Kristina Elfhag

Personality traits and eating behavior in the obese: poor self-control in emotional and external eating but personality assets in restrained eating.

Personality traits can give a fuller understanding for eating behaviors in obesity. The objective was to describe eating behavior (Dutch Eating Behaviour Questionnaire) in terms of the Big Five personality traits (NEO Personality Inventory-Revised) in obesity patients (n=442). Emotional eating was strongly positively associated to Neuroticism, in particular impulsiveness and depression, and further linked to lower Conscientiousness mainly seen in lower self-discipline, and lower Extraversion. External eating was likewise mainly associated to the facets impulsiveness and lower self-discipline. Restrained eating was on the other hand related to higher Conscientiousness, Extraversion and Openness, and lower Neuroticism. These results imply that poor self-control seen in impulsiveness and lower self-discipline was most important for eating due to negative emotions as well as in response to external food stimuli, suggesting that the inhibition of eating and difficulties to govern ones behavior are major aspects of these eating behaviors. Attempts to control food intake and body weight seen in restrained eating were associated with more character strengths and ambitions, and also a more outgoing personality style with more stable emotions.

Initial weight loss is the best predictor for success in obesity treatment and sociodemographic liabilities increase risk for drop-out

OBJECTIVE To identify pre-treatment factors related to weight loss in obesity treatment. METHODS Weight-related and psychological factors were tested in relation to three different weight loss phases: spontaneous weight loss after screening visit (Pre-treatment), weight loss after a preparatory 5-week series of lectures (Step I) and after group treatment lasting two semesters (Step II) in 247 obesity patients. RESULTS The strongest factor for predicting weight loss in the Step II treatment was initial Step I weight loss. At least 1kg weight loss in Step I predicted 13% of the variation in Step II weight loss. Spontaneous pre-treatment weight loss after screening and a history of more weight losses were also related to more Step II weight loss. Psychological encumbrances such as eating disorders and mental distress were not related to weight loss, neither were self-reported motivation nor weight locus of control. The overall attrition rate was 63% and associated with lower education, being an immigrant, lack of occupation, fewer previous weight losses and higher body dissatisfaction. CONCLUSION Initial weight loss is the most certain factor for predicting treatment outcome. PRACTICE IMPLICATION A treatment design including an introductory phase with a minimum weight loss criterion for continuing treatment is suggested.

Eating habits in relation to body fatness and gender in adolescents – results from the ‘SWEDES’ study

Objective:To investigate if eating habits among adolescents are related to body fatness and gender.Design:Cross-sectional study.Setting:Obesity Unit, Huddinge University Hospital, Sweden, 2001–2002.Subjects:Two hundred and seventy-five girls and 199 boys, aged 16–17 years.Method:Questionnaires were used for dietary intake and meal frequency, BodPod for measuring body fatness (BF%). In all, 169 girls and 128 boys were classified as adequate reporters (AR) of energy intake, and were used in the dietary analyses. The whole sample was used in the meal frequency analyses.Results:The correlation between reported energy intake and weight in the AR group was 0.23 (P<0.01) for girls and 0.36 for boys (P<0.001). The correlations were inverse or not significant in the whole sample. The following variables correlated significantly with a high BF% (r s=±0.2): a low intake of milk in both girls and boys, a high intake of fibre and alcohol and a low intake of sugar in girls and a low intake of breakfast cereals in boys. Those with regular breakfast habits had healthier food choices than others, but this was not related to BF%. Boys had more meals per day (4.9 vs 4.6, P=0.02), especially early in the morning and late at night, whereas girls reported a higher relative intake of light meals and fruit and a lower intake of milk than boys.Conclusions:A few associations between eating habits and body fatness were found, but without any obvious patterns. The true differences in eating habits between lean and overweight adolescents are probably very small.

Correlates of soft drink and fruit juice consumption among Swedish adolescents.

The aim of the study was to investigate how soft drink and fruit juice consumption in teenagers is associated with life-style, other food choices, eating behaviour and maternal characteristics. A cross-sectional study of 16-year-old girls (n 275) and boys (n 199) and their mothers was undertaken. Questionnaires were used to assess habitual dietary intake, eating behaviour, physical activity, smoking and educational level. Weight and height were measured. It was found that eating breakfast less than five times per week was independently associated with a high soft drink consumption in both girls and boys. A low intake of cooked meals and milk and a high intake of salty snacks were associated with soft drinks in boys only, and a low intake of fruits in girls only. A high maternal juice intake, low milk and high fruit consumption were independent correlates of fruit juice intake in both girls and boys. In girls, being a smoker, having a smoking mother, a high soft drink intake, scoring low on emotional eating and high on cognitive restraint were also associated with fruit juice intake. A low intake of soft drinks and cooked meals was associated with fruit juice intake in boys only. Neither soft drinks nor fruit juice was associated with BMI. In conclusion, a high intake of both fruit juice and soft drinks were associated with a lower intake of foods such as milk and cooked meals. It might be possible to influence fruit juice intake among teenagers by aiming at their mothers, whereas the adolescents themselves should be targeted when the aim is to reduce soft drink consumption.

Personality correlates of obese eating behaviour: Swedish universities Scales of Personality and the Three Factor Eating Questionnaire

Objective: To study the relationship between personality characteristics and eating behaviour in obese patients. Method: The participants were 45 patients with a mean body mass index (BMI) of 39 kg/m2. Eating behaviour was measured with the Three Factor Eating Questionnaire (TFEQ) also taking the subscales Flexible Control and Rigid Control into account, and Personality was assessed with the Swedish universities Scales of Personality (SSP). Results: In linear regression analyses the personality characteristic greater Lack of Assertiveness could explain 17% of Disinhibited eating and 13% of Hunger scores, whereas less Lack of Assertiveness could explain 12% of Flexible Control. BMI was negatively related to one of the personality characteristics, Adventure Seeking. Discussion: A lacking ability to be socially self-assertive and confident characterized obese patients with more problematic eating behaviours that imply a risk for over consumption of food. A greater selfassertiveness was found in patients with a relatively more efficient eating strategy such as flexible control over eating.

Socioeconomic differences in obese patients with and without eating disorders

Objective: The present study aims to evaluate whether there are any socioeconomic differences in obese patients with and without eating disorders. Method: 567 obese participants referred to obesity treatment were divided into one eating-disordered group and one group without eating disorders. Those groups were compared regarding four socioeconomic variables: education, occupational status, daily occupation and housing area. Results: The prevalence of eating disorders in the sample was 9.8%. Female participants with an eating disorder (ED) had a higher BMI than female participants without an ED. Women with an ED were more often actively occupied, implying that they at the present time were working or studying, and they were also more frequently living in a lower income housing area. No statistically significant differences were found for education or occupational status. Conclusion: Our study shows that prevalence of eating disorders does not differ as a function of education or occupational status in patients referred to obesity treatment, but that differences in daily occupation and housing area can prevail for the women in particular.