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Objective-This study compared an objective measurement of physical activity (PA) in individuals with anorexia nervosa (AN) at low-weight, weight-restored, and post-treatment time points, and also compared PA in AN with that of healthy controls (HC).Method-Sixty-one female inpatients with AN wore a novel accelerometer (the IDEEA) which measured PA at three time points: a) low-weight, b) weight-restored, and c) one month posthospital discharge. Twenty-four HCs wore the IDEEA at one time point.Results-Inpatients with AN became more physically active than they were at low-weight at weight restoration and following treatment discharge. Post-treatment patients with AN were more physically active than HCs during the day and less active at night, which was primarily accounted for by amount of time spent on feet, including standing and walking. Greater time spent on feet during the weight-restoration time point of inpatient treatment was associated with more rapid decrease in BMI over the 12 months following treatment discharge. Fidgeting did not differ between patients and controls, did not change with weight restoration, and did not predict posttreatment weight change.Discussion-Use of a novel accelerometer demonstrated greater PA in AN than in healthy controls. PA following weight restoration in AN, particularly time spent in standing postures, may contribute to weight loss in the year following hospitalization. Keywords Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptAnorexia Nervosa (AN) is a serious psychiatric illness marked by self-starvation and overvaluation of shape and weight. There has been a longstanding interest in the role of physical activity (PA) in the etiology, maintenance, and prognosis of AN. A range of methods has been used to assess PA in AN, from subjective patient report of exercise frequency and drive to exercise, to objective devices such as accelerometers, which can quantify the frequency and duration of PA.Despite low weight, a significant subset of individuals with AN report that they engage in "excessive" or "compulsive" exercise (1), with one of the earliest clinical observations of a patient with AN by Dr. William Gull from 1868 noting that despite extremely low weight, the patient was "restless and active...it seemed hardly possible that a body so wasted could undergo the exercise which seemed agreeable"(2). This elevated level of exercise is associated with heightened psychopathology, such as depression, anxiety, and eating disorder symptomatology (3-6). Compulsive exercise during treatment is also negatively associated with improvements in eating disorder pathology by treatment discharge (3) and subjective report of compulsive exercise is associated with long-term lack of recovery from AN (7).Notwithstanding the longstanding clinical observation of heightened PA in AN, investigation of objective activity levels in patients with AN has yielded mixed results. While some studies have found that patients with AN are more active than healthy controls (8), oth...

Objective: Behavioral weight loss (BWL) programs are not sufficiently effective at promoting high levels of moderate-to-vigorous physical activity (MVPA), despite the clear health benefits of exercise and the possibility that high levels of MVPA may improve long-term weight loss. This three-arm randomized controlled trial tested the hypotheses that 1) BWL interventions with an intensive focus on exercise would result in higher amounts of MVPA and greater long-term weight loss, compared to standard BWL, and 2) among interventions with an intensive focus on exercise, outcomes would be superior when skills for exercise promotion were taught from an acceptance-based theoretical framework (which fosters willingness to accept discomfort in the service of valued behaviors), versus a traditional behavioral approach. Method: Three hundred and twenty adults with overweight/obesity received group-based BWL for induction of weight loss (Months 1–6) and were randomized to receive one of three interventions for weight loss maintenance (Months 7–18): continued standard behavioral treatment (BT), behavioral treatment with an emphasis on exercise (BT + PA), or acceptance-based treatment with an emphasis on exercise (ABT + PA). Results: MVPA and percent weight loss did not significantly differ by condition at 12 or 18 months. Participants engaging in relatively higher levels of MVPA had greater long-term weight losses compared to participants engaging in lower levels of MVPA. Conclusions: Further clinical innovations are needed so that participants in BWL programs can more readily adopt and maintain the recommended amounts of MVPA.

The changes to eating disorders, recommended by the Eating Disorders Work Group, aim to clarify existing criteria and to decrease the frequency with which individuals are assigned to the heterogeneous residual category, eating disorder not otherwise specified, which provides little clinical utility.

Summary Background Most adults with overweight/obesity participating in behavioural weight loss (BWL) programmes never achieve prescribed physical activity (PA) levels. This study examined changes in PA barriers, their relationships with accelerometer‐measured PA during and after a 12‐month BWL programme, and associations between PA barriers and participant characteristics. Methods Adults (N = 283) in a BWL programme completed the Barriers to Being Active Quiz, a 21‐item self‐report measure that assesses seven perceived PA barriers, and they wore an accelerometer for seven consecutive days at baseline and at 6 (midtreatment), 12 (end of treatment), 18 (6‐mo follow‐up), and 24 months (12‐mo follow‐up). Weight and height were measured, and demographic information was collected at baseline. Results Repeated‐measures analyses of variance (ANOVAs) revealed a significant quadratic effect of time on total PA barriers, P < .001, such that PA barriers decreased by midtreatment, remained below baseline levels by end of treatment, but increased to near‐baseline levels by follow‐up. Perceived PA barriers were negatively associated with baseline moderate‐to‐vigorous PA (MVPA), P < .001, and decreases in perceived PA barriers were related to greater MVPA at 6 (P = .004), 12 (P < .001), and 24 months (P = .007). Participants who were younger, P = .02, and white, P = .009, reported more baseline barriers. Conclusions Perceived PA barriers meaningfully decreased during BWL treatment, which in turn was associated with greater MVPA. This pattern suggests that, on average, BWL effectively addresses perceived PA barriers, which contributes to increased PA. Future research should identify interventions to maintain decreases in barriers after end of treatment.

The collection and use of demographic data in psychological sciences has the potential to aid in transforming inequities brought about by unjust social conditions toward equity. However, many current methods surrounding demographic data do not achieve this goal. Some methods function to reduce, but not eliminate, inequities, whereas others may perpetuate harmful stereotypes, invalidate minoritized identities, and exclude key groups from research participation or access to disseminated findings. In this article, we aim to (a) review key ethical and social-justice dilemmas inherent to working with demographic data in psychological research and (b) introduce a framework positioned in ethics and social justice to help psychologists and researchers in social-science fields make thoughtful decisions about the collection and use of demographic data. Although demographic data methods vary across subdisciplines and research topics, we assert that these core issues—and solutions—are relevant to all research within the psychological sciences, including basic and applied research. Our overarching aim is to support key stakeholders in psychology (e.g., researchers, funding agencies, journal editors, peer reviewers) in making ethical and socially-just decisions about the collection, analysis, reporting, interpretation, and dissemination of demographic data.

Background Few have examined nutrition literacy (i.e., capacity to process and make informed nutritional decisions) in behavioral weight loss. Nutrition literacy (NL) may impact necessary skills for weight loss, contributing to outcome disparities. Purpose The study set out to: identify correlates of NL; evaluate whether NL predicted weight loss, food record completion and quality, and session attendance; and investigate whether the relations of race and education to weight loss were mediated by NL and self-monitoring. Methods This is a secondary analysis of 6-months of a behavioral weight loss program in which overweight/obese adults (N = 320) completed a baseline measure of NL (i.e., Newest Vital Sign). Participants self-monitored caloric intake via food records. Results NL was lower for black participants (p <.001) and participants with less education (p = .002). Better NL predicted better 6-month weight loss (b = −.63, p = .04) and food record quality (r = .37, p <.001), but not food record completion or attendance (ps > 0.05). Black participants had lower NL, which was associated with poorer food record quality, which adversely affected weight loss. There was no indirect effect of education on weight loss through NL and food record quality. Conclusions Overall, results suggest lower NL is problematic for weight loss. For black participants, NL may indirectly impact weight loss through quality of self-monitoring. This might be one explanation for poorer behavioral weight loss outcomes among black participants. Additional research should investigate whether addressing these skills through enhanced treatment improves outcomes. NCT02363010.

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