Contexte : L’obésité est une problématique multifactorielle qui peut s’accompagner d’un lot de complications autant chez les enfants que chez les adultes. Certains comportements alimentaires ont été associés à l’obésité pédiatrique, comme manger en absence de faim (MAF). Or, les déterminants de MAF n’ont pas tous été élucidés, en partie parce que ce comportement est difficile à évaluer. Objectifs : Le premier objectif est d’effectuer une revue systématique sur les déterminants individuels, familiaux et environnementaux de MAF chez les enfants et les adolescents âgés de 3 à 17 ans. Le deuxième objectif est de valider une traduction française d’un questionnaire permettant de mesurer MAF chez les enfants québécois de 7 à 15 ans. Méthodes : Pour la revue systématique (objectif #1), les critères d’éligibilité incluaient, entre autres, une population pédiatrique (3 à 17 ans) et l’évaluation d’au moins un facteur associé à MAF. Pour la validation transculturelle du questionnaire (objectif #2), des garçons et des filles âgés de 7 à 15 ans ont rempli le questionnaire à deux reprises dans un intervalle de 4 semaines. Nous avons évalué la validité de construit (structure et association avec le score z d’IMC) et la fidélité du questionnaire (cohérence interne et stabilité temporelle). Résultats : La synthèse des 81 articles inclus dans la revue systématique a révélé que chez les enfants, MAF était positivement associé à l’âge, à l’adiposité et à la présence de l’allèle A du gène FTO (fat mass and obesity associated gene). MAF semblait également davantage présent les garçons que chez les filles, mais certains facteurs familiaux, comme l’utilisation de pratiques parentales restrictives, étaient davantage associés à la présence de MAF chez les filles. MAF semble se stabiliser et persister à l’adolescence. L’étude sur la validation du questionnaire a montré que le questionnaire traduit possède une structure similaire à celle du questionnaire original. Chacune des 3 dimensions (émotions négatives, la fatigue ou l’ennui et les facteurs externes) avait une cohérence interne et une stabilité adéquate et MAF en réponse aux émotions négatives était associé à un score z d’IMC plus élevé. Conclusion : Ce mémoire contribuera au développement des connaissances sur le comportement MAF chez les enfants et les adolescents, en faisant le point sur les facteurs qui sont associés à MAF et en fournissant un outil permettant de mesurer facilement MAF en français / Background: Obesity is a multifactorial problematic which can lead to a variety of complications in both children and adults. Eating behaviors have been associated with obesity during childhood, such as eating in the absence of hunger (EAH). However, not all determinants of EAH have been elucidated, in part because this behavior is difficult to assess. Objectives: The first objective is to conduct a systematic review of the literature on individual, familial and environmental factors associated with EAH in children and adolescents aged 3-17 years old. The second objective is to perform a transcultural validation of a French translation of a questionnaire for the assessment of EAH in children and adolescents aged 7-15 years old. Methods: For the systematic review (objective #1), eligibility criteria for the study selection included a pediatric population (3-17 years of age) and evaluation of at least one factor potentially associated with EAH. For the transcultural validation of the questionnaire (objective #2), boys and girls aged 7-15 years old completed the questionnaire twice within 4 weeks. We assessed construct validity (structural validity and associations with BMI z-score) and reliability (internal consistency and temporal stability) of the questionnaire. Results: Synthesis of the 81 included studies in this systematic review revealed that among children, EAH is positively associated with age, with adiposity and with the presence of the A allele of the FTO gene (fat mass and obesity associated gene. This behavior is also more prevalent among boys than girls, but some familial factors, such as parental restrictive feeding practices, were associated with more EAH in girls. EAH also appears to remain present into adolescence. The transcultural validation revealed that the French translated version of the questionnaire had a similar structure compared to the original questionnaire. All dimensions (negative affect, fatigue/boredom and external cues) had an adequate internal consistency and temporal stability and EAH in response to negative affect was associated with a higher BMI z-score. Conclusions: This dissertation will contribute to fill the knowledge gaps about EAH in children and adolescents, by identifying factors associated with EAH and by providing a tool to easily measure EAH in French.

Contexte. L’adolescence est une période complexe marquée par une quête identitaire importante. Les comportements alimentaires adoptés à cette période tendent à perdurer dans le temps et influencent la croissance et la santé à long terme. De multiples facteurs d’ordre individuel, social, environnemental et sociétal peuvent influencer leurs choix alimentaires. Objectifs. Cette étude vise à explorer ce qui est le plus spontanément exprimé comme motivations alimentaires par les adolescents québécois âgés de 12 à 14 ans. Inspiré de l’étude des motivations alimentaires de Renner et coll. (2012), les déterminants des choix alimentaires de ces jeunes seront identifiés pour ensuite dégager les principaux facteurs d’influence agissant sur leurs choix alimentaires (Story et coll. 2002). Méthodes. Ce projet est une analyse de données qualitatives tirées de la recherche « Ados 12-14 : Les dimensions socioculturelles des pratiques alimentaires et d’activité physique des adolescents » (2014). Il repose sur l’analyse d’entrevues individuelles menées auprès de 50 filles et garçons âgés entre 12 et 14 ans. Sur un corpus d’entrevues retranscrites intégralement, une approche déductive fut utilisée avec l’échelle de mesure de motivations alimentaires de Renner et coll. (2012) comme grille d’analyse. Résultats. Parmi les nombreux facteurs d’influence, les facteurs individuels et ceux liés aux environnements sociaux se sont particulièrement démarqués. Au final, l’influence parentale, les préférences alimentaires, le désir de créer une impression sociale favorable et la santé sont déterminants, parfois même au détriment du plaisir. Conclusion. Cette étude révèle une variété de facteurs pouvant influencer les comportements alimentaires des adolescents québécois. Les constats dégagés de l’analyse des données effectuée sont pertinents pour les acteurs en nutrition en santé publique lesquels y trouveront des facteurs à prendre en compte dans la mise en place d’interventions de promotion des saines habitudes alimentaires auprès des adolescents québécois. / Context. Adolescence is a complex period marked by an important identity quest. Eating behaviours adopted during this period of life tend to influence growth and health in the long term. Individual, social, environmental and societal factors can influence teenagers’ eating habits. Objectives. This study is aimed at exploring what is most spontaneously expressed as feeding motivations by teenagers between 12 and 14 years old. Inspired by Renner et al.’s study (2012) about eating motivations, determinants of the adolescent food choices will be identified and then the main influence factors guiding their eating habits will be explored (Story et al., 2002). Methods. This project is an analysis of the qualitative data from the research project “Teenagers 12-14: Sociocultural dimensions of eating habits and physical activity of teenagers’’ (Ados 12-14: Les dimensions socioculturelles des pratiques alimentaires et d’activité physique des adolescents (2014)). It is based on the analysis of individual interviews with 50 girls and boys aged between 12 and 14 years old. Interview transcripts were analyzed using a deductive approach and the motivation measuring scale of Renner et al. (2012) as an analysis grid. Results. Amongst numerous factors, individual and socioenvironmental factors stood out. Globally, parents’ influence, eating preferences, the desire to make a good social impression, and health were decisive factors, sometimes even stronger than pleasure. Conclusion. Many factors impacting eating behaviors in the teenage population of Québec were identified in this study. The results generated by this data analysis will be useful for public health nutritionists for the design of intervention plans for the promotion of healthy eating habits within the Québec teenage population.

No description available.

Weight loss maintenance is essential for the reduction of obesity-related health impairments. However, only a minority of individuals successfully maintain reduced weight in the long term. Research has provided initial evidence for associations between weight-related teasing (WRT) and greater non-normative eating behaviors. Further, first evidence was found for associations between non-normative eating behaviors and weight loss maintenance. Hence, the present study aimed to examine the predictive value of WRT for weight loss maintenance and the role of non-normative eating behaviors as possible mediators of this relationship. The study was part of the German Weight Control Registry that prospectively followed individuals who had intentionally lost at least 10% of their maximum weight and had maintained this reduced weight for at least one year. In N = 381 participants, retrospective WRT during childhood and adolescence, current non-normative eating behaviors (i.e., restrained, external, emotional eating), and change in body mass index (BMI, kg/m2) over two years were examined using self-report assessments. Structural equation modeling was used to analyze the assumed mediational relationship. As a result, a greater effect of retrospective WRT during childhood and adolescence predicted less successful adult weight loss maintenance over two years. Current emotional eating fully mediated this relationship while current restrained and external eating yielded no mediational effects. Hence, a greater effect of WRT predicted greater current emotional eating, which in turn predicted a smaller decrease or a greater increase in BMI. Our findings suggest that suffering from WRT during childhood and adolescence might lead to emotional eating which in turn impairs long-term weight loss maintenance. Thus, our results highlight the need for interventions aiming at reducing weight stigmatization and targeting emotional eating for successful long-term weight loss maintenance.

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.

Inledning: Många människor spenderar ofta mycket tid på en arbetsplats och därigenom äts det även många måltider där. Arbetsplatsen är även en plats för sociala relationer. De sociala relationerna har en stor inverkan på individens matvanor. Syfte: Syftet är att undersöka om och hur arbetskollegor påverkar individens val av matlådans innehåll. Material och metod: Studien baseras på en kvantitativ, webbaserad enkätundersökning med kvalitativa inslag. Rekrytering av respondenter skedde via Facebook. Resultat: 596 personer deltog i undersökningen, varav 340 kvinnor, 244 män och 12 annat. Många respondenter upplevde att det förekommer kommentarer kring maten som äts på ens arbetsplats. Kollegornas kommentarer var både positiva och negativa och påverkade individen på olika sätt. En del ändrade sin portionsstorlek, medan andra anpassade matlådans innehåller efter vad som ansågs socialt accepterat. Det visade sig även att kollegornas matlådor inspirerade individen till att prova nya maträtter och att äta mer vegetariskt. Slutsats: Både positiva och negativa kommentarer förekom på arbetsplatser. Respondenterna påverkades på olika sätt, en del ignorerade kommentarerna och anpassade sig inte medan andra tog åt sig så pass mycket att de slutade ha med sig matlåda och istället åt ute. Även positiv påverkan i form av inspiration förekom på många arbetsplatser. Studiens resultat bekräftar att individens matval påverkas av gruppen och det sociala samspelet, där arbetsplatsen kan spela en central roll. / Introduction: A great deal of time is spent at the workplace which means that many of our meals takes place there. The workplace is a place for social relationships. These relationships have a great impact on the individual’s food choices. Aim: The aim is to examine if and how colleagues influence the individual's food choices Material and methods: The method used was a quantitative online survey with qualitative elements. Respondents were recruited on Facebook. Results: 596 people took part in the online survey, 340 women, 244 men and 12 other. Respondents experienced comments on the food that they brought to the workplace. The co-workers’ comments were both positive and negative and affected the individual in different ways. Some individuals changed the size of their portions while others did not bring food that was not viewed as socially accepted. The study also showed that the co-workers inspired one another to try new dishes and to eat more vegetarian food. Conclusions: Negative and positive comments occurred at the workplaces. The effect of the comments varied, some participants did not change their eating behavior while others were greatly affected and stopped bringing a lunchbox to the workplace. At many workplaces the co-workers inspired each other to try new things. The study’s results confirm that the individual’s food choices are affected by the group and the social environment, where the workplace can play a central role.

The purpose of this study was to examine any differences that may exist among demographic variables such as gender, age, and race in regard to internalization of society and media messages leading to body dissatisfaction that may lead to disordered eating behaviors such as preoccupation with weight, dieting, and eating restraint. A total of 324 participants completed the demographic questionnaire, the Multidimensional Body Self Relations Questionnaire, the Sociocultural Attitudes Towards Appearance Questionnaire for women, the Sociocultural Attitudes Towards Appearance Questionnaire-Revised-Male-Version for men, and Rotter’s Internal-External (I-E) Locus of Control Scale. The results of this study found, as predicted, that Caucasians reported higher internalization, higher body dissatisfaction, and higher preoccupation with weight, dieting, and eating restraint than African Americans. This study showed no differences regarding men’s and women’s internalization or body dissatisfaction but did reveal that women reported higher preoccupation with weight, dieting, and eating restraint than men. Regarding age, this study found that age did not predict internalization, body dissatisfaction, or preoccupation with weight, dieting, and eating restraint.

Das Krankheitsbild der Adipositas hat sich weltweit zu einem relevanten Gesundheitsproblem entwickelt. Die bariatrische Chirurgie wird zunehmend als wirkungsvolle Behandlung bei schwer ausgeprägter Adipositas eingesetzt. Jedoch ist über die Rolle psychologischer Variablen im bariatrischen Behandlungsverlauf noch wenig bekannt. Die vorliegende Dissertation untersucht Einfluss und Veränderung patientenberichteter Gesundheitsmerkmale in der chirurgischen Adipositastherapie. Dazu werden in einer naturalistischen Beobachtungsstudie Patienten mit schwerer Adipositas vor und im Durchschnitt zwei Jahre nach einer bariatrischen Operation (OP) befragt. Ziele der Arbeit sind 1) die Charakterisierung adipöser Patienten vor OP hinsichtlich bio-psycho-sozialer Variablen; 2) die Identifikation möglicher Einflussvariablen auf den gewichtsbezogenen Behandlungserfolg nach OP; 3) die Untersuchung von Auswirkungen der OP auf das Essverhalten; und 4) die Analyse von Veränderungen in der essstörungsbezogenen Psychopathologie und in der gesundheitsbezogenen Lebensqualität nach OP. Die Ergebnisse der bariatrischen Patienten werden im Vergleich zu denen konservativ behandelter Patienten betrachtet. Die Ergebnisse zeigen, dass Patienten mit bariatrischem Behandlungswunsch eine somatisch und psychisch belastete Patientengruppe darstellen. Die bariatrische OP führt im zweiten postoperativen Jahr zu einer nachhaltigen und klinisch bedeutsamen Gewichtsreduktion. Der präoperative Body-Maß-Index, das Bildungsniveau und aktives Problembewältigungsverhalten sind mit dem Gewichtsverlust nach OP assoziiert. Im Vergleich zur konservativen Behandlung berichten die Patienten, die sich der OP unterziehen, über stärker ausgeprägte Verbesserungen in ihrem Essverhalten und eine Steigerung ihrer Lebensqualität. Auf Basis der Befunde wird ein routinemäßiges Monitoring der somatischen und psychischen Situation der Patienten nach bariatrischer OP empfohlen, um die gezeigten Behandlungserfolge optimal zu sichern. / Obesity has become a relevant global health problem. Bariatric surgery is an effective treatment for severe obesity. However, while the number of operations performed continues to increase, the role of psychological variables throughout the bariatric surgery pathway remains uncertain. The present dissertation investigates the patient-reported health status as it impacts and results from bariatric surgery. In a naturalistic observational study, patients with severe obesity are assessed before and, on average, two years after the surgical treatment. Main aims are 1) to characterize obese patients prior to bariatric surgery in terms of biological, psychological and socio-demographic variables; 2) to identify possible predictors for the postoperative weight-related treatment success after bariatric surgery; 3) to examine changes in eating behaviors; and 4) to analyze changes in eating-related psychopathology and in health-related quality of life (HRQoL). The outcomes of surgical patients are compared with those of conservatively treated patients for the same follow-up period. The findings show that bariatric surgery candidates represent a vulnerable patient group with high physical and psychological burden. In the second postoperative year after bariatric surgery, a sustainable and clinically meaningful weight reduction is achieved. The preoperative body mass index, education level and active coping behavior are associated with weight loss after surgery. Compared with conservative treatment, patients who undergo bariatric surgery report not only greater improvements in their eating behavior and eating-related psychopathology but also an increase in their HRQoL. Based on the results, the provision of a routine monitoring of the somatic and psychological situation of patients following bariatric surgery is recommended to secure longer-term treatment success.