Self‐weighing behavior in individuals with eating disorders

Pacanowski, Carly R.; Pisetsky, Emily M.; Berg, Kelly C.; Crosby, Ross D.; Crow, Scott J.; Linde, Jennifer A.; Mitchell, James E.; Engel, Scott G.; Klein, Marjorie H.; Benjamin, Lorna Smith; Grange, Daniel Le; Wonderlich, Stephen A.; Peterson, Carol B.

doi:10.1002/eat.22537

Cited by 13 publications

(9 citation statements)

References 18 publications

(43 reference statements)

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“…This finding reflects prior reports of intense obsessions and interests being a cause of excessive screen-time in autistic children (Durkin, 2010;Mazurek et al, 2012). For other participants (Elle and Brelle), echoing the prior accounts of autistic women (Brede et al, 2020), their intense obsessions with their bodies were perceived to contribute to behaviors commonly observed in adults with eating disorders (Pacanowski et al, 2016). Elle explained, "I'm obsessive about the numbers.…”

Section: Theme 2 Asd Traits and Health-related Behaviorssupporting

confidence: 69%

“This cage that I’m stuck inside”: Autistic adults’ perceptions of weight management, body weight, and body image

Healy

Pacanowski

Kennedy

et al. 2021

Autism

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Personal beliefs and attitudes about body weight and body image are important determinants of weight management practices. To inform efforts to prevent and treat obesity among autistic adults, this study examined how autistic adults perceive weight management, body weight, and body image. Eleven adults participated in semi-structured interviews. Consistent with an interpretive paradigm, an interpretative phenomenological analysis methodology was employed, resulting in four themes: (a) Mental and physical health: direct and indirect interactions, (b) ASD traits and health-related behaviors, (c) Body dissatisfaction: Unrealistic ideals and misperceptions, and (d) Sources of information. This study’s findings have several implications for research and practice. First, participants viewed overweight and obesity as just one component of a holistic perspective of health. A dynamic, bidirectional relationship between mental health and physical health, including overweight/obesity was described, leading us to posit that the promotion of mental health is crucial for the promotion of overall health among autistic adults. Second, body dissatisfaction was pervasive among participants in this sample. This finding requires future research as it may be an important target for intervention, with relevance for mental health and weight management practices. Finally, interactions with medical professionals regarding weight management were perceived to be inadequate. Lay abstract Our beliefs and feelings about our bodies and our body weight influence our weight management behaviors, such as physical activity and eating behaviors. These beliefs and feelings are largely shaped by how we interact with, and compare ourselves to, people in our lives. Due to the social traits associated with autism, autistic adults may have different perceptions of body weight, body image, and weight management than neurotypical adults. To explore this, for the first time, we interviewed 11 autistic adults. The participants’ perceptions can be summarized in four findings. First, the participants viewed overweight and obesity as just one part of their overall health. Participants described how their mental health and physical health, including overweight/obesity, were closely connected. Second, some traits related to autism made weight management difficult; for example, eating and physical activity were negatively impacted by social anxiety, sensory sensitivity, obsessiveness, and a strong desire for routine. Third, participants were generally dissatisfied with how they looked. This was primarily due to a disconnect between how they felt their body looked and how it actually looked in real life. Other people, including on social media, also negatively influenced how they perceived themselves. Fourth, and finally, participants described how they got most of their weight management-related information online. Medical professionals were frequently described as being unprepared to provide them assistance related to weight management.

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Section: Theme 2 Asd Traits and Health-related Behaviorssupporting

confidence: 69%

“This cage that I’m stuck inside”: Autistic adults’ perceptions of weight management, body weight, and body image

Healy

Pacanowski

Kennedy

et al. 2021

Autism

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“…Similar to prior work, we found self-weighing to be more frequent among those with eating disorders [ 39 ] and those with higher BMI [ 9 , 40 ]. It is important to consider that there is likely overlap between these two groups, given that individuals with a higher BMI are more likely to have an eating disorder compared to individuals of lower BMI in population-based samples [ 41 , 42 ].…”

Section: Discussionsupporting

confidence: 87%

Self-weighing among young adults: who weighs themselves and for whom does weighing affect mood? A cross-sectional study of a population-based sample

et al. 2021

Self Cite

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Background Self-weighing is widespread among young adults and is sometimes recommended by healthcare providers for weight management. The present study aims to deepen our understanding of who is frequently self-weighing among young adults, and to examine for whom self-weighing impacts mood based on weighing frequency and other eating and weight-related characteristics. Methods Survey data were collected from a large population-based sample of young adults (31.1 ± 1.6y) participating in Project EAT-IV (n = 1719). Cross-sectional data were stratified across sex and analyzed with chi-square, t-tests, and linear and logistic regressions controlling for age, ethnicity/race, education level, and income. Results Self-weighing frequency was higher among male and female young adults with a current eating disorder, those trying to lose weight or who endorsed any disordered eating behaviors or cognition, and females with higher BMI. Young adult females were significantly more likely than males to report that self-weighing impacted their mood (53% vs 27%, p < 0.05). Among both male and female young adults, there was a higher probability of participants reporting that self-weighing impacted their mood among those who were self-weighing more frequently, had higher BMI, were trying to lose weight, and endorsed disordered eating behaviors or cognitions. Conclusion Findings suggest that for many young adults, particularly females and those with weight-related concerns, self-weighing is a behavior that comes with emotional valence. The emotional consequences of self-weighing should be considered when making public health and clinical recommendations regarding the usefulness of self-weighing.

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“…The present findings suggest that frequency of weighing was not significantly related to adverse treatment outcomes, including binge-eating, percent weight loss and eating-disorder psychopathology in a clinical sample of individuals with obesity and BED. Our prospective findings add to the growing literature suggesting that self-weighing in patients with BED with comorbid obesity might not have negative effects [ 34 ], and this seems to be the case for those with and without food addiction. Importantly, studies examining individuals with other eating disorders characterized by highly restrictive eating behaviors (i.e., anorexia nervosa, bulimia nervosa) or young adult women and girls, however, have found that more frequent self-weighing is associated with greater eating-disorder psychopathology [ 34 , 35 , 36 , 37 ].…”

Section: Discussionsupporting

confidence: 68%

“…Our prospective findings add to the growing literature suggesting that self-weighing in patients with BED with comorbid obesity might not have negative effects [ 34 ], and this seems to be the case for those with and without food addiction. Importantly, studies examining individuals with other eating disorders characterized by highly restrictive eating behaviors (i.e., anorexia nervosa, bulimia nervosa) or young adult women and girls, however, have found that more frequent self-weighing is associated with greater eating-disorder psychopathology [ 34 , 35 , 36 , 37 ]. The present study also found that individuals without food addiction who weighed more often were significantly more likely to achieve 5% weight loss, suggesting some benefit to regularly weighing.…”

Section: Discussionsupporting

confidence: 68%

Examining Self-Weighing Behaviors and Associated Features and Treatment Outcomes in Patients with Binge-Eating Disorder and Obesity with and without Food Addiction

et al. 2020

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Food addiction (FA) has been linked to clinical features in binge-eating disorder (BED) and obesity. A feature of behavioral weight loss (BWL) treatment involves frequent weighing. However, little is known regarding how frequency of self-weighing and related perceptions are associated with BWL outcomes among individuals with BED and obesity stratified by FA status. Participants (n = 186) were assessed with the Eating Disorder Examination before and after BWL treatment. Mixed effects models examined FA (presence/absence) before and after (post-treatment and 6- and 12-month follow-up) treatment and associations with frequency of weighing and related perceptions (reactions to weighing, sensitivity to weight gain and shape/weight acceptance). Participants with FA reported more negative reactions to weighing and less acceptance of shape/weight throughout treatment and follow-ups, and both variables were associated with greater disordered eating at follow-ups among participants with FA. Sensitivity to weight gain decreased over time independent of FA status. Frequency of weighing was associated with a greater likelihood of achieving 5% weight loss only among those without FA. Reactions to weighing and sensitivity to weight gain are associated with FA and poorer treatment outcomes in individuals with BED and obesity. Targeting these features may improve BWL outcomes among individuals with BED, obesity and FA.

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Self‐weighing behavior in individuals with eating disorders

Cited by 13 publications

References 18 publications

“This cage that I’m stuck inside”: Autistic adults’ perceptions of weight management, body weight, and body image

“This cage that I’m stuck inside”: Autistic adults’ perceptions of weight management, body weight, and body image

Self-weighing among young adults: who weighs themselves and for whom does weighing affect mood? A cross-sectional study of a population-based sample

Examining Self-Weighing Behaviors and Associated Features and Treatment Outcomes in Patients with Binge-Eating Disorder and Obesity with and without Food Addiction

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