Natasha Schvey | Uniformed Services University (original) (raw)

Papers by Natasha Schvey

ObjectiveLimited data suggest that the children of U.S. service members may be at increased risk ... more ObjectiveLimited data suggest that the children of U.S. service members may be at increased risk for disordered-eating. To date, no study has directly compared adolescent military-dependents to their civilian peers along measures of eating pathology and associated correlates. We, therefore, compared overweight and obese adolescent female military-dependents to their civilian counterparts along measures of eating-related pathology and psychosocial functioning.Limited data suggest that the children of U.S. service members may be at increased risk for disordered-eating. To date, no study has directly compared adolescent military-dependents to their civilian peers along measures of eating pathology and associated correlates. We, therefore, compared overweight and obese adolescent female military-dependents to their civilian counterparts along measures of eating-related pathology and psychosocial functioning.MethodAdolescent females with a BMI between the 85th and 97th percentiles and who reported loss-of-control eating completed interview and questionnaire assessments of eating-related and general psychopathology.Adolescent females with a BMI between the 85th and 97th percentiles and who reported loss-of-control eating completed interview and questionnaire assessments of eating-related and general psychopathology.ResultsTwenty-three military-dependents and 105 civilians participated. Controlling for age, race, and BMI-z, military-dependents reported significantly more binge episodes per month (p < 0.01), as well as greater eating-concern, shape-concern, and weight-concern (p's < 0.01) than civilians. Military-dependents also reported more severe depression (p < 0.05).Twenty-three military-dependents and 105 civilians participated. Controlling for age, race, and BMI-z, military-dependents reported significantly more binge episodes per month (p < 0.01), as well as greater eating-concern, shape-concern, and weight-concern (p's < 0.01) than civilians. Military-dependents also reported more severe depression (p < 0.05).DiscussionAdolescent female military-dependents may be particularly vulnerable to disordered-eating compared with civilian peers. This potential vulnerability should be considered when assessing military-dependents. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015).Adolescent female military-dependents may be particularly vulnerable to disordered-eating compared with civilian peers. This potential vulnerability should be considered when assessing military-dependents. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015).

Objective: The internalization of weight bias is associated with clinically significant eating pa... more Objective: The internalization of weight bias is associated with clinically significant eating pathology among overweight adults. However, these relationships have not yet been assessed in lean individuals, who may perceive themselves to be overweight and subsequently internalize weight bias. The aim of the present study, therefore, was to determine whether lean individuals internalize weight bias and if the internalization of weight bias among lean respondents is associated with eating pathology. Method: Participants were 197 lean (mean BMI: 22.28 ± 1.89, range 15.80-24.98) adults who completed the Weight Bias Internalization Scale (WBIS) and measures of disordered eating behaviors and attitudes via an anonymous online survey. Results: Based on convergence of responses from the EDE-Q and QEWP-R, and using DSM-5 behavioral criteria, 10% and 15% of participants were classified into a binge eating and binge/purge group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology. Bivariate correlations revealed positive associations between WBIS score and BMI, depression, and all EDE-Q subscales (restraint, eating concern, shape concern, weight concern). Logistic regressions indicated that internalized weight bias was significantly associated with binge/purge behaviors (OR = 4.67, 95% CI: 2.38-9.17, p b .001) and binge eating (OR = 2.29, 95% CI: 1.26-4.19, p b .01).

OBJECTIVE: To determine the physiological impact of exposure to weight stigma by examining alter... more OBJECTIVE:
To determine the physiological impact of exposure to weight stigma by examining alterations in salivary cortisol among lean and overweight women.

METHODS:
Participants were 123 lean and overweight adult women (mean body mass index = 26.99 [7.91] kg/m(2)). Participants' salivary cortisol was assessed both before and after either a weight stigmatizing or a neutral video. Participants completed self-report measures of mood and reactions to the video. Height and weight were obtained at the conclusion of the study.

RESULTS:
Participants in the stigmatizing condition exhibited significantly greater cortisol reactivity when compared with those in the neutral condition, irrespective of weight status (Pillai trace = 0.077; F(1,85) = 7.22, p = .009). Lean and overweight women in the stigmatizing condition were equally likely to find the video upsetting and were equally likely to report that they would rather not see obese individuals depicted in a stigmatizing manner in the media.

CONCLUSIONS:
Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women. These findings highlight the potentially harmful physiological consequences of exposure to weight stigma.

International Journal of Obesity

OBJECTIVE: To investigate the influence of a defendant's weight on simulated jurors' perceptions ... more OBJECTIVE: To investigate the influence of a defendant's weight on simulated jurors' perceptions of guilt. DESIGN AND METHODS: Participants were 471 lean and overweight adults (mean body mass index: 25.34 ± 5.91) who read a vignette describing a case of check fraud while viewing one of four images of the alleged defendant (a lean male, a lean female, an obese male or an obese female). Participants rated the defendant's culpability on a 5-point Likert scale and completed measures of anti-fat attitudes. RESULTS: Male respondents endorsed greater overall weight bias than females (F (1470) ¼ 23.815, Po0.01, Z 2 ¼ 0.048). A three-way interaction was detected between participant sex, defendant sex and defendant weight on perceptions of guilt such that when the defendant was female, male participants were significantly more likely to find her guilty if she was obese than if she was lean (guilt ratings ¼ 4.05±0.83; 3.31±1.03, respectively; F(1467) ¼ 5.935, P ¼ 0.015, R 2 ¼ 0.060). In addition, lean male participants were significantly more likely to believe that the obese female defendant met criteria for check fraud, and indicated greater belief she would be a repeat offender, compared with the lean female defendant (t(90) ¼ 2.081, P ¼ 0.040; t(90) ¼ 2.395 P ¼ 0.019, respectively). There were no differences in perceptions of guilt or responsibility between the obese male and the lean male defendants.

Annual Review of Clinical Psychology, Jan 1, 2012

There is a pressing need to reduce both the prevalence and impact of obesity. This review begins ... more There is a pressing need to reduce both the prevalence and impact of obesity. This review begins with a discussion of the roles of treatment and prevention. Two overriding issues, weight bias and the addictive nature of food, are covered because of their importance not only to the individuals affected but also to public policy. We then cover promising policy areas in which changes can be implemented to support healthy behaviors: school policy, food marketing, food labeling and packaging, and taxes on unhealthy foods. The roles of the food industry and federal, state, and local governments are also discussed. 405 Annu. Rev. Clin. Psychol. 2012.8:405-430. Downloaded from www.annualreviews.org by Yale University -SOCIAL SCIENCE LIBRARY on 09/10/12. For personal use only.

Advances in Eating Disorders: Theory, Research and Practice

Journal of Adolescent Health

To examine the relationships between cognitive eating restraint and both bone mineral density (BM... more To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents.One hundred thirty-seven overweight (BMI 39.1 ± 6.8 kg/m2) African American and Caucasian adolescent (age = 14.4 ± 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured.After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (β = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (β = −.15, p < .05). Dietary restraint was not a significant predictor in any of these models.These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.

Virtual Mentor, Jan 1, 2010

Appetite

Eating in the absence of hunger (EAH), studied in the context of laboratory paradigms, has been a... more Eating in the absence of hunger (EAH), studied in the context of laboratory paradigms, has been associated with obesity and is predictive of excess weight gain in children. However, no easily administered questionnaire exists to assess for EAH in children.We developed an Eating in the Absence of Hunger Questionnaire to be administered to children and adolescents (EAH-C) and examined psychometric properties of the measure.Two-hundred and twenty-six obese (BMI ≥ 95th percentile for age and sex, n = 73) and non-obese (BMI < 95th percentile, n = 153) youth (mean age ± S.D., 14.4 ± 2.5 y) completed the EAH-C and measures of loss of control and emotional eating, and general psychopathology. Temporal stability was assessed in a subset of participants.Factor analysis generated three subscales for the EAH-C: Negative Affect, External Eating, and Fatigue/Boredom. Internal consistency for all subscales was established (Cronbach's alphas: 0.80–0.88). The EAH-C subscales had good convergent validity with emotional eating and loss of control episodes (p's < 0.01). Obese children reported higher Negative Affect subscale scores than non-obese children (p ≤ 0.05). All three subscales were positively correlated with measures of general psychopathology. Intra-class correlation coefficients revealed temporal stability for all subscales (ranging from 0.65 to 0.70, p's < 0.01). We conclude that the EAH-C had internally consistent subscales with good convergent validity and temporal stability, but may have limited discriminant validity. Further investigations examining the EAH-C in relation to laboratory feeding studies are required to determine whether reported EAH is related to actual energy intake or to the development of excess weight gain.

International Journal of Eating Disorders

ObjectiveInterpersonal psychotherapy (IPT) is effective at reducing binge episodes and inducing w... more ObjectiveInterpersonal psychotherapy (IPT) is effective at reducing binge episodes and inducing weight stabilization in obese adults with binge eating disorder.Interpersonal psychotherapy (IPT) is effective at reducing binge episodes and inducing weight stabilization in obese adults with binge eating disorder.MethodWe piloted the administration of IPT to girls at-risk for excess weight gain (BMI 75th–97th percentile; IPT-WG) with and without loss of control (LOC) eating. Thirty-eight girls (12–17 years) were randomized to IPT-WG or a standard-of-care health education group.We piloted the administration of IPT to girls at-risk for excess weight gain (BMI 75th–97th percentile; IPT-WG) with and without loss of control (LOC) eating. Thirty-eight girls (12–17 years) were randomized to IPT-WG or a standard-of-care health education group.ResultsAll 38 girls completed the programs and all follow-up visits through 6 months. Thirty-five of 38 returned for a complete assessment visit at 1 year. Among girls with baseline LOC (n = 20), those in IPT-WG experienced greater reductions in such episodes than girls in health education (p = .036). Regardless of LOC status, over 1 year girls in IPT-WG were less likely to increase their BMI as expected for their age and BMI percentile (p = .028).All 38 girls completed the programs and all follow-up visits through 6 months. Thirty-five of 38 returned for a complete assessment visit at 1 year. Among girls with baseline LOC (n = 20), those in IPT-WG experienced greater reductions in such episodes than girls in health education (p = .036). Regardless of LOC status, over 1 year girls in IPT-WG were less likely to increase their BMI as expected for their age and BMI percentile (p = .028).DiscussionIPT-WG is feasible and acceptable to adolescent girls at-risk for adult obesity and may prevent excess weight gain over 1 year. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:701–706IPT-WG is feasible and acceptable to adolescent girls at-risk for adult obesity and may prevent excess weight gain over 1 year. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:701–706

… Journal of Eating …, Jan 1, 2009

ObjectiveLimited data suggest that disordered-eating may predispose children to excessive weight ... more ObjectiveLimited data suggest that disordered-eating may predispose children to excessive weight gain. We investigated the relationship between baseline responses to the Eating Disorder Examination adapted for Children (ChEDE) and change in BMI (kg/m2) in children at high risk for adult obesity.Limited data suggest that disordered-eating may predispose children to excessive weight gain. We investigated the relationship between baseline responses to the Eating Disorder Examination adapted for Children (ChEDE) and change in BMI (kg/m2) in children at high risk for adult obesity.MethodChildren (6–12 years) were administered the ChEDE to assess loss of control (LOC) eating, dietary restraint, and eating, shape, and weight concern. Height and weight were measured at baseline and annually.Children (6–12 years) were administered the ChEDE to assess loss of control (LOC) eating, dietary restraint, and eating, shape, and weight concern. Height and weight were measured at baseline and annually.ResultsBetween July, 1999, and August, 2007, 772 measurements were obtained from 143 children over 4.5 ± 1.9 years. LOC eating predicted an increased rate of BMI growth over time (p = .02). Compared with children without LOC, those reporting LOC gained an additional mean 2.4 kg of weight per year.Between July, 1999, and August, 2007, 772 measurements were obtained from 143 children over 4.5 ± 1.9 years. LOC eating predicted an increased rate of BMI growth over time (p = .02). Compared with children without LOC, those reporting LOC gained an additional mean 2.4 kg of weight per year.ConclusionLOC is a salient predictor of weight gain during middle childhood. Interventions that decrease LOC eating should be evaluated for their ability to prevent excessive pediatric weight gain. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009LOC is a salient predictor of weight gain during middle childhood. Interventions that decrease LOC eating should be evaluated for their ability to prevent excessive pediatric weight gain. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009

American Journal of …, Jan 1, 2009

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