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Objective Both the cortisol awakening response (CAR; corresponding to the state measurement) and hair cortisol concentration (HCC; corresponding to the trait measurement) are considered reliable markers of hypothalamus-pituitary-adrenal axis activity. Because cortisol has long been associated with adiposity, this systematic review and meta-analysis aims to summarize and compare the literature around CAR and HCC and their association with obesity or fat distribution indices. Methods The PubMed, Web of Science (Web of Science Core Collection and Medline), EBSCO Information Services, Embase, and PsycNET databases were searched, and full-text articles investigating the association between CAR or HCC and markers of adiposity in humans were included. Meta-analyses were then performed to compare studies associating CAR or HCC with BMI (a marker of general adiposity) and waist circumference (a marker of fat distribution). Results The results of this review highlight inconsistencies in cortisol sampling and CAR computation, which makes comparisons between studies difficult. It was found that adiposity indices are not associated with CAR but that they correlate significantly and positively with HCC. The subgroup analysis hinted to possible age differences in the magnitude of the association between HCC and BMI. Conclusions Trait rather than state measurement of the hypothalamus-pituitary-adrenal axis activity is associated with increased general and abdominal adiposity in humans.

Disordered eating attitudes and behaviors (DEAB) in childhood have been prospectively associated with eating disorders and obesity in adolescence. Therefore, evaluating DEAB in children with a reliable, sensitive and well-adapted scale is very important. The Children’s Eating Attitudes Test (ChEAT) is one of the most popular measuring tools for DEAB in children, but no French version is available. Moreover, while completion time is an important factor to be considered when working with children, only one recent study proposed a shorter version of the ChEAT. Taking the previous works of Murphy and colleagues (2019) as a starting point, the current study aimed to provide the first French-speaking validated 14-item short version of the ChEAT. A sample of 1092 boys and girls aged between 8 and 12 years old were recruited in two urban areas in the province of Quebec, Canada. They completed the ChEAT, and their height and weight were measured at school. Factorial structure and internal consistency were assessed. After the initial factorial analysis, two “vomiting (or purging)” items were yielded as problematic and were thus removed from the analysis. The remaining 12 items provided a good fit to the data and a good internal consistency. Moreover, the factorial structure was proved to be invariant across sexes. This study is the first to provide a French assessment of DEAB in elementary school children. The French short version of the ChEAT provided a quick and reliable assessment for DEAB with non-clinical children population and could be used as a screening tool, even though no cut-off was established yet. Cross-sectional, descriptive study, Level V.

Objective Given the growing interest in personality traits among the young population with eating disorders (EDs) and the recognition that a better understanding of personality can facilitate clinical management, this meta-analytic study reviewed evidence concerning the relationship between personality traits and the presence of an ED during adolescence. Method We conducted a systematic literature search to identify studies that examined personality traits among adolescents with an ED (anorexia nervosa, bulimia nervosa, binge-eating disorder, eating disorder not otherwise specified) and that compared these traits with a normative group without an ED. The personality traits investigated in the selected studies were organized according to the personality trait domains presented in the Diagnostic and Statistical Manual of Mental Disorders (fifth ed.). Effect sizes of the mean differences were calculated for each domain. We performed meta-regressions to assess the moderating effect of ED subtype and age on the combined effect sizes. Results Twenty-six studies met our inclusion criteria, containing a total of 63 effect sizes. Adolescents with EDs differed from the non-ED group according to traits related to negative affectivity (g = 0.78), detachment (g = 0.69), and conscientiousness (g = -0.53). The presence of an anorexia nervosa diagnosis moderated the relationship between an ED and personality traits; this diagnosis was more strongly associated with conscientious traits compared to other EDs. Discussion Our findings provide evidence that personality traits are related to EDs in adolescents. Thus, considering personality traits could lead to a better understanding of etiological and maintenance factors for EDs.

Similarities have been observed between substance dependence and overconsumption of food, leading to the development of the food addiction (FA) concept. While psychological markers of FA have often been documented, data on physiological markers remains scarce. This study aimed to investigate HPA-axis functioning through cortisol awakening response (CAR) in relation to FA among bariatric candidates. We hypothesized that participants presenting high FA symptomatology would present a blunted CAR when compared to participants presenting low FA symptomatology and that significant associations between CAR and eating behaviors would be observed within both groups. The final sample comprised 40 participants, who were invited to complete questionnaires and provide saliva samples upon awakening (T0, T15, and T30). Results from the two-way ANOVA with repeated measures showed a non-significant “time x group” interaction, indicating that CAR did not differ between groups. Moreover, results from correlational analyses showed different patterns of associations between CAR and eating behaviors within each group; further analyses showed that the relationship between CAR and food cravings triggered by cues in the environment was significantly moderated by FA symptomatology, as higher CAR was related to lower cue-triggered food cravings only in individuals presenting low FA symptomatology. While these findings do not support the presence of HPA-axis functioning differences in relation to FA, they suggest that the association of CAR with eating behaviors may depend on whether or not addictive tendencies are present. Further investigation of the association between CAR and eating behaviors in the context of FA will thus be essential.

Unlike patients suffering from egodystonic disorders, people with eating disorders sometimes attribute positive meanings to their symptoms, and this attribution process contributes to the maintenance of the disorder. This study aims at exploring psychological meanings of eating disorders and their associations with symptoms, motivation toward treatment, and clinical evolution. Eighty-one adults with an eating disorder (anorexia nervosa, n = 46 and bulimia nervosa, n = 35) treated in a day-hospital program were asked, each week over an 8-week period, to identify the psychological meanings they ascribed to their eating disorder. Avoidance was the most frequently identified meaning, followed by mental strength, security, death, confidence, identity, care, and communication. Avoidance was more frequently mentioned by participants with bulimia than in cases of anorexia. Security and mental strength were associated with less motivation toward treatment. Death was associated with more depressive and anxious symptoms. An exploratory factor analysis showed that these meanings formed three main dimensions: Avoidance, Intrapsychic, and Relational. Findings suggest that psychological meanings associated with eating disorders can be assessed and used as a clinical tool to increase treatment acceptability and effectiveness.

Background Regular monitoring of the population's food and nutrient intake is essential to develop effective nutrition-focused public health policies. The aim of this study was to provide dietary intake estimates using an age- and sex-representative sample of French-speaking adults with Internet access from 5 administrative regions in the province of Quebec, Canada. Methods PREDicteurs Individuels, Sociaux et Environnementaux (PREDISE) is a multicentre cross-sectional study that used a Web-based approach to collect individual, social, and environmental data on factors associated with adherence to dietary recommendations. Dietary intake was estimated from the average of 3 validated Web-based 24-hour recalls. Results Mean (± SD) age of the 1147 participants (50.2% women) was 43.2 ± 4.6 years and median body mass index was 26.3 (interquartile range, 23.3-30.3). Less than 25% of participants met Canada's Food Guide recommendations for vegetables and fruit intake (prevalence, 23.6%; 95% confidence interval [CI], 21.1-26.0). Most participants reported consuming more than 2300 mg of sodium (prevalence, 80.5%; 95% CI, 78.2-82.7) and more than 10% energy as saturated fats (prevalence, 74.2%; 95% CI, 71.6-76.7). Mean Canadian Healthy Eating Index score on a scale of 0-100 was 54.5 (95% CI, 53.8-55.2), reflecting relatively poor diet quality according to current dietary recommendations. Conclusions Self-reported dietary intakes measured using a new validated Web-based 24-hour recall in this sample of French-speaking adults from Quebec and with access to Internet suggest low adherence to current Canadian dietary guidelines. These data emphasize the need for more effective nutrition-focused public health policies to maximize cardiovascular disease prevention at the population level.

Objectives The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) was designed to assess food addiction using a shorter version than the YFAS 2.0. We lack data about the psychometric properties of the mYFAS 2.0 in patients with obesity, as well as studies comparing the psychometric properties of the mYFAS 2.0 versus the full YFAS 2.0. This study aimed to validate the French-language mYFAS 2.0 in a non-clinical population (study 1, n = 250), to determine the yet unknown psychometric properties of this scale in patients with obesity (study 2, n = 345), and to compare the full YFAS 2.0 and the mYFAS 2.0 in terms of food addiction (FA) prevalence and symptoms detection in both populations. Method Study 1 included 250 non-clinical individuals (non-underweight and non-obese persons screened negative for eating disorders). Study 2 included 345 bariatric surgery candidates recruited in three centers (Quebec, Canada; Reims and Tours, France). The mYFAS 2.0 structure was investigated using confirmatory factorial analyses with tetrachoric correlations. Convergent validity was tested using the full YFAS 2.0, the Binge Eating Scale (both studies), the revised 18-item Three Factor Eating Questionnaire (study 1), the Beck Depression Inventory (study 2), and the body mass index (BMI; both studies). Results The mYFAS 2.0 was unidimensional, and had adequate (study 1: KR-20 = .78) and acceptable (study 2: KR-20 = .73) internal consistency. In study 1, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, BMI, binge eating, cognitive restraint, uncontrolled eating and emotional eating; in study 2, the mYFAS 2.0 had good convergent validity with the YFAS 2.0, binge eating, depression, but not BMI. Participants endorsed fewer symptoms with the mYFAS 2.0 than with the YFAS 2.0; FA prevalences were similar between questionnaires in the non-clinical, but not in the clinical sample. A FA 'diagnosis' and risk of binge eating disorder were associated but did not completely overlap. Conclusions The mYFAS 2.0 has close psychometric properties to the YFAS 2.0 in non-clinical and clinical samples. However, the use of the mYFAS 2.0 in bariatric surgery candidates might lead to a significant underestimation of FA prevalence and number of FA symptoms.

This cross-sectional study examined the associations between 3rd trimester attitudes toward weight gain and (1) pre-pregnancy BMI, (2) gestational weight gain (GWG) and (3) eating behaviours assessed in the 3rd trimester. Seventy-nine (79) pregnant women completed the French version of the Pregnancy Weight Gain Attitude Scale (PWGAS), the Three-Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale-2 (IES-2) in their 3rd trimester. Total GWG was calculated as the difference between the weight recorded before delivery and self-reported pre-pregnancy weight. Most (55.6%) women gained weight above the Institute of Medicine’s (IOM) recommendations, but there was no association between PWGAS scores and total or 3rd trimester GWG. Women with obesity had lower PWGAS total scores compared to women with overweight (3.48 ± 0.6 vs. 3.99 ± 0.3, p = 0.005), indicating more negative attitudes in women with obesity vs. overweight. Higher total PWGAS scores were positively correlated with intuitive eating scores (r = 0.28, p

Purpose: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. Design: Cross-sectional web-based study. Participants: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. Subjects: A probability sample of 1092 participants (50% female). Measures: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. Analysis: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. Results: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI ( P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: −0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association ( P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). Conclusion: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.

This narrative review summarizes literature on the stigma and prejudices experienced by individuals based on their weight in the context of romantic relationships. Individuals presenting with overweight or obesity, particularly women, are disadvantaged in the formation of romantic relationships compared with their normal-weight counterparts. They are also more prone to experience weight-based stigmatization towards their couple (from others), as well as among their couple (from their romantic partner). Currently available studies showed that weight-based stigmatization by a romantic partner was found to be associated with personal and interpersonal correlates, such as body dissatisfaction, relationship and sexual dissatisfaction, and disordered eating behaviors. Scientific literature on weight-based stigmatization among romantic relationships is still scarce. Prospective researches are clearly needed to identify consequences of this specific type of stigmatization on individuals’ personal and interpersonal well-being. The use of dyadic designs could help to deepen our understanding as it would take into account the interdependence of both partners.

BackgroundBeing the target of peer victimization is frequent among children categorized as overweight and obese and is thought to play a central role in disordered eating behavior development. In accordance with a previous theoretical model, this cross-sectional study aimed to replicate among children the mediating role of weight-related victimization from peers and body dissatisfaction in the association between body mass index (BMI) and children’s disordered eating attitudes and behaviors (CDEAB), while also taking into account the contribution of parents’ disordered eating attitudes and behaviors (PDEAB).MethodsParticipants were 874 children aged between 8 and 12 years old who were recruited in elementary schools. Height and weight were measured and used to calculate BMI. Self-reported questionnaires were used to measure weight-related victimization, body dissatisfaction, CDEAB and PDEAB.ResultsFor both girls and boys, a path analysis showed no direct effect of BMI on CDEAB, but a significant indirect effect was found, indicating that weight-related victimization and body dissatisfaction mediated this relationship. In addition, the indirect effect of weight-related victimization and body dissatisfaction remained significant even when controlling for PDEAB.ConclusionWhile weight itself appears to be insufficient to explain CDEAB, weight-related victimization may lead children to see their weight as problematic and develop disordered attitudes and behaviors toward eating. This suggests that weight-related victimization from peers and body dissatisfaction must be taken seriously and that preventive and intervention efforts must be pursued.

The first conception of food addiction (FA) as substance addiction, measured by the Yale Food Addiction Scale (YFAS), is controversial. Some proposed that FA would be better conceptualized with a behavioral approach. In accordance with this conceptualization, Ruddock and colleagues published a new self-reported scale for food addiction, the Addiction-like Eating Behavior Scale (AEBS). Overall, preliminary validation of the scale demonstrated good psychometric properties with a community sample. The aim of the present study is twofold, to validate the French–Canadian version of the AEBS with a community sample and to examine how well the instrument fits into a clinical sample with overweight/obesity. A community sample (N = 466) and a clinical sample with overweight/obesity seeking help for their eating difficulties (N = 126) completed an online survey regarding FA, binge eating, dietary restraint, depression, and BMI. Factor analysis, internal consistency, and construct validity were assessed. With the community sample, factorial structure, and psychometric properties of the AEBS were replicated. With the clinical sample, proper convergent validity was demonstrated with the YFAS 2.0 and binge eating, and proper divergent validity was demonstrated with dietary restraint. Among the clinical sample, AEBS explain similar variance of BMI and depression level when compared to YFAS 2.0. This study provided evidence that the French–Canadian version of the AEBS is a valid measure of food addiction, but it did not permit to establish advantages over YFAS 2.0 with a clinical sample. Clinical implications of the AEBS and FA characteristic are discussed. Level V, cross-sectional, descriptive study.

This study aimed to examine cognitive factors associated to food addiction (FA) symptoms in a non-clinical sample of adolescents. A group of 25 adolescents (12&ndash, 18 years, Mean age = 15.2 years) with a high level of FA symptoms (two and more) were compared to a control group without FA symptoms (n = 25), matched on sex and age, on four Cambridge Neuropsychological Test Automated Battery (CANTAB) neuropsychological tasks (MT: Multitasking Test, OTS: One Touch Stockings of Cambridge, SST: Stop Signal Task, RVP: Rapid Visual Information Processing). They were also compared on self-reported questionnaires assessing binge eating, depressive and anxiety symptoms, impulsivity levels, as well as executive functioning difficulties. Group comparisons did not show significant differences on neuropsychological tasks&rsquo, performances. However, effect sizes&rsquo, estimates showed small to medium effect sizes on three scores: adolescents with a high level of FA symptoms showed a higher probability of an error following an incorrect answer (OTS), a higher probability of false alarm, and a poorer target sensitivity (RVP). When referring to self-reported measurements, they reported significantly more executive functioning difficulties, more binge eating, depressive symptoms and higher impulsivity levels. Overall, results suggested that cognitive difficulties related to FA symptoms seem to manifest themselves more clearly when assessing daily activities with a self-reported questionnaire, which in turn are strongly related to overeating behaviors and psychological symptoms. Future longitudinal research is needed to examine the evolution of those variables, their relationships, and contribution in obesity onset. More precisely, the present findings highlighted the importance of affective difficulties related to this condition, as well as the need to take them into account in its assessment.

We sought to deepen our understanding of the relationship between pathological narcissism and eating disorders (ED) by examining specific facets that composed grandiose and vulnerable narcissism while taking into account self-esteem, a well-known and consistent risk factor for ED. Twenty-seven women diagnosed with anorexia nervosa (AN) and 23 women diagnosed with bulimia nervosa (BN) completed standardized measures of pathological narcissism, self-esteem, and dysfunctional eating attitudes and behaviors. Different patterns of associations between the facets of pathological narcissism and eating pathology arose between AN and BN diagnoses. Closer examination of the facets of pathological narcissism revealed that hiding the self, a vulnerable narcissistic facet, contributed significantly to dysfunctional eating attitudes and behaviors over and above self-esteem for women with AN. Hiding the self should continue to be explored in regard to treatment of ED.

Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS’ Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks’ difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments. Level of evidence Level V, descriptive study.

Given that traditional interventions promoting the adoption of a healthy diet are having limited impacts on the population's food choices and eating behaviours, researchers and health practitioners could explore alternative strategies such as the use of eating pleasure to promote healthy eating. To inform future interventions using this approach, this study aimed to explore how a sample of Quebecers perceives and defines eating pleasure and healthy eating. Specific objectives were to verify what commonalities can be found between their definitions of eating pleasure and healthy eating, and what differences can be observed in their answers based on their sex and body mass index (BMI). Twelve focus groups were conducted in Quebec City, Canada, among women and men with a normal weight and with obesity (n = 92). Verbatim transcripts were double-coded using NVivo10. Participants mostly defined eating pleasure through food characteristics related to sensory qualities and psychosocial contexts. In contrast, they mostly mentioned food characteristics related to nutritional quality and ways to regulate eating behaviours to define healthy eating. Most salient perceptions were similar among subgroups based on sex or BMI. Results showed that in participants' perceptions, the concepts of eating pleasure and healthy eating were different, but appeared to be mostly compatible, which makes the integration of eating pleasure a promising avenue for interventions promoting healthy eating.

Visceral adipose tissue accumulation is an important determinant of metabolic risk and can be estimated by the visceral adiposity index (VAI). Visceral adiposity may impact brain regions involved in eating behavior. We aimed to examine the association between adiposity measurements, binge eating behavior, and grey matter density. In 20 men and 59 women with severe obesity, Grey matter density was measured by voxel-based morphometry for six regions of interest associated with reward, emotion, or self-regulation: insula, orbitofrontal cortex, caudal and rostral anterior cingulate cortex (ACC), ventromedial prefrontal cortex (vmPFC), and dorsolateral prefrontal cortex (DLPFC). Binge eating behavior, depression and impulsivity was assessed by the Binge Eating Scale, Beck Depression Inventory and UPPS Impulsive Behavior Scale, respectively. Men and women were distinctively divided into two subgroups (low-VAI and high-VAI) based on the mean VAI score. Women with high-VAI were characterized by metabolic alterations, higher binge eating score and lower grey matter density in the caudal ACC compared to women with low-VAI. Men with high-VAI were characterized by a higher score for the sensation-seeking subscale of the UPPS–Impulsive Behavior Scale compared to men with low-VAI. Using a moderation–mediation analysis, we found that grey matter density in the caudal ACC mediates the association between VAI and binge eating score. In conclusion, visceral adiposity is associated with higher binge eating severity in women. Decreased grey matter density in the caudal ACC, a region involved in cognition and emotion regulation, may influence this relationship.

The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery. Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits. Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity. These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context. Level V, descriptive study.

The French version of the Yale Food Addiction Scale (YFAS), used to evaluate food addiction symptomatology, has only been validated among the general population. The aim of this study was thus to explore the psychometric properties (factor structure, internal consistency, convergent and divergent validity) of the French version of the YFAS in a clinical sample, namely individuals suffering from severe obesity and awaiting bariatric surgery. Participants (N = 146; mean BMI = 48.29 kg/m2) were recruited at the Quebec Heart and Lung Institute (Canada) during their pre-operative visit. They were asked to complete questionnaires, including the YFAS. Factorial and correlational analyses were performed. Some items had to be removed from the factorial analysis due to a lack of variability (#4, #10, #11, #12, and #22) and low factor loading (#24). The analysis conducted on the remaining 16 items revealed a one-factor structure, with factor loadings higher than .30 and excellent internal consistency (α = .92). The present findings are consistent with previous validation studies of samples presenting obesity and support the use of a 16-item version of the French YFAS among bariatric candidates. However, the need for further investigation remains important in order to better assess the stability of the instrument when used in clinical samples.

ObjectiveThe present study aimed to develop and validate a nutrition knowledge questionnaire in a sample of French Canadians from the province of Quebec, taking into account dietary guidelines.DesignA thirty-eight-item questionnaire was developed by the research team and evaluated for content validity by an expert panel, and then administered to respondents. Face validity and construct validity were measured in a pre-test. Exploratory factor analysis and covariance structure analysis were performed to verify the structure of the questionnaire and identify problematic items. Internal consistency and test–retest reliability were evaluated through a validation study.SettingOnline survey.SubjectsSix nutrition and psychology experts, fifteen registered dietitians (RD) and 180 lay people participated.ResultsContent validity evaluation resulted in the removal of two items and reformulation of one item. Following face validity, one item was reformulated. Construct validity was found to be adequate, with higher scores for RDv. non-RD (21·5 (sd2·1)v. 15·7 (sd3·0) out of 24,Pα=0·73). Assessment of test–retest reliability resulted in significant associations for the total knowledge score (r=0·59,PConclusionsThis nutrition knowledge questionnaire was found to be a suitable instrument which can be used to measure levels of nutrition knowledge in a Canadian population. It could also serve as a model for the development of similar instruments in other populations.

Objective Health At Every Size® (HAES®) interventions have been increasingly recognized as a sustainable strategy in obesity management. Nevertheless, heterogeneity among obese individuals leads to challenges as it translates in mixed responses to treatment. In this context, our objective was to identify trajectories of responses to a non-diet intervention for adult overweight/obese women to highlight profiles of responders. Method Based on data from a multicentric quasi-experimental study, a latent class growth modeling (LCGM) was performed. Two hundred and ten women with high body mass index (BMI ≥ 25, MBMI = 36.53) who followed a non-diet intervention offered in Health and Social Services Centres completed questionnaires at T = 0, 4 and 16 months. Outcomes used in the LCGM were intuitive eating and body esteem, two central components in HAES® interventions. Types of responders were then profiled on sociodemographic, weight, lifestyle, psychological and eating variables. Results The LCGM revealed a 4-trajectory model (p Conclusions Findings strongly support the relevance of considering psychological characteristics to move towards personalized healthcare in obesity management.

Research has demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence suggesting that they may be best considered within a common etiological model. Although we know that body dissatisfaction is likely to be a risk factor for both outcomes, other proposed risk and protective factors for each condition have not been adequately explored. The current paper tests a conceptual model that is based on a review of the existing literature from both areas of scholarship. It considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. The model will be tested in a longitudinal design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5400 participants). Questionnaires will be completed online on two occasions, 12 months apart. The first full phase of the study commenced in July 2018, the same time Body Image was approached to publish this protocol paper (the final revised paper was submitted in September 2019), and data collection will be finalized in December 2019. Multi-group path analysis will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight, and how these vary across countries and gender. ispartof: BODY IMAGE vol:31 pages:139-149 ispartof: location:Netherlands status: published

The research aimed at examining how liking for foods high in salt and fat and for foods high in sugar are associated with overall diet quality and how these associations differ according to individual characteristics (i.e., sex, age, education, income, nutrition knowledge, and energy reporting status) in French-speaking adults from the Province of Quebec, Canada. As part of the web-based cross-sectional PREDISE study, 1096 men and women completed online questionnaires. The Food Liking Questionnaire assessed reported liking for a variety of salty foods (high in salt and fat) and sweet foods (high in sugar and either high-fat or low-fat) on a scale from 1 to 9. The Canadian Healthy Eating Index (C-HEI) was computed based on data collected using 24-hour food recalls. Women (vs. men) reported lower liking for salty foods (5.97 ± 1.34 vs. 6.58 ± 1.16, p

International audience; The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study in-vestigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.

This brief report tests the mediating effect of self-esteem in the relationship between body dissatisfaction and symptoms of depression and anxiety. A sample of 409 adolescents (females = 58.4%) aged between 14 and 18 years completed the Rosenberg Self-Esteem Scale, the Contour Drawing Rating Scale, the Multidimensional Anxiety Scale for Children, and the Center for Epidemiologic Studies Depression Scale. Overall, results for the indirect effects analysis were significant for both anxiety and depression, which confirmed the mediating role of self-esteem. Thus, a negative perception of one’s body image has the effect of lowering self-esteem, which in turn increases psychological distress.

Muscle dysmorphia is primarily characterized by an excessive preoccupation that one's body is not muscular or lean enough. Muscle dysmorphia has shown clinical similarities with eating disorders. The present study aims to explore the psychosocial factors underlying muscle dysmorphia symptoms by referring to Stice's dual pathway model (1994), a theoretical model of eating disorders. Three hundred and eighty-six men were recruited to complete an online survey including questionnaires assessing social pressures to reach a muscular body and internalization of the muscular body, drive for muscularity, muscular-enhancing behaviors, negative affect, narcissistic traits, and symptoms of muscle dysmorphia. Path analyses showed that the original model has a good fit, without, however, confirming a significant relationship between the drive for muscularity and negative affect. Thus, social pressure to reach a muscular body and its internalization were associated to a drive for muscularity and then, to muscle dysmorphia symptoms. The drive for muscularity was indirectly related to symptoms of muscle dysmorphia through muscle-enhancing behaviors as well as negative affect (although, only for individuals with higher levels of narcissistic vulnerability). Results supported the adaptation of the Stice's model to explain muscle dysmorphia symptoms and underlined the possible influence of narcissistic vulnerability traits in this condition.

Weight loss has been associated with changes in eating behaviors and appetite sensations that favor a regain in body weight. Since traditional weight loss approaches emphasize the importance of increasing cognitive dietary restraint (CDR) to achieve negative energy imbalance, it is difficult to untangle the respective contributions of energy restriction and increases in CDR on factors that can eventually lead to body weight regain. The present study aimed at comparing the effects of energy restriction alone or in combination with experimentally induced CDR on eating behavior traits, appetite sensations, and markers of stress in overweight and obese women. We hypothesized that the combination of energy restriction and induced CDR would lead to more prevalent food cravings, increased appetite sensations, and higher cortisol concentrations than when energy restriction is not coupled with induced CDR. A total of 60 premenopausal women (mean BMI: 32.0 kg/m2; mean age: 39.4 y) were provided with a low energy density diet corresponding to 85% of their energy needs during a 4-week fully controlled period. At the same time, women were randomized to either a condition inducing an increase in CDR (CDR+ group) or a condition in which CDR was not induced (CRD− group). Eating behavior traits (Three-Factor Eating Questionnaire and Food Craving Questionnaire), appetite sensations (after standardized breakfast), and markers of stress (Perceived Stress Scale; postawakening salivary cortisol) were measured before (T = 0 week) and after (T = 4 weeks) the 4-week energy restriction, as well as 3 months later. There was an increase in CDR in the CDR+ group while no such change was observed in the CDR− group (p=0.0037). No between-group differences were observed for disinhibition, hunger, cravings, appetite sensations, perceived stress, and cortisol concentrations. These results suggest that a slight increase in CDR has no negative impact on factors regulating energy balance in the context of energy restriction.

The present study used the presentation of food pictures and judgements about their duration to assess the emotions elicited by food in women suffering from an eating disorder (ED). Twenty-three women diagnosed with an ED, namely anorexia (AN) or bulimia nervosa (BN), and 23 healthy controls (HC) completed a temporal bisection task and a duration discrimination task. Intervals were marked with emotionally pre-rated pictures of joyful and disgusting food, and pictures of neutral objects. The results showed that, in the bisection task, AN women overestimated the duration of food pictures in comparison to neutral ones. Also, compared to participants with BN, they perceived the duration of joyful food pictures as longer, and tended to overestimate the duration of the disgusting ones. These effects on perceived duration suggest that AN women experienced an intense reaction of fear when they were confronted to food pictures. More precisely, by having elevated the arousal level and activated the defensive system, food pictures seemed to have speeded up the rhythm of the AN participants’ internal clock, which led to an overestimation of images’ duration. In addition, the results revealed that, in both tasks, ED women presented a lower temporal sensitivity than HC, which was related to their ED symptomatology (i.e., BMI, restraint and concern) and, particularly, to their weaker cognitive abilities in terms of attention, processing speed and working memory. Considered all together, the findings of the present experiment highlight the role of fear and anxiety in the manifestations of AN and point out the importance of considering non-temporal factors in the interpretation of time perception performance.

Objective Describe and predict sex-stratified trajectories of weight change in youths transitioning from childhood to adolescence. Methods Using an accelerated longitudinal design, 461 children between 8 and 12 years old at baseline were followed over three years. Body mass index was calculated from self-reported height and weight. Latent class growth analysis was used to identify BMI trajectories and multinomial logistic regressions, to predict group membership. Results A four-group heterogeneous trajectory model emerged for boys and girls alike. Characteristics of the trajectories differed between sexes and no obesity group was found for boys. Sociocultural factors, such as media influence, body dissatisfaction, weight victimization, awareness of thin-ideal standards and related pressures were important correlates of trajectory membership. Conclusion BMI trajectories during preadolescence are stable over time for heavier children. Body image concerns and weight stigmatization stand out as important factors in the prediction of developmental weight trajectories and could therefore be integrated in weight gain prevention programs for children of all weights as well as in weight management interventions for overweight and obese children.

Eating disorders (EDs) are often characterised by a low self-esteem. Further examination of the different facets of self-esteem (explicit and implicit) and its relationship to a key personality trait, narcissism, might deepen our understanding of EDs. The aim of the present study is to examine the relationship between explicit and implicit self-esteem as well as grandiose and vulnerable narcissism in a population with EDs. Explicit and implicit self-esteem as well as pathological narcissism were compared in participants with EDs (n = 69), participants with anxiety disorders (n = 51) and participants with no history of psychiatric disorders (n = 93). All participants completed a battery of questionnaires and participated in a categorization task to measure implicit self-esteem, the Implicit Association Test (IAT). The participants with EDs had the lowest explicit self-esteem (p < 0.001), the highest levels of vulnerable narcissism (p < 0.001) and they presented higher levels of grandiose narcissism compared to participants with no history of psychiatric disorders. However, they were not different than the other groups on implicit self-esteem (p = 0.271). Participants with EDs are characterised by a low convergent self-esteem (low explicit and implicit self-esteem). Our findings also suggest that participants with EDs present narcissistic fragilities that are better explained by explicit self-esteem alone rather than by implicit self-esteem or an interaction of both facets of self-esteem.

The concept of food addiction (FA) represents a set of problematic eating behaviors related to overeating. According to the Yale Food Addiction Scale (YFAS), which was based on the DSM-IV-TR substance dependence diagnostic criteria, a FA diagnosis is assigned when at least three criteria and the criterion evaluating clinically significant distress and/or functional impairment are endorsed. Considering the decisive role of this last criterion, the present study aimed to investigate its endorsement among individuals suffering from severe obesity and awaiting bariatric surgery. A total of 146 individuals were recruited at the Quebec Heart and Lung Institute and were invited to complete various questionnaires. Differences between individuals who endorsed at least three FA criteria and reported distress/impairment (FA+D/I; N = 24) and individuals who endorsed at least three FA criteria but did not report distress/impairment (FA-D/I; N = 27) were examined. Results revealed that 16% of the total sample fulfilled a FA diagnosis when considering the clinically significant distress/functional impairment criterion; however, this prevalence rate climbed to 35% when removing the inclusion of distress/impairment. Furthermore, individuals from the FA+D/I group showed more FA symptomatology and hedonic hunger, but did not statistically differ from the FA-D/I group on expected markers of psychological distress (depressive symptoms and quality of life). Lastly, the experience of withdrawal symptoms and hedonic hunger were found to be the best predictors of the endorsement of the distress/impairment criterion. This study underlines the impact of this criterion in establishing a FA diagnosis and highlights the importance of considering alternative ways to interpret findings from the YFAS when dealing with clinical samples.

Background Differences between men and women with respect to dietary intakes and eating behaviours have been reported and could be explained by gender differences in motivational variables associated with the regulation of food intake. The main objectives of the present study were to identify gender differences in dietary intakes, eating behaviours and motivational variables and to determine how motivational variables were associated with dietary intakes and eating behaviours in men and women. Methods Sixty-four men and 59 premenopausal women were included in the present study and presented cardiovascular risk factors. The Regulation of Eating Behaviours scale was completed to assess motivational variables. A validated food frequency questionnaire was administered to evaluate dietary intakes and subjects completed the Three-Factor Eating questionnaire to assess eating behaviours. Results Men had higher energy intake, energy density and percentage of energy from lipids and lower percentage of energy from carbohydrates than women (P ≤ 0.04). Men also had a lower emotional susceptibility to disinhibition than women (P = 0.0001). Women reported a higher score for eating-related self-determined motivation [i.e. eating-related self-determination index (SDI)] than men (P = 0.002). The most notable gender difference in the pattern of associations was that eating-related SDI was negatively associated with energy density (r = −0.30; P = 0.02), only in women. Conclusions Women had a better dietary profile and higher eating-related SDI than men. However, gender differences in dietary variables might be explained by a potential gender-specific pattern of association of eating-related SDI with dietary intakes and eating behaviours.

Recent studies on food addiction (FA) provided a better understanding of this condition in various populations. Indeed, authors have shown that FA was nearly as prevalent in adolescents as in adults, and similar correlates were observed in both populations (disordered eating behaviors, depressive and anxiety symptoms, impulsivity). The aim of the present study was to characterize FA in adolescents, according to psychological symptoms and executive functioning difficulties. A sample of 969 adolescents, aged between 12 and 18 years old, was recruited in the Quebec City area. They completed a series of questionnaires, including the Yale Food Addiction Scale 2.0 to measure FA symptoms, the Behaviour Rating Inventory of Executive Function to measure executive functioning difficulties, as well as other self-reported questionnaires assessing psychological symptoms (depressive and anxiety symptoms, impulsivity). Group comparisons showed that adolescents with a high level of FA symptoms reported significantly more psychological symptoms (binge eating, depression, anxiety, impulsivity), and more executive functioning difficulties. Finally, the relationship between FA symptoms and executive functioning difficulties was moderated by age and sex. More precisely, the previously mentioned relationship was stronger in young teen girls. The present work provides a preliminary framework in the developmental study of FA.

To characterise individuals who reported present and past weight loss behaviours on psycho-behavioural factors known to influence body weight, e.g. overeating, dietary restriction. An online questionnaire was distributed to a university community. Questions pertaining to present weight loss, previous weight loss, eating behaviour tendencies, perceived stress and sleep quality were answered by 3,069 individuals. Body weight and height were self-reported. Present and past weight loss behaviours were prevalent in the sample, with 33.3 % of the participants who reported trying to lose weight, 33.1 % who reported having previously lost weight (>10 lbs), and 18.8 % who reported repeated weight loss behaviour (i.e. present and past weight loss behaviours). Trying to lose weight and previous weight loss were both independently associated with increased risk for psycho-behavioural characteristics known to be associated with obesity, e.g. overeating tendencies, perceived stress, short sleep duration. This risk was particularly elevated among the underweight/normal-weight individuals who reported repeated weight loss behaviours. Indeed, adjusted odds ratios for reporting restrictive and overeating tendencies, perceived stress and short sleep for these individuals were significantly higher compared to their underweight/normal-weight peers who did not report repeated weight loss behaviours (adjusted odds ratios 4.7, 2.7, 1.8, and 1.8, respectively, p

Objectives To identify the decisional needs of postmenopausal women with abdominal obesity choosing between two nutritional approaches for weight loss: a low-fat diet or a diet rich in fruit and vegetables. Study design Our descriptive qualitative study was based on the Ottawa Decision Support Framework. Main outcome measures Four focus groups were conducted with postmenopausal women. A thematic content analysis was performed to determine the decisional needs influencing the choice of a low-fat diet or a diet rich in fruit and vegetables. Results Seventeen postmenopausal women participated in the study (median age 59 years). Most frequently reported decisional needs for each nutritional approach were sufficient levels of nutritional skills and knowledge, consideration of the physiological impacts and the sensory aspect of approaches, food availability, social support, finances and motivation. Partners, friends and daughters were considered as the most important individuals involved in the decision. Conclusions We identified several decisional needs influencing postmenopausal women when choosing between a low-fat diet and a diet rich in fruit and vegetables. These findings could inform the design of decision support interventions that address the decisional needs of women for making and implementing informed decisions about a nutritional approach for weight loss.

Restrained eaters and overweight and obese people are prone to increase their food intake during stressful situations. This study examines the impact of a stressful couple discussion on food intake in both spouses, while simultaneously taking into account the effect of BMI and restraint on this association. For 15min, 80 heterosexual couples discussed an aspect that they wanted their partner to change followed by an individual bogus taste test for the purpose of measuring his or her stress-induced food intake. Prior to and after the discussion, subjective mood state was assessed, as well as appetite perceptions, and the mood change before and after the discussion was calculated. Multiple regression analyses with a three-way interaction between mood change, BMI, and restraint were used to predict food intake for both men and women, while controlling for appetite perceptions. Only restrained women with a high BMI ate more when their mood worsened. For men, only appetite perceptions significantly predicted food intake. These results suggest that an induced negative mood in the form of a stressful couple discussion impacts food intake differently for men and women, and that particular attention should be given to the concomitant effect of both restraint and BMI when studying stress-induced eating among women.

Summary Background & aims Previous studies have shown improvements in eating behaviors following a Health-At-Every-Size approach (HAES). However, to our knowledge, no study has yet investigated how a HAES intervention could influence dietary intakes and eating patterns in overweight women. Therefore, objectives of this study were to determine changes in dietary intakes and eating patterns in premenopausal overweight women in response to a HAES intervention compared to a social support intervention and a control group, and then to determine whether changes in eating behaviors were associated with changes in dietary intakes and eating patterns in response to the HAES intervention. Methods Women completed a 3-day food record and the Three-Factor Eating Questionnaire was used to assess eating behaviors. Results Energy intake (main effect of time; p = 0.045) and snack frequency (main effect of time; p = 0.0004) decreased similarly over time in the three groups whereas proportion of energy intake from breakfast (main effect of time; p = 0.03) increased over time. Within HAES group, decreases in hunger and external hunger were associated with a decrease in total daily energy intake (r = 0.50, p = 0.0009 and r = 0.50, p = 0.0007, respectively). Conclusions HAES intervention has no specific impact on eating patterns. However, a decrease in hunger, which characterizes women who respond well to HAES, is associated with a decrease in overall energy intake. Clinical trial registration number ( www.clinicaltrials.gov ): NCT01240499.

Neurophysiological and behavioral similarities have been evidenced between excessive food consumption leading to obesity and addiction to other substances. In accordance, food addiction was defined following the DSM-IV diagnostic criteria for substance dependence. The aim of this pilot study was to identify a subgroup of women suffering from food addiction (n = 11), and to compare them to women suffering from substance-use disorder (n = 23), and to women seeking treatment for compulsive overeating but free from food addiction (n = 12) on addiction-related characteristics (reward sensitivity, impulsivity, personality traits, depression, emotion dysregulation). We hypothesized that women with food addiction would be similar to women with substance-use disorders, and different from women with compulsive overeating without food addiction. Participants completed self-reported questionnaires assessing food addiction and other variables related to addiction. Almost half (47.8%) of women with compulsive overeating fulfilled the criteria for food addiction. Although food addiction does not account for every case of compulsive overeating, it characterizes a specific subgroup of overweight/obese women who show more severe overeating. Women with food addiction seem to be more similar to women suffering from substance-use disorders than to other women with overeating difficulties, particularly regarding impulsivity and self-directedness.

Our objective was to determine gender differences in the impact of a nutritional intervention based on the self-determination theory and promoting the Mediterranean diet on changes in eating-related self-determined motivation and adherence to the Mediterranean diet. Changes in eating-related self-determined motivation were larger in men than in women in response to the intervention and at follow-up, but the magnitude of change decreased with time in both genders. Changes in eating-related self-determined motivation were positively associated with changes in the Mediterranean diet adherence in response to the intervention and at follow-up in men only, suggesting that the nutritional program seems to fit better men than women.

To compare changes in eating behaviors in response to two dietary interventions: one focusing on restrictive messages to limit consumption of high-fat foods (LOFAT) and the other one based on non-restrictive messages to increase consumption of fruits and vegetables (HIFV).Sixty-eight overweight-obese postmenopausal women were randomly assigned to one of the two 6-month dietary interventions that included three group sessions and ten individual sessions with a dietitian. Anthropometric variables and eating behaviors were measured at baseline, 3months and 6months.Body weight decreased significantly in both groups at 6months compared to baseline (LOFAT: -3.5±2.9kg; HIFV: -1.6±2.9kg). At 6months, dietary restraint score was higher in the LOFAT group compared to the HIFV group (12.7±4.2 vs 10.5±4.9; p0.05). Disinhibition and hunger decreased significantly in the HIFV group after 6months while only hunger decreased in the LOFAT group.A weight loss approach based on increasing fruit and vegetable consumption leads to a significant weight loss and is associated with a decrease in disinhibition and hunger without any increase in dietary restraint.

Individuals' ways of coping with psychological stress have often been associated with body weight regulation through their impact on eating behaviours. In particular, emotion-oriented and distraction-oriented coping styles have been steadily related to disordered eating. Couple dissatisfaction may be experienced as an important psychological stressor and could therefore affect eating behaviours through the use of inadequate coping strategies. The study proposes 1) to compare women reporting a low vs a high level of couple satisfaction, and 2) to test mediational models including couple satisfaction, coping styles, and eating variables. Analyses were performed among 65 overweight/obese premenopausal women who reported being weight-preoccupied. Women exhibiting couple dissatisfaction (34.8%) showed a higher level of EDE-Q restraint, more intense concerns about eating and shape, a higher level of disinhibition and susceptibility to hunger and endorsed more often a distraction-oriented coping style, independently of their body weight. Furthermore, distraction- oriented coping style seemed to be a valid mediator of the relation between couple dissatisfaction and eating behaviours. Since non-normative eating behaviours, namely disinhibition and susceptibility to hunger, have been particularly linked to a higher body weight status, it is relevant to extend the scope of interest to more distal contributing factors, such as couple dissatisfaction.

The aim of the present study was to compare the long-term effects of two dietary approaches on changes in dietary intakes, eating behaviours and body weight: (1) approach using restrictive messages to limit high-fat foods (low-fat intake; LOFAT); (2) approach emphasising non-restrictive messages directed towards the inclusion of fruits and vegetables (high intake of fruits and vegetables; HIFV). A total of sixty-eight overweight or obese postmenopausal women were randomly assigned to one of the two dietary approaches. The 6-month dietary intervention included three group sessions and ten individual sessions with a dietitian. Dietary intakes, eating behaviours and anthropometrics were measured at baseline, at the end of the dietary intervention (T = 6) and 6 months and 12 months after the end of the intervention (T = 12 and T = 18). In the LOFAT group, energy and fat intakes were lower at T = 6 when compared with baseline and remained lower at T = 12 and T = 18. In the HIFV group, fruit and vegetable intakes increased significantly at T = 6 but were no longer significantly different from baseline at T = 12 and T = 18. Dietary restraint increased at T = 6 and remained higher than baseline at T = 18 in the LOFAT group while no significant change was observed in the HIFV group. At T = 6, body weight was significantly lower than baseline in both groups (LOFAT: − 3·7 (sd 2·8) kg; HIFV: − 1·8 (sd 3·0) kg) and no significant difference in body-weight change from baseline was found between groups at T = 18. We concluded that weight loss was similar at 1-year follow-up in both dietary approaches. Despite relatively good improvements in the short term, the adherence to a 6-month dietary intervention promoting high intakes of fruits and vegetables was difficult to maintain.

To compare the effects of two dietary approaches on changes in dietary intakes and body weight: (1) an approach emphasizing nonrestrictive messages directed toward the inclusion of fruits and vegetables (HIFV) and (2) another approach using restrictive messages to limit high-fat foods (LOFAT).A total of 68 overweight-obese postmenopausal women were randomly assigned to one of the two dietary approaches. The 6-month dietary intervention included three group sessions and ten individual sessions with a dietitian. Dietary food intake and anthropometric variables were measured at baseline, at 3 months and at 6 months.Energy density decreased in both groups after the intervention compared with baseline (HIFV, -0.3+/-0.2 kcal/g; LOFAT, -0.3+/-0.3 kcal/g; P0.0001). Although body weight decreased significantly in both groups after the intervention compared with baseline (HIFV, -1.6+/-2.9 kg; LOFAT, -3.5+/-2.9 kg; P0.0001), women in the LOFAT group lost significantly more body weight than women in the HIFV group (P=0.01). In the HIFV group, the decrease in energy density was found to be an independent predictor of body weight loss.The LOFAT approach induces more weight loss than does the HIFV approach in our sample of overweight-obese postmenopausal women.

Background Poor long-term success observed with current weight-control strategies stresses the relevance to explore new weight management approaches. Objective To assess the effects of a Health-At-Every-Size (HAES) intervention on eating behaviors, appetite sensations, metabolic and anthropometric variables, and physical activity levels in women at 6-month and 1-year postintervention. Design Randomized controlled trial; measurements at baseline, at the end of the intervention period (4 months), and at 6-month and 1-year postintervention (10 months and 16 months, respectively). Intervention and testing took place from September 2003 to August 2006. Participants/setting Premenopausal overweight/obese women (n=144; mean age of 42.3±5.6 years), recruited from free-living, general community. Intervention Women were randomly assigned to: HAES group (n=48), social support group (n=48), or control group (n=48). Main outcome measures Eating behaviors (restraint, disinhibition, and susceptibility to hunger), appetite ratings (desire to eat, hunger, fullness, and prospective food consumption), anthropometric and metabolic variables (body mass index, waist and hip circumferences, blood lipid levels, and blood pressure), and engagement in moderate to intense physical activity (energy cost ≥1.2 kcal×kg −1 ×15 minutes −1 [≥4.8 metabolic equivalents]). Statistical analyses performed Changes for each dependent variable were assessed by linear mixed models according to a group (HAES vs social support vs control) by time (baseline vs 4 months vs 10 months vs 16 months) split-plot design. Results Situational susceptibility to disinhibition and susceptibility to hunger significantly decreased over time in both HAES group (−0.9±0.2 and −1.3±0.5, respectively) and the social support group (−0.4± 0.2 and −1.4±0.5, respectively). Although eating behavior scores observed at 16 months did not differ between HAES and social support groups (situational susceptibility to disinhibition: 2.5±0.2 in HAES group vs 2.7 ± 0.2 in social support group; susceptibility to hunger: 4.2±0.5 in both groups), they were lower in these groups than scores noted in the control group (3.3±0.2 for situational susceptibility to disinhibition and 5.9±0.5 for susceptibility to hunger). Conclusions These results suggest that, when compared to a control group, an HAES approach could have long-term beneficial effects on eating behaviors related to disinhibition and hunger. In addition, our study did not show distinctive effects of the HAES approach in comparison to a social support intervention.

This study aimed at assessing the extent to which personality traits are related to BMI and eating behaviors in overweight and obese women (N=154; mean body mass index (BMI) of 30.5+/-3.0 kg/m(2)). The NEO Five-Factor Inventory was used to capture the five dimensions of personality (neuroticism, extraversion, openness to experience, agreeableness and conscientiousness). Anthropometric measurements (weight, height and BMI) were performed and eating behaviors (cognitive dietary restraint, disinhibition and susceptibility to hunger) were measured by the Three-Factor Eating Questionnaire. Regressional analyses showed that only conscientiousness was positively related to BMI. A higher level of neuroticism was identified as a significant predictor of higher scores for cognitive dietary restraint, disinhibition and susceptibility to hunger. Conscientiousness was also found to be a positive determinant of cognitive dietary restraint and a higher level of agreeableness predicted a lower score of susceptibility to hunger. Results also underline the presence of other psychological factors, i.e. dysphoria and body esteem, involved in the associations between personality traits and some eating behaviours. These findings suggest that particular dimensions of personality may contribute, either directly or through their association with other psychological factors, to a better understanding of weight and eating behaviors in overweight and obese women.

Objective: To assess the effects of a “Health-At-Every-Size” (HAES) intervention on eating behaviors and appetite ratings in 144 premenopausal overweight women. Research Methods and Procedures: Women were randomly assigned to one of the 3 groups: HAES group, social support (SS) group, and control group (N = 48 in each group). Interventions were conducted over a 4-month period, and measurements were taken before and after this period. Eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) were evaluated by the Three-Factor Eating Questionnaire. Appetite ratings (desire to eat, hunger, fullness, and prospective food consumption) were assessed by visual analogue scales before and after a standardized breakfast. Results: More important decreases in susceptibility to hunger and external hunger were observed in the HAES group when compared with the SS group (p = 0.05, for susceptibility to hunger) and the control group (p = 0.02 and p = 0.005, for susceptibility to hunger and external hunger, respectively). In addition, women from the HAES group had more important decreases in postprandial area under the curve for desire to eat (p = 0.02) and hunger (p = 0.04) when compared with the control group. The change in the desire to eat noted in the HAES group was also different from the one observed in SS group (p = 0.02). Women from the HAES group experienced significant weight loss at 4 months (−1.6 ± 2.5 kg, p < 0.0001), which did not differ significantly from the SS and control groups (p = 0.09). An increase in flexible restraint was significantly related to a greater weight loss in both HAES and SS groups (r = −0.39, p < 0.01; and r = −0.37, p < 0.05, respectively). A decrease in habitual susceptibility to disinhibition was also associated with a greater weight loss in HAES and control groups (r = 0.31, p < 0.05; and r = 0.44, p < 0.05, respectively). Discussion: These results suggest that a HAES intervention could have significant effects on eating behaviors and appetite ratings in premenopausal overweight women, when compared with an SS intervention or a control group.

Summary Background & aims Health at Every Size ® (HAES ® ) interventions focus on healthy lifestyle by promoting behavioral changes related to diet and physical activity while emphasizing self-acceptance and well-being through an empowerment and intuitive approach. The purpose of this study was to investigate the effects of a HAES ® program on intuitive eating and diet quality in women. Methods The HAES ® intervention, offered by professionals from Health and Social Services Centers in Quebec (Canada), was composed of thirteen 3-h weekly meetings and a 6-h intensive day. For this study, 216 women (1.9% normal-weight, 21.1% overweight, 77.0% obese) who took part to the HAES program were compared to 110 women (3.9% normal-weight, 23.3% overweight, 72.8% obese) from a control group (waiting list). Intuitive eating was assessed using the Intuitive Eating Scale and diet quality was evaluated through the calculation of the Healthy Eating Index (HEI) from a validated web-based self-administrated food frequency questionnaire. Measurements were performed at baseline, post-intervention, and at one-year follow-up. Results Women who participated in the HAES ® program significantly increased their intuitive eating score compared to women in the control group at post-intervention and at follow-up (group by time interaction, p = 0.0002). A significant improvement in diet quality was also observed in the HAES ® group in comparison with the control group at post-intervention (group by time interaction, p = 0.0139). The intuitive eating score and the HEI score were positively associated in the HAES ® group at post-intervention ( r = 0.20, p = 0.0237) and one-year follow-up ( r = 0.22, p = 0.0359), but no such associations were noted in the control group (post-intervention, r = 0.04, p = 0.70; one-year follow-up, r = −0.15, p = 0.30). Conclusions The HAES ® program seems effective in improving intuitive eating and also favours improvements in diet quality. However, the association between intuitive eating and diet quality remains unclear, being positive and significant only after the HAES ® intervention.