Body shape perception in men and women without obesity during caloric restriction: a secondary analysis from the CALERIE study

Abstract

Objective To examine body shape perception in 218 adults without obesity or history of eating disorders during caloric restriction (CR). Methods Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) is a 2-year, randomized clinical trial using a 2:1 assignment (CR, 25% reduction in calories; Control, typical diet). For this secondary analysis, we examined perceived body shape using the Body Shape Questionnaire (BSQ). Analyses of BSQ scores are reported by group, over time, by sex, and by BMI. Data for body fat percentage, symptoms of depression, food cravings, maximal oxygen consumption, and stress were analyzed for their association with BSQ scores. Results Compared to control, CR reduced BSQ scores. Women tended to have greater concern with body shape than men across all measurement times. There was no difference in change in BSQ scores at 12 or 24 months between those with a BMI < 25 kg/m2 or ≥ 25 kg/m2. Change in body fat percentage was most correlated with change in BSQ score from 0 to 12 (r = 0.39) and 0–24 months (r = 0.38). For change in BSQ score, Akaike/ Bayesian information criterion (AIC/BIC) found that the model of best fit included the following three change predictors: change in body fat percentage, depression symptoms, and food cravings. For 0–12 months, AIC/BIC = 1482.0/1505.6 and for 0–24 months AIC/BIC = 1364.8/1386.5. Conclusions CR is associated with reduced concern for body shape in men and women without obesity and with no history of eating disorders. Body shape perception among this sample was complex and influenced by multiple factors. Level of evidence Level I, randomized controlled trial.

Exploring Caloric Restriction in Inpatients with Eating Disorders: Cross-Sectional and Longitudinal Associations with Body Dissatisfaction, Body Avoidance, Clinical Factors, and Psychopathology

“…Body image was assessed with the Body Shape Questionnaire (BSQ), Italian version [30], and the Body Image Avoidance Questionnaire (BIAQ), Italian version [31]. Both questionnaires were previously used with patients with EDs [32], and BSQ was used in the CALERIE study [3]. Cronbach's alpha in the sample was 0.97 for BSQ and 0.88 for BIAQ.…”

“…2 Fisher's exact test; Welch two-sample t-test. 3 Total increase in caloric intake (kcal/day) during the inpatient stay. 4 Mean weekly increase in caloric intake (kcal/day) during the inpatient stay.…”

“…CR is different from dietary restraint in that the latter refers to the cognitive control exerted over food intake but does not necessarily involve actual caloric reduction [1]. Whereas dietary restraint has been associated with body image concerns and the development of disordered eating, recent studies challenged the belief that the actual controlled reduction in food intake during CR programs would be associated with dysregulated eating and body image concerns [3]. It is important to note, however, that individuals with any psychiatric issue were excluded from studies on CR [4], and different considerations should be made for individuals who are affected by eating disorders (EDs) or are predisposed to their development.…”

“…(2) Does the current body mass and the amount of weight lost over the course of an individual's life have a role in these relationships? (3) Lastly, what are the clinical and psychopathological predictors influencing caloric intake reached after an inpatient treatment program?…”