Betty G. Kirkley

Is Social Support Beneficial for Dietary Change? A Review of the Literature

It is often assumed that support from others in the environment is beneficial for persons attempting to make health behavior changes, including dietary change. However, many questions remain unanswered about the actual effects of social support on peoples abilities to change their diets and the best methods for increasing support for dietary change. This review outlines the possible ways that social support may have an effect on dietary change, identifies which groups benefit from what types or sources of support, and assesses whether negative effects are associated with support provided for dietary change. Strategies for increasing social support, as well as guidelines for the inclusion of support in dietary change interventions, are also presented.

A comparison of binge-purgers, obese binge eaters, and obese nonbinge eaters on the MMPI

This study compared the (MMPI) score distributions obtained by binge-purgers (n=34), obese binge eaters (n=34), and obese nonbingers (n=34) of similar age. Significant differences emerged among the three groups on all MMPI scales except Masculinity-feminity (Mf) and Mania (Ma), and there was a consistent trend on the clinical scales for binge-purgers to obtain the highest scores and obese nonbingers the lowest. Obese binge eaters were statistically different from obese nonbingers on 10 of 13 scales and from binge-purgers on 4 of 13 scales. The results suggest that these groups represent three distinct populations, with obese nonbingers exhibiting the least psychological disturbance and binge-purgers exhibiting the most

Relapse as a model of nonadherence to dietary treatment of diabetes.

The generality of Marlatt and Gordons (1980, 1985) model of relapse to dietary treatment of diabetes was tested. Forty-six adults with insulin-dependent diabetes mellitus (IDDM) and 43 obese adults with non-insulin-dependent diabetes mellitus were interviewed regarding their most recent dietary violations, and the results were coded using the schema developed by Marlatt and Gordon. As the model would predict, most nonadherence episodes occurred in a limited range of high-risk situations. Although the two diagnostic groups lapsed in remarkably similar situations, there was a tendency for the IDDM adults to report a larger proportion of lapses in situations characterized by negative emotions. Approximately 27% of the dietary lapses occurred when the person was busy with a competing activity or had no choice, and these lapses did not fit into Marlatt and Gordons coding schema. These violations consistently differed from those studied by Marlatt and Gordon in that they were errors of omission rather than errors of commission. Evidence for the abstinence violation effect was not found in this sample. Overall, the results suggest that most nonadherence to dietary treatment of diabetes may be best understood as intermittent lapses that typically do not develop into full-blown relapses.

Nutritional inadequacy in the diets of treated bulimics

Twenty-two female bulimics self-monitored their eating and vomiting before and after receiving 16 weeks of bulimia treatment. Before treatment their food intake averaged nearly 4,500 Kcal/day with a wide range from marked restriction to great excess (450–18,202 Kcal/day). Caloric intake greatly decreased for the group as a whole following treatment, averaging 1,874 Kcal/day, while those who had ceased vomiting averaged 1,458 Kcal/day. There was evidence of nutritional inadequacy in diets of treated bulimics, particularly those who ceased bingeing and vomiting.