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Purpose: Nonhomeostatic drives (e.g., reward and negative emotion) for eating are associated with weight gain over time. Higher average and lower intraindividual variability in physical activity (PA) levels are positively associated with health and weight outcomes, but have not been evaluated in relation to nonhomeostatic eating. The aim of this paper is to examine the associations between PA and nonhomeostatic drives for eating. The hypotheses were that average levels of and consistency in PA would be negatively correlated with nonhomeostatic eating., Methods: Adult participants (N = 432) were recruited online and asked to report objectively measured PA using commercially available PA monitors for the previous 7 days and to complete self-report measures of reward-driven and emotional eating., Results: Average daily steps (M = 6519.36) were negatively associated with emotional eating, but were not significantly related to reward-driven eating. Intraindividual variability in steps (M = 2209.85) was not associated with either type of nonhomeostatic eating. Adjusting for relevant covariates (e.g., age, BMI, gender), average daily step count was negatively associated with emotional eating (p = 0.01) but not reward-driven eating (p = 0.31) and variability in step counts was positively associated with reward-driven eating (p = 0.04) but not emotional eating (p = 0.52)., Conclusion: The results suggest that greater average levels and lower variability in PA are related to lower nonhomeostatic eating; thus, complex associations between PA and eating exist, and may impact weight and outcomes of treatment related to eating and weight., Level of Evidence: V, cross-sectional correlation study., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: This secondary analysis examined physical activity (PA) changes and their prognostic significance among Latinx patients with obesity, with and without binge eating disorder (BED), who participated in a randomized, placebo-controlled trial testing the addition of orlistat to behavioral weight-loss (BWL) treatment in a "real-world" clinical setting., Methods: In this randomized controlled trial at a community mental health center serving economically disadvantaged Spanish-speaking-only Latinx patients, 79 patients with obesity (40 with BED and 39 without BED) received BWL treatment and were randomized to orlistat or placebo. PA, weight, depression, and binge eating were assessed at baseline, posttreatment (end of treatment [4 months]), and the 6-month follow-up (10 months after baseline)., Results: PA was low at baseline (9.3% categorized as "active"), increased during treatment (32.9% categorized as "active" at posttreatment), and declined from posttreatment to the 6-month follow-up (28.2% classified as "active"). At baseline, PA was lower among patients with BED than those without BED. Changes in PA during and after treatment did not differ by BED status or medication condition. PA change was associated with reduced depression but not weight loss., Conclusions: Latinx patients with obesity receiving BWL treatment achieved significant, albeit modest, increases in PA. Although PA changes were not associated with weight loss, they were associated with reduced depression. Identifying methods to increase PA further is necessary., (© 2021 The Obesity Society.)

Stigma and recurrent discriminatory experiences can lead to distress and internalization of biases. Self-compassion is a widely-recognized resilience factor that may decrease the impact of discrimination on psychological well-being. Research highlights the potential utility of self-compassion in counteracting the harmful effects of discrimination, reducing psychological distress, and preventing the development of eating disorders. The current study examined the roles of self-compassion and psychological distress in perceived discrimination, internalized weight bias, body image, and eating pathology. Participants (N=694) living in the United States completed an online battery of measures assessing perceived discrimination, weight bias internalization, self-compassion, psychological distress, body appreciation, and eating pathology. Self-compassion was associated negatively with perceived discrimination, weight-bias internalization, psychological distress, and eating pathology and was associated positively with body appreciation. Moderated mediation analyses examined whether psychological distress statistically mediated the relationship between perceived discrimination (Model 1) or weight bias internalization (Model 2) on body appreciation, as well as between perceived discrimination (Model 3) or weight bias internalization (Model 4) on eating psychopathology. For all models, self-compassion was explored as a moderator of indirect and direct effects. Results revealed how psychological distress mediated the link between perceived discrimination and body appreciation/eating psychopathology, as well as between weight bias internalization and body appreciation, but not eating psychopathology. For weight bias internalization models only, the statistical links between psychological distress in relation to body appreciation/eating psychopathology were stronger for those with lower self-compassion. Self-compassion may promote more effective coping and outcomes for individuals who are subject to societal stigma.

Background: Financial incentives and feedback on behavior offer promise for promoting physical activity. However, evidence for the effect of each of these techniques is inadequate. The present study evaluated the effects of daily versus weekly feedback and incentives contingent on reaching a daily walking goal versus noncontingent incentives in a 2 × 2 trial., Methods: Participants (N = 57) had a body mass index >25 kg/m2 and were insufficiently active. Participants received a daily walking goal that adapted weekly., Results: Participants receiving daily feedback increased daily steps (P = .03) more than those receiving weekly feedback. Participants receiving contingent incentives did not significantly increase steps (P = .12) more than those receiving noncontingent incentives. A trend-level effect (P = .09) suggested that there may be an interaction such that the combination of daily feedback and contingent incentives is most effective., Conclusions: Results indicate that feedback is an important component of remotely delivered PA interventions and that evaluating each component of low-intensity interventions may help to improve efficacy. Moreover, results indicate that possible synergistic effects of feedback and rewards should be investigated further to help optimize interventions.

Early weight loss is associated with greater weight loss following treatment cessation and years later. The present study aimed to identify pretreatment correlates associated with early weight loss in adults participating in weight-loss treatment in primary care. Participants (N = 89) were in the overweight/obesity range seeking weight-loss treatment in primary-care settings and randomized to one of three treatments: Motivational Interviewing and Internet Condition (MIC), Nutrition Psychoeducation and Internet Condition (NPC), or Usual Care (UC). At baseline, participants were assessed with the Eating Disorder Examination (EDE) interview and completed self-report measures of emotional overeating, exercise, exercise self-efficacy, and depression. Percent weight loss at week six was used as the Early Weight Loss variable. MIC/NPC groups had significantly greater Early Weight Loss than UC. Among MIC/NPC participants only, greater Early Weight Loss was associated with significantly lower pretreatment disordered eating and depressive symptoms. Participants in MIC/NPC who achieved clinically meaningful weight loss (>2.5%) by week six compared with those who did not (<2.5%) reported lower pretreatment disordered eating. Demographic factors and binge-eating disorder diagnosis were unrelated to Early Weight Loss. Our findings suggest that greater early weight loss may be associated with less pretreatment disordered eating and depressive symptoms., Clinical Trials: NCT01558297., (© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose of Review: Research suggests that cultural factors influence eating behaviors, however little is known about the relationship between food addiction and culture. This narrative review aimed to i) review theoretically related work on the relationship between sociocultural demographic variables, food cravings, and eating disorders; ii) review the available literature assessing cultural aspects of food addiction, specifically the rates of food addiction across the globe and notable differences in relevant sociodemographic variables: race, ethnicity, gender and acculturation level; iii) discuss the potential impact of culture on our current understanding of food addiction and future research directions emphasizing the inclusion of sociocultural variables., Recent Findings: Preliminary data suggest that food addiction symptoms occur cross-culturally, and that there may be significant differences between sociodemographic groups. Issues related to adequate lexicalization of concepts central to food addiction (e.g., craving, addiction) and global variations in eating culture and presentation of similar constructs (e.g. binge-eating) contribute to questions raised and identify avenues for further research., Summary: Multidimensional cultural assessment is called for to characterize food addiction among diverse groups and improve our understanding of the etiology, maintenance, and sequelae of food addiction cross-culturally., Competing Interests: Conflict of Interest The authors declare no conflicts of interest.

Objective: Dietary lapses drive weight loss failure, and specific factors influence risk of lapse. Physical activity (PA) may be one such risk factor, though whether PA increases or decreases appetite, and thus risk of lapse, is unclear. In fact, most studies examining the relation between PA and energy intake are limited by use of laboratory-based settings, intensive PA manipulations, and healthy-weight samples. This study aimed to maximize ecological validity by examining the extent to which free-living PA of various intensities prospectively predicts same-day dietary lapses among individuals enrolled in a weight loss program., Method: Participants were 130 adults with overweight/obesity in a behavioral weight loss treatment instructed to follow a PA and dietary prescription. At midtreatment, moderate-to-vigorous PA (MVPA) and light PA were measured using hip-worn Actigraph GT3X+ accelerometers (Actigraph, Pensacola, FL). Lapses were assessed using ecological momentary assessment. Within-subject total PA ( b = -0.012, SE = 0.005, p = .01) and light PA ( b = -0.014, SE = 0.006, p = .01) negatively predicted lapse. MVPA followed the same pattern, but the effect was not statistically significant ( b = -0.013, SE = 0.009, p = .12)., Conclusion: This study was the first to investigate if objectively measured PA prospectively predicts lapse from a weight loss program. Results suggested that for every additional 10 min of total PA one engaged in, the risk of lapse decreased by 1%. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Introduction: Many individuals engaged in behavioral weight loss make suboptimal increases in moderate-to-vigorous physical activity (MVPA). Theoretically, reductions in negative affect could reinforce MVPA. However, little work has been done investigating the association between facets of negative affect (e.g., average levels of negative affect, variability in negative affect) and MVPA among individuals attempting to increase MVPA as part of a behavioral weight loss attempt., Methods: Participants ( n = 139) provided data at month 6 of a year-long behavioral weight loss program (at which point the prescription for MVPA had reached the highest level). Participants wore an accelerometer and provided EMA ratings of affect over the same week., Results: Individuals engaged in more frequent and longer periods of MVPA had lower average negative affect and variability in negative affect across the assessment period. Lower negative affect one day predicted greater time spent in MVPA on the next day; lower variability in negative affect than one's average level also predicted greater time spent in MVPA on the next day. Greater engagement in MVPA than one's own mean on one day did not predict mean or variability in affect., Discussion: Engaging in MVPA over time may reduce negative affect, while lower negative affect may increase motivation to engage in MVPA. Importantly, day-to-day effects indicated that affect is an important acute predictor of MVPA behavior. It is possible that individuals, particularly those with higher negative affect or variability in negative affect, may benefit from the inclusion of skills to manage negative affect in programs prescribing physical activity., Competing Interests: Declarations of interest: None

Background: Despite interest in financial incentive programs, evidence regarding the feasibility, acceptability, and effectiveness of deposit contracts (ie, use of participants' own money as a financial reward) for increasing physical activity (PA) is limited. Furthermore, evidence regarding the use of feedback within incentive programs is limited., Purpose: To evaluate: (1) the feasibility and acceptability of deposit contracts for increasing objectively measured PA and (2) the effects of deposit contracts with or without ongoing feedback on PA., Methods: Participants (n = 24) were exposed to 3 conditions (1) self-monitoring, (2) incentive, and (3) incentive with feedback in an ABACABAC design, with the order of incentive conditions counterbalanced across participants., Results: Effect sizes suggest that individuals had a modest increase in PA during the incentive conditions compared with self-monitoring. Presentation order moderated results, such that individuals exposed to incentives with feedback first performed more poorly across both incentive conditions. In addition, individuals often cited the deposit contract as a reason for not enrolling, and those who did participate reported inadequate acceptability of the incentives and feedback., Conclusions: Results suggest that while deposit contracts may engender modest increases in PA, this type of incentive may not be feasible or acceptable for promoting PA.

Background: Most adults with overweight/obesity participating in behavioural weight loss (BWL) programmes never achieve prescribed physical activity (PA) levels. This study examined changes in PA barriers, their relationships with accelerometer-measured PA during and after a 12-month BWL programme, and associations between PA barriers and participant characteristics., Methods: Adults (N = 283) in a BWL programme completed the Barriers to Being Active Quiz, a 21-item self-report measure that assesses seven perceived PA barriers, and they wore an accelerometer for seven consecutive days at baseline and at 6 (midtreatment), 12 (end of treatment), 18 (6-mo follow-up), and 24 months (12-mo follow-up). Weight and height were measured, and demographic information was collected at baseline., Results: Repeated-measures analyses of variance (ANOVAs) revealed a significant quadratic effect of time on total PA barriers, P  < .001, such that PA barriers decreased by midtreatment, remained below baseline levels by end of treatment, but increased to near-baseline levels by follow-up. Perceived PA barriers were negatively associated with baseline moderate-to-vigorous PA (MVPA), P  < .001, and decreases in perceived PA barriers were related to greater MVPA at 6 ( P  = .004), 12 ( P  < .001), and 24 months ( P  = .007). Participants who were younger, P  = .02, and white, P  = .009, reported more baseline barriers., Conclusions: Perceived PA barriers meaningfully decreased during BWL treatment, which in turn was associated with greater MVPA. This pattern suggests that, on average, BWL effectively addresses perceived PA barriers, which contributes to increased PA. Future research should identify interventions to maintain decreases in barriers after end of treatment., Competing Interests: The authors declare that they have no conflicts of interest to disclose., (© 2019 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)

Objective: While physical activity (PA) is known to have positive effects on psychological and physical health, little is understood about the association between non-compensatory PA (ie, not compulsive or intended to control weight or shape) and psychopathology among individuals with eating-disorder features. The present study explored associations between non-compensatory PA and psychopathology among adults categorised with bulimia nervosa (BN) and binge-eating disorder (BED). We further explored the association between compensatory PA and psychopathology among those who engaged in that form of "purging.", Method: Participants were recruited through Mechanical Turk, an online recruitment platform. Individuals categorised with core features of BED (N = 138) and BN (N = 138) completed measures of eating-disorder psychopathology (Eating Disorder Examination - Questionnaire [EDE-Q] and Questionnaire on Eating and Weight Patterns - 5), depression (Patient Health Questionnaire - 2) and PA (both non-compensatory and compensatory, measured using the EDE-Q and Godin Leisure-Time Exercise Questionnaire)., Results: Engagement in non-compensatory PA was associated with lower frequency of binge-eating episodes, lower overvaluation of shape/weight and lower dissatisfaction with shape/weight (Ps < .05). Engagement in compensatory PA was related to greater frequency of binge-eating episodes and greater restraint (Ps < .05)., Discussion: Non-compensatory PA was associated with lower eating-disorder psychopathology. This suggests that PA is an important, though understudied, health behaviour among persons with features of BED and BN. Future research should examine the potential role of non-compensatory PA in interventions for individuals with core features of these eating disorders., (© 2019 John Wiley & Sons Ltd.)

Objectives: Identification as an exerciser may promote physical activity. This study examined exercise identity (EI) and its relationship with demographic characteristics and exercise among adults participating in behavioral weight loss treatment, which is a key target population for increasing exercise., Design: Longitudinal., Method: Participants ( N = 320) completed a measure of EI and exercise was assessed with accelerometers at baseline and 6 months., Results: Baseline EI and exercise were positively related and EI and exercise increased over time. However, change in EI was not meaningfully related to change in exercise, baseline EI did not predict change in exercise, and 6-month EI was not related to 6-month exercise. Participants identifying as non-White reported greater EI but lower exercise., Conclusions: Although EI and exercise may increase among weight loss participants, the two may not be meaningfully related during active weight loss treatment. The relationship between EI and exercise may also differ based on race., Competing Interests: Declarations of interest Dr. Butryn reports royalties from books on acceptance-based approaches, published by New Harbinger and Oxford University Press. The other authors declare no conflict of interest.

Behavioral weight loss (WL) trials show that, on average, participants regain lost weight unless provided long-term, intensive-and thus costly-intervention. Optimization solutions have shown mixed success. The artificial intelligence principle of "reinforcement learning" (RL) offers a new and more sophisticated form of optimization in which the intensity of each individual's intervention is continuously adjusted depending on patterns of response. In this pilot, we evaluated the feasibility and acceptability of a RL-based WL intervention, and whether optimization would achieve equivalent benefit at a reduced cost compared to a non-optimized intensive intervention. Participants (n = 52) completed a 1-month, group-based in-person behavioral WL intervention and then (in Phase II) were randomly assigned to receive 3 months of twice-weekly remote interventions that were non-optimized (NO; 10-min phone calls) or optimized (a combination of phone calls, text exchanges, and automated messages selected by an algorithm). The Individually-Optimized (IO) and Group-Optimized (GO) algorithms selected interventions based on past performance of each intervention for each participant, and for each group member that fit into a fixed amount of time (e.g., 1 h), respectively. Results indicated that the system was feasible to deploy and acceptable to participants and coaches. As hypothesized, we were able to achieve equivalent Phase II weight losses (NO = 4.42%, IO = 4.56%, GO = 4.39%) at roughly one-third the cost (1.73 and 1.77 coaching hours/participant for IO and GO, versus 4.38 for NO), indicating strong promise for a RL system approach to weight loss and maintenance.

Objective: This study was designed to examine the variability in timing of peak weight loss in behavioral treatment (BT), that is, when treatment participants reach their greatest amount of cumulative weight loss., Methods: Secondary data analyses were conducted, drawing upon data from two clinical trials that provided 12 months of group-based BT, with sessions meeting less frequently in the second half of the treatment year. Weight was measured at the beginning of each treatment session., Results: Cumulative proportions of participants reaching peak weight loss were as follows: 25.0% of study 1 and 20.0% of study 2 participants by month 4; 43.2% of study 1 and 52.2% of study 2 participants by month 6; 54.5% of study 1 and 77.8% of study 2 participants by month 8. Among participants who peaked after 4 months, the mean amount of additional weight loss achieved between 4 months and the peak session was 4.74 kg in study 1 and 4.07 kg in study 2., Conclusions: Substantial variability in the timing of peak weight loss was observed, with larger than expected proportions of participants reaching their greatest amount of cumulative weight loss in the final months of treatment. This variability may create methodological and clinical challenges., (© 2018 The Obesity Society.)

Prior work has yielded mixed results regarding the association between previous weight loss and success in a current weight loss attempt. The present study evaluated differences in baseline psychosocial processes, changes in these over time, and weight loss during a yearlong behavioral weight loss program between individuals who have and have not previously been successful losing weight through self-regulating dietary intake. Individuals with prior success had greater weight losses over time than those without. Differences in baseline and change over time in some facets of motivation and self-efficacy were observed, but only differences in attendance accounted for differential weight loss. Prior success with dietary self-regulation may predict better adherence to and success in behavioral weight control programs. Evaluating the type of weight control efforts that have previously helped induce weight losses may help to better match individuals to treatments likely to yield success.

Sedentary behavior, particularly in prolonged periods, is an important determinant of health. Little research exploring changes in sedentary behavior during behavioral weight loss programs exists. This study evaluated the magnitude of changes in total and prolonged sedentary behavior and how these changes related to changes in weight and cardiovascular outcomes during a behavioral weight loss program. Participants (n = 450) in two lifestyle modification programs underwent assessments of sedentary behavior (by accelerometry), weight, waist circumference, blood pressure, and resting heart rate at baseline and after 6 months of treatment. Sedentary behavior was defined as both total and prolonged (≥30 continuous minutes) sedentary minutes/day. Reductions in total and prolonged sedentary time were significant and were accounted for by increases in moderate-to-vigorous physical activity (MVPA). Only changes in MVPA significantly predicted change in weight when entered into a model simultaneously with changes in sedentary behavior. Changes in total and prolonged sedentary time were not associated with changes in waist circumference, heart rate, or blood pressure. Change in sedentary time was not independently associated with change in health outcomes during a behavioral weight loss treatment. High variability in changes in sedentary time indicate that individual differences may be important to examine. Reducing sedentary time may not be powerful enough to impact these health outcomes above the effects of other changes made during these programs; alternatively, it may be that increasing focus in treatment on reducing sedentary time may engender greater decreases in sedentariness, which could lead to better health outcomes.

Background: Weight regain following bariatric surgery is common and potentially compromises the health benefits initially attained after surgery. Poor compliance to dietary and physical activity prescriptions is believed to be largely responsible for weight regain. Patients may benefit from developing specialized psychological skills necessary to engage in positive health behaviors over the long term. Unfortunately, patients often face challenges to physically returning to the bariatric surgery program for support in developing and maintaining these behaviors. Remotely delivered interventions, in contrast, can be conveniently delivered to the patient and have been found efficacious for a number of health problems, including obesity. To date, they have received little attention with bariatric surgery patients. The study aimed to evaluate a newly developed, remote acceptance-based behavioral intervention for postoperative weight regain., Methods: Patients at least 1.5 years out from surgery who experienced postoperative weight regain were recruited to receive the 10-week intervention. Participants were assessed at baseline, mid-treatment, post-treatment, and at 3-month follow-up., Results: Support for the intervention's feasibility and acceptability was achieved, with 70 % retention among those who started the program and a high mean rating (4.7 out of 5.0) of program satisfaction among study completers. On average, weight regain was reversed with a mean weight loss of 5.1 ± 5.5 % throughout the intervention. This weight loss was maintained at 3-month follow-up. Significant improvements in eating-related and acceptance-based variables also were observed., Conclusions: This pilot study provides initial support for the feasibility, acceptability, and preliminary efficacy of a remotely delivered acceptance-based behavioral intervention for postoperative weight regain.

Background: Tens of thousands of bariatric surgery patients each year experience sub-optimal weight loss, significant regain, or both. Weight regain can contribute to a worsening of weight-related co-morbidities, and for some, leads to secondary surgical procedures. Poor weight outcomes have been associated with decreased compliance to the recommended postoperative diet. Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the effects of surgery (on appetite, hunger, and desire for food) decrease. Many behavioral interventions do not sufficiently address these challenges and often have limited effectiveness. The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of a novel 10-week acceptance-based behavioral intervention to stop postoperative weight regain., Methods: A sample of bariatric surgery patients (n = 11) who regained at least 10 % of their maximum lost postoperative weight was recruited. All participants received the intervention, which emphasized psychological skills thought to be integral to successful weight control post-surgery., Results: The intervention was shown to be feasible and acceptable, with 72 % retention and high mean rating (4.25 out of 5.00) of program satisfaction among completers. Weight regain was stopped, and even reversed, with a mean total body weight loss of 3.58 ± 3.02 % throughout the 10-week intervention. There were also significant improvements in eating-related and acceptance-related variables., Conclusions: These findings provide initial support for the use of a psychological acceptance-based intervention for weight regain in bariatric surgery patients.

Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition - both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n = 17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: Evaluate the association between pretreatment and during-treatment weight change, as well as differences in self-regulation between those who gain weight, remain weight stable, and lose weight pretreatment., Methods: Data from the first 6 months of a behavioral weight loss study were used. Participants (n = 283) were weighed at two assessment points (screening visit and baseline) prior to the start of treatment and at every treatment session. Participants were divided into those who gained weight, remained weight stable, or lost weight between the screening visit and the first treatment session., Results: Pretreatment weight change was not significantly associated with during-treatment change. Weight change from the screening visit to month 6 was significantly different by category, with losses of 11% and 7% for those who lost and gained weight pretreatment, respectively. Weight change from first treatment session to month 6 was not different by category. Poorer self-regulation was associated with pretreatment weight gain and better self-regulation with pretreatment weight loss., Conclusions: Pretreatment weight change may not relate to success during behavioral weight loss treatment. Researchers should carefully consider when the "baseline" assessment takes place to reduce bias introduced by pretreatment weight change. Poorer self-regulation may place individuals at risk for weight gain prior to treatment., (© 2016 The Obesity Society.)

Background: A substantial minority of bariatric surgery patients display clinically significant weight regain and recurrence of obesity-related comorbidities. Although postoperative follow-up and behavioral interventions are associated with better weight loss outcomes, many patients fail to attend or receive these services. More information is needed to better target and increase the probability of sustained treatment in those patients experiencing postoperative weight regain. The purpose of this study was to understand the challenges that patients perceive themselves to be facing and assess their receptivity and preferences for postoperative interventions., Methods: A survey developed by the authors was sent to patients who received bariatric surgery from a program based in an academic medical center between September 2008 and December 2010 (n = 751)., Results: Data from 154 responders indicate that the vast majority of individuals who have undergone bariatric surgery are satisfied with surgery and their weight losses; however, most reported being on a trajectory of weight regain. Patients endorsed concerns about both current eating behavior and, additional, future weight regain. In addition, these patients expressed strong interest in participating in postoperative programs aimed at stopping and reversing regain., Conclusions: The results provide novel information about bariatric surgery patients' receptivity to and preferences for interventions after bariatric surgery.

Current gold standard treatments for eating disorders (EDs) lack satisfactory efficacy, and traditional psychological treatments do not directly address executive functioning deficits underpinning ED pathology. The goal of this paper is to explore the potential for enhancing ED treatment outcomes by improving executive functioning deficits that have been demonstrated to underlie eating pathology. To achieve our objective, we (1) review existing evidence for executive functioning deficits that underpin EDs and consider the extent to which these deficits could be targeted in neurocognitive training programs, (2) present the evidence for the one ED neurocognitive training program well-studied to date (Cognitive Remediation Therapy), (3) discuss the utility of neurocognitive training programs that have been developed for other psychiatric disorders with similar deficits, and (4) provide suggestions for the future development and research of neurocognitive training programs for EDs. Despite the fact that the body of empirical work on neurocognitive training programs for eating disorders is very small, we conclude that their potential is high given the combined evidence for the role of deficits in executive functioning in EDs, the initial promise of Cognitive Remediation Training, and the success in treating related conditions with neurocognitive training. Based on the evidence to date, it appears that the development and empirical evaluation of neurocognitive training programs for EDs is warranted., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Physical activity (PA) is essential for health, but many adults find PA adherence challenging. Acceptance of discomfort related to PA may influence an individual's ability to begin and sustain a program of exercise. The aim of this study was to evaluate the psychometric properties of the Physical Activity Acceptance Questionnaire (PAAQ)., Methods: The PAAQ was administered to 3 distinct samples (N = 418). Each sample completed additional self-report measures; 1 sample also wore accelerometers for 7 days (at baseline and 6 months later)., Results: The PAAQ demonstrated high internal validity for its total score (α = .89) and 2 subscales (Cognitive Acceptance α = .86, Behavioral Commitment α = .85). The PAAQ also showed convergent validity with measures of mindfulness, self-reported physical activity levels, and accelerometer-verified levels of moderate-to-vigorous PA (MVPA; P-values < .05). The Cognitive Acceptance subscale showed predictive validity for objectively-verified PA levels among individuals attempting to increase PA over 6 months (P = .05). Test-retest reliability for a subset of participants (n = 46) demonstrated high consistency over 1 week (P < .0001)., Conclusions: The PAAQ demonstrates sound psychometric properties, and shows promise for improving the current understanding of PA facilitators and barriers among adults.

Objective: Mindfulness and its related constructs (e.g., awareness and acceptance) are increasingly being recognized as relevant to understanding eating disorders and improving treatment. The purpose of this study was to (1) examine the relationship between mindfulness and ED symptomatology at baseline and (2) examine how changes in mindfulness relate to change in ED symptomatology., Method: Measures of mindfulness and ED symptomatology were administered to 88 patients upon admission to residential ED treatment and at discharge., Results: Baseline ED symptomatology was associated with lower awareness, acceptance, and cognitive defusion, and higher emotional avoidance. Improvements in these variables were related to improvement in ED symptomatology., Discussion: Interventions targeting mindfulness could be beneficial for patients with EDs., (Copyright © 2012 Elsevier Ltd. All rights reserved.)