Is Caloric Restriction Associated With Development of Eating-Disorder Symptoms? Results From the CALERIE Trial

Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
Health Psychology (Impact Factor: 3.59). 02/2008; 27(1 Suppl):S32-42. DOI: 10.1037/0278-6133.27.1.S32
Source: PubMed


This study tested a secondary hypothesis of the CALERIE trial (Heilbronn et al., 2006) that a 12-month period of intentional dietary restriction would be associated with an increase in eating disorder symptoms.
To test this hypothesis, 48 overweight adults were randomly assigned to four treatment arms in a 12-month study: (1) 25% calorie restriction, (2) 12.5% calorie restriction and 12.5% increased energy expenditure by structured exercise, (3) low-calorie diet, and (4) healthy diet (no-calorie restriction).
Primary outcome measures for the study were changes in: eating disorder symptoms, mood, dietary restraint, body weight, and energy balance.
All three dietary restriction arms were associated with increased dietary restraint and negative energy balance, but not with increased ED symptoms or other harmful psychological effects. Participants in the three calorie restriction arms lost significant amounts of body weight. The psychological and behavioral effects were maintained during a 6-month follow-up period.
These results did not support the hypothesis that caloric restriction causes increased eating disorder symptoms in overweight adults. In general, caloric restriction had either benign or beneficial psychological and behavioral effects.

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Available from: Stephen D Anton, Feb 23, 2015
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    • "Conversely, intervention trials that assigned subjects to weightloss-inducing diets have shown that participants with higher levels of restraint had lower attrition rate (Clark, Marcus, Pera, & Niaura, 1994) and experienced greater weight loss (Foster et al., 1998; Karlsson et al., 1994; Lowe, Foster, Kerzhnerman, Swain, & Wadden, 2001; Stice, Presnell, Groesz, & Shaw, 2005; Williamson et al., 2008). Moreover, results have been further complicated by the fact that restraint has often been associated with disinhibition, which has shown a consistent positive association with BMI (Bellisle et al., 2004; Carmody, Brunner, & St Jeor, 1995; Hays et al., 2002; Lawson et al., 1995) and weight gain (Drapeau et al., 2003; Provencher, Drapeau, Tremblay, Després, & Lemieux, 2003). "
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    ABSTRACT: In modern societies characterized by food abundance, dietary restraint may serve as a factor in the successful control of weight or facilitation of weight loss. This secondary analysis of data examined whether changes in cognitive eating restraint (CER) and disinhibition predicted weight loss in a sample of 60 overweight/obese premenopausal women [mean±SD, age=35.9±5.8 y; weight=84.4±13.1 kg; body mass index (BMI)=31.0±4.3 kg/m2]. Changes in weight, BMI, waist circumference, hip circumference, waist-to-hip ratio and body fat percentage (BF%) were examined in relation to changes in CER, disinhibition and hunger as measured by the Eating Inventory questionnaire at baseline and week 18 of an 18-week dietary intervention. Multivariate linear regression analysis was used to identify predictors of weight loss and changes in other anthropometric variables from baseline to study completion. Increase in CER was found to be the most robust predictor of reduction in weight (P<0.0001), BMI (P<0.0001), waist circumference (P<0.001), hip circumference (P<0.0001) and BF% (P<0.0001). Effect of increase in CER on change in BMI, hip circumference and BF% was moderated by increase in disihibition (all P<0.05). Results suggest that strategies that target CER and disinhibition should be emphasized in programs proposed to treat and prevent obesity.
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    Preview · Article · Nov 2007 · International Journal of Eating Disorders
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    ABSTRACT: OBJECTIVE: This study tested whether baseline behavioral and psychological variables predict weight and fat loss among overweight, non-obese individuals participating in a six-month calorie restriction trial. Participants (N=48) were randomly assigned to four groups, three of which included a calorie restriction program and one of which served as a healthy diet weight maintenance control. For the purposes of this study, data were analyzed only for participants assigned to the three calorie restriction groups (n=36). Ten psychological and behavioral measures were investigated through principal components factor analysis to examine whether these measures were assessing similar or distinct psychological and behavioral constructs. Based on the obtained six-factor solution, one measure from each domain was selected for inclusion in hierarchical regression analyses, which was used to test the relative importance of psychosocial and behavioral variables in predicting percent weight and fat loss over six months. After controlling for demographic and treatment variables, the behavioral and psychological measures of negative mood states, poor psychosocial functioning, and somatic symptoms were associated with less weight loss (R2=0.68, p<0.001) and fat loss (R2=0.65, p<0.001) over six months. Among overweight individuals, poor psychological adjustment, somatic symptoms, and negative mood states appear to form a psychosocial profile that is predictive of less weight and fat loss in calorie restriction programs.
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