least 5 adolescents from low-income backgrounds to WM interventions. Applied thematic analysis was used for data analysis. Results Identified themes included weight-related discussions with adolescents as potentially fraught, as providers want to address weight-related health concerns while being thoughtful about potential harm. Providers also noted varied factors affecting their decision to refer to WM programs, including health implications, perceived motivation of the patient and family, and availability of programs. Providers identified that many families experience shame or guilt around referral to WM. Few themes were identified regarding impact of income on weight-related conversations with adolescents. Conclusion Findings were novel in regard to discussions of weight in adolescents with obesity leading to WM referral. Despite being a primary focus of the present study, few themes were identified regarding specific considerations for adolescents from low-income backgrounds. Future clinical research should focus on provider-focused interventions to increase sensitivity regarding weight-related discussions and attention to diversity, equity, and inclusion. [ABSTRACT FROM AUTHOR]

Weight-based victimization (WBV) is associated with poor weight-related outcomes in adolescence. Family support may be one protective factor against the negative impact of WBV. The goal of this study is to examine the moderating effect of family support on the association between WBV and early weight loss for adolescents in a clinical weight management program. Parents of adolescents (N = 78) completed psychosocial measures at baseline. Objective height and weight were measured at baseline and follow-up (Visit 3). The overall model was significant (p =.02), explaining 12.76% of the variance in weight change over the first 2 months of treatment. As hypothesized, there was a significant moderating effect of family support on the association between WBV and weight change (p =.04), accounting 5.0% of the variance in weight change. Increased support from the family buffered the negative impact of WBV on early treatment outcomes for adolescents in a weight management program. [ABSTRACT FROM AUTHOR]

Objective Adolescents from low-income backgrounds are at increased risk for obesity and related negative health outcomes. Furthermore, these adolescents have less access to, and success in, weight management (WM) programs. This qualitative study sought to better understand engagement in a hospital-based WM program from the perspective of adolescents and caregivers at different levels of program initiation and engagement. Methods Qualitative interviews were conducted with 55 participants (29 adolescents and 26 caregivers). This included: (a) those that were referred to, but never initiated, WM treatment (non-initiators); (b) those that prematurely disengaged from treatment (drop-outs); and (c) those that had ongoing participation in treatment (engaged). Data were analyzed using applied thematic analysis. Results Related to program initiation, participants across all groups (including adolescents and caregivers) noted that they did not have a full understanding of the scope or goals of the WM program following initial referral. In addition, many participants identified misperceptions of the program (e.g. perceptions of a screening visit as compared to an intensive program). Both caregivers and adolescents identified caregivers as drivers of engagement, with adolescents often hesitant about participation in the program. However, engaged adolescents found the program valuable and sought ongoing participation following caregiver initiation. Conclusions When considering initiation and engagement in WM services for adolescents at highest risk, healthcare providers should provide more detailed information concerning WM referrals. Future research is needed to improve adolescent perception of WM, especially for adolescents from low-income backgrounds, which could increase initiation and engagement for this population. [ABSTRACT FROM AUTHOR]

Childhood obesity is associated with negative physical and psychosocial outcomes, especially for children from low-income backgrounds. It is critical to adapt evidence-based family healthy weight programs to meet the needs of this population. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions was used to describe the process of using qualitative data from community and intervention stakeholders, children with overweight or obesity from low-income backgrounds, and caregivers to guide adaptations to the JOIN for ME pediatric weight management intervention. Qualitative interviews were conducted with key community and intervention stakeholders (e.g. nurse care managers, prior JOIN for ME coaches; N = 21). Focus groups were conducted in both Spanish and English with children with overweight or obesity from low-income backgrounds (N = 35) and caregivers of children with overweight or obesity from low-income backgrounds (N = 71). Qualitative data analysis informed modifications including content adaptations to simplify and tailor materials, contextual adaptations to improve intervention engagement and framing, resource awareness, and modality of delivery, training adaptations, and implementation/scale-up activities to increase connections with community partners. The process of engaging multiple stakeholder perspectives to tailor an existing intervention can provide a model for future researchers to improve the potential disseminability of an intervention. [ABSTRACT FROM AUTHOR]

The prevalence of overweight and obesity in youth with type 1 diabetes mellitus (T1D) now exceeds that of youth without T1D. Comorbid T1D and excess adiposity are associated with multiple serious negative health outcomes. Unfortunately, youth with T1D are often excluded from and/or not referred to standard behavioral lifestyle interventions. This is often attributed to the complexities of managing T1D and an effort not to overburden persons who have T1D. Furthermore, standard behavioral weight management intervention recommendations can be perceived as contradicting T1D disease management (e.g., removing sugar-sweetened beverages from diet, energy balance with exercise, and caloric restriction). A weight management intervention specifically designed for youth with T1D is needed to provide treatment to youth with comorbid T1D and overweight/obesity. The current study interviewed adolescents with T1D and overweight/obesity (n = 12), their caregivers (n = 12), and pediatric endocrinologists (n = 9) to understand (a) whether they would be interested in a weight management intervention adapted for youth with T1D and (b) specific adaptations they would want and need. Five central themes emerged following applied thematic analysis: (1) program content, (2) programmatic messaging, (3) program structure, (4) social support, and (5) eating disorder risk. Results provide detailed recommendations for the adaptation of a behavioral weight management intervention for youth with T1D. [ABSTRACT FROM AUTHOR]

Objective: Over the past two decades, there has been a steady increase in research focused on the association between weight-based stigma and mental health outcomes in children and adolescents. The present study is a systematic review and meta-analysis of the associations between weight stigma and mental health in youth.Methods: A systematic search of PubMed, PsychInfo, and Embase databases was conducted in January 2020. Inclusion criteria included the following: (a) examined an association between weight stigma and a mental health outcome, (b) mean sample age <18 (+1 standard deviation) years, (c) written in English, and (d) peer reviewed. Forty eligible articles were identified. The moderating effects of age, sex (percent female), weight status (percent with overweight/obesity), and study quality were examined.Results: Overall, meta-analytic findings using a random-effects model indicated a statistically significant moderate association between weight stigma and poorer mental health outcomes (r = .32, 95% confidence interval [0.292, 0.347], p < .001). Age and study quality each moderated the association between weight stigma and mental health. Generally, the study quality was fair to poor, with many studies lacking validated measurement of weight stigma.Conclusions: Although there was a significant association between weight stigma and mental health in youth, study quality hinders the current body of literature. Furthermore, findings highlight the lack of consideration of internalized weight stigma in child populations, the importance of using validated measures of weight stigma, and the need for increased awareness of how these associations affect populations of diverse backgrounds. [ABSTRACT FROM AUTHOR]

Summary: The U.S. Preventive Services Task Force (USPSTF) has set forth recommendations for clinicians to screen youth (6‐18 years) for obesity. Those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behaviour (ie, diet, physical activity, behaviour change). However, these recommendations are primarily based upon outcomes from randomized controlled trials and the feasibility of meeting these guidelines for adolescents in a clinical setting is unknown. The present study employed a multi‐informant qualitative approach with adolescents, parents, and physicians, to identify and understand multiple perspectives on the feasibility and acceptability of implementing the USPSTF guidelines. In‐depth interviews with seven adolescents, seven parents, and four physicians were analysed. Generally, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs, indicating that it would be difficult for many adolescents to participate in a program that was not tailored to their needs and resources. Future research should focus on adapting clinical weight management programs to meet both USPSTF guidelines and the needs of adolescents and their families. [ABSTRACT FROM AUTHOR]

Summary: Controlling child feeding practices (restriction and pressure‐to‐eat) have been theorized to predict increased child weight status. However, mixed evidence has been found for this association within previous narrative reviews. The present study quantitatively examined the association between controlling feeding practices and child weight status and examine potential study‐level and person‐level moderators. PubMed, PsychINFO, and Cochrane databases were utilized. Studies examining the association of controlling child feeding practices and child weight were included. Data from 51 studies, with 17 431 parent‐child dyads, were included. There was a small but significant association between restrictive child feeding practices and child weight (d =.22, 95% CI,.14 to.30). Restriction was significantly associated with higher child weight status. This association was significantly moderated by child age and household income. There was also a significant association between pressure‐to‐eat child feeding practices and child weight (d = −.30, 95% CI, −.38 to −.22). No significant moderators were identified. Pressure‐to‐eat was significantly associated with lower child weight status. There was a high degree of heterogeneity of effects between studies included in analyses. Longitudinal studies are needed to examine the effect of controlling feeding on child weight over time. [ABSTRACT FROM AUTHOR]

The current study examined the association between barriers that primary care providers (PCPs) face in addressing pediatric obesity and current pediatric weight management practices. Seventy-six (77% female) PCPs in a midwestern children's hospital system completed a survey of their current practices for obesity and barriers to addressing pediatric obesity. Regression analysis showed higher levels of barriers were associated with lower levels of current practices (β = -0.39, p = 0.001). Provider preferences of tools (e.g., handouts, trainings) for pediatric weight management are reported. Development of tools to aide intervention for pediatric weight management may be vital to optimal weight management intervention within primary care. [ABSTRACT FROM AUTHOR]

Although literature is mixed, some research suggests that food insecurity likely predicts obesity beginning in childhood. Child feeding practices may be one possible mechanism for this association. Parents of children ages 7-17 (n = 790) completed the USDA Core Food Security Module and the Child Feeding Questionnaire. Child BMI percentile was calculated using parent-reported child height and weight. Restrictive and controlling feeding practices each mediated the association between food insecurity and child BMI percentile, controlling for familial income and child age. Findings from this preliminary study suggest that feeding practices may be one mechanism through which food insecurity is related to obesity. [ABSTRACT FROM AUTHOR]

This study sought to examine whether social support moderates the relationship between stress eating and body mass index (BMI) change over the freshman year in males and females. This longitudinal study included 70 college students (72.9% female; M age = 18.23) who completed self-reported measures of stress eating and perceived social support, with objective height and weight measurements collected. Among males, social support moderated the relationship between stress eating and BMI change. Among males, social support may serve as a buffer against the impact of stress eating on weight gain during the freshman year of college. [ABSTRACT FROM AUTHOR]

Following a biopsychosocial model of food insecurity, this study examined differences in physical health and mental health outcomes among young adults (N = 98) with and without a history of food insecurity. Young adults with a history of food insecurity had higher average levels of body mass index, waist-to-height ratio, depressive symptoms, stress, and disordered eating scores than individuals with no history of food insecurity. No differences were found with symptoms of anxiety. Future research should examine interventions targeted at decreasing negative mental health outcomes and risk for overweight among young adults who have experienced food insecurity. [ABSTRACT FROM AUTHOR]

Adolescents with type 1 diabetes (T1D) have elevated eating disorder risk. No studies have examined weight stigma as a potential factor associated with disordered eating. This study investigated cross-sectional associations among weight-based victimization, weight bias internalization, and disordered eating in adolescents with T1D. Adolescents (12–17 years; N = 166) self-reported experiences of weight-based victimization from peers, family members, and healthcare professionals. The Weight Bias Internalization Scale (WBIS) and Diabetes Eating Problems Survey (DEPS-R) assessed internalized weight bias and disordered eating, respectively. In a series of multiple hierarchical linear regression analyses (controlling for zBMI, diabetes duration, HbA1c, sex), weight bias internalization, weight-based victimization, and frequency of weight-based victimization by peers, family, and healthcare professionals were all positively associated with disordered eating. Weight stigma is an understudied but potentially important factor to address in adolescents with T1D. Reducing weight stigma may be a promising, novel target for eating disorder prevention in this population. [ABSTRACT FROM AUTHOR]

Purpose: Weight stigma is a common experience for adolescents at high weight statuses. Prior research regarding experiences of weight stigma in adolescence has been in primarily homogenous samples. The present study sought to characterize weight stigma experiences and internalization in adolescents from low-income backgrounds. This was done by reporting on teen's experiences of weight stigma in daily life and in conversations with health-care professionals, and examining the effect of internalization of this stigma., Methods: This study is a secondary analysis of semi-structured qualitative interviews conducted with adolescents with high weight from low-income backgrounds who had been referred to weight management, as well as their caregivers. Data was analyzed using applied thematic analysis., Results: Fifty-five participants (29 adolescents and 26 caregivers) from low-income backgrounds participated in semi-structured interviews. Given the broader focus of the primary study, weight stigma was not a focus of interviews. However, almost all participants identified weight stigma and bias as influencing their lives and medical care. Identified themes included the following: (1) difficulty identifying preferences regarding weight-related terminology; (2) commonality of experienced weight stigma; and (3) significant effect of internalized weight bias on adolescent daily living., Discussion: Overall, the present study identified nearly ubiquitous experiences of weight stigma for a sample of youth from low-income backgrounds living in larger bodies. This highlights the pervasive presence of weight stigma and bias throughout adolescents' lives, including in health-care settings. These findings are particularly stark, given that weight stigma was not a topic within the interview guide., (Copyright © 2025 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Biofeedback is commonly used for both pediatric and adult patients with a myriad of diagnoses in clinical settings. The majority of previous research has focused on the use of biofeedback in adults, with only a small body of literature examining the usefulness of biofeedback in treating children. The current systematic review and meta-analysis seeks to quantitatively examine the usefulness of biofeedback in addressing pediatric conditions. A systematic review of biofeedback interventions in children was conducted using four databases (Ovid MEDLINE, EMBASE, PsycINFO, and Cochrane CENTRAL). Outcomes included changes in symptoms of associated conditions or changes in physiological functioning. Out of 3,128 identified articles, 23 studies (with 24 effect sizes) were eligible for inclusion in the meta-analysis. Using a random effects model, the overall effect of pediatric biofeedback was statistically significant with a large effect size. Despite the large effect size, general study quality was low, limiting interpretation of findings. Despite widespread clinical use of biofeedback in pediatric populations, research is still limited concerning the efficacy of biofeedback in children. While findings suggest potential positive effects of biofeedback to address pediatric conditions, high-quality studies are necessary to fully support the use of biofeedback in children., (© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)