Publications by authors named "Kristin M von Ranson"

45 Publications

Feeding and eating problems in children and adolescents with autism: A scoping review.

Autism 2021 Mar 2:1362361321995631. Epub 2021 Mar 2.

University of Calgary, Canada.

Lay Abstract: Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms "feeding" and "eating" problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use "eating problems" when behaviors involve preoccupation with food, eating, or body image, and "feeding problems" when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child's treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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http://dx.doi.org/10.1177/1362361321995631DOI Listing
March 2021

Negative urgency combined with negative emotionality is linked to eating disorder psychopathology in community women with and without binge eating.

Int J Eat Disord 2021 Feb 24. Epub 2021 Feb 24.

Department of Psychology, University of Calgary, Calgary, Canada.

Objective: Previous research has shown that negative emotionality (NE) and negative urgency (NU) are each risk factors for disordered eating behaviors among undergraduates and treatment-seekers. However, the interaction of these traits in community-based adults with clinical levels of binge eating is unknown and has implications for risk and maintenance models of disordered eating.

Method: We examined a moderated-mediation model of cross-sectional associations among levels of NE (independent variable), NU (mediator), and eating disorder psychopathology (i.e., eating, shape, and weight concerns, and restraint; dependent variable) in 68 community-recruited women with current regular binge eating and 75 control women with no eating disorder history (group = moderator). Participants completed semi-structured diagnostic interviews and self-report questionnaires measuring NE, NU, eating disorder psychopathology, and anxiety and depression symptoms.

Results: After adjusting for anxiety and depression symptoms and body mass index, women with binge eating experienced greater NU and eating disorder psychopathology than control women with no eating disorder history. Despite similar levels of NE across groups, both groups exhibited an indirect effect of NE on eating disorder psychopathology via NU.

Discussion: Our findings suggest that greater NE, coupled with a propensity to engage in rash action when experiencing negative emotions, are associated with eating disorder psychopathology in women with and without eating disorders characterized by binge eating. These findings may help explain why some individuals engage in disordered eating behaviors when experiencing negative affect.
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http://dx.doi.org/10.1002/eat.23491DOI Listing
February 2021

Self-reported eating disorder psychopathology prevalence in community-based female and male Albertans: Gender and age group comparisons.

Int J Eat Disord 2021 Mar 9;54(3):438-444. Epub 2020 Dec 9.

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

Objective: We describe and compare eating disorder (ED) psychopathology prevalence in Canadian females and males across five age groups.

Method: This secondary data analysis study used the Eating Disorder Examination Questionnaire (EDE-Q) to assess ED psychopathology in 1,316 Alberta community-based female and male participants, aged 15 to 71.

Results: Overall, 15.3% of female and 8.2% of male participants reported clinically-significant ED disturbances. Female participants reported greater global ED psychopathology than male participants, except older men and women aged 65-71, who reported similar, relatively low levels of global ED psychopathology. Women aged 65-71 endorsed less global ED psychopathology than younger females. More females than males reported regular binge eating and self-induced vomiting, whereas other ED behaviors were endorsed at similar rates.

Discussion: This large-scale study, the first involving a Canadian sample, contributes to a small literature on ED psychopathology in community-based samples. The finding that 15% of female and 8% of male Albertans aged 15 to 71 endorsed clinically-significant ED disturbances is concerning; however, women aged 65-71 reported lower ED psychopathology than younger females. Gender and age differences were observed in global ED psychopathology. Routine ED screening of non-clinical adolescents and adults is warranted to permit prevention and early intervention.
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http://dx.doi.org/10.1002/eat.23434DOI Listing
March 2021

Prevalence of social, cognitive, and emotional impairment among individuals with food addiction.

Eat Weight Disord 2020 Sep 20. Epub 2020 Sep 20.

Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.

Purpose: The clinical utility of the construct of food addiction has been heavily debated. Though food addiction has been associated with psychosocial impairment in clinical samples, it is critical to examine these associations in non-clinical samples, to obtain unbiased evidence regarding this phenomenon's clinical significance. It is also unknown which types of impairment are most common in food addiction. This observational study explored the association of self-reported food addiction with impairment in the domains of social, cognitive, and emotional functioning.

Methods: Participants (356 university students and 544 adults recruited through Mechanical Turk) completed the Yale Food Addiction Scale 2.0 and Clinical Impairment Assessment 3.0 questionnaire, as well as measures of emotional eating, reward-driven eating, binge eating, and general disordered eating.

Results: Food addiction scores showed large correlations with emotional (r = 0.55, 0.57), social (r = 0.56, 0.59), and cognitive impairment (r = 0.58, 0.53) in the student and Mechanical Turk samples, respectively. The most common difficulties endorsed were emotional (e.g., feeling ashamed or critical of oneself, upset, or worried due to one's eating habits), followed by social and cognitive.

Conclusion: Food addiction was strongly associated with psychosocial impairment in two non-clinical samples, suggesting this phenomenon merits further investigation. We found substantial associations of food addiction with emotional as well as social and cognitive impairment.
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http://dx.doi.org/10.1007/s40519-020-01014-2DOI Listing
September 2020

Conceptualizing addictive-like eating: A qualitative analysis.

Appetite 2019 10 19;141:104326. Epub 2019 Jun 19.

Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada. Electronic address:

Debates regarding addictive-like eating have generated several conceptualizations of this construct. Qualitative research helps ensure that conceptualizations capture how individuals may experience addictive-like eating. In this study, we conducted semi-structured interviews with ten participants who identified themselves as addicted to food, or to food and eating, to determine how they conceptualized their addictive-like eating. Using thematic analysis, we identified four themes: (1) Social Environment, describing how past and present social environments affected addictive-like eating; (2) Situational Cues, encompassing situational contributions to addictive-like eating; (3) Persistent Cognitions, including preoccupation with food and loss of control; and (4) Impact of Weight, encompassing weight gain and its perceived impact on health, body image, and distress. Participants described properties specific to their preferred foods, as well as environmental and cognitive factors contributing to addictive-like eating. These descriptions were not completely captured by either the substance-based "food addiction" or behavioural "eating addiction" frameworks, though characteristics consistent with both were present. Further, existing scales of addictive-like eating do not assess the impact of social and situational cues, suggesting a need for new or revised measures. We propose a working definition of addictive-like eating that incorporates the characteristics described.
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http://dx.doi.org/10.1016/j.appet.2019.104326DOI Listing
October 2019

"There is no way to avoid the first bite": A qualitative investigation of addictive-like eating in treatment-seeking Brazilian women and men.

Appetite 2019 06 20;137:35-46. Epub 2019 Feb 20.

Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada. Electronic address:

There has been polarizing debate on addictive-like eating in recent years. To move toward valid definition and measurement of this construct, qualitative research describing individuals' experiences is needed. The present study explored how Brazilian men and women define and experience addictive-like eating. Interviews were conducted with 7 men and 8 women (M = 46.6 years, M = 35.43 kg/m) seeking treatment for addictive-like eating. Thematic analysis of interviews identified three saturated, overarching themes describing participants' conceptualizations of the (1) characteristics, (2) causal factors, and (3) consequences of addictive-like eating. Lack of control was a key characteristic of addictive-like eating described by all participants. A causal factor which most participants described was emotional eating. Consequences included emotional, interpersonal, occupational, and health-related impairments which appeared primarily related to weight gain, rather than to the pattern of addictive-like eating itself. These results are largely consistent with those of previous qualitative studies. Importantly, the symptoms described by our participants and in previous qualitative studies may be inadequately captured by existing self-report questionnaires designed to assess addictive-like eating. To address this potential limitation, we provide recommendations for assessing the full range of possible addictive-like eating symptoms.
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http://dx.doi.org/10.1016/j.appet.2019.02.008DOI Listing
June 2019

Fitspiration and thinspiration: a comparison across three social networking sites.

J Eat Disord 2018 26;6:39. Epub 2018 Nov 26.

3Department of Psychology, University of Calgary, 2500 University Drive N.W, Calgary, AB T2N 1N4 Canada.

Background: Fitspiration, or images and text promoting health and fitness, and thinspiration, or images and text promoting thinness, have both received criticism for their negative effects on body image and dieting behaviors. In this study, we critically examined and compared the content of fitspiration and thinspiration on three social networking sites (SNS).

Methods: Fitspiration and thinspiration posts ( = 360) from three photo-sharing SNS (Instagram, Tumblr, and Twitter) were collected quasi-randomly on four days over two weeks. Image and associated text content were coded for variables related to weight and shape, muscularity, thin ideal, and eating. Chi-square and Fisher's exact tests compared content of fitspiration and thinspiration posts overall and among the three SNS.

Results: Thinspiration images portrayed body parts more frequently than fitspiration (69.8% vs. 30.2%). Similarly, posts highlighting bony body features and references to mental illness appeared only in thinspiration. No differences were found between fitspiration and thinspiration posts with regard to sexual suggestiveness, appearance comparison, and messages encouraging restrictive eating. Fitspiration and thinspiration posts included similar images across the three SNS-focusing on appearance, sexually suggestive images, and restrictive eating-with three exceptions. Fitspiration posts exhibiting body positivity were found only on Tumblr. In thinspiration posts, references to mental illness were more frequent on Tumblr and Instagram than on Twitter, and bone emphasis was coded more frequently on Twitter than on Instagram.

Conclusions: Although fitspiration posts were less extreme than thinspiration posts on the whole, notable similarities in their content support that fitspiration endorses problematic attitudes towards fitness, body image, and restrictive eating in pursuit of a fit-and-thin body ideal.
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http://dx.doi.org/10.1186/s40337-018-0227-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260773PMC
November 2018

Evaluating an abbreviated three-factor version of the Eating Disorder Examination Questionnaire in three samples.

Eat Behav 2019 01 14;32:18-22. Epub 2018 Nov 14.

Department of Psychology, University of Calgary, Calgary, AB, Canada.

A brief, three-factor structure for the Eating Disorder Examination-Questionnaire (EDE-Q) has been identified that has stronger psychometric properties than the original four-factor EDE-Q structure. However, there is a need for independent replication of the brief version in different samples, and examination of how comparable the brief version is in women and men of diverse ages. This study compared factor structure fit and other psychometric properties between the original and brief versions in three independent samples of adults to evaluate the reliability and validity of this brief version. It also examined measurement invariance across gender in a middle-aged community sample. Participants included university women (N = 659), university women and men (N = 358), and crowdsourced community women and men (N = 544). Across samples, compared to the original version the brief version demonstrated greater internal consistency, somewhat less item overlap, and superior model fit in confirmatory factor analyses, although some fit indices fell below recommended cut-offs. Separate confirmatory factor analyses of the brief version in community women and men suggested the brief version may better fit community men than women, and measurement invariance across gender for the brief version was not supported for the community sample. This independent replication supports the factorial validity of the brief version in three samples of students and crowdsourced community adults, and highlights the importance of further examination of the psychometric properties of this brief three-factor version across gender and age categories, among others sample characteristics.
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http://dx.doi.org/10.1016/j.eatbeh.2018.11.003DOI Listing
January 2019

Canadian Senate Report on Obesity: Focusing on Individual Behaviours versus Social Determinants of Health May Promote Weight Stigma.

J Obes 2018 2;2018:8645694. Epub 2018 Jul 2.

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4.

Very little attention has been given to unintended consequences of government reporting on obesity. This paper argues that the 2016 Senate report, "Obesity in Canada: A Whole-Of-Society Approach," exemplifies the systemic public health issue of weight stigma. The purpose of this viewpoint is to critique the approach taken in the Report, by illustrating that it (1) takes a weight-centric approach to health, (2) does not acknowledge important limitations of the definition and measurement of obesity, (3) reifies obesity as a categorical phenomenon that must be prevented, and (4) uses aggressive framing and disrespectful terminology. The Report perpetuates a focus on the individual, thereby failing to recognize the role that governments can play in reducing weight stigma and addressing social determinants of health. If steps are taken to avoid propagating weight stigma, future reports could more constructively address health promotion, equity, and social determinants of health in their policies.
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http://dx.doi.org/10.1155/2018/8645694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051051PMC
July 2019

Moving beyond the "eating addiction" versus "food addiction" debate: Comment on Schulte et al. (2017).

Appetite 2018 11 21;130:286-292. Epub 2018 Jun 21.

Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada. Electronic address:

In a recent commentary, Schulte et al. (2017) argued that addictive-like eating should be conceptualized as a substance use disorder rather than a behavioural addiction, and noted that many parallels that Hebebrand et al. (2014) drew between addictive-like eating and behavioural addictions apply likewise to substance use disorders. However, we argue that many of the arguments advanced by Schulte et al. (2017) in support of a substance-based food addiction model, including the important role played by ingested substances, are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, notably eating disorders, which raises the question of whether the phenomenon of addictive-like eating is encompassed by existing eating disorder diagnoses. Similarities between addictive-like eating and substance use, no matter how compelling, do not ensure the validity or clinical utility of a substance-based food addiction model and should not drive the conceptualization of addictive-like eating. The present commentary discusses problems with Schulte et al.'s (2017) arguments for substance-based food addiction, and draws attention to alternative conceptualizations of addictive-like eating which risk being overlooked when this conversation is framed as a dichotomous debate between the food and eating addiction models.
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http://dx.doi.org/10.1016/j.appet.2018.06.025DOI Listing
November 2018

Reciprocal Associations Between Eating Pathology and Parent-Daughter Relationships Across Adolescence: A Monozygotic Twin Differences Study.

Front Psychol 2018 7;9:914. Epub 2018 Jun 7.

Department of Psychology, University of Minnesota, Minneapolis, MN, United States.

This prospective study explored longitudinal, bidirectional associations between eating pathology and perceptions of the parent-child relationship (i.e., parent-child regard and involvement) across adolescence. Specifically, this study examined whether twin differences in mother-daughter and father-daughter relationship problems emerged as a risk factor for, or outcome of, twin differences in eating pathology. By examining twin differences, this study explored associations between variables while controlling for shared environmental and genetic effects. A population-based sample of 446 monozygotic twin girls and their mothers completed questionnaires when twins were approximately 11, 14, and 17 years. Responses were analyzed using longitudinal cross-lagged models. Overall, few strong longitudinal associations were observed. Where longitudinal associations emerged, overall patterns indicated reciprocal associations that shifted across adolescence. Whereas twin differences in parent-daughter relationship variables more often predicted later twin differences in eating pathology across early adolescence, conversely, twin differences in eating pathology more often predicted later twin differences in parent-daughter relationship variables across later adolescence. In particular, the twin who reported greater eating pathology later reported more negative perceptions of the father-daughter relationship, as compared to her co-twin. Findings raise questions for future research regarding parental-in particular, paternal-responses to adolescent eating pathology and suggest the potential importance of efforts to support the parent-daughter relationship within the context of adolescent eating pathology.
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http://dx.doi.org/10.3389/fpsyg.2018.00914DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999748PMC
June 2018

Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder.

Eur Eat Disord Rev 2018 09 24;26(5):508-518. Epub 2018 May 24.

Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil.

Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention.
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http://dx.doi.org/10.1002/erv.2606DOI Listing
September 2018

Innovation in eating disorders research and practice: Expanding our community and perspectives at the 2018 International Conference on Eating Disorders: Editorial to accompany IJED Virtual Issue in honor of the 2018 International Conference on Eating Disorders.

Int J Eat Disord 2018 06 8;51(6):585-587. Epub 2018 May 8.

Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Objective: This virtual issue of the International Journal of Eating Disorders (IJED) highlights the excellent and innovative research and practice discussed at the 2018 International Conference on Eating Disorders held in Chicago, Illinois, USA.

Method And Results: The virtual issue contains a series of articles recently published in IJED, which we have curated to reflect and expand on the insights delivered during the conference keynote and plenary presentations.

Discussion: In line with the conference theme of Innovation in Research and Practice: Expanding our Community and Perspectives, we hope this collection of articles will spark new ideas for research, practice, and collaboration to accelerate knowledge on eating disorder risk factors and recovery, and the reach and impact of evidence-based treatment, prevention, and policy efforts.
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http://dx.doi.org/10.1002/eat.22881DOI Listing
June 2018

Attention to fat- and thin-related words in body-satisfied and body-dissatisfied women before and after thin model priming.

PLoS One 2018 15;13(2):e0192914. Epub 2018 Feb 15.

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

Understanding the cognitive processes underlying body dissatisfaction provides important information on the development and perpetuation of eating pathology. Previous research suggests that body-dissatisfied women process weight-related information differently than body-satisfied women, but the precise nature of these processing differences is not yet understood. In this study, eye-gaze tracking was used to measure attention to weight-related words in body-dissatisfied (n = 40) and body-satisfied (n = 38) women, before and after exposure to images of thin fashion models. Participants viewed 8-second displays containing fat-related, thin-related, and neutral words while their eye fixations were tracked and recorded. Based on previous research and theory, we predicted that body-dissatisfied women would attend to fat-related words more than body-satisfied women and would attend to thin-related words less. It was also predicted that exposure to thin model images would increase self-rated body dissatisfaction and heighten group differences in attention. The results indicated that body-dissatisfied women attended to both fat- and thin-related words more than body-satisfied women and that exposure to thin models did not increase this effect. Implications for cognitive models of eating disorders are discussed.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192914PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813977PMC
April 2018

Behavioral weight-loss treatment plus motivational interviewing versus attention control: lessons learned from a randomized controlled trial.

Trials 2017 07 25;18(1):351. Epub 2017 Jul 25.

Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.

Background: Studies evaluating the benefit of adding motivational interviewing (MI) to behavioral weight-loss programs (BWLPs) have yielded mixed findings.

Methods: The aims of this randomized controlled trial were to: (1) assess the efficacy of adding MI to a BWLP on weight loss and adherence among 135 individuals with overweight and obesity (77.8% female; mean BMI = 33.6 kg/m) enrolled in a 12-week BWLP and (2) explore levels of importance, confidence, and readiness for change ratings.

Results: Participants, who were randomized to receive two MI sessions or two attention control sessions, were assessed at baseline, the end of the BWLP, and 6 months post BWLP. Both groups decreased their weight from baseline to the end of the BWLP; however, there was no weight change in either group when measured between baseline and 6 months post BWLP. We observed no group differences in importance, confidence, and readiness for change after each session.

Conclusions: We highlight some important lessons learned from the present trial that can be applied to MI + BWLP research. Participants may not have benefited from MI because they were already highly motivated to change, which highlights the importance of pretreatment assessment. Findings also suggest that treatment monitoring may help to enhance MI + BWLP efficacy by guiding a stepped-care approach that identifies individuals for whom additional MI sessions are needed, and when. A focus on refining elements of treatment remains an important direction.

Trial Registration: ClinicalTrials.gov, Identifier: NCT02649634 . Retrospectively registered on 5 January 2016.
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http://dx.doi.org/10.1186/s13063-017-2094-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526285PMC
July 2017

Weight bias: a call to action.

J Eat Disord 2016 7;4:34. Epub 2016 Nov 7.

Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, T2N 4Z6 Calgary, AB Canada.

Weight-related issues (including excess weight, disordered eating and body concerns) are often considered as comprising distinct domains of 'obesity' and 'eating disorders'. In this commentary we argue that the concept of weight bias is an important variable when considering wellbeing across the spectrum of weight-related issues. We make the following six points in support of this argument: i) weight bias is common and has adverse health consequences, ii) shaming individuals for their body weight does not motivate positive behaviour change, iii) internalized weight bias is particularly problematic, iv) public health interventions, if not carefully thought out, can perpetuate weight bias, v) weight bias is a manifestation of social inequity, and vi) action on weight bias requires an upstream, population-level approach. To achieve sustainable reductions in weight bias at a population level, substantive modifications and collaborative efforts in multiple settings must be initiated. We provide several examples of population-level interventions to reduce weight bias.
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http://dx.doi.org/10.1186/s40337-016-0112-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100338PMC
November 2016

Future research in weight bias: What next?

Obesity (Silver Spring) 2016 06 30;24(6):1207-9. Epub 2016 Apr 30.

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

The 2015 Canadian Weight Bias Summit disseminated the newest research advances and brought together 40 experts, stakeholders, and policy makers in various disciplines in health, education, and public policy to identify future research directions in weight bias. In this paper we aim to share the results of the Summit as well as encourage international and interdisciplinary research collaborations in weight bias reduction. Consensus emerged on six research areas that warrant further investigation in weight bias: costs, causes, measurement, qualitative research and lived experience, interventions, and learning from other models of discrimination. These discussions highlighted three key lessons that were informed by the Summit, namely: language matters, the voices of people living with obesity should be incorporated, and interdisciplinary stakeholders should be included.
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http://dx.doi.org/10.1002/oby.21480DOI Listing
June 2016

A sad mood increases attention to unhealthy food images in women with food addiction.

Appetite 2016 May 9;100:55-63. Epub 2016 Feb 9.

University of Calgary, Canada. Electronic address:

Food addiction and emotional eating both influence eating and weight, but little is known of how negative mood affects the attentional processes that may contribute to food addiction. The purpose of this study was to compare attention to food images in adult women (N = 66) with versus without food addiction, before and after a sad mood induction (MI). Participants' eye fixations were tracked and recorded throughout 8-s presentations of displays with healthy food, unhealthy food, and non-food images. Food addiction was self-reported using the Yale Food Addiction Scale. The sad MI involved watching an 8-min video about a young child who passed away from cancer. It was predicted that: (1) participants in the food addiction group would attend to unhealthy food significantly more than participants in the control group, and (2) participants in the food addiction group would increase their attention to unhealthy food images following the sad MI, due to increased emotional reactivity and poorer emotional regulation. As predicted, the sad MI had a different effect for those with versus without food addiction: for participants with food addiction, attention to unhealthy images increased following the sad MI and attention to healthy images decreased, whereas for participants without food addiction the sad MI did not alter attention to food. These findings contribute to researchers' understanding of the cognitive factors underlying food addiction.
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http://dx.doi.org/10.1016/j.appet.2016.02.008DOI Listing
May 2016

Perspectives of Canadian fitness professionals on exercise and possible anorexia nervosa.

J Eat Disord 2015 17;3:40. Epub 2015 Nov 17.

Department of Psychology, University of Calgary, Calgary, Canada.

Background: Many individuals with eating disorders, including anorexia nervosa (AN), engage in overexercise. Little is known about fitness professionals' perceptions of their responsibilities when interacting with clients with possible AN. The purpose of the current study was to examine Alberta fitness professionals' experiences with clients suspected of having AN, and their views on related ethical issues. Specifically, we aimed to examine (1) their experiences with fitness clients suspected of having AN; (2) their opinions about related ethical responsibilities of fitness professionals; and (3) their views on related training and ethical issues.

Methods: We administered a 21-item online survey to 143 Canadian fitness professionals about their experiences and perspectives on encountering individuals with possible AN in exercise classes and at their exercise facilities.

Results: Sixty-two percent of respondents had encountered a client they believed had AN. Three-quarters had never received any training on managing clients with AN and felt inadequately prepared for such situations. Although most felt ethically obliged to intervene with such a client, more than two-thirds reported no relevant guidelines in their professional training.

Conclusions: Many fitness professionals are faced with clients with possible AN, have the desire to help, feel ethically obligated to take action, but do not know what course of action to take, if any. Work is needed to clarify ethical issues and related training needs for certification programs for fitness professionals regarding AN.
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http://dx.doi.org/10.1186/s40337-015-0074-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650513PMC
November 2015

The influence of impulsiveness on binge eating and problem gambling: A prospective study of gender differences in Canadian adults.

Psychol Addict Behav 2015 Sep 11;29(3):805-12. Epub 2015 May 11.

School of Public Health and Faculty of Nursing, University of Alberta.

This study investigated the degree to which facets of impulsiveness predicted future binge eating and problem gambling, 2 theorized forms of behavioral addiction. Participants were 596 women and 406 men from 4 age cohorts randomly recruited from a Canadian province. Participants completed self-report measures of 3 facets of impulsiveness (negative urgency, sensation seeking, lack of persistence), binge-eating frequency, and problem-gambling symptoms. Impulsiveness was assessed at baseline, and assessments of binge eating and problem gambling were followed up after 3 years. Weighted data were analyzed using zero-inflated negative binomial and Poisson regression models. We found evidence of transdiagnostic and disorder-specific predictors of binge eating and problem gambling. Negative urgency emerged as a common predictor of binge eating and problem gambling among women and men. There were disorder-specific personality traits identified among men only: High lack-of-persistence scores predicted binge eating and high sensation-seeking scores predicted problem gambling. Among women, younger age predicted binge eating and older age predicted problem gambling. Thus, there are gender differences in facets of impulsiveness that longitudinally predict binge eating and problem gambling, suggesting that treatments for these behaviors should consider gender-specific personality and demographic traits in addition to the common personality trait of negative urgency.
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http://dx.doi.org/10.1037/adb0000069DOI Listing
September 2015

Eye gaze tracking reveals heightened attention to food in adults with binge eating when viewing images of real-world scenes.

Appetite 2015 Aug 14;91:233-40. Epub 2015 Apr 14.

University of Calgary, Calgary, Canada. Electronic address:

Individuals with eating disorders often exhibit food-related biases in attention tasks. To assess the engagement and maintenance of attention to food in adults with binge eating, in the present study, eye gaze tracking was used to compare fixations to food among non-clinical adults with versus without binge eating while they viewed images of real-world scenes. Fifty-seven participants' eye fixations were tracked and recorded throughout 8-second presentations of scenes containing high-calorie and/or low-caloriefood items in various settings (restaurants, social gatherings, etc.). Participants with binge eating fixated on both high-calorie and low-calorie food items significantly more than controls, and this was the case when the high- and low-calorie food items were presented in the same image and in different images. Participants with binge eating also fixated on food items significantly earlier in the presentations. A time course analysis that divided each 8-second presentation into 2-second intervals revealed that participants with binge eating attended to food items more than control participants throughout the 8-second presentation. These results have implications for theory regarding the initiation and maintenance of binge eating.
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http://dx.doi.org/10.1016/j.appet.2015.04.046DOI Listing
August 2015

Change in emotion regulation during the course of treatment predicts binge abstinence in guided self-help dialectical behavior therapy for binge eating disorder.

J Eat Disord 2014 11;2(1):35. Epub 2014 Dec 11.

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta Canada.

Background: Dialectical behavior therapy (DBT), which appears to be an effective treatment for binge eating disorder (BED), focuses on teaching emotion regulation skills. However, the role of improved emotion regulation in predicting treatment outcome in BED is uncertain.

Methods: This secondary analysis explored whether change in self-reported emotion regulation (as measured by the Difficulties in Emotion Regulation Scale) during treatment was associated with abstinence from binge eating at post-treatment and 4-, 5-, and 6-month follow-up in individuals who received a guided self-help adaptation of DBT for BED. Participants were 60 community-based men and women with BED who received a self-help manual and six 20-minute support phone calls.

Results: Greater improvement in self-reported emotion regulation between pre- and post-treatment predicted abstinence from binge eating at post-treatment, 4-, 5-, and 6-month follow-up. However, some follow-up results were no longer significant when imputed data was excluded, suggesting that the effect of emotion regulation on binge abstinence may be strongest at 4-month follow-up but decline across a longer duration of follow-up.

Conclusions: This study provides preliminary support for the theoretical role played by improved emotion regulation in achieving binge eating abstinence. If this finding is replicated with larger samples, further research should identify specific techniques to help more individuals to effectively regulate their emotions over a longer duration.
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http://dx.doi.org/10.1186/s40337-014-0035-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267713PMC
December 2014

A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder.

Behav Res Ther 2013 Nov 19;51(11):723-8. Epub 2013 Aug 19.

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada. Electronic address:

This study examined the efficacy of guided self-help based on dialectical behaviour therapy (DBTgsh) for binge eating disorder (BED). Individuals (88.3% female; mean 42.8 years) were randomized to DBTgsh (n=30) or wait-list (WL; n=30). DBTgsh participants received an orientation, DBT manual, and six 20-min support calls over 13 weeks. All participants were assessed pre- and post-treatment using interview and self-report; also, DBTgsh participants were re-assessed six months post-treatment. At treatment end, DBTgsh participants reported significantly fewer past-month binge eating episodes than WL participants (6.0 versus 14.4) and significantly greater rates of abstinence from binge eating (40.0% versus 3.3%). At six-month follow-up, DBTgsh participants reported significantly improved quality of life and reduced ED psychopathology compared to baseline scores. In addition, most improvements in the DBTgsh group were maintained, although binge eating abstinence rates decreased to 30%. These preliminary positive findings indicate that DBTgsh may offer an effective, low-intensity treatment option for BED.
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http://dx.doi.org/10.1016/j.brat.2013.08.001DOI Listing
November 2013

An examination of the representativeness assumption for twin studies of eating pathology and internalizing symptoms.

Behav Genet 2013 Sep 30;43(5):427-35. Epub 2013 Jul 30.

Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.

Little research has investigated whether the twin representativeness assumption (that results from twin research generalize to singletons) holds for eating pathology and internalizing symptoms. This study compared disordered eating, depression, and anxiety among young adult female twins versus singletons. Participants included 292 twins and 997 singletons in three samples. Questionnaires included the Minnesota Eating Behavior Survey, Eating Disorder Examination Questionnaire, Beck Depression Inventory, and State-Trait Anxiety Inventory. We examined mean differences between twins' and singletons' scores, after adjusting for age, body mass index, and ethnicity. We found statistically significant mean differences on psychopathology, with twins reporting less disordered eating and internalizing symptoms compared with singletons. Effect sizes of these mean differences were small to moderate. Our results suggest that twins report less disordered eating and internalizing symptoms than singletons, which, combined with the generally small effect sizes, indicate that results from twin samples generalize to singletons.
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http://dx.doi.org/10.1007/s10519-013-9603-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955199PMC
September 2013

Psychotherapies provided for eating disorders by community clinicians: infrequent use of evidence-based treatment.

Psychother Res 2013 23;23(3):333-43. Epub 2012 Oct 23.

Psychology, University of Calgary, Calgary, Alberta T2N 1N4, Canada.

This study describes the psychological interventions used for eating disorders (EDs) by community practitioners. Of 573 clinicians we screened across Alberta, 130 (22.7%) had treated EDs; 118 (90.8%) were interviewed. Clinicians reported varied reasons for psychotherapy choice and diverse training experiences; the primary approaches used varied by education and field. The most common primary approach was eclectic (43.2%), followed by cognitive-behavior therapy (CBT; 22.9%). However, self-reported CBT clinicians used specific CBT techniques infrequently. Half of clinicians incorporated addictions-based techniques. These results indicate that ED treatment provided by community clinicians is varied and generally does not align with evidence-based practice guidelines.
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http://dx.doi.org/10.1080/10503307.2012.735377DOI Listing
February 2014

Eating disorders, substance use disorders, and impulsiveness among disordered gamblers in a community sample.

Eur Eat Disord Rev 2013 Mar 19;21(2):148-54. Epub 2012 Oct 19.

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada.

Disordered gambling and many eating disorders (EDs) involve recurrent loss of impulse control. We examined rates of specific EDs, ED psychopathology, substance use disorders, and their interrelationships with impulsiveness among community members with disordered gambling. Community-recruited adults with pathological (n = 95) or problem (n = 9) gambling (N = 104; 51% female) completed structured interviews and questionnaires. We observed high rates of substance dependence, lifetime EDs, and current ED psychopathology; 20.8% of women (vs 1.9% of men) had a DSM-IV ED, and 37.8% (vs 3.9%) had an ED according to proposed DSM-5 criteria. Although disordered gambling severity was not associated with ED diagnosis or severity of ED psychopathology, greater disordered gambling severity and an ED diagnosis were both associated with increased impulsiveness. These findings suggest that impulsiveness might constitute a common personality characteristic that underlies disordered gambling and EDs.
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http://dx.doi.org/10.1002/erv.2207DOI Listing
March 2013

Adding thin-ideal internalization and impulsiveness to the cognitive-behavioral model of bulimic symptoms.

Eat Behav 2012 Aug 3;13(3):219-25. Epub 2012 Mar 3.

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, Canada T2N 1N4.

This study evaluated the cognitive-behavioral (CB) model of bulimia nervosa and an extension that included two additional maintaining factors - thin-ideal internalization and impulsiveness - in 327 undergraduate women. Participants completed measures of demographics, self-esteem, concern about shape and weight, dieting, bulimic symptoms, thin-ideal internalization, and impulsiveness. Both the original CB model and the extended model provided good fits to the data. Although structural equation modeling analyses suggested that the original CB model was most parsimonious, hierarchical regression analyses indicated that the additional variables accounted for significantly more variance. Additional analyses showed that the model fit could be improved by adding a path from concern about shape and weight, and deleting the path from dieting, to bulimic symptoms. Expanding upon the factors considered in the model may better capture the scope of variables maintaining bulimic symptoms in young women with a range of severity of bulimic symptoms.
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http://dx.doi.org/10.1016/j.eatbeh.2012.02.007DOI Listing
August 2012

Perceptions and use of empirically-supported psychotherapies among eating disorder professionals.

Behav Res Ther 2012 Mar 3;50(3):215-22. Epub 2012 Jan 3.

Department of Psychology, University of Calgary, 2500 University Drive N.W. Calgary, Alberta T2N 1N4, Canada.

Despite growing support for the dissemination of empirically-supported treatments (ESTs), treatment providers have been slow to take up using ESTs. This study explored eating disorders (EDs) professionals' views of empirical support for psychotherapies for EDs and the role of empirical evidence in ED treatment selection. We distributed a web-based survey to members of two international organizations of ED practitioners and researchers; 402 members (32.7%) were eligible and participated. Most providers reported they used ESTs in treating EDs, but these ESTs were often folded into eclectic approaches rather than used in forms that had been evaluated in research trials. Use of ESTs and perceptions of empirical support for psychotherapies differed between participants who were and were not recently involved in research. We conclude that perceptions of available research evidence may be important to target in efforts to increase the uptake of ESTs in clinical practice and to help close the research-practice gap.
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http://dx.doi.org/10.1016/j.brat.2011.12.006DOI Listing
March 2012

Weighing in on risk factors for body dissatisfaction: a one-year prospective study of middle-adolescent girls.

Body Image 2012 Jan 9;9(1):20-30. Epub 2011 Nov 9.

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.

Body dissatisfaction is a common problem among adolescent girls that is linked to serious outcomes, including the development of eating disorders. This study tested to what degree five theorized risk factors (weight-related teasing, thin-ideal internalization, body mass index [BMI], self-esteem, and perfectionism) predicted prospective changes in body dissatisfaction. At baseline, 393 10th and 11th grade girls (M=15.8 years) completed questionnaires and had their height and weight measured. One year later, 316 participants' body dissatisfaction was reassessed (80.4% retention). Results suggested that self-esteem was the most potent risk factor, followed by BMI, when used to categorize girls into high- and low-risk groups for body dissatisfaction at follow-up. However, weight-related teasing, thin-ideal internalization, and perfectionism did not prove to be risk factors. These results suggest self-esteem and BMI are relevant variables for helping to identify middle-adolescent girls who may be at risk for subsequent increases in body dissatisfaction.
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http://dx.doi.org/10.1016/j.bodyim.2011.07.004DOI Listing
January 2012

Treatment manuals: use in the treatment of bulimia nervosa.

Behav Res Ther 2011 Nov 14;49(11):815-20. Epub 2011 Sep 14.

Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, Alberta, Canada.

As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians' most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and "eclecticism" is at odds with efforts to disseminate manuals into clinical practice.
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http://dx.doi.org/10.1016/j.brat.2011.09.002DOI Listing
November 2011