Biomedical subjects

K D Brownell

Publications and source records attributed to K D Brownell.

At least 19 recordsLinked to original sources

PubMed2001

Bias, discrimination, and obesity.

This article reviews information on discriminatory attitudes and behaviors against obese individuals, integrates this to show whether systematic discrimination occurs and why, and discusses needed work in the field. Clear and consistent stigmatization, and in some cases discrimination, can be documented in three important areas of living: employment, education, and health care. Among the findings are that 28% of teachers in one study said that becoming obese is the worst thing that can happen to a person; 24% of nurses said that they are "repulsed" by obese persons; and, controlling for income and grades, parents provide less college support for their overweight than for their thin children. There are also suggestions but not yet documentation of discrimination occurring in adoption proceedings, jury selection, housing, and other areas. Given the vast numbers of people potentially affected, it is important to consider the research-related, educational, and social policy implications of these findings.

Attitude of Health Personnel↗

PubMed2001

Implicit anti-fat bias among health professionals: is anyone immune?

OBJECTIVE: To investigate whether negative implicit attitudes and beliefs toward overweight persons exist among health professionals who specialize in obesity treatment, and to compare these findings to the implicit anti-fat bias evident in the general population. DESIGN: Health care professionals completed a series of implicit and explicit attitude and belief measures. Results were compared to measures obtained from a general population sample. SUBJECTS: A total of 84 health professionals who treat obesity (71% male, mean age 48 y, mean body mass index (BMI) 25.39). MEASUREMENTS: Participants completed an attitude- and a belief-based lmplicit Association Test. This reaction time measure of automatic memory-based associations asked participants to classify words into the following target category pair. 'fat people' vs 'thin people'. Simultaneously, the tasks required categorization of words into one of the following descriptor category pairs: good vs bad (attitude measure) or motivated vs lazy (stereotype measure). Participants also reported explicit attitudes and beliefs about fat and thin persons. RESULTS: Clear evidence for implicit anti-fat bias was found for both the attitude and stereotype measures. As expected, this bias was strong but was lower than bias in the general population. Also as predicted, only minimal evidence for an explicit anti-fat bias was found. Implicit and explicit measures of the lazy stereotype were positively related although the attitude measures were not. CONCLUSION: Even health care specialists have strong negative associations toward obese persons, indicating the pervasiveness of the stigma toward obesity. Notwithstanding, there appears to be a buffering factor, perhaps related to their experience in caring for obese patients, which reduces the bias.

Adult↗

PubMed2000

Studying intergenerational transmission of eating attitudes and behaviors: methodological and conceptual questions.

Associations between parent and child attitudes and behaviors related to eating and weight were examined among college-age men and women and their mothers and fathers (ns = 44, 47, 87, and 66, respectively). Parent attitudes and behaviors were assessed from the perspective of the parent and the student, and 2 pathways of influence were examined: modeling and direct criticism. In general, students' attitudes and behaviors were more strongly related to perceptions of their parents rather than to parents' own self-reports. There was more support for perceived direct criticism as a pathway of influence, particularly for daughters. Perceived criticism about eating and appearance had large associations with student attitudes and behaviors. Weight loss behavior was related to perceived criticism among daughters and to perceived paternal eating attitudes among sons. Results highlight important methodological and conceptual questions for intergenerational research.

Adolescent↗

PubMed2000

Small taxes on soft drinks and snack foods to promote health.

Health officials often wish to sponsor nutrition and other health promotion programs but are hampered by lack of funding. One source of funding is suggested by the fact that 18 states and 1 major city levy special taxes on soft drinks, candy, chewing gum, or snack foods. The tax rates may be too small to affect sales, but in some jurisdictions, the revenues generated are substantial. Nationally, about $1 billion is raised annually from these taxes. The authors propose that state and local governments levy taxes on foods of low nutritional value and use the revenues to fund health promotion programs.

Candy↗

PubMed1999

Lesbians, bisexual women, and body image: an investigation of gender roles and social group affiliation.

OBJECTIVE: This study examined the effects of considering oneself to be masculine, feminine, or androgynous in appearance, of having friends who share one's gender and sexual orientation, and of affiliating with three subcommunities within the lesbian society on various aspects of body image. METHOD: Self-report measures were obtained from 188 lesbian and bisexual females. RESULTS: Feminine women reported lower body satisfaction than did androgynous or masculine identified subjects. Those whose friends shared their sexual orientation and gender had more positive body images than those whose friends shared only gender. In contrast, community affiliation was unrelated to body satisfaction. DISCUSSION: Within-group differences among lesbians may be central to understanding body image in this group.

Adolescent↗

PubMed1999

Marital status, marital satisfaction, and body image dissatisfaction.

OBJECTIVE: This study examined whether married individuals have comparable body image disturbance to nonmarried individuals and whether the quality of a marital relationship is significantly related to body image disturbance in a sample of dieters. METHOD: Measures of marital status, marital satisfaction, and body dissatisfaction were administered to a sample of 16,377 subjects who had tried to lose weight at least once within the previous 3 years. RESULTS: Marital status was not associated with increased body dissatisfaction. Marital satisfaction was significantly related to body dissatisfaction when controlling for age, body mass index, self-esteem, and gender. DISCUSSION: Body dissatisfaction occurs at comparable levels among married and single individuals and the study of marital functioning among eating-disordered individuals represents a large gap in the literature.

Adult↗

PubMed1999

Eating attitudes and behaviors in pregnancy and postpartum: global stability versus specific transitions.

Global changes in eating attitudes were examined prospectively across pregnancy and 4 months postpartum in a sample of 90 women. In addition, specific changes in dieting behavior and weight/shape satisfaction were assessed at 4 months postpartum for concurrent and retrospective time points. Measures included the Eating Attitudes Test (EAT) and weight/shape satisfaction in pregnancy and at 4 months postpartum, as well as prepregnancy, pregnancy, and postpartum weight loss efforts. While global EAT scores were stable across time, dieting scores (Factor I) increased between pregnancy and postpartum. Weight/shape satisfaction was higher in pregnancy, and satisfaction was related to EAT scores at 4 months postpartum but not during pregnancy. Prepregnancy dieters and nondieters were best discriminated by higher weights, elevated pregnancy dieting scores, and lower postpartum weight/shape satisfaction. Results emphasize the importance of looking beyond changes in global eating attitudes and behaviors to more specific eating concerns or behaviors. Lastly, the results have implications for identifying women at risk for eating- and weight-related concerns during this period of rapid physical change.

Adaptation, Psychological↗

PubMed1999

The central role of lifestyle change in long-term weight management.

Lifestyle change--most notably, modification of eating behavior, physical activity, and psychologic factors like attitudes, goals, and emotions--is the central determinant of whether people will lose weight and maintain the loss. Even when medical intervention appears to be the primary treatment, as with pharmacotherapy, behavior plays the determining role in successful weight loss. For example, the likelihood that a patient will take his or her prescribed medication is influenced by thoughts, attitudes, behaviors, and social environment. The patient who is dissatisfied with the moderate weight loss produced by most treatments, and hence is prone to relapse, is affected by the same factors. Methods are available to help people develop the self-management skills necessary to produce long-term lifestyle change (1-3). As individuals internalize a new set of attitudes and behaviors, resisting old habits and acquiring new ones become easier. Only then will there be any reasonable chance of long-term weight-loss success.

Behavior Therapy↗

PubMed1998

Binge eating in an obese community sample.

OBJECTIVE: The present study sought to examine the validity and utility of diagnostic criteria for binge-eating disorder (BED) by replicating and extending a study reported by de Zwaan and colleagues (International Journal of Eating Disorders, 15, 43-52, 1994). METHOD: Four groups of obese individuals were selected from a large community-based sample of men and women: 33 women and 20 men with BED, 79 women and 40 men with subthreshold BED, 21 women and 39 men who reported recurrent overeating, and 80 female and 80 male normal controls. The groups were compared on measures of body image concern, dieting behavior, and associated psychological distress. RESULTS: Individuals with BED were distinguishable from overeaters and normal controls on a number of psychological and behavioral variables. Few differences were found between subthreshold and full-syndrome BED, raising questions about the diagnostic validity of the frequency threshold. Men with BED did not differ from women with BED above and beyond the gender-related differences observed across all four groups. DISCUSSION: Our findings support the view of BED as a distinct syndrome.

Adult↗

PubMed1998

Motivations for running and eating attitudes in obligatory versus nonobligatory runners.

OBJECTIVE: This study examined the association between motivations to run and eating disturbances in a sample of obligatory and nonobligatory runners. METHOD: 240 males and 84 females were evaluated for running habits, motivations for running, and eating and weight concerns. 26.2% of the men and 25% of the women were classified as obligatory runners. RESULTS: Obligatory runners were more motivated to run by negative factors such as guilt for stopping, scored significantly higher on the Eating Attitudes Test (EAT), and had lower weights. These effects were strongest in women. DISCUSSION: The results suggest that female obligatory runners may be at increased risk for eating disorders.

Adolescent↗

PubMed1998

Eating disturbances in white and minority female dieters.

OBJECTIVE: This study examined disordered eating, attitudes about weight and appearance, self-esteem, weight loss, and reasons for weight regain in a sample of white, black, Asian, and Hispanic female dieters. METHOD: In this cross-sectional descriptive study, we scrutinized survey responses of a large number of households subscribing to Consumer Reports magazine. Females (N = 9,971) between 21 and 65 years old (M = 42.9, SD = 10.4) with a mean body mass index (BMI) of 27.2 (SD = 6.2) were selected for comparisons. RESULTS: Ethnic groups were different in terms of age, BMI, household income, and marital status. Therefore, these variables were used as covariates in the analyses. More black women were overweight and purged compared to the other groups. Asian women valued the beneficial role of exercise in weight control more, while black women were more inclined to attribute weight gain to cravings and slow metabolism. The groups did not differ in terms of binge eating, attitudes about weight and appearance, self-esteem, the number of attempts to lose weight, and the reasons for their failures. CONCLUSIONS: This study suggests that unhealthy eating attitudes and practices may be similar for women who diet, irrespective of ethnic background. However, the generalizability of these findings is limited by the inherent sampling bias.

Adult↗

PubMed1998

Beliefs about weight gain and attitudes toward relapse in a sample of women and men with obesity.

OBJECTIVE: The purpose of this study was to examine beliefs regarding reasons for weight gain, likely responses to weight loss relapse, notions of reasonable weight loss, and correlations between beliefs and attitudes in a large nonclinical sample of men and women with obesity. RESEARCH METHODS AND PROCEDURES: Participants were 3,394 white women (n=1,674) and men (n=1,720) with obesity who had responded to a survey about body image and eating behaviors conducted by Consumer Reports magazine. RESULTS: Women and men indicated that the most important reasons for their weight gain were lack of exercise and enjoying eating; the least important reason was a need to avoid social or sexual situations. Both groups reported that their most likely response to relapse is to start watching food intake, whereas their least likely response is to ask a friend, spouse, or family member for help. Women rated depression, stress, low self-esteem, and need to avoid situations as more important reasons for their weight gain than did men, and women were more likely to feel terrible and regain as a response to relapse. There was no relationship between an individual's beliefs about weight gain, responses to relapse, or notions of reasonable weight loss. DISCUSSION: Implications of these findings for the treatment of obesity are discussed.

Depression↗

PubMed1998

Differential relation of psychological functioning with the history and experience of weight cycling.

Two measures of weight cycling and indexes of psychological functioning were examined in a large sample of dieters. History of weight cycling was assessed to include number of dieting attempts, total lifetime weight lost and regained, and number of weight cycles over 20 lb (9.1 kg). Experience of weight cycling measured perception of being a yo-yo dieter and perceived success at maintaining past weight losses. Experience was more strongly related than history to all psychological measures. Further, when controlling for the effects of age, body mass index, and experience, the relation between history and the psychological variables was nonsignificant. This finding suggests that an individual's perception of being a weight cycler may be more related to psychological problems than the actual number of pounds lost and regained over time.

Body Image↗

PubMed1998

Diet, exercise and behavioural intervention: the nonpharmacological approach.

Behaviour is an important factor in both the aetiology and treatment of obesity. Successful long-term weight management ultimately depends on the ability of patients to change their behaviour patterns, particularly with regard to diet and exercise. Many patients find such changes extremely difficult to initiate and maintain. The failure to properly address behavioural modification is part of the reason why so many weight loss programmes cannot produce long-term weight loss, even though initial weight loss is often achieved with relative ease. Four examples of lifestyle changes are discussed in this paper: exercise; relapse prevention; the concept of a reasonable weight; and attribution theory. Behavioural therapy should be an integral part of a multifaceted approach for managing obesity and associated conditions, such as type II (non-insulin-dependent) diabetes.

Behavior Therapy↗

PubMed1998

Physical activity, genetic, and nutritional considerations in childhood weight management.

Almost one-quarter of U.S. children are now obese, a dramatic increase of over 20% in the past decade. It is intriguing that the increase in prevalence has been occurring while overall fat consumption has been declining. Body mass and composition are influenced by genetic factors, but the actual heritability of juvenile obesity is not known. A low physical activity (PA) is characteristic of obese children and adolescents, and it may be one cause of juvenile obesity. There is little evidence, however, that overall energy expenditure is low among the obese. There is a strong association between the prevalence of obesity and the extent of TV viewing. Enhanced PA can reduce body fat and blood pressure and improve lipoprotein profile in obese individuals. Its effect on body composition, however, is slower than with low-calorie diets. The three main dietary approaches are: protein sparing modified fast, balanced hypocaloric diets, and comprehensive behavioral lifestyle programs. To achieve long-standing control of overweight, one should combine changes in eating and activity patterns, using behavior modification techniques. However, the onus is also on society to reduce incentives for a sedentary lifestyle and over-consumption of food. To address the key issues related to childhood weight management, the American College of Sports Medicine convened a Scientific Roundtable in Indianapolis.

Adolescent↗

PubMed1997

Comparison of men and women with binge eating disorder.

OBJECTIVE: This study examined gender differences in individuals with binge eating disorder (BED) on eating-related psychopathology and general psychological functioning. METHOD: Subjects were age-matched men (n = 21) and women (n = 21) with BED who were administered the Eating Disorders Examination (EDE), the Structured Clinical Interview for DSM-III-R (SCID) and SCID II, and who completed the Emotional Eating Scale (EES) and other questionnaires regarding psychological functioning. RESULTS: Men and women did not differ on measures of eating disturbance, shape and weight concerns, interpersonal problems, or self-esteem, but more men than women met criteria for at least one Axis I diagnosis and had a lifetime diagnosis of substance dependence. Women were more likely to report eating in response to negative emotions, particularly anxiety, anger and frustration, and depression. DISCUSSION: Results from our study suggest that while men and women presenting for treatment for BED are very similar, males may have more Axis I psychiatric disturbance and less emotional eating than their female counterparts. These findings are discussed in terms of the role of gender in BED and possible treatment implications are explored.

Adult↗

PubMed1997

Age of onset for binge eating: are there different pathways to binge eating?

OBJECTIVE: In examining individuals with binge eating disorder (BED), we aimed to determine whether their binge eating preceded their first diet or their first diet preceded their binge eating, the age of their first diet, the age of their first binge, and the age when they met DSM-IV criteria for BED. Additionally, we aimed to identify psychological factors that may distinguish the two groups. METHODS: Eighty-seven individuals with BED (19 men and 68 women) were administered the Eating Disorders Examination, the Structured Clinical Interview for DSM-III-R, and several other measures of psychological functioning and psychiatric disturbance. RESULTS: Forty-five percent of the subjects reported that dieting preceded their first binge episode (dietfirst) and 55% reported that binge eating preceded their first diet (bingefirst). There were no significant differences in current eating disturbance, body mass index (BMI), or age for these two groups, but they differed on the age of the first episode of binge eating and the age when binging met BED criteria. The group reporting having binged first had a younger age of onset of binge eating and a younger age at which binge eating met diagnostic criteria than the dietfirst group. The bingefirst group also had a history of more psychiatric problems and were more likely to have an Axis II personality disorder. DISCUSSION: Age of onset of the first binge and BED is markedly different depending on whether an individual began dieting or binging first. These findings suggest that there may be important etiological differences between individuals who binge first and those who diet first. Moreover, individuals who binge first may be at greater risk for psychiatric disturbance.

Adolescent↗

PubMed1997

Relationship of weight, body dissatisfaction, and self-esteem in African American and white female dieters.

OBJECTIVE: The present study examined the relationship among weight, body dissatisfaction, and self-esteem in a large group of African American and white female dieters who were generally overweight and of middle to high socioeconomic status. METHOD: Subjects were participants in a survey of dieting practices undertaken by Consumer Reports magazine. Major outcome measures included the Rosenberg Self-Esteem Scale and an assessment of shape and weight attitudes. RESULTS: No significant differences between African American and white women were found for body dissatisfaction, self-esteem, discrepancies between actual and ideal weight and shape, or the relationship between self-esteem and body dissatisfaction. Body mass index contributed less to body satisfaction scores in African American than in white women. DISCUSSION: This study provides a comparison of African American and white women in the upper social classes, and raises the possibility that previous findings of less body concern in African American women reflect class rather than race effects.

Adult↗