Behavioral Sciences

Research

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428 KiB

Open AccessFeature PaperArticle

Efficacy of Web-Based Weight Loss Maintenance Programs: A Randomized Controlled Trial Comparing Standard Features Versus the Addition of Enhanced Personalized Feedback over 12 Months

by Clare E. Collins, Philip J. Morgan, Melinda J. Hutchesson, Christopher Oldmeadow, Daniel Barker and Robin Callister

Behav. Sci. 2017, 7(4), 76; https://doi.org/10.3390/bs7040076 - 8 Nov 2017

Cited by 5 | Viewed by 6503

Abstract

Few randomized controlled trials (RCT) have evaluated the efficacy of web-based programs targeting maintenance of lost weight. The aims of this study were to evaluate two versions of a commercially available web-based weight loss maintenance (WLM) program and examine whether the provision of [...] Read more.

Few randomized controlled trials (RCT) have evaluated the efficacy of web-based programs targeting maintenance of lost weight. The aims of this study were to evaluate two versions of a commercially available web-based weight loss maintenance (WLM) program and examine whether the provision of enhanced feedback was associated with better WLM. The study was an assessor-blinded RCT of change in body mass index (BMI) over 12 months WLM. Participants were 227 adults (44% male, 42.3 ± 10.1 years, BMI 30.4 ± 4.1 kg/m²) randomized to either a basic (Basic WLM) or enhanced program with additional support (Enhanced WLM). Analysis was intention-to-treat with imputation using last observation carried forward. There was no significant weight rebound from the start of weight loss maintenance to 12 months for either group (mean: basic 1.3%, enhanced 1.5%) and limited change in secondary outcomes for either program. There were no significant between-group differences in the primary outcome of change in BMI (basic −0.5 (1.9) kg/m², enhanced −0.5 (1.6) kg/m², p = 0.93). In conclusion, a web-based WLM program was effective in preventing weight regain over one year following weight loss. However, the addition of personalized e-feedback provided limited additional benefits compared to a standard program. Given the potential reach of web-based approaches, further research examining which web-based program components optimize weight outcomes long-term is required. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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500 KiB

Open AccessArticle

Food Addiction, Binge Eating Disorder, and Obesity: Is There a Relationship?

by Tracy Burrows, Janelle Skinner, Rebecca McKenna and Megan Rollo

Behav. Sci. 2017, 7(3), 54; https://doi.org/10.3390/bs7030054 - 14 Aug 2017

Cited by 98 | Viewed by 14124

Abstract

Existing research suggests that there is an overlap between binge eating disorder (BED) and the construct of ‘food addiction’ (FA). The objective of this study was to determine the overlapping features of BED and FA through a comparison of the individual scales of [...] Read more.

Existing research suggests that there is an overlap between binge eating disorder (BED) and the construct of ‘food addiction’ (FA). The objective of this study was to determine the overlapping features of BED and FA through a comparison of the individual scales of commonly used tools including the Binge Eating Scale (BES) and the Yale Food Addiction Scale (YFAS) in a sample of Australian adults. Adults (>18 years of age) were invited to complete an anonymous online survey on FA. Binge eating was assessed through the BES and addictive eating behaviours were assessed through the YFAS (n = 1344). The prevalence and severity of both FA and binge eating increased across weight categories. The overall correlation between the total score from the BES and FA symptoms was r = 0.76, p < 0.001; for females it was r = 0.77, p < 0.001, and for males it was r = 0.65, p < 0.001. Total BES score and the BES emotion factor were most often associated with FA symptoms, as was demonstrated to produce stronger correlations with FA symptoms. In contrast, the BES behaviour factor was less strongly associated to FA with the majority of correlations <0.6. This study demonstrates the overlap between BED and FA, and highlights the possible unique differences between the forms of disordered eating. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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264 KiB

Open AccessFeature PaperArticle

The Influence of Ethnic and Mainstream Cultures on African Americans’ Health Behaviors: A Qualitative Study

by Ewelina M. Swierad, Lenny R. Vartanian and Marlee King

Behav. Sci. 2017, 7(3), 49; https://doi.org/10.3390/bs7030049 - 4 Aug 2017

Cited by 21 | Viewed by 11141

Abstract

Background: Culture plays an important role in shaping individuals’ health behaviors. This qualitative research examines the relationship between African Americans’ ethnic and mainstream cultures and their health behaviors (i.e., food intake and physical activity). Methods: This study used in-depth semi-structured interview format with [...] Read more.

Background: Culture plays an important role in shaping individuals’ health behaviors. This qualitative research examines the relationship between African Americans’ ethnic and mainstream cultures and their health behaviors (i.e., food intake and physical activity). Methods: This study used in-depth semi-structured interview format with a group of 25 African Americans to examine the influence of ethnic and mainstream culture on African Americans’ food intake and physical activity. Thematic analysis was used to identify common themes and patterns related to African Americans’ health behaviors as well as to report these patterns within data. Results: The present study found that African Americans position both their ethnic and mainstream culture as important influences on their health behaviors pertaining to food intake and physical activity. Most participants reported taking advantage of “the best of both worlds” by engaging in picking and choosing healthy behaviors from both cultures to which they belong, and they perceived preparing healthy makeovers as a way to optimize their health. They also identified a range of practical considerations that can facilitate or hinder engagement in healthy eating and physical activity (e.g., affordability, social support). Participants discussed a number of other positive (e.g., resilience, spirituality) and negative (e.g., experience of discrimination) influences on health behaviors. Conclusions: African Americans consider both their ethnic and mainstream cultures important in shaping their health behaviors. These cultural influences need to be understood in the context of other psycho-socio-environmental factors that affect individuals’ health behaviors. The current study has practical implications for designing health promotion programs for African Americans. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

375 KiB

Open AccessFeature PaperArticle

Exploring Relationships between Recurrent Binge Eating and Illicit Substance Use in a Non-Clinical Sample of Women over Two Years

by Henry Kewen Lu, Haider Mannan and Phillipa Hay

Behav. Sci. 2017, 7(3), 46; https://doi.org/10.3390/bs7030046 - 18 Jul 2017

Cited by 9 | Viewed by 7097

Abstract

(1) Background: With the new edition of the Diagnostic and Statistical Manual of Mental disorders, 5th Edition (DSM-5), numerous parallels have been drawn between recurrent binge eating (RBE) and substance use disorders, with many authors examining RBE or binge eating disorder (BED) as [...] Read more.

(1) Background: With the new edition of the Diagnostic and Statistical Manual of Mental disorders, 5th Edition (DSM-5), numerous parallels have been drawn between recurrent binge eating (RBE) and substance use disorders, with many authors examining RBE or binge eating disorder (BED) as a “food addiction”. The present study aims to clarify the relationship between recurrent binge eating (RBE) and illicit substance use (ISU) through investigating the temporal association between the two problems. (2) Methods: This study was embedded within a larger longitudinal study of non-clinical adult women recruited from Australian tertiary institutions. Participants responded at year 2 and year 4 of follow-up to the Eating Disorder Examination—Questionnaire. ISU was measured using a modified questionnaire taken from the Australian Longitudinal Study on Women’s Health. (3) Results: RBE and ISU co-morbidity was 5.88% in this non-clinical sample, and having one condition increased the likelihood of the other. The two conditions had a different trajectory over two years whereby ISU participants had significant risk of developing RBE in addition to or in place of their ISU but the reverse was not found for RBE participants. (4) Conclusion: This unidirectional relationship suggests that in spite of the similarities of RBE and ISU they may be distinct with respect to their co-morbidity over time. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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748 KiB

Open AccessFeature PaperArticle

The Role of Regular Eating and Self-Monitoring in the Treatment of Bulimia Nervosa: A Pilot Study of an Online Guided Self-Help CBT Program

by Sarah Barakat, Sarah Maguire, Lois Surgenor, Brooke Donnelly, Blagica Miceska, Kirsty Fromholtz, Janice Russell, Phillipa Hay and Stephen Touyz

Behav. Sci. 2017, 7(3), 39; https://doi.org/10.3390/bs7030039 - 26 Jun 2017

Cited by 27 | Viewed by 13230

Abstract

Background: Despite cognitive behavioural therapy (CBT) being regarded as the first-line treatment option for bulimia nervosa (BN), barriers such as its time-consuming and expensive nature limit patient access. In order to broaden treatment availability and affordability, the efficacy and convenience of CBT [...] Read more.

Background: Despite cognitive behavioural therapy (CBT) being regarded as the first-line treatment option for bulimia nervosa (BN), barriers such as its time-consuming and expensive nature limit patient access. In order to broaden treatment availability and affordability, the efficacy and convenience of CBT could be improved through the use of online treatments and selective emphasis on its most ‘potent’ components of which behavioural techniques form the focus. Method: Twenty-six individuals with BN were enrolled in an online CBT-based self-help programme and 17 completed four weeks of regular eating and food-monitoring using the online Food Diary tool. Participants were contacted for a weekly check-in phone call and had their bulimic symptom severity assessed at five time points (baseline and weeks 1–4). Results: There was a significant decrease in the frequency of self-reported objective binge episodes, associated loss of control and objective binge days reported between pre- and post-treatment measures. Significant improvements were also observed in most subscales of the Eating Disorder Examination-Questionnaire. Conclusion: This study provides encouraging preliminary evidence of the potential of behavioural techniques of online CBT in the treatment of BN. Online therapy with this focus is potentially a viable and practical form of treatment delivery in this illness group. These preliminary findings support the need for larger studies using control groups. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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242 KiB

Open AccessFeature PaperArticle

Insights into the Experiences of Treatment for An Eating Disorder in Men: A Qualitative Study of Autobiographies

by Priyanka Thapliyal, Deborah Mitchison and Phillipa Hay

Behav. Sci. 2017, 7(2), 38; https://doi.org/10.3390/bs7020038 - 16 Jun 2017

Cited by 19 | Viewed by 7640

Abstract

Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion [...] Read more.

Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

2771 KiB

Open AccessFeature PaperArticle

Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change

by Camilla Lindvall Dahlgren and Kristin Stedal

Behav. Sci. 2017, 7(2), 23; https://doi.org/10.3390/bs7020023 - 18 Apr 2017

Cited by 11 | Viewed by 8576

Abstract

Cognitive remediation therapy (CRT) has recently been developed for children and adolescents with anorexia nervosa (AN). It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little [...] Read more.

Cognitive remediation therapy (CRT) has recently been developed for children and adolescents with anorexia nervosa (AN). It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little is known regarding the specifics of its feasibility, and the perception of change associated with the intervention. Consequently, the aim of the current study was to explore service users’ perspective on CRT with a specific focus on treatment delivery, treatment content, and perceived change. Twenty adolescents (age 13–18) with AN participated in a 10-session course of CRT. A 20-item treatment evaluation questionnaire was administered at the end of treatment, focusing on four aspects of the intervention: (1) general attitudes towards treatment, (2) treatment specifics, (3) the perception of change and (4) the patient-therapist relation. The main findings suggest high levels of treatment satisfaction, but somewhat limited perceptions of change. The current study is one of the most detailed accounts of adolescents’ perspective on CRT published on eating disorders, and highlights several important aspects of the treatment viewed through the eye of the receiver. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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398 KiB

Open AccessFeature PaperArticle

Investigating Philosophies Underpinning Dietetic Private Practice

by Claudia Harper and Judith Maher

Behav. Sci. 2017, 7(1), 11; https://doi.org/10.3390/bs7010011 - 1 Mar 2017

Cited by 11 | Viewed by 8048

Abstract

There is limited theory or knowledge regarding dietitians’ practice philosophies and how these philosophies are generated and incorporated into their professional practices. For the purposes of this study, a conceptual framework will explain and define the ‘philosophies’ as three different types of knowledge; [...] Read more.

There is limited theory or knowledge regarding dietitians’ practice philosophies and how these philosophies are generated and incorporated into their professional practices. For the purposes of this study, a conceptual framework will explain and define the ‘philosophies’ as three different types of knowledge; episteme, techne, and phronesis. This study aimed to develop an explanatory theory of how dietitians in private practice source, utilise, and integrate practice philosophies. A grounded theory qualitative methodology was used to inform the sampling strategy, data collection, and analytical processes. Semi-structured interviews with dietitians in private practice were undertaken and data were collected and analysed concurrently. The results show that dietitians form collaborative relationships with their clients, in order to nurture change over time. They use intrinsic and intertwined forms of episteme, techne, and phronesis, which allow them to respond both practically and sensitively to their clients’ needs. The learning and integration of these forms of knowledge are situated in their own practice experience. Dietitians adapt through experience, feedback, and reflection. This study highlights that private practice offers a unique context in which dietitians deal with complex issues, by utilising and adapting their philosophies. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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247 KiB

Open AccessFeature PaperArticle

Early Maladaptive Schemas and Cognitive Distortions in Adults with Morbid Obesity: Relationships with Mental Health Status

by Felipe Q. Da Luz, Amanda Sainsbury, Phillipa Hay, Jessica A. Roekenes, Jessica Swinbourne, Dhiordan C. Da Silva and Margareth Da S. Oliveira

Behav. Sci. 2017, 7(1), 10; https://doi.org/10.3390/bs7010010 - 28 Feb 2017

Cited by 12 | Viewed by 9653

Abstract

Dysfunctional cognitions may be associated with unhealthy eating behaviors seen in individuals with obesity. However, dysfunctional cognitions commonly occur in individuals with poor mental health independently of weight. We examined whether individuals with morbid obesity differed with regard to dysfunctional cognitions when compared [...] Read more.

Dysfunctional cognitions may be associated with unhealthy eating behaviors seen in individuals with obesity. However, dysfunctional cognitions commonly occur in individuals with poor mental health independently of weight. We examined whether individuals with morbid obesity differed with regard to dysfunctional cognitions when compared to individuals of normal weight, when mental health status was controlled for. 111 participants—53 with morbid obesity and 58 of normal weight—were assessed with the Mini-Mental State Examination, Young Schema Questionnaire, Cognitive Distortions Questionnaire, Depression, Anxiety and Stress Scale, and a Demographic and Clinical Questionnaire. Participants with morbid obesity showed higher scores in one (insufficient self-control/self-discipline) of 15 early maladaptive schemas and in one (labeling) of 15 cognitive distortions compared to participants of normal weight. The difference between groups for insufficient self-control/self-discipline was not significant when mental health status was controlled for. Participants with morbid obesity showed more severe anxiety than participants of normal weight. Our findings did not show clinically meaningful differences in dysfunctional cognitions between participants with morbid obesity or of normal weight. Dysfunctional cognitions presented by individuals with morbid obesity are likely related to their individual mental health and not to their weight. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

Review

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233 KiB

Open AccessFeature PaperReview

Strategies to Improve Adherence to Dietary Weight Loss Interventions in Research and Real-World Settings

by Alice A. Gibson and Amanda Sainsbury

Behav. Sci. 2017, 7(3), 44; https://doi.org/10.3390/bs7030044 - 11 Jul 2017

Cited by 117 | Viewed by 25846

Abstract

Dietary interventions are the cornerstone of obesity treatment. The optimal dietary approach to weight loss is a hotly debated topic among health professionals and the lay public alike. An emerging body of evidence suggests that a higher level of adherence to a diet, [...] Read more.

Dietary interventions are the cornerstone of obesity treatment. The optimal dietary approach to weight loss is a hotly debated topic among health professionals and the lay public alike. An emerging body of evidence suggests that a higher level of adherence to a diet, regardless of the type of diet, is an important factor in weight loss success over the short and long term. Key strategies to improve adherence include designing dietary weight loss interventions (such as ketogenic diets) that help to control the increased drive to eat that accompanies weight loss, tailoring dietary interventions to a person’s dietary preferences (and nutritional requirements), and promoting self-monitoring of food intake. The aim of this paper is to examine these strategies, which can be used to improve adherence and thereby increase the success of dietary weight loss interventions. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

380 KiB

Open AccessFeature PaperReview

Virtual Reality as a Promising Strategy in the Assessment and Treatment of Bulimia Nervosa and Binge Eating Disorder: A Systematic Review

by Marcele Regine De Carvalho, Thiago Rodrigues de Santana Dias, Monica Duchesne, Antonio Egidio Nardi and Jose Carlos Appolinario

Behav. Sci. 2017, 7(3), 43; https://doi.org/10.3390/bs7030043 - 9 Jul 2017

Cited by 67 | Viewed by 13175

Abstract

Several lines of evidence suggest that Virtual Reality (VR) has a potential utility in eating disorders. The objective of this study is to review the literature on the use of VR in bulimia nervosa (BN) and binge eating disorder (BED). Using PRISMA (Preferred [...] Read more.

Several lines of evidence suggest that Virtual Reality (VR) has a potential utility in eating disorders. The objective of this study is to review the literature on the use of VR in bulimia nervosa (BN) and binge eating disorder (BED). Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for reporting systematic reviews, we performed a PubMed, Web of Knowledge and SCOPUS search to identify studies employing VR in the assessment and treatment of BN and BED. The following search terms were used: “virtual reality”, “eating disorders”, “binge eating”, and “bulimia nervosa”. From the 420 articles identified, 19 were selected, nine investigated VR in assessment and 10 were treatment studies (one case-report, two non-controlled and six randomized controlled trials). The studies using VR in BN and BED are at an early stage. However, considering the available evidence, the use of VR in the assessment of those conditions showed some promise in identifying: (1) how those patients experienced their body image; and (2) environments or specific kinds of foods that may trigger binge–purging cycle. Some studies using VR-based environments associated to cognitive behavioral techniques showed their potential utility in improving motivation for change, self-esteem, body image disturbances and in reducing binge eating and purging behavior. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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471 KiB

Open AccessReview

Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects—A Narrative Review of Human and Animal Evidence

by Michelle Harvie and Anthony Howell

Behav. Sci. 2017, 7(1), 4; https://doi.org/10.3390/bs7010004 - 19 Jan 2017

Cited by 120 | Viewed by 89887

Abstract

Intermittent energy restriction (IER) has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons [...] Read more.

Intermittent energy restriction (IER) has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons of intermittent and isoenergetic continuous energy restriction for weight loss to manage overweight and obesity. It also summarises the potential beneficial or adverse effects of IER on body composition, adipose stores and metabolic effects from human studies, including studies amongst normal weight subjects and relevant animal experimentation. Six small short term (<6 month) studies amongst overweight or obese individuals indicate that intermittent energy restriction is equal to continuous restriction for weight loss, with one study reporting greater reductions in body fat, and two studies reporting greater reductions in HOMA insulin resistance in response to IER, with no obvious evidence of harm. Studies amongst normal weight subjects and different animal models highlight the potential beneficial and adverse effects of intermittent compared to continuous energy restriction on ectopic and visceral fat stores, adipocyte size, insulin resistance, and metabolic flexibility. The longer term benefits or harms of IER amongst people who are overweight or obese, and particularly amongst normal weight subjects, is not known and is a priority for further investigation. Full article

(This article belongs to the Special Issue Advances in the Prevention and Management of Obesity and Eating Disorders)

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