Gastric banding as a weight loss surgery has increased in popularity in the United States since its approval by the Food and Drug Administration in 2001. Successful weight loss after weight loss surgery is most frequently defined as greater than 50 percent of excess weight loss (EWL). Systematic reviews show that the band is widely effective in achieving successful weight loss in most patients, however individual studies show more inconsistent outcomes. Although previous research supports gastric bypass surgery as having a positive effect on quality of life after gastric bypass, there is very little data to support this relationship in gastric banding patients. Weight loss outcomes after gastric banding surgery at Virginia Commonwealth Health System were less than 50 per cent EWL at one and two years. A retrospective, descriptive study sought to answer the following questions: 1) What is the relationship between physical activity, eating behaviors and hunger control on weight loss and quality of life after gastric banding surgery and 2) Does successful weight loss at one year predict successful weight loss at two years. The International Physical Activity Questionnaire Sort Form (IPAQ) was used to assess participation in physical activity. The Medical Outcomes Study Short Form (SF-36) was used to determine quality of life. Weight loss outcomes were 34.6 per cent at one year and 39.7 per cent at two years, which was less than the established success rate of greater than 50 per cent EWL, However, most patients lost some weight and demonstrated a significant improvement in most domains of health related quality of life. Participation in physical activity increased fro preoperatively to year one but decreased in year two. Although participation in physical activities overall decreased from year one to year two, there was a significant relationship between participation in greater than 150 minutes per week of moderate or vigorous physical activity and adequate weight loss (p =0.025) and participation in health enhancing physical activities and adequate weight loss (p < 0.05). There was no statistically significant relationship noted between any of these eating behaviors and the percentage of excess weight loss at one or two years. There was a significant relationship between degree of hunger reported by patients and successful weight loss at one year (p < 0.05). There is sufficient statistical evidence of a positive linear relationship between two- year weight loss and one- year weight loss (p < 0.05). That is, one-year weight loss is a significant predictor for two- year weight loss. Based on the results of this study, it is recommended that gastric banding patients participate in at least 150 minutes per week of moderate to vigorous physical activity. Additionally, clinicians should consider development of adjustment protocols that achieve early reduction of hunger in the banding patient.

The purpose of this study was to examine the experiences and perceptions of behavioral factors that contribute to successful weight loss in male bariatric patients. By analyzing participant experiences and perceptions, this study contributes to a better understanding of which factors are most important in the postoperative phase of gastric bypass in males owing to successful weight loss. Although there is a tremendous amount of quantitative research within the bariatric population, there is a significant gap within the qualitative literature as it relates to male outcomes. As such, by conducting interviews with 10 postoperative male gastric bypass patients, this study was able to further understand how and why these participants obtained successful weight loss. Furthermore, by identifying relevant categories and thematic responses from the participants, this study may serve future researchers in designing other qualitative studies that target best practices in males for successful weight loss outcomes. The findings of this study indicate that participants found greater weight loss success by following proper eating behaviors and engaging in physical activity whereas support group attendance was not found to be an important factor in successful weight loss. This study also revealed that follow up with the bariatric nurse coordinator was greatly viewed as a positive step in adjusting to lifestyle postsurgery. As such, this supportive role by the nurse coordinator may provide further impetus for the ways in which bariatric personnel interact with patients who might not always be able to see their surgeon for follow-up.

Developmental and prevention researchers aim to determine how unhealthy behaviors emerge. Mediation analysis offers a statistical tool that allows researchers to describe the processes underlying early risk and later health outcomes. Among existing longitudinal mediation models, latent difference score mediation stands out due to its unique ability to capture variations in changes both within and across individuals, as well as its ability to examine non-linear change over time. However, the literature currently lacks sample size guidelines for latent difference mediation models, which has proven to make the use of these models difficult. The current project addresses this limitation by offering an empirical set of sample guidelines for a variety of latent difference mediation score models through a Monte Carlo simulation study. By offering empirical sample size guidelines for latent difference score mediation models, future developmental and prevention researchers can make informed sampling decisions prior to data collection. Moreover, women who misuse alcohol have been found to experience more severe medical consequences than men. However, minimal research has evaluated how gender specific risk factors influence its onset. The current project addresses this limitation by applying latent difference score mediation to evaluate how disordered eating behaviors among adolescent girls influence alcohol misuse among adult women.

The purpose of this study is to explore the relationship between the individual’s relationship with God, body image, eating attitudes and eating behaviors amongst religious individuals in Sweden. This study is designed as a qualitative research study. The empirical data is collected via eight semi-structured interviews with open-ended questions in order to understand the individual’s lived experiences as a believer, through the body, and of eating. The sample consisted of both religiously and ethnically heterogeneous individuals living in Sweden (Male=3, Female=5, Age 22-40). The theory used for the data analysis is mainly attachment theory, which has the evolutionary origins of the attachment system and its manifestation in child – caregiver relationship. This theory is applied to religiosity by assuming that the individual’s close relationship with a personal God is an attachment relationship. Complementarily, a set of theoretical perspectives on the body - Grosz’s (1994) application of Merleau-Ponty’s phenomenological approach to the body and Bell’s (1992) ritualization theory – are also used for the analysis. Further, an acculturation perspective is used in order to explore cultural contexts, in which the respondents are situated. The results show that multiple factors have influences on the respondents’ past and current body images, attitudes towards the body, eating attitudes and behaviors. However, faith in, and relationships with God are identified as one of the most important and influential factors for their body images, attitudes towards the body, eating attitudes and behaviors except one respondent, whose case is not fit in the result. The results indicate that positive attachment relationships with God/other super natural figures can play a role in the establishment and maintenance of positive body image as well as problem free eating behaviors.

Available research has shown a relationship between emotional intelligence (EI) and health behaviors. However, the link between EI and eating behaviors has not been well explained. Thus, the purpose of this study was to investigate the correlations among EI, eating behaviors, as measured by the Dutch Eating Behavior Questionnaire (DEBQ), and body mass index (BMI) in college students. One hundred and eighty four students (118 (64%) female, 66 (36%) male, average BMI = 23.8kg/m2) were recruited to complete an online survey. The survey consisted of basic demographic questions, academic information with grade point average (GPA), ACT and SAT scores, a 19-item Self-Rated EI Scale, and 18-item Consumer EI Scale (CEIS) and the 33-item DEBQ. BMI was computed using self-report data. Results showed that the overall SREIS and the understanding emotions subscale were positively correlated with BMI. Both the SREIS and CEIS managing emotions subscales were correlated with eating behavior. GPA was correlated with BMI and both EI measures. Gender differences were found for both EI measures. In conclusion, the results indicate that certain aspects of EI may be related to eating behavior. To resolve the current obesity epidemic, emotional intelligence should be addressed in developing effective interventions.

Eating behaviors, notably eating behaviors conceptualized as appetitive traits, have been suggested as important determinants of individual differences in body weight and thus overweight and obesity. Such appetitive traits include emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating. Yet little is known about the factors that influence the development of these appetitive traits. Therefore, the current study prospectively investigated a range of predictors of appetitive traits related to both individual child characteristics and parent factors in a large population-based sample of children followed from age 6 to 8 years (N = 689). When adjusting for the initial levels of the specific appetitive trait in question at age 6 and the other predictors, the results showed that instrumental feeding and low levels of effortful control predicted emotional overeating at age 8, whereas instrumental feeding and parental restrained eating predicted food responsiveness at age 8. Enjoyment of food, satiety responsiveness and slowness in eating were not affected by any of the predictors investigated in this study. In conclusion, these findings support low effortful control and instrumental feeding as predictors of emotional overeating, and instrumental feeding and parental restrained eating as predictors of food responsiveness. These findings are relevant in providing a better understanding of the development of children’s eating behaviors, in addition to informing prevention and treatment strategies for childhood obesity.

abstract: Growing concern about obesity prevalence among youth has prompted the examination of socio-environmental influences that shape the development of eating and activity behaviors believed to regulate weight. Given the presumed significance of close friendships during adolescence, the present investigation assessed longitudinal relations between friends' physical activity, sedentary activity, and healthy eating behaviors and explored whether friends' obesity-promoting behaviors are linked to heightened obesity risk among adolescents. This prospective study utilized two Waves of data from 862 reciprocal and 1908 nonreciprocal same-sex friend dyads participating in the National Longitudinal Study of Adolescent Health. To account for nonindependence tied to membership in a particular friendship dyad, multi-level models were estimated for indistinguishable (i.e., reciprocal) and distinguishable (i.e., nonreciprocal) friend pairs using the Actor Partner Interdependence Model. Adolescents' self-reported physical activity and healthy eating were significantly associated with their own and their friends' physical activity and healthy eating one year later; the strength of socialization across friend dyads did not vary with the frequency of interaction between friends or the stability of friendships over time. Limited support was found for a cumulative risk model of obesity-promoting behaviors as a predictor of increased obesity risk; heightened risk for weight gain was found only for adolescents whose reciprocal same-sex friends reported a higher number of obesity-promoting eating and activity behaviors. Overall, study findings highlight the role of close friends for adolescents' obesity risk and obesity-related behaviors. Stronger evidence of socialization resulted for adolescents that perceived their friends to be salient social models, as reflected by their acknowledgement of an existing friendship with such peers (i.e., reciprocal friends and nominators within nonreciprocal friend dyads). / Dissertation/Thesis / Ph.D. Family and Human Development 2011

La recherche s’est très peu intéressée aux groupes de soutien (Moisio et Beruchashvili, 2010), et notamment aux communautés en ligne dédiées à la santé et à leur impact sur le comportement des consommateurs (Ma, Chen et Xiao, 2010). Ce travail doctoral a pour but d’étudier les effets positifs et négatifs de la participation à une communauté en ligne de soutien à la perte de poids (degré de participation et soutien social) sur les comportements alimentaires (restriction, diversification et auto-efficacité alimentaires). Ce lien est testé au travers d’une double médiation : l’identification aux membres de la communauté et la sensibilité à l’influence de la communauté (ou sensibilité à l’influence sociale). En effet, l’influence sociale a été étudiée dans le contexte de l’alimentation mais principalement dans le cadre de la prise d’un repas en compagnie d’autres personnes (De Castro et De Castro, 1989 ; McFerran et al., 2010 ; Vartanian, Herman et Wansink, 2008). Cette recherche vient également compléter les travaux sur l’influence sociale négative qui sont peu nombreux et concernent les réseaux sociaux tels que Facebook (Wilcox et Stephen, 2013). Ainsi, deux phases qualitatives exploratoires ont été menées auprès de 23 experts en nutrition, puis auprès de 25 utilisateurs de ce type de communautés. Ces entretiens ont permis de mieux comprendre les mécanismes de la sensibilité à l’influence de la communauté ainsi que son lien avec la comparaison sociale, l’homophilie (combinaison de la similitude et de la proximité perçues), les normes de la communauté et l’estime de soi. Par ailleurs, la restriction alimentaire est apparue comme une conséquence négative de l’influence de la communauté. Une phase quantitative a ensuite été conduite auprès de 335 utilisateurs de communautés en ligne de soutien à la perte de poids. Les résultats montrent que la participation active et le soutien social ont un effet positif sur la restriction et la diversification alimentaires, par l’intermédiaire de l’identification à la communauté et de certaines variables liées à la sensibilité à l’influence de la communauté. Ces relations n’avaient pas été mises en lumière dans la littérature. Cette recherche doctorale est également la première à montrer que la sensibilité à l’influence informationnelle a un effet positif sur la diversification alimentaire, alors que la sensibilité à l’influence normative a une influence positive sur la restriction. De plus, la comparaison sociale a un effet sur certaines variables liées à l’influence sociale dans la lignée des travaux de Polivy et Pliner (2015) qui n’avaient pas établi ce lien empiriquement. De nouveaux standards et critères de comparaison ont aussi été mis en évidence. L’homophilie liée à la perte de poids, les normes de la communauté et l’estime de soi ont également un lien avec la sensibilité à l’influence de la communauté. La thèse permet de conclure qu’il est nécessaire de sensibiliser les individus souffrant de surpoids ou d’obésité sur les dangers de la restriction et sur l’importance de la diversification de différentes manières : par les professionnels de santé, par les pouvoirs publics et par les modérateurs de communautés. / Research has shown little interest in support groups (Moisio & Beruchashvili, 2010), and especially in online health support communities and their impact on consumers’ behavior (Ma, Chen & Xiao, 2010). This doctoral research aims at studying the positive and negative effects of participating in an online dieting support community (participation level and social support) on eating behaviors (restrained eating, food variety and eating self-efficacy). A double mediation is assumed to occur: identification to community’s members and susceptibility to community influence (or susceptibility to social influence). Indeed, the effect of social influence on eating behavior was only studied when sharing a meal with other people (De Castro & De Castro, 1989; McFerran et al., 2010; Vartanian, Herman & Wansink, 2008), but not in an online context. In addition, this study extends the very few works on negative social influence which are related to online social networks like Facebook (Wilcox & Stephen, 2013). To address this issue, two exploratory qualitative studies were carried out by interviewing 23 nutrition experts, and then 25 communities’ users. Interviews enable to better understand the mechanisms of susceptibility to community influence and its link with social comparison, homophily (to feel both similar and close with others), community norms and self-esteem. A quantitative study was then conducted by questioning 335 online dieting support communities’ users. Results show that active participation and social support has a positive effect on restrained eating, food variety and eating self-efficacy, through community identification and some aspects of susceptibility to community influence. These relations were not highlighted in existing literature. So, this doctoral research is the first work to point out that susceptibility to informational influence has a positive effect on food variety whereas susceptibility to normative influence has a positive influence on restrained eating. Social comparison appears to be linked with some aspects of social influence, in line with Polivy and Pliner (2015) that dit not precisely addressed this link. New comparison standards and criteria are extracted. Homophily related to weight loss, community norms and self-esteem are also related to susceptibility to community influence. The conclusion of this work is that awareness of overweight and obese people have to be raised by health professionals, public authorities and communities’ moderators in order to avoid restraint behaviors and to promote food variety.

The field of treating and learning about eating disorders in athletes is a growing field that continues to flourish as more knowledge is acquired. The purpose of this study is to examine the influence that length of time in the sport, age at which an individual starts a competitive sport, level of competitiveness, and type of sport (leanness vs. non-leanness focused) has on disordered eating behaviors. The participants were college students who were involved in at least one competitive sport in their life. They completed the EAT-26 questionnaire as well as a basic questionnaire. There was not enough data collected to conduct a logistic regression so descriptive statistics are reported. This remains an area to be further explored as there is a gap in the literature on the age at which individuals begin competitive sports and the length of time in sports and how that relates to disordered eating behaviors.

Poor sexual function is comprised of diminished sexual desire and arousal, presence of sexual pain, inability to reach orgasm, and low satisfaction. Worse sexual function is associated with disordered eating behavior; however, the mechanism through which this association exists remains unclear. Theory of sexual function suggests that depression mediates the association of disordered eating behaviors and poor sexual function in female service members and veterans, but this has yet to be tested empirically. The purpose of the current study was to examine whether depression mediated the association of disordered eating behaviors and sexual dysfunction. Participants (N=511) were partnered females who completed measures of sexual function, disordered eating behavior, depression severity, and demographic and military characteristics. Nearly 60% reported probable sexual dysfunction, 19.6% reported probable eating disorder, and 44.4% reported probable depressive disorder. Higher depression symptoms were associated with lower sexual function (r=-.40, p<.001) and higher disordered eating behavior (r=.45, p<.001). Mediation analyses revealed that the association between disordered eating behavior and sexual function was indirect, through depression severity (indirect effect: -1.12, 95% confidence interval [-1.42, -0.85]). Depression is a potential mechanism through which disordered eating behaviors are related to poor sexual function. Findings are congruent with sexual function theory, and underscore the importance of addressing depression when treating sexual function in those with disordered eating behavior.