Early Intervention of Eating- and Weight-Related Problems

Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Box 8134, St. Louis, MO 63110, USA.
Journal of Clinical Psychology in Medical Settings (Impact Factor: 1.49). 10/2010; 17(4):285-300. DOI: 10.1007/s10880-010-9209-0
Source: PubMed


Obesity and other eating-related problems are widespread and are associated with harmful physical, psychological, and social problems. The dramatic increases in rates of pediatric obesity has created a mounting need for psychologists and other mental health care providers to play a significant role in the assessment and treatment of youth with eating- and weight-related problems. Therefore, it is imperative for providers to be aware of the causes and consequences of eating- and weight-related problems and to be familiar with evidence-based assessment and intervention approaches. Currently, the most well-established intervention approaches are family-based behavioral treatments, and weight loss maintenance treatments with a socio-ecological focus are promising. This paper provides a comprehensive review of these topics and highlights the important roles that mental health care providers can have. Medical settings are often the patient's first point of contact within the healthcare system, making mental health care providers in such settings uniquely suited to assess for a broad range of eating- and weight-related problems and associated comorbidities, to deliver relevant evidence-based interventions, and to make appropriate referrals. Moving forward, providers and researchers must work together to address key questions related to the nature of eating- and weight-related problems in youth and to achieve breakthroughs in the prevention and treatment of such problems in this vulnerable population.

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    • "The link between obesity and mortality and morbidity is generally accepted [8], however, recent research suggests that this relationship may not be as strong as once thought in the mild to moderately obese [9]. It has also been proposed that some obesity related co-morbidities may be the result of ineffective dieting rather than excess weight [10]. "
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    ABSTRACT: Background The limited success of traditional diet focused obesity interventions has led to the development of alternative non-dieting approaches. The current study evaluated the impact of a community based non-dieting positive body image program for overweight/obese people on a range of psychosocial outcomes. The characteristics of this real-world sample presenting for a non-dieting weight management intervention are also described. Method Overweight and obese participants enrolled in the eight week ‘No More Diets’ (NMD) group program completed self-report questionnaires assessing disordered eating thoughts and behaviours, body image, motivation for exercise and psychopathology pre- and post-treatment. Results Participants (n = 17; 16 female) were aged between 19 and 78 years, with a BMI ranging from 25.2 kg/m2 (Overweight) to 55.9 kg/m2 (Severely Obese). They reported elevated levels of eating disorder pathology, body shape preoccupation, depression, anxiety and stress compared to community norms (p < .05). Following treatment there were significant improvements in reported body shape preoccupation, shape concern and eating attitudes (p < .05), and clinically significant changes (small to medium effect sizes; 0.3-0.35) for improvements in reported weight concern, eating competence, stress and health evaluation. There were no changes in reported dietary restraint, emotional eating and uncontrolled eating, or eating concern (p > .05). Conclusion Individuals presenting for the NMD program demonstrated increased eating disorder pathology and more generalised psychopathology compared to community norms. The NMD program was particularly beneficial for body image and shape concern. Addressing these body image factors may help to address some of the perpetuating factors of obesity and disordered eating, which are often not addressed in the traditional diet-based weight loss interventions.
    International Journal of Eating Disorders 12/2013; 1(Suppl 1):44. DOI:10.1186/2050-2974-1-44 · 3.13 Impact Factor
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    • "Compared to behavioral skills maintenance (BSM) approaches, which emphasize self-regulation behaviors like monitoring weight loss, social facilitation maintenance (SFM) groups experience less weight relapse than groups assigned cognitive behavioral approaches or no ongoing contact after an initial weight loss program (Wake et al. 2009; Wilfley et al. 2010). SFM techniques involve the facilitation of peer networks to support healthy eating and physical activity (Wilfley et al. 2010). Overall, more research is needed on what constitutes effective cooperative involvement and the processes for sustaining involvement. "
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    ABSTRACT: With the growing interest in how online sedentary activity can mediate offline health practices, we present a study of social media activity related to personal health and fitness. We aim to identify the type of content and motivations for sharing health-related activity in social media outlets. To this end, we performed a qualitative analysis of Twitter posts, as well as an extensive set of interviews with experienced users who post messages on Twitter about exercise, diet, and weight loss activities. The qualitative analysis exposes varying levels of activity actualization and message sentiment. The interviews help us reason about the users practices and motivations for posting activity related to the pursuit and maintenance of volitional health behaviors. Our findings extend existing theoretical frameworks and can inform the design of technology that uses social media to help initiate and maintain challenging activities like exercise and diet.
    International Conference on Web and Social Media, Boston, MA; 01/2013
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    ABSTRACT: Binge eating is characterized by significant imbalance in food intake regulation and is often comorbid with obesity and depression. Mindfulness-based approaches may reduce compulsive overeating, address associated behavioral and emotional dysregulation, and promote internalization of change. This randomized trial explored the efficacy of Mindfulness-Based Eating Awareness Training (MB-EAT), a 12-session group treatment, in comparison to a psychoeducational/cognitive–behavioral intervention (PECB) and a wait list control. MB-EAT incorporates sitting and guided mindfulness practices to cultivate greater awareness of hunger and fullness cues, sensory-specific satiety, and emotional and other triggers for eating. The two-site study randomized 150 overweight or obese (body mass index = 40.3) individuals (12 % men; 14 % African-American/Hispanic; average age = 46.6 years), 66 % of whom met the full DSM-IV-R criteria for binge eating disorder (BED). Compared to the wait list control, MB-EAT and PECB showed generally comparable improvement after 1 and 4 months post-intervention on binge days per month, the Binge Eating Scale, and depression. At 4 months post-intervention, 95 % of those individuals with BED in MB-EAT no longer met the BED criteria vs. 76 % receiving PECB; furthermore, binges that occurred were likely to be significantly smaller. Amount of mindfulness practice predicted improvement on a range of variables, including weight loss (r = −0.38, p < 0.05). Results suggest that MB-EAT decreased binge eating and related symptoms at a clinically meaningful level, with improvement related to the degree of mindfulness practice.
    Mindfulness 06/2013; 5(3). DOI:10.1007/s12671-012-0179-1
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