Publications by authors named "Rachel F Rodgers"

138 Publications

Critical measurement issues in the assessment of social media influence on body image.

Body Image 2022 Jan 12;40:225-236. Epub 2022 Jan 12.

School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia; Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Australia.

Progress towards understanding how social media impacts body image hinges on the use of appropriate measurement tools and methodologies. This review provides an overview of common (qualitative, self-report survey, lab-based experiments) and emerging (momentary assessment, computational) methodological approaches to the exploration of the impact of social media on body image. The potential of these methodologies is detailed, with examples illustrating current use as well as opportunities for expansion. A key theme from our review is that each methodology has provided insights for the body image research field, yet is insufficient in isolation to fully capture the nuance and complexity of social media experiences. Thus, in consideration of gaps in methodology, we emphasise the need for big picture thinking that leverages and combines the strengths of each of these methodologies to yield a more comprehensive, nuanced, and robust picture of the positive and negative impacts of social media.
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http://dx.doi.org/10.1016/j.bodyim.2021.12.007DOI Listing
January 2022

Demographic predictors of objectification theory and tripartite influence model constructs: The U.S. Body Project I.

Body Image 2021 Dec 28;40:182-199. Epub 2021 Dec 28.

Department of Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

We examined how demographic factors (gender, sexual orientation, racial group, age, body mass) were linked to measures of sociocultural appearance concerns derived from objectification theory and the tripartite influence model (McKinley & Hyde, 1996; Schaefer et al., 2015) among 11,620 adults. Men were less likely than women to report high body surveillance, thin-ideal internalization, appearance-related media pressures, and family pressures; did not differ in peer pressures; and reported greater muscle/athletic internalization. Both men and women expressed greater desire for their bodies to look "very lean" than to look "very thin". Compared to gay men, heterosexual men reported lower body surveillance, thin-ideal internalization, peer pressures, and media pressures. Black women reported lower thin-ideal internalization than White, Hispanic, and Asian women, whereas Asian women reported greater family pressures. Being younger and having higher BMIs were associated with greater sociocultural appearance concerns across most measures. The variation in prevalence of sociocultural appearance concerns across these demographic groups highlights the need for interventions.
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http://dx.doi.org/10.1016/j.bodyim.2021.12.012DOI Listing
December 2021

"My critical filter buffers your app filter": Social media literacy as a protective factor for body image.

Body Image 2021 Dec 27;40:158-164. Epub 2021 Dec 27.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France.

Exposure to idealized appearance images on social media is recognized as having a damaging effect on body image. Identifying and harnessing protective factors are, therefore, important research foci. Building on traditional media literacy concepts, one proposed protective factor is social media literacy, that is, the application of a critical analysis of motivations behind social media posts and the constructed, generally unrealistic nature of images, when viewing appearance-focused images on social media. This article describes theoretical models of social media literacy and current measurement approaches. In addition, it examines empirical support for a protective role for social media literacy, before considering directions for future research. It was concluded that, although there is still much that needs to be understood, there is modest preliminary support for a protective role for social media literacy, especially in girls and young women.
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http://dx.doi.org/10.1016/j.bodyim.2021.12.009DOI Listing
December 2021

Correlation between maternal eating disorder and early infant feeding regulation: a cross -sectional study.

BMC Pregnancy Childbirth 2021 Dec 20;21(1):838. Epub 2021 Dec 20.

Speech and Neurodevelopment Lab, Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.

Background: The post-partum period is a vulnerable time for mothers in terms of eating disorder symptoms and is critical for the establishment of feeding patterns in infants. This study aimed to investigate the relationships between maternal eating disorder symptoms and objective indices of feeding regulation at 3 months, as well as perceived breastfeeding self-efficacy.

Methods: A sample of n = 73 full-term mother-child dyads (44% female) participated in the study. Mothers self-reported eating disorder symptoms and breastfeeding self-efficacy and objective indices of infant feeding regulation were obtained in the home.

Results: Findings revealed the existence of relationships between higher maternal eating disorder symptoms, and objective indices of infant feeding regulation with substantial gender differences in the patterns emerging. Among mother-daughter dyads, maternal weight and shape concerns were associated with higher infant transfer volume and rate during bottle feeding. In contrast, among mother-son dyads, higher maternal eating disorder symptoms, including weight, shape, and eating concern, were associated with lower infant transfer volume and rate as well as lower levels of proficiency while taking their bottle.

Conclusion: Relationships emerged between higher maternal eating disorder symptoms and feeding regulation with substantial gender differences in these patterns. Additional research clarifying the underlying mechanisms of these associations is warranted and further efforts should be directed towards supporting mothers during the postpartum period.
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http://dx.doi.org/10.1186/s12884-021-04317-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8690522PMC
December 2021

Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model.

Appetite 2022 Feb 2;169:105833. Epub 2021 Dec 2.

Speech & Neurodevelopment Lab, Department of Communication Sciences and Disorders, Northeastern University, Boston, USA.

Background: Recent research among postpartum women has considered body image and eating attitudes as well as exclusive breastfeeding within common theoretical models. However, these efforts have so far neglected to include partner-related constructs, which constitutes an important gap. Thus, the aim of this study was to examine an integrated model of body image and eating concerns, and exclusive breastfeeding among mothers of infants six months and younger, that included partner appearance influences as well as general postpartum support.

Methods: A sample of new mothers (N = 156), aged 20-47 years, mean = 32.7 (SD = 4.7) years, reported on postpartum partner support and appearance pressures, thin-ideal internalization and body dissatisfaction, symptoms of disordered eating, depression, breastfeeding self-efficacy and exclusive breastfeeding. Path analyses were conducted to test the hypothetical model.

Results: Findings revealed that the final model was a good fit to these data. Postpartum partner support was associated with lower depression and higher breastfeeding self-efficacy, through which it was related to higher reports of exclusive breastfeeding and lower eating disorder symptoms. In addition, partner appearance pressures and thin-ideal internalization were associated with higher body dissatisfaction, and thin-ideal internalization was also related to lower breastfeeding self-efficacy.

Conclusions: Partner influences may be important to account for in models of body image and eating concerns among postpartum women, and exclusive breastfeeding, and further research on ways in which they can support mothers of young infants is warranted.
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http://dx.doi.org/10.1016/j.appet.2021.105833DOI Listing
February 2022

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls.

Nutrients 2021 Oct 27;13(11). Epub 2021 Oct 27.

School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants ( = 892; M = 12.77, = 0.74; range 11-15; 49.5% male) were randomized by school ( 8) to receive either weekly SoMe ( = 483) or control sessions (lessons as usual; 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.
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http://dx.doi.org/10.3390/nu13113825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674763PMC
October 2021

Adolescent Eating Disorder Risk and the Social Online World: An Update.

Child Adolesc Psychiatr Clin N Am 2022 Jan;31(1):167-177

University of Wisconsin, Parkside, 900 Wood Road, Advising and Career Center, Kenosha, WI 53144, USA.

The role of traditional media (television and magazines) in creating eating disorder risk has long been a topic of discussion and research, but the proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Recent research describes the relationship between Internet and social media use and eating disorders risk, with the greatest associations found among youth with high levels of engagement and investment in photo-based activities and platforms. Here, we review different types of online content and how they are relevant to eating disorders and consider the theoretical frameworks predicting relationships between Internet and social media and eating disorders, before examining the empirical evidence for the risks posed by the online content in the development and maintenance of eating disorders. We describe proeating disorder content specifically and examine the research related to it; we then consider the implications of such content, highlight directions for future research, and discuss possible prevention and intervention strategies.
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http://dx.doi.org/10.1016/j.chc.2021.09.004DOI Listing
January 2022

A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field.

Int J Eat Disord 2022 Jan 13;55(1):3-38. Epub 2021 Nov 13.

School of Psychology, Deakin University, Geelong, Victoria, Australia.

Objective: Research investigating the effects of COVID-19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature.

Method: Empirical research on COVID-19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings (n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID-19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic-related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID-19.

Results: Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during-and due to-the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at-risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID-19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective.

Discussion: Evidence for COVID-19 effects is mostly limited to participant self-report or retrospective recall, cross-sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.
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http://dx.doi.org/10.1002/eat.23640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646470PMC
January 2022

Body image and internalization of appearance ideals in Black women: An update and call for culturally-sensitive research.

Body Image 2021 Dec 5;39:313-327. Epub 2021 Nov 5.

Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA.

Extant research on body image supports sociocultural theories emphasizing the internalization of societal pressures to attain the thin-ideal, as well as other White or Eurocentric ideals that are predominant in mainstream media. While earlier research suggests that Black women are less likely to report body dissatisfaction and thin-ideal internalization compared to women of other racial backgrounds, recent studies argue that most measures of body image and appearance ideals may not be accurate assessments of body dissatisfaction for this population. In this paper, we summarize the literature over the past two decades on body image and appearance ideals among cisgender Black girls and women and discuss the applications of well-established sociocultural theories of body dissatisfaction. We additionally highlight existing gaps in culturally-sensitive theory and assessment tools and consider the benefits of applying intersectionality-informed research. We lastly propose future directions in research, assessment, and intervention to develop more culturally-sensitive approaches to identifying, assessing, and addressing body dissatisfaction among Black girls and women. This paper encourages researchers to apply culturally-sensitive and intersectionality-informed theory to improve efforts in assessing early warning signs of body dissatisfaction and developing effective interventions for this population.
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http://dx.doi.org/10.1016/j.bodyim.2021.10.005DOI Listing
December 2021

Factor structure and psychometric properties of the Muscularity-Oriented Eating Test in university women in Australia.

Int J Eat Disord 2021 11 18;54(11):1956-1966. Epub 2021 Oct 18.

Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

Objective: Toned muscularity continues to emerge as a salient aspect of women's body image. However, there is a dearth of research investigating the potentially maladaptive eating practices and related cognitions that accompany the drive for muscularity in women. This may be attributable to the limited empirical and clinical attention previously given to muscularity-oriented disordered eating and, accordingly, the lack of validated measures assessing these concerns. To address this knowledge gap, our study aimed to provide a preliminary evaluation of the factor structure and core psychometric properties of a recently developed measure of muscularity-oriented disordered eating, the Muscularity-Oriented Eating Test (MOET), in university women in Australia.

Method: Participants included 419 university women who completed the 15-item MOET and other self-report measures for validity evaluation as part of an online survey. Data from split-half samples were used to undertake an exploratory factor analysis and subsequent confirmatory factor analysis.

Results: Factor analytic results supported a briefer (12-item), one-factor scale in this sample of university women. The internal consistency reliability and validity (convergent and discriminant) of this 12-item unidimensional MOET was supported.

Discussion: Our study provides preliminary support for this modified MOET as a psychometrically sound self-report measure of muscularity-oriented disordered eating in university women in Australia, providing a useful tool for understanding maladaptive eating behaviors and cognitions concomitant to the pursuit of muscularity in this population.
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http://dx.doi.org/10.1002/eat.23621DOI Listing
November 2021

#Beautyunedited: Is labeling unedited selfies helpful for body image and mood among young women?

Body Image 2021 Dec 26;39:156-165. Epub 2021 Aug 26.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA.

Research has shown that social media content that has not been digitally altered may help support positive body image. However, the effects of adding labels to such images has received little research attention. This study compared the effects of selfies that were: edited, unedited, and unedited + labeled. A sample of 350 young women, mean age (SD) = 21.87 (2.28) years, were randomly allocated to one of three conditions and completed pre and post exposure measures of state body image and mood, as well as trait risk and protective factors. Findings revealed that participants allocated to the unedited + labeled condition reported greater increases in state appearance satisfaction as compared to those who viewed the edited selfies. In addition, participants with higher levels of social media literacy benefited most from the unedited + labeled selfies. Findings suggest that selfies bearing a label indicating that they have not been edited may be more helpful for body image among young women as comapred to edited selfies. Thus, labels could represent useful social marketing tools on social media and contribute to efforts to increase the realism of social media imagery.
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http://dx.doi.org/10.1016/j.bodyim.2021.08.001DOI Listing
December 2021

Prevalence and correlates of weight gain attempts across five countries.

Int J Eat Disord 2021 10 20;54(10):1829-1842. Epub 2021 Aug 20.

School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Objective: To determine the prevalence and correlates of weight gain attempts in a pooled sample of adults aged 18 and older from Canada, Australia, the United Kingdom, the United States, and Mexico.

Method: Data collected during 2 years (2018 and 2019) of the International Food Policy Study (N = 42,108) were analyzed. Unadjusted 12-month prevalence of weight gain attempts was estimated based on body mass index (BMI; kg/m ), weight perception, country, survey year, and sex. Logistic regression analyses were estimated to determine the sociodemographic correlates (age, race/ethnicity, education, BMI, weight perception, weight perception accuracy, and self-rated mental health) of weight gain attempts among the pooled sample stratified by sex.

Results: Men (10.4%) were significantly more likely than women (5.4%) to report weight gain attempts (p < .001). Nearly one in five (17.1%) men with a BMI in the "normal" range (≥18.5 to <25.0) reported weight gain attempts. Among both men and women, minority group identity was associated with higher odds, while older age and higher BMI category were associated with lower odds, of reporting weight gain attempts. Country differences over the two survey years showed the prevalence of weight gain attempts in 2019 (vs. 2018) was higher among women in Australia (p < .05) and men in the United States (p < .01).

Discussion: Weight gain attempts are more common among men, compared to women, across five countries, potentially reflecting the global salience of the pursuit of a muscular body.
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http://dx.doi.org/10.1002/eat.23595DOI Listing
October 2021

Digging up the dirt on "clean" dietary labels: Public health considerations and opportunities for increased Federal oversight.

Int J Eat Disord 2022 Jan 26;55(1):39-48. Epub 2021 Jul 26.

Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED), Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Background: "Clean" dietary labels are often viewed by consumers as referencing products that are minimally processed, without additives, preservatives, artificial colors, or ingredients, but may also be interpreted as vegan, gluten-free, dairy-free, "real," or "natural." Although the "clean" diet trend continues to grow in popularity, there is a lack of consensus regarding the definition and use of this terminology with a corresponding lack of regulation for such labels in the United States.

Method: This multidisciplinary scoping review examines the public health implications of the "clean" label trend and the legal and policy landscape for regulation. We report on findings from case law and legal research generated through the Westlaw database and from the U.S. Food and Drug Administration (FDA) enforcement actions and website documents to discuss options for federal- and state-level intervention to mitigate harm.

Results: One feasible avenue for change is for the FDA to provide industry guidance, disseminate public statements to debunk myths, and enforce labeling statutes to police deceptive "clean" labeling claims. We also suggest consumer-protection litigation and state-level litigation via attorneys general as alternative actions to combat the abundant misinformation associated with "clean" diets and labels.

Discussion: Although the FDA has taken some enforcement actions, these efforts are insufficient given the proliferation of "clean" label products in the marketplace and the potential for adverse impacts on public health including increased risk for disordered eating. The current unregulated, undefined landscape for "clean" dietary labels thus requires urgent action by federal authorities and state attorneys general.
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http://dx.doi.org/10.1002/eat.23585DOI Listing
January 2022

Prevalence and demographic, substance use, and mental health correlates of fasting among U.S. college students.

J Eat Disord 2021 Jul 21;9(1):88. Epub 2021 Jul 21.

Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, 550 16th Street, Box 0110, San Francisco, San Francisco, CA, 94158, USA.

Background: Fasting is an unhealthy behavior that has been frequently used as part of weight loss attempts. To date, little research has been conducted to determine the prevalence and substance use and mental health correlates of fasting among college students. Therefore, the aim of this study was to estimate the prevalence and associations between any (≥ 1 time) and regular (≥ 13 times) occurrences of fasting in the past 4 weeks and substance use and mental health correlates among a large sample of college students from 2016 to 2020.

Methods: Data from four academic survey years (2016-2020; N = 8255) of the national (USA) Healthy Minds Study were analyzed. Unadjusted prevalence of any and regular fasting by survey year and gender was estimated. Multiple logistic regression analyses were conducted to estimate the associations between any and regular fasting and the demographic (age, body mass index, race/ethnicity, sexual orientation, highest parental education), substance use (cigarette use, marijuana use, other illicit drug use, alcohol use), and mental health (depression, anxiety, eating disorder symptoms, suicidal ideation, non-suicidal self-injury) correlates.

Results: Any fasting in the past 4 weeks was common among both men (14.77%) and women (18.12%) and significantly increased from 2016 (10.30%) to 2020 (19.81%) only among men. Regular fasting significantly increased among both men and women from 2016 (men: 1.46%; women: 1.79%) to 2020 (men: 3.53%; women: 6.19%). Among men and women, both any and regular fasting in the past 4 weeks were associated with higher odds of all mental health symptoms, including a positive depression, anxiety, and eating disorder screen, suicidal ideation, and non-suicidal self-injury. Among women, but not men, any and regular fasting in the past 4 weeks were associated with higher odds of marijuana use and other illicit drug use (e.g., cocaine, ecstasy).

Conclusions: The results from this study underscore both the high and increasing prevalence of fasting among a national sample of college students, as well as the substance use and mental health symptoms associated with this behavior. Healthcare professionals both on and off campus should consider screening for fasting behaviors among college students and provide appropriate intervention when needed.
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http://dx.doi.org/10.1186/s40337-021-00443-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293526PMC
July 2021

Real beauty: Effects of a body-positive video on body image and capacity to mitigate exposure to social media images.

Br J Health Psychol 2021 Jul 18. Epub 2021 Jul 18.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.

Objective: Recent industry-created social marketing campaigns have targeted positive body image; however, research investigating the effects of such social media campaigns on body image has largely neglected non-Western English-speaking groups. This study explored the effects on body image of a video produced by Dove for a Japanese audience 'Real Beauty ID', and its capacity to modify the effects of subsequent exposure to celebrity social media images of young women.

Method: Young women from Japan (n = 568), mean age (SD) = 25.38 (3.52) years, were randomly allocated to view either the Dove Real Beauty ID video, or a control video, followed by exposure to celebrity social media images (female celebrities or landscapes). Finally, participants reported on state and trait appearance-based comparisons, thin ideal internalization, body appreciation, and media similarity scepticism.

Results: Among participants with high levels of thin ideal internalization, those who viewed the Dove Real Beauty ID video reported significantly lower satisfaction with body and facial features, as well as more negative mood (p < .05) compared with the control video. Little support emerged for the capacity of the Dove Real Beauty ID video to modify the effects of exposure to celebrity social media images, nor were these effects moderated by risk and resilience factors.

Conclusions: In sum, no usefulness emerged for the Dove Real Beauty ID video in promoting positive body image, and limited usefulness was seen in buffering the effects of exposure to celebrity social media images among Japanese young women. Given the reach of such interventions, exploring whether interventions that are culturally adapted and theoretically driven are more helpful is warranted.
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http://dx.doi.org/10.1111/bjhp.12547DOI Listing
July 2021

Compulsive exercise and vaping among a sample of U.S. College students aged 18-26 years.

Eat Weight Disord 2021 Jun 28. Epub 2021 Jun 28.

Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.

Purpose: To determine the association between compulsive exercise and vaping among college students aged 18-26 years, and to characterize the type of vaping used among participants who report compulsive exercise.

Methods: Cross-sectional, pooled data from two survey years (2018-2020; N = 2125) of the national (U.S.) Healthy Minds Study were analyzed. Compulsive exercise was measured based on number of occurrences in the past 28 days (analyzed continuously and among those who reported  ≥ 1 and ≥ 20 occurrences). Vaping was measured based on reported use in the past 30 days. Most recent type of vaping was assessed only among participants who reported vaping. Logistic regression analyses were conducted to estimate the associations between compulsive exercise and vaping, while adjusting for covariates.

Results: For every additional occurrence of compulsive exercise reported by participants, their odds of also reporting vaping increased by 5% (95% CI 1.01-1.09). Participants who reported 20 or more occurrences of compulsive exercise in the past 28 days, a clinical threshold, had 3.71 (95% CI 1.28-10.76) higher odds of vaping in the past 30 days. Among participants who endorsed vaping, nicotine vaping was the most common recent type for those who reported any (76.2%) or 20 or more (50.2%) occurrences of compulsive exercise.

Conclusion: Compulsive exercise is associated with vaping in a national, U.S. sample of college students, with nicotine vaping being the most common type used. Screening for both compulsive exercise and vaping, particularly if either is reported, among college-age young adults is necessary to implement prevention and intervention strategies.

Level Of Evidence: V, cross-sectional descriptive study.
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http://dx.doi.org/10.1007/s40519-021-01251-zDOI Listing
June 2021

Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls.

Eur Child Adolesc Psychiatry 2021 Jun 15. Epub 2021 Jun 15.

The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne, 3056, Australia.

Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls.
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http://dx.doi.org/10.1007/s00787-021-01824-4DOI Listing
June 2021

Beauty ideals, social media, and body positivity: A qualitative investigation of influences on body image among young women in Japan.

Body Image 2021 Sep 11;38:358-369. Epub 2021 Jun 11.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France. Electronic address:

Body image and eating concerns are prevalent among Japanese young women and result in part from exposure to unrealistic media imagery. In Western contexts, a growing body of research has explored the impact of social media on body image and eating disorder risk, and the potential for body positive media to mitigate these harmful effects. However, similar research in Japan is lacking. The aim of the present study was to qualitatively explore media and social media influences on body image and associated behaviors among young women in Japan, with a specific focus on body positive media content. Female university students in Japan (n = 29) participated in majority group and some individual interviews. Thematic analysis revealed four primary themes: (1) media appearance pressures: additive pressures of Japanese and Western ideals through globalization, (2) criticism of, resistance to, and negotiating appearance ideals, and (3) presence of body positivity in Japan, and (4) media as a background for interpersonal appearance pressures. High pressure towards thinness emerged, perceived as contributing to weight control behaviors that were calibrated to avoid being "unhealthy." Desire for greater body diversity in Japanese media emerged; however, findings suggest body positive messaging is scarce and mainly limited to high-profile celebrities.
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http://dx.doi.org/10.1016/j.bodyim.2021.05.001DOI Listing
September 2021

Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates.

Eat Weight Disord 2021 May 22. Epub 2021 May 22.

Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.

Purpose: To provide 5-year time trends in prevalence and demographic, substance use, and mental health correlates of compulsive exercise among a national sample of college men and women.

Methods: We analyzed 4 academic survey years (2016-2020; N = 8251) of the national (USA) Healthy Minds Study. Compulsive exercise was measured by self-report of any occurrence of "compulsive" exercise in the past 4 weeks. Unadjusted prevalence of compulsive exercise in the past 4 weeks was estimated across the 4 survey years by sex. Multiple logistic regression analyses were conducted among the pooled sample and stratified by sex to estimate the associations between compulsive exercise in the past 4 weeks and demographic, substance use, and mental health correlates.

Results: Among the pooled sample, 11% (95% confidence interval [CI] 9.60-12.42%) of men and 17% (95% CI 15.86-18.24%) of women reported compulsive exercise in the past 4 weeks. Prevalence across the 4 survey years remained stable among men and women. Higher body mass index was associated with greater odds of any compulsive exercise in the past 4 weeks among men, while any sports participation was associated with greater odds of any compulsive exercise in the past 4 weeks among women. Compulsive exercise in the past 4 weeks was associated with greater odds of all mental health symptoms and illicit drug use among men and women, and higher odds of alcohol use among women.

Conclusion: Compulsive exercise is relatively common among college men and women and is associated with substance use behaviors and poor mental health symptoms.

Level Of Evidence: V, cross-sectional descriptive study.
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http://dx.doi.org/10.1007/s40519-021-01210-8DOI Listing
May 2021

Body image concerns and intuitive eating in older women.

Appetite 2021 09 26;164:105275. Epub 2021 Apr 26.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, United States; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France.

Intuitive eating has been described as representing a positive relationship with food that can support health. However, to date, most of the extant research on intuitive eating has been conducted among young women, limiting our understanding of how intuitive eating can contribute to supporting health in aging women. This study aimed to bridge this gap by exploring body image and eating correlates of intuitive eating in older women. The hypotheses were that among older women, intuitive eating would be significantly associated with lower disordered eating, weight and shape concerns, and fewer depressive symptoms, and that an indirect relationship between BMI and intuitive eating via weight and shape concerns would exist. Community women aged 60-75 (N = 200) completed questionnaires assessing intuitive eating, disordered eating, body concern, depressive symptoms and body mass index (BMI). Higher intuitive eating global scores were associated with lower restraint, lower eating concern, lower body concern, fewer depressive symptoms, and lower BMI. An indirect relationship between BMI and intuitive eating via weight and shape concern emerged, suggesting that being preoccupied by one's appearance hinder the ability to practice intuitive eating. These results suggest that intuitive eating is associated with positive outcomes among older women and might be a useful target for interventions designed to increase healthy aging.
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http://dx.doi.org/10.1016/j.appet.2021.105275DOI Listing
September 2021

Weight Goals, Disordered Eating Behaviors, and BMI Trajectories in US Young Adults.

J Gen Intern Med 2021 09 19;36(9):2622-2630. Epub 2021 Apr 19.

Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.

Background: Community sample data indicate that weight control efforts in young adulthood may have associations with greater increases in body mass index (BMI) over time.

Objective: To determine the prospective associations between weight goals and behaviors in young adults and BMI trajectories over 15-year follow-up using a nationally representative sample.

Design: Longitudinal cohort data collected from 2001 to 2018 of the National Longitudinal Study of Adolescent to Adult Health.

Participants: Young adults aged 18-26 years old at baseline stratified by gender and BMI category.

Main Measures: Predictors: weight goals, any weight loss/maintenance behaviors, dieting, exercise, disordered eating behaviors.

Outcomes: BMI at 7- and 15-year follow-up.

Key Results: Of the 12,155 young adults in the sample (54% female, 32% non-White), 33.2% reported a goal to lose weight, 15.7% to gain weight, and 14.6% to maintain weight. In unadjusted models, all groups have higher mean BMI at 7- and 15-year follow-up. In mixed effect models, goals to lose weight in men with BMI < 18.5 (5.94 kg/m; 95% CI 2.58, 9.30) and goals to maintain weight in men with BMI ≥ 25 (0.44; 95% CI 0.15, 0.72) were associated with greater BMI increase compared to no weight goal. Engaging in disordered eating behaviors was associated with greater BMI increase in men with BMI < 18.5 (5.91; 2.96, 8.86) and women with 18.5 ≤ BMI < 25 (0.40; 0.16, 0.63). Dieting (- 0.24; - 0.41, - 0.06) and exercise (- 0.31; - 0.45, - 0.17) were associated with lower BMI increase in women with 18.5 ≤ BMI < 25. In women with BMI < 18.5, dieting was associated with greater BMI increase (1.35; 0.33, 2.37).

Conclusions: Weight control efforts may have variable effects on BMI over time by gender and BMI category. These findings underscore the need to counsel patients on the effectiveness of weight control efforts and long-term weight management.
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http://dx.doi.org/10.1007/s11606-021-06702-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390712PMC
September 2021

Cross-sectional and Longitudinal Associations between Peer Television Co-viewing and Media Internalization in Adolescent Girls and Boys.

J Youth Adolesc 2022 Jan 17;51(1):86-99. Epub 2021 Apr 17.

Bouvé College of Health Sciences, Department of Applied Psychology, Northeastern University, Boston, MA, USA.

Despite the potential of peers to reinforce cultural appearance ideals, little work on peer media co-viewing has focused on body image. This study therefore examined relationships among peer television co-viewing, perceptions of media as important appearance-related information sources, and internalization of media appearance ideals. Adolescents aged 10-14 were included (Study 1: N = 363, M (SD) = 12.30 (0.86), 56.5% female; Study 2: N = 959, M (SD) = 11.17 (1.11), 48.9% female). Evidence emerged for a positive cross-sectional relationship between peer television co-viewing and media internalization, via media credibility. However, longitudinally, among adolescents reporting frequent media-related peer conversations, peer television co-viewing was negatively associated with media credibility. Peer co-viewing and mediation may be implicated in appearance-related beliefs among adolescents.
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http://dx.doi.org/10.1007/s10964-021-01437-9DOI Listing
January 2022

Eating disorder prevalence among multiracial US undergraduate and graduate students: Is multiracial risk different than the sum of each identity?

Eat Behav 2021 04 22;41:101501. Epub 2021 Mar 22.

Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.

The number of individuals identifying as multiracial in the United States (US) has significantly increased in the past few decades, yet they are rarely the focus of study in eating disorders (ED) research. The current study is among the first to examine prevalence estimates of ED pathology across several distinct multiracial groups, to contrast prevalence estimates of ED pathology in each multiracial group with those among the corresponding monoracial identities, and to investigate these findings intersectionally with gender identity. Data from 145,379 US students, 11,433 of whom were multiracial, were collected from 199 US colleges and universities participating in the Healthy Minds Study between 2014 and 2019. Elevated ED pathology was defined as a score ≥ 2 on the SCOFF. Multiracial individuals identifying as American Indian/Alaskan Native and Hispanic/Latinx exhibited the highest prevalence estimates of elevated ED pathology (41.4% compared to 23.5% in the full sample). This group, as well as some other doubly marginalized groups (African American/Black and Hispanic/Latinx; African American/Black and Asian American/Asian), exhibited higher prevalence of elevated ED pathology than expected based on the observed prevalence estimates in their corresponding monoracial groups. Across gender identities, greater than expected prevalence estimates of elevated ED pathology were observed among multiracial individuals identifying as African American/Black and White and lower than expected prevalence estimates were observed among multiracial individuals identifying as Middle Eastern/Arab/Arab American and White. These results have important implications for understanding ED pathology in multiracial individuals and should inform intervention and treatment efforts to support individuals from these underserved groups.
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http://dx.doi.org/10.1016/j.eatbeh.2021.101501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164451PMC
April 2021

#Take idealized bodies out of the picture: A scoping review of social media content aiming to protect and promote positive body image.

Body Image 2021 Sep 30;38:10-36. Epub 2021 Mar 30.

School of Psychology and Public Health, La Trobe University, Bundoora (Melbourne), VIC, Australia.

Much evidence has highlighted detrimental effects of social media on body image, and attention has turned towards identifying content that could support and promote positive body image. This study aimed to conduct a scoping review of the emerging evidence focused on social media content that might support positive body image. A total of n = 35 studies (21 experimental) examining social media were identified along with n = 11 studies not specifically focusing on social media but with clear implications. Overall, findings suggest that images that do not portray individuals are most helpful for body image, as well as those portraying appearances diverging from appearance ideals. Our review also identifies types of social media content that have so far not been found to protect body image, and those not sufficiently evaluated. Regarding textual captions and comments, the most promising avenue involves highlighting the contrived and unrealistic nature of social media content. However, empirical data are limited and not robust. Body acceptance-related statements have so far not been found to be helpful for body image, and findings regarding the usefulness of using social marketing strategies (such as hashtags) to identify content that may be more realistic is nascent and conflicted.
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http://dx.doi.org/10.1016/j.bodyim.2021.03.009DOI Listing
September 2021

Body image flexibility and its correlates: A meta-analysis.

Body Image 2021 Jun 5;37:188-203. Epub 2021 Mar 5.

School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia; Center for Social and Early Emotional Development, Deakin University, Burwood, VIC, 3125, Australia.

Body image flexibility refers to the ability to openly experience thoughts or feelings about the body without acting on them or trying to change them. Accumulating evidence has demonstrated that body image flexibility is connected to numerous adaptive processes, and that it is sensitive to change during psychological interventions. However, a quantitative synthesis of empirical research on body image flexibility is lacking. We conducted the first meta-analysis on body image flexibility and its correlates. Sixty-two studies were included. Random effects meta-analyses were conducted on 19 psychological correlates, divided into three clusters: eating and body image disturbances, positive body-related and general psychological constructs, and general psychopathology. Meta-analyses showed inverse correlations between body image flexibility and each construct within the eating and body image disturbances cluster (rs= -.45 to -.67), and the general psychopathology cluster (rs= -.37 to -.58). Body image flexibility was positively associated with each positive psychology construct (rs = .23 - .58). Men reported higher levels of body image flexibility than women (d = 0.32). Psychological interventions were more effective than control groups at enhancing body image flexibility in randomized controlled trials (d = 0.42). Findings confirm that body image flexibility is consistently connected to indices of mental health, and that it can be enhanced during psychological interventions.
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http://dx.doi.org/10.1016/j.bodyim.2021.02.005DOI Listing
June 2021

Development and validation of the Sociocultural Influences on Fear of Fat Scale (SI-FAT).

Body Image 2021 Jun 5;37:181-187. Epub 2021 Mar 5.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA.

The stigmatization of larger bodies is omnipresent in Western society and may be associated with fear of fat, one of the core elements of body image and eating concerns. To date, while much work has focused on sociocultural influences towards thinness, parallel work exploring sociocultural influence on fear of fat is lacking. This study therefore aimed to develop and evaluate a measure of sociocultural influences on fear of fat (SI-FAT). Study 1 included N = 235 women, mean (SD) age = 19.75 (1.35) years; a subsample of whom provided additional data two-weeks later (n = 140). Exploratory factor analyses supported a four-factor structure with 4-item media, peer, family, and partner subscales. These subscales revealed excellent internal and test-rest reliability. In addition, support for convergent validity with body dissatisfaction, fear of fat, and rigid dietary control emerged. Study 2, among N = 317 women, 19.82 (SD = 1.5) years, further supported the factor structure and provided additional evidence of convergent validity with weight-based teasing, divergent validity with anti-fat attitudes, and incremental validity in the prediction of dietary restriction above and beyond anti-fat bias. Together, findings suggest that the SI-FAT is a useful tool for assessing sociocultural influences on fear of fat.
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http://dx.doi.org/10.1016/j.bodyim.2021.02.009DOI Listing
June 2021

The longitudinal relationship between family and peer teasing in young adulthood and later unhealthy weight control behaviors: The mediating role of body image.

Int J Eat Disord 2021 05 28;54(5):831-840. Epub 2021 Feb 28.

Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.

Objective: Sociocultural theories hold that family and peer weight-related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross-sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population.

Method: Data were drawn from three waves of Project EAT over a 15-year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female).

Results: Among female participants, a mediated indirect pathway emerged with family weight-related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood.

Discussion: These findings support the long-term impact of family weight-related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed.
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http://dx.doi.org/10.1002/eat.23492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119351PMC
May 2021

A qualitative investigation of Orthorexia Nervosa among U.S. college students: Characteristics and sociocultural influences.

Appetite 2021 07 20;162:105168. Epub 2021 Feb 20.

APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France. Electronic address:

Background: Current studies on Orthorexia Nervosa (ON) are predominantly correlational and have largely been conducted outside of the U.S. with little attention to cultural aspects. This study aimed to qualitatively examine ON-related attitudes and behaviors among U.S. college students, with a particular focus on exploring concerns related to healthy eating and diet quality as defined by proposed diagnostic criteria, body image concerns and disordered eating, and sociocultural influences.

Method: Eighteen women and 3 men, aged 18-23 years (M = 19.5, SD = 1.6), who had reported high levels of ON symptoms participated in individual interviews. Interviews were transcribed verbatim and examined for evidence of the proposed diagnostic criteria of ON. In addition, thematic analysis was conducted to examine concurrent body image and eating concerns, as well as sociocultural influences.

Results: The patterns of the presence of diagnostic criteria varied, with the importance of food quality, and associated severely restricted eating patterns emerging as some of the most common elements. Six themes emerged from the thematic analysis: healthy eating concerns and diet quality, frequency and nature of food-related thoughts, definitions of healthy eating and healthy foods, disordered eating and body image, interpersonal social influence, and media and other influence from the broader social context.

Discussion: The findings suggest that ON symptoms may be concurrent with, or an evolution of other eating disorder presentations. In addition, our results highlight the role of family and sociocultural factors in ON, pointing to the usefulness of examining these behaviors within sociocultural frameworks that have been successfully applied to other types of disordered eating.
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http://dx.doi.org/10.1016/j.appet.2021.105168DOI Listing
July 2021

Orthorexia nervosa, intuitive eating, and eating competence in female and male college students.

Eat Weight Disord 2021 Dec 13;26(8):2625-2632. Epub 2021 Feb 13.

APPEAR, 404 Inv, Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.

Orthorexia nervosa (ON) has emerged as a new pattern of disordered eating behaviors characterized by preoccupations related to diet quality and health concerns, rather than driven by weight and shape concerns. A growing body of cross-sectional empirical data has documented associations between orthorexia nervosa symptoms and other indicators of disordered eating. However, little attention has been paid to the potential relationship between ON symptoms and indicators of healthy eating or positive eating behaviors. The aim of the present study was therefore to evaluate the relationships between ON symptomatology and the different facets of intuitive eating and eating competence. A sample of n = 605, 19% male, college students from the USA completed an online survey assessing orthorexia nervosa behaviors, the four facets of intuitive eating, and eating competence. Overall, orthorexia nervosa behaviors were found to be associated with lower levels of positive eating attitudes and behaviors. However, among men, curvilinear convex relationships emerged for two facets of intuitive eating, Body-Food Choice Congruence and Reliance on Hunger and Satiety Cues, such that the highest levels of intuitive eating were reported by those with mid-range levels of orthorexia nervosa behaviors. Taken together, these findings suggest that broadly, patterns of eating characterized by restriction, albeit for health reasons, are associated with less positive eating behaviors particularly among women. Further work focused on evaluating how drive for a healthy diet can be associated with flexible and positive eating patterns is warranted.Level of evidence Level V descriptive cross-sectional study.
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http://dx.doi.org/10.1007/s40519-020-01054-8DOI Listing
December 2021

"Waste not and stay at home" evidence of decreased food waste during the COVID-19 pandemic from the U.S. and Italy.

Appetite 2021 05 9;160:105110. Epub 2021 Jan 9.

School of Psychology, Deakin University, Victoria, Australia.

The COVID-19 pandemic has profoundly disrupted household food purchasing and preparation, including elements identified as important drivers of household food waste. The two main aims of this study were (1) to examine changes in food waste behaviors since the start of the COVID-19 pandemic in the U.S. and Italy; and (2) to investigate potential predictors of food waste behavior, including avoidance of supermarkets, increased home cooking, and increased role of health concerns in food choices. A sample of n = 478 (79% female) individuals from the U.S., mean (SD) age = 30.51 (10.85), and n = 476 individuals from Italy, (78% female), mean (SD) age = 33.84 (12.86), completed an online survey between April 8th and April 28 2020. Just under half of respondents (49%) reported decreased food waste since the start of the pandemic. Rates were significantly higher among the U.S. sample (61.5%, n = 294) compared to the Italian sample (38%, n = 180). Controlling for the time since restrictions were introduced, age, gender, and perceived financial security, logistic regression revealed greater reduction in food waste since the beginning of the pandemic for U.S. individuals relative to participants from Italy (OR = 0.47, p < .001). In addition, increased importance of health concerns when making food choices (OR = 1.34, p < .005) as well as more frequent cooking (OR = 1.35, p < .001), and greater avoidance of supermarkets (OR = 1.15, p = .049) were associated with greater probability of less food waste. Scarcity and greater reliance on cooking may encourage individuals to reflect on food waste practices. Further research should explore how these factors may be targeted to reduce food waste beyond the pandemic.
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http://dx.doi.org/10.1016/j.appet.2021.105110DOI Listing
May 2021
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