Gerard J. Musante

Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults

OBJECTIVE To evaluate the associations between weight-based stigmatization, psychological distress, and binge eating behavior in a treatment-seeking obese sample. METHODS Ninety-three obese adults completed three questionnaires: 1) Stigmatizing Situations Inventory, 2) Brief Symptoms Inventory, and 3) Binge Eating Questionnaire. Correlational analyses were used to evaluate the association between stigmatizing experiences, psychological distress and binge eating behavior. RESULTS Stigmatizing experiences predicted both binge eating behavior (R(2)=.20, p<.001) and overall psychological distress (R(2)=.18, p<.001). A substantial amount of the variance in binge eating predicted by weight-based stigmatization was due to the effect of psychological distress. Specifically, of the 20% of the variance in binge eating accounted for by stigmatizing experiences, between 7% and 34% (p<.01) was due to the effects of various indicators of psychological distress. CONCLUSIONS These data suggest that weight-based stigmatization predicts binge eating behavior and that psychological distress associated with stigmatizing experiences may be an important mediating factor.

Sex differences in the relation of weight loss self-efficacy, binge eating, and depressive symptoms to weight loss success in a residential obesity treatment program.

The aim of the current study was to examine whether weight loss self-efficacy, binge eating, and depressive symptoms predicted weight loss during treatment, and whether gender moderates these associations with prospective data from 297 participants (223 women and 74 men) enrolled in a residential obesity treatment program. Men reported higher initial levels of self-efficacy than women, whereas women reported greater pre-treatment levels of binge eating and depressive symptoms. Higher pre-treatment levels of weight control self-efficacy, binge eating, and depressive symptoms predicted greater weight loss in men, but not in women. Results suggest that certain psychological and behavioral factors should be considered when implementing weight loss interventions, and indicate a need to consider gender differences in predictors of weight loss treatment. Future research should seek to identify predictors of weight loss among women.

Application of multidimensional scaling to ratings of foods for obese and normal weight individuals.

Abstract Sixteen obese patients, aged 19–31, and 27 normal weight individuals, aged 18–22, tasted and smelled fresh, unseasoned blended foods while blindfolded. Then they rated the foods on 51 semantic differential adjective scales which related to stimulation of the gustatory, olfactory, and trigeminal systems. The stimuli included fruits, vegetables, meat, fish, nuts, dairy products, grains, and a set of four standards: sucrose (sweet), NaCl (salty), lemon (sour), and coffee (bitter) in a thin cornstarch base. Proximity measures among stimuli for each subject were developed from the ratings on the adjective scales. Two multidimensional scaling (MDS) procedures, SINDSCAL (a variation of INDSCAL) and ALSCAL, were applied to the proximity measures yielding two-dimensional food maps which were very similar. Both MDS procedures provided weights for each subject on the two dimensions of the space common for all subjects. The weights indicated that the obese subjects found the first dimension, which was related to the hedonic and flavorous aspects of the stimuli, relatively more important than normal weight individuals. Also, obese subjects were significantly better at identifying the blended foods when compared to normal weight subjects.

The dietary rehabilitation clinic: Evaluative report of a behavioral and dietary treatment of obesity

This paper describes an intensive, outpatient treatment program for 229 patients in an applied clinical setting. One purpose is to bring the behavioral treatment of obesity beyond the demonstration stage by presenting an evaluative report of the Dietary Rehabilitation Clinic (DRC), an intensive weight reduction ongoing clinic at Duke University. The program includes a 700 calorie diet served in the clinic dining room where patients eat three meals each day; a behavior modification program; daily dietary, behavioral, and medical supervision; a patient education lecture series; physical activity; and a general medical program. Overall, treatment is designed to help each patient learn new eating habits; learn about foods, and achieve the goal of changed behavior necessary for maintenance of weight loss and general good health. Over one-half of patients lost 20 or more pounds, and approximately one-quarter lost 40 or more pounds.

The gender specificity of emotional, situational, and behavioral indicators of binge eating in a diet‐seeking obese population

OBJECTIVE This study investigated the unique gender correlates of binge eating severity in a diet-seeking population. METHOD This sample consisted of 288 self-admitted patients enrolled in a residential weight loss program between 1996 and 1997. Subjects were administered several questionnaires including (a) the Binge Eating Scale, (b) the Beck Depression Inventory, (c) the Rosenberg Self-Esteem Scale, (d) 5-point scales of eating related foci, and (e) 7-point scales of subject confidence in controlling their eating under various circumstances. Data were analyzed in terms of stepwise regression analyses. RESULTS Regression results revealed that while men and women share some common predictors of binge eating severity, there are also some gender-specific correlates. Men in our sample were prone to binge eat because of negative emotions (i.e., depression and anger), while binge eating severity for women in our sample was most strongly related to diet failure and tests of moderate eating. DISCUSSION The strength of the distinctive gender-specific regressions for binge eating severity suggests that the problems of binging in obese males and females are derivatives of differential sex role expectations. This interpretation and clinical implications are the focus of the discussion.

The elimination of a boy's high-building phobia by in vivo desensitization and game playing

Abstract A 7-yr-old boy with a phobia for high buildings was treated for his avoidance behavior by in vivo desensitization combined with game playing. Game playing in the presence of the phobic object proved to be an effective counter conditioning agent. After six sessions, rapid change was effected, with little apparent fear of tall buildings. The mother reported no apparent fear 3 months later when the boy visited a large metropolitan area. One year later, the phobiass demise was still apparent.

Changing eating behavior: a preliminary study to consider broader measures of weight control treatment success.

This study evaluated changes in the self-reported eating behaviors (snacking, binge eating, portion sizes, and meal skipping) of 52 obese adults (33 women and 19 men) attending a residential weight loss facility on two consecutive occasions. For each of the eating patterns studied, subjects reported engaging in the behavior significantly less frequently at the time of their return visit. It is proposed that changes in eating behaviors provide a useful and appropriate nonweight based outcome measure for estimating treatment success in diet-seeking clients.

The mediating effect of eating self-efficacy on the relationship between emotional arousal and overeating in the treatment-seeking obese.

In this study, we tested the proposition that the emotion-based eating of obese individuals is mediated by the effects of emotional arousal tendencies on brittle dieting self-restraint. Our indices of emotion-aroused eating, overeating, and brittle restraint were derived from a set of measures administered to 632 female and 254 male participants in a residential weight control and lifestyle change program. Mediation analyses indicated that (a) the relationship between positive emotion and overeating was entirely mediated by restraint tendencies and (b) the relationship between negative emotion eating and overeating was only partially mediated by brittle restraint. These findings held for both males and females. The results are discussed in relation to the viability of the psychosomatic hypothesis for understanding the relationship between emotions and overeating.

Assessment of behavior therapy training

Abstract Structured assessment should be used to evaluate training programs in behavior therapy. This study evaluates the 7th Annual Behavior Therapy Institute at Temple University Medical School, using a questionnaire which provides orderly feedback of trainee evaluations, one important aspect of assessment. Findings concerning organization, content, method of presentation, and supervision are discussed, and suggestions are made as to what should be included in training programs. It is urged that they should teach the fundamentals thoroughly rather than attempt to cover the whole range of techniques and research issues.

E's Presence: Effect on S's Performance

This study was designed to see if the presence of E was sufficient to produce “demand characteristics” in a psychological experiment. Two physiological indices, electromyogram and heart rate, measured performance of a task, i.e., not to respond to a tone. Es presence facilitated Ss ability not to respond as indicated by EMG. Es presence had a facilitating effect and “demand characteristics” of psychological experimentation appear to exist.