Debra A. Hoffmann

Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss

The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

Food consumption by young children: a function of parental feeding goals and practices.

Staggering health implications are associated with poor child diet. Given the importance of parents in impacting childrens eating outcomes, the current study examined a theoretical framework in which both parental feeding goals and practices impact specific healthy and unhealthy child eating behaviors. Participants were 171 mothers of 3-6year old children who were diverse both socioeconomically and with regard to BMI. Mothers completed questionnaires via Mechanical Turk, an online workforce through Amazon.com. Structural Equation Modeling showed an adequate model fit in which Negative Feeding Practices (e.g., using food as a reward) mediated the relationship between Health-Related Feeding Goals (i.e., feeding children with health-oriented goals in mind) and Negative Eating Behaviors (e.g., consumption of candy and snacks). However, Negative Feeding Practices did not mediate the relationship between Health-Related Feeding Goals and Positive Eating Behaviors (i.e., fruits and vegetables). These findings suggest the important role of habitual food parenting practices in childrens eating and have implications for parental health education programs.

Combining behavioral weight loss treatment and a commercial program: A randomized clinical trial

To test the hypothesis that a novel weight loss approach that combined the fundamental components of professionally delivered behavioral weight loss (BWL) treatment with the existing Weight Watchers (WW) program would produce better weight losses than WW alone no differences were expected between the novel treatment and BWL alone.

Stereotypical images and implicit weight bias in overweight/obese people

PurposeIn this brief report, an unanswered question in implicit weight bias research is addressed: Is weight bias stronger when obese and thin people are pictured engaging in stereotype consistent behaviors (e.g., obese—watching TV/eating junk food; thin—exercising/eating healthy) as opposed to the converse?MethodsImplicit Associations Test (IAT) data were collected from two samples of overweight/obese adults participating in weight loss treatment. Both samples completed two IATs. In one IAT, obese and thin people were pictured engaging in stereotype consistent behaviors (e.g., obese—watching TV/eating junk food; thin—exercising/eating healthy). In the second IAT, obese and thin people were pictured engaging in stereotype inconsistent behaviors (e.g., obese—exercising/eating healthy; thin—watching TV/eating junk food).ResultsImplicit weight bias was evident regardless of whether participants viewed stereotype consistent or inconsistent pictures. However, implicit bias was significantly stronger for stereotype consistent compared to stereotype inconsistent images.ConclusionImplicit anti-fat attitudes may be connected to the way in which people with obesity are portrayed.

Implementation of parental feeding practices: does parenting style matter?

OBJECTIVES To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices. DESIGN Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazons Mechanical Turk, an online survey system. SETTING USA. SUBJECTS Mothers of children aged 7-11 years (n 193). RESULTS Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed. CONCLUSIONS Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

Background: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment. Methods: Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.5; female = 67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6 weeks, while the other half remained in their groups regardless of weight loss. Results: There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC = 4.9% vs. BWLP = 7.8%; p = .10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p < .01). Conclusion: There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.

Implicit bias about weight and weight loss treatment outcomes.

OBJECTIVES The goal of the current study was to examine the impact of a weight loss intervention on implicit bias toward weight, as well as the relationship among implicit bias, weight loss behaviors, and weight loss outcomes. Additionally, of interest was the relationship among these variables when implicit weight bias was measured with a novel assessment that portrays individuals who are thin and obese engaged in both stereotypical and nonstereotypical health-related behaviors. METHODS Implicit weight bias (stereotype consistent and stereotype inconsistent), binge eating, self-monitoring, and body weight were assessed among weight loss participants at baseline and post-treatment (N=44) participating in two weight loss programs. RESULTS Stereotype consistent bias significantly decreased from baseline to post-treatment. Greater baseline stereotype consistent bias was associated with lower binge eating and greater self-monitoring. Greater post-treatment stereotype consistent bias was associated with greater percent weight loss. Stereotype inconsistent bias did not change from baseline to post-treatment and was generally unrelated to outcomes. CONCLUSION Weight loss treatment may reduce implicit bias toward overweight individuals among weight loss participants. Higher post-treatment stereotype consistent bias was associated with a higher percent weight loss, possibly suggesting that losing weight may serve to maintain implicit weight bias. Alternatively, great implicit weight bias may identify individuals motivated to make changes necessary for weight loss.

A randomized trial comparing two approaches to weight loss

Weight loss programs evidence considerable variability in treatment outcomes, and weight regain is common, signaling the need for the refinement of effective treatments. This study compared the recently developed Transforming Your Life program to the Diabetes Prevention Program, considered the “Gold Standard” in behavioral weight loss treatment. A total of 98 participants (Transforming Your Life = 51; Diabetes Prevention Program = 47) were randomized to the two weight loss interventions. The Transforming Your Life program and Diabetes Prevention Program produced comparable weight loss and maintenance outcomes. Individuals may benefit from engagement in the Transforming Your Life program, if they are searching for a somewhat novel approach to losing weight other than that offered by the Diabetes Prevention Program.

Friday Night Is Pizza Night: A Comparison of Children’s Dietary Intake and Maternal Perceptions and Feeding Goals on Weekdays and Weekends

Childhood obesity is a serious issue in the U.S. While obesity is the result of a multitude of factors, a great deal of research has focused on children’s dietary intake. While children’s eating patterns vary throughout the week, not much else is known about weekday-weekend differences. Therefore, the current study examined differences in the frequency and portion size of school-age children’s consumption of common foods and beverages, as well as mothers’ perceptions of those items and their child feeding goals, on weekdays and weekends. A total of 192 mothers of children aged 7 to 11 were recruited through Amazon’s Mechanical Turk. Results showed a consistent pattern of more frequent consumption and larger portions of unhealthy foods and beverages on weekends. This aligned with mothers’ perceptions of those foods and beverages as weekend items, as well as their feeding goals of health and price being less important on weekends. It is quite possible that weekends are viewed as having less structure and facilitate schedules that allow children to consume more meals away from home. These findings shed light on additional risk factors in children’s eating patterns and highlight the serious implications that day of the week can have on childhood obesity.

Structure, coercive control, and autonomy promotion: A comparison of fathers’ and mothers’ food parenting strategies

This study explored differences in mothers’ and fathers’ food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5–7.5 years (N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.