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Weight stigma is a key aspect of the lived experience of individuals with obesity, and adversely affects health. This article provides an overview of recent evidence examining links between experiences of weight stigma and weight-related behaviors and health (e.g., maladaptive eating, physical activity, stress, obesity, weight loss), including health consequences for individuals with heightened vulnerability to weight stigma (e.g., youth and people seeking bariatric surgery) and implications for clinicians working with individuals who have obesity. This literature points to weight stigma as a psychosocial contributor to obesogenic behaviors, yet the role of weight stigma in weight loss among treatment-seeking individuals has received little attention. Research priorities are identified, including the need for future studies to (a) determine the potentially predictive value of specific characteristics of weight-stigmatizing experiences for weight loss (such as the time period, interpersonal sources, and coping responses for stigma experiences), (b) identify mechanisms through which weight stigma may undermine or facilitate weight-related treatment outcomes, and (c) test strategies that can be implemented in weight management programs to reduce the negative impact of weight stigma on health behaviors. Broadly, more attention should be directed to weight stigma in the obesity field as a relevant psychosocial factor in obesity-focused prevention and treatment. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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PMID:Weight stigma as a psychosocial contributor to obesity. 3205

Although previous studies have documented spousal resemblance in health attributes, questions remain regarding the longitudinal resemblance of spouses' body mass index (BMI) and the possible formation of couple-level BMI trajectory patterns. Consequentially, we know little about how the longitudinal resemblance of spouses' BMI may link couples' varying socioeconomic experiences to their physical health outcomes in later years. Thus, the present study using prospective data from a sample of 255 couples in enduring marriages over a period of 26 years (from 1991 to 2017) examined (a) the existence of couple-level BMI trajectory patterns in mid-later years, (b) their social stratification into heterogeneous groups of couples associated with family economic hardship (FEH), and (c) differential later-life health outcomes of these groups. The results provided evidence for groups of couples with distinct BMI trajectory patterns. These groups were associated with latent groups of FEH trajectories, suggesting a persistent association between couple BMI and FEH. Couple BMI trajectory patterns were consequential for physical health consequences in later years. Two features of couple BMI trajectory patterns, severity and synchrony, were utilized to explain these associations. Taken together, the results provided evidence for a couple-level FEH-BMI-health process over the life course and emphasize the impact of severity and synchrony in couples' BMI for their health problems in later adulthood. Findings are discussed as they relate to health policies and interventions focusing on the well-being of married couples in later life, particularly the need for couple-focused obesity-related interventions and policies that mitigate economic hardship given its long-lasting health impacts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Couple BMI trajectory patterns during mid-later years: Socioeconomic stratification and later-life physical health outcomes. 3210 98

In light of increasing rates of overweight and obesity worldwide, there is a critical need for accurate self-report measures of disinhibited and restrained eating behaviors across the weight spectrum. Item response theory was used to determine whether differences in disinhibited and restrained eating between healthy weight and overweight or obese individuals were due to item bias (i.e., differential item functioning). Study 1 participants were healthy weight (n = 510) or overweight or obese (n = 304) adults recruited from the community. Study 2 participants were healthy weight (n = 778) or overweight or obese (n = 320) college students. Study 1 participants completed the Eating Disorder Examination-Questionnaire (EDE-Q), Eating Disorder Inventory-3, Dutch Eating Behaviors Questionnaire, Restraint Scale, and Three-Factor Eating Questionnaire. Study 2 participants completed the Eating Pathology Symptoms Inventory (EPSI). Items on the Restraint Scale demonstrated the most evidence for bias (60% of items), whereas the majority of other scales demonstrated low to moderate levels of item bias (17-38% of items). However, EDE-Q Restraint and EPSI Binge Eating, Cognitive Restraint, Excessive Exercise, Muscle Building, and Negative Attitudes Toward Obesity scales did not show any evidence of differential item functioning among weight groups. Participants with the same level of disordered eating responded differently to certain eating disorder self-report items due to weight-bias, rather than true between-groups differences. Nevertheless, EDE-Q Restraint, EPSI Cognitive Restraint, and EPSI Binge Eating did not exhibit any evidence of bias and are ideal for assessing restrained and disinhibited eating across the weight spectrum in both research and clinical settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Do differences between individuals who are healthy weight or overweight on self-report measures of disinhibited eating and restrained eating reflect reality or item "bias"? 3219 Oct 76

Although many facets of social status (i.e., socioeconomic status, gender, race) are fairly stable, limited work has assessed how youths' identification with their status changes over time. Subjective social status (SSS) refers to one's perception of standing or rank relative to others, and for youth status is generally in the context of society or school. The current study assessed how adolescents' SSS in American society and in their school changes and predicts health and well-being during and after high school. A total of 336 adolescents (Mage = 16.40 at Wave 1) reported their SSS at up to three time points, each 2 years apart, such that youth provided data between the 10th grade and 3 years following the transition from high school. Piecewise multilevel modeling was used, including discontinuities to assess the importance of the transition from high school. Society SSS decreased across the period, especially among youth with lower family income, youth whose parents reported lower SSS, and youth who did not attend college. School SSS was stable during high school, declined after 12th grade, and remained stable thereafter. Moderation analyses revealed that school SSS declines more consistently among female adolescents than male adolescents and Latinos relative to other ethnic groups. Lower society and school SSS were associated with more depressive symptoms and greater likelihood of obesity, highlighting the relevance of SSS for health during this important developmental transition. Results suggest declines in SSS are especially common among disadvantaged groups as they age, and that lower SSS may indicate risk for poorer health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Subjective social status and health during high school and young adulthood. 3222 95

Physiological regulation is so fundamental to survival that natural selection has greatly favored the evolution of robust regulatory systems that use both reactive and preemptive responses to mitigate the disruptive impact of biological and environmental challenges on physiological function. In good health, robust regulatory systems provide little insight into the typically hidden complex array of sensor-effector interactions that accomplish successful regulation. Numerous health disorders have been traced to defective regulatory mechanisms, and generations of scientists have worked to discover ways to correct these defects and restore normal physiological function. Despite progress, numerous chronic health disorders remain resistant to treatment, and indeed for some disorders the incidence is increasing. We propose that an individual's susceptibility to acquire certain persistent dysregulatory disorders can be traced to interindividual variation in how that individual's regulatory system responds to challenges. Preexisting reliable individual differences among regulatory systems are typically unrecognized until appropriate regulatory challenges (e.g., exposure to a drug of abuse) lead to dysregulation (e.g., drug addiction). Specific characteristics of an individual's regulatory responsiveness may include etiological factors that participate in the acquisition, escalation and maintenance of health disorders characterized by dysregulation. By appropriately challenging a healthy individual's regulatory systems to identify its underlying characteristics, it is possible to ascertain whether an individual has an elevated risk for acquiring a dysregulated health condition and thereby enable strategies designed to prevent, rather than treat, the condition. This model is applied to drug addiction, and in addition we relate this approach to other dysregulated conditions such as obesity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Individual differences in biological regulation: Predicting vulnerability to drug addiction, obesity, and other dysregulatory disorders. 3233 36

The way we process rewarding stimuli is widely held to play a key role in normal and abnormal behavior. Biased processing of food-arguably the most primal form of reward-has been strongly implicated in the obesity crisis. Paradoxically, however, existing evidence suggests that both too much and too little attention can potentially lead to overeating. Here we sought to explain this contradiction within the framework of the load theory of attention, while also elucidating the relatively understudied role of memory biases. In 3 experiments, we presented food and nonfood images as irrelevant distractors during a letter search task with high and low levels of perceptual load, followed by a forced choice recognition task. As predicted, increasing perceptual load consistently powerfully reduced distraction by food and nonfood images alike. Similarly, food images encountered under high perceptual load were less likely to be recognized in a surprise memory test. Unexpectedly, however, there was a striking absence of attentional bias to food above and beyond salient nonfood stimuli, either within-subjects or in relation to traits implicated in food-biases. By contrast, a food memory bias was consistently observed across participants, and appeared independent of attentional biases. Food memory was consistently heightened in individuals with high levels of trait disinhibition (a measure of opportunistic eating). Our findings suggest that attention and memory for food and nonfood are similarly impacted by perceptual load. We discuss implications of the load theory framework for the wider literature on food-related cognition and for real world eating behaviors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Testing a load theory framework for food-related cognition. 3240 12

How do people mentally represent distinct interpersonal threats? Across human history, interpersonal threats such as infectious disease and violence have posed powerful selection pressures. Such pressures selected for psychological systems that help identify and reduce threats posed by other people. In the case of infectious disease, psychology researchers have found that such systems respond to a variety of infection cues (e.g., rashes, swelling) as well as cues that merely resemble infection cues (e.g., birthmarks, obesity). Are such cues part of people's mental representations, and if so, are those cues unique to infection representations or are they included in representations of other threats? Using a multimethod approach, we find that when participants listed traits or drew mental representations of threat, they perceived infected and violent others to differ along threat-specific features. However, when using a data-driven, reverse correlation method that restricted participants from deliberating on and editing their representations, participants generated mental images that were similar on many of the features that both researchers and laypeople expect to distinguish infection and violence threats. These findings suggest that our understanding of threat processing may suffer from a potential disconnect between the threat cues derived from the expectations of researchers and those revealed when expectations are constrained. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:A multimethod approach to measuring mental representations of threatening others. 3246 75

Objective: Research concerning trans-disease processes aims to ascertain an underlying mechanism of several seemingly dissonant behaviors, pathological conditions, or both. The theory of reinforcer pathology posits that excessive delay discounting and the maladaptive overvaluation of a particular commodity underlie a variety of dysfunctional health behavior ranging from substance abuse to overeating and financial responsibility. The present study extends recent health behavior research by examining the extent delay discounting and food valuation correlate with engagement in a latent factor model of health and financial behaviors among healthy-weight participants and participants with obesity using the Health Behaviors Questionnaire. Method: A total of 700 participants (n = 340, body mass index [BMI] < 30; n = 360, BMI > 30 kg/m2) were recruited using Amazon Mechanical Turk. Participants completed a monetary delay discounting assessment, the Health Behaviors Questionnaire, and 2 measures of food valuation: Behavioral economic demand and the Power of Food Scale (PFS). Results: Utilizing structural equation modeling, both delay discounting and food valuation significantly correlated with engagement in health and financial behavior for both groups. The comparison of latent factors between groups indicated that participants with obesity were less likely to engage in multiple health behaviors and that these differences can be partially attributed to differences in delay discounting and food valuation. Conclusion: These results replicate previous research and further support the role of delay discounting as a trans-disease process. Given these results, trans-disease interventions, such as episodic future thinking, designed to specifically target reinforcer pathology may have a profound effect on overall functioning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:A reinforcer pathology model of health behaviors in individuals with obesity. 3295 79

Objective: Mexican American (MA) children are more likely to grow up in poverty than their non-Hispanic/Latinx white peers and are at an elevated risk for early onset obesity. The current study evaluated the effects of prenatal family- and neighborhood-level disadvantage on children's weight and weight gain from 12 months through 4.5 years of age. Maternal breastfeeding duration was evaluated as a potential mechanism underlying the relation between multilevel disadvantage and weight. Methods: Data was collected from 322 low-income, MA mother-child dyads. Women reported the degree of family socioeconomic disadvantage and breastfeeding status. Neighborhood disadvantage was evaluated with census-level metrics. Children's weight and height were measured at laboratory visits. Results: Greater prenatal neighborhood disadvantage predicted higher child Body Mass Index (BMI) at 12 months, over and above family-level disadvantage; this effect remained stable through 4.5 years. Breastfeeding duration partially mediated the effect of neighborhood disadvantage on child BMI. Breastfeeding duration predicted child BMI at all timepoints. Conclusions: Maternal prenatal residence in a neighborhood with high concentrated disadvantage may place low-income, MA children at increased risk of elevated weight status during the first few years of life. Breastfeeding duration emerged as potentially modifiable pathway through which the prenatal neighborhood impacts children's early life weight. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Multilevel prenatal socioeconomic determinants of Mexican American children's weight: Mediation by breastfeeding. 3296 98

The use of systematic dose-finding designs to develop behavioral health interventions is lacking. In contrast, drug development research consistently follows a prescribed, regulated, and iterative pathway that begins with empirically establishing optimal drug dose. Adapting dose-finding methodologies from the drug development literature offers several advantages to increasing the feasibility, efficiency, and rigor of this important intervention refining step for behavioral intervention development. This article discusses the current state of the science for dose finding within the behavioral intervention development literature. A detailed overview of one drug development dose-finding methodology (the Accelerated Biased Coin Up-and-Down design) is then presented, using our work to adapt the Prevention Plus Intervention for treatment of pediatric obesity for mHealth delivery as an example of how this design can be applied to empirically derive the dose for a behavioral intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Adapting pharmacological dose-finding designs for early phase behavioral intervention development research. 3315 25


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