Abstract
Purpose
“Making weight” behaviors are unhealthy weight control strategies intended to reduce weight in an effort to meet weight requirements. This study aimed to examine a brief measure of making weight and to investigate the relationship between making weight and weight, binge eating, and eating pathology later in life.
Methods
Participants were veterans [N = 120, mean age 61.7, mean body mass index (BMI) 38.0, 89.2% male, 74.2% Caucasian] who were overweight/obese and seeking weight management treatment. Participants completed the making weight inventory (MWI), a measure of making weight behaviors engaged in during military service, and validated measures of eating behavior. Analyses compared participants who engaged in at least one making weight behavior (MWI+) versus those who did not (MWI−).
Results
The MWI had good internal consistency. One-third of participants were MWI+ and two-thirds were MWI−. The most frequently reported behavior was excessive exercise, reported in one-quarter of the sample, followed by fasting/skipping meals, sauna/rubber suit, laxatives, diuretics, and vomiting. MWI+ participants were significantly more likely to be in a younger cohort of veterans, to be an ethnic/racial minority, and to engage in current maladaptive eating behaviors, including binge eating, vomiting, emotional eating, food addiction, and night eating, compared to the MWI− group. Groups did not differ on BMI.
Conclusions
One-third of veterans who were overweight/obese screened positive for engaging in making weight behaviors during military service. Findings provide evidence that efforts to “make weight” are related to binge eating and eating pathology later in life. Future research and clinical efforts should address how to best eliminate unhealthy weight control strategies in military service while also supporting healthy weight management efforts.
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Data availability
The datasets generated and/or analyzed during the current study are not publicly available due to privacy protections regarding the use and distribution of VA data.
References
Bartlett BA, Mitchell KS (2015) Eating disorders in military and veteran men and women: a systematic review. Int J Eat Disord 48(8):1057–1069. https://doi.org/10.1002/eat.22454
Bodell L et al (2014) Consequences of making weight: a review of eating disorder symptoms and diagnoses in the United States Military. Clin Psychol (New York) 21(4):398–409. https://doi.org/10.1111/cpsp.12082
Das SR et al (2005) Obesity prevalence among veterans at veterans affairs medical facilities. Am J Prev Med 28(3):291–294. https://doi.org/10.1016/j.amepre.2004.12.007
Vieweg WVR et al (2007) Posttraumatic stress disorder as a risk factor for obesity among male military veterans. Acta Psychiatr Scand 116(6):483–487. https://doi.org/10.1111/j.1600-0447.2007.01071.x
Rosenberger PH et al (2011) BMI trajectory groups in veterans of the Iraq and Afghanistan wars. Prev Med 53(3):149–154. https://doi.org/10.1016/j.ypmed.2011.07.001
Wang A et al (2005) Obesity and weight control practices in 2000 among veterans using VA facilities. Obes Res 13(8):1405–1411. https://doi.org/10.1038/oby.2005.170
Cawley J, Maclean JC (2012) Unfit for service: the implications of rising obesity for US military recruitment. Health Econ 21(11):1348–1366. https://doi.org/10.1002/hec.1794
Reyes-Guzman CM et al (2015) Overweight and obesity trends among active duty military personnel: a 13-year perspective. Am J Prev Med 48(2):145–153. https://doi.org/10.1016/j.amepre.2014.08.033
Antczak AJ, Brininger TL (2008) Diagnosed eating disorders in the US Military: a 9 years review. Eat Disord 16(5):363–377. https://doi.org/10.1080/10640260802370523
Vieweg WV et al (2006) Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications. Prim Care Companion J Clin Psychiatry 8(1):25–31. https://doi.org/10.4088/pcc.v08n0104
McFarlane AC (2010) The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry 9(1):3–10
Maguen S et al (2013) The relationship between body mass index and mental health among Iraq and Afghanistan veterans. J Gen Intern Med 28(Suppl 2):S563–S570. https://doi.org/10.1007/s11606-013-2374-8
Jacobson IG et al (2009) Disordered eating and weight changes after deployment: longitudinal assessment of a large US military cohort. Am J Epidemiol 169(4):415–427. https://doi.org/10.1093/aje/kwn366
Maguen S et al (2012) Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with post-traumatic stress disorder. Womens Health Issues 22(1):e61–e66. https://doi.org/10.1016/j.whi.2011.07.010
Tanofsky-Kraff M et al (2013) Obesity and the US military family. Obesity (Silver Spring) 21(11):2205–2220. https://doi.org/10.1002/oby.20566
Breland JY et al (2017) Military sexual trauma is associated with eating disorders, while combat exposure is not. Psychol Trauma 1:1. https://doi.org/10.1037/tra0000276
Breland JY et al (2017) Military experience can influence Women’s eating habits. Appetite 118:161–167. https://doi.org/10.1016/j.appet.2017.08.009
Harrow JJ, Cordoves RI, Hulette RB (2006) Attitudes toward intentional weight loss and dietary behavior among US Army reserve soldiers during annual training. Mil Med 171(7):678–683. https://doi.org/10.7205/milmed.171.7.678
Wisbach GG et al (2018) Are navy weight management programs ensuring sailor physical readiness? An analysis at Naval Medical Center San Diego. Mil Med 183(9–10):e624–e632. https://doi.org/10.1093/milmed/usx123
Murray J et al (2017) Selected weight management interventions for military populations in the United States: a narrative report. Nutr Health 23(2):67–74. https://doi.org/10.1177/0260106017704797
Lennon RP, Oberhofer AL, McQuade J (2015) Body composition assessment failure rates and obesity in the United States Navy. Mil Med 180(2):141–144. https://doi.org/10.7205/MILMED-D-14-00231
Afari N et al (2019) Design for a cohort-randomized trial of an acceptance and commitment therapy-enhanced weight management and fitness program for Navy personnel. Contemporary Clin Trials Commun 1:1. https://doi.org/10.1016/j.conctc.2019.100408
Malkawi AM et al (2018) Dietary, physical activity, and weight management interventions among active-duty military personnel: a systematic review. Mil Med Res 5(1):43. https://doi.org/10.1186/s40779-018-0190-5
Personnel, C.o.N. (2013) Separation by reason of Physical Fitness Assessment (PFA) failure. In: MILPERSMAN 1910-170, D.o.D. Navy
Stice E et al (2017) Risk factors that predict future onset of each DSM-5 eating disorder: predictive specificity in high-risk adolescent females. J Abnorm Psychol 126(1):38–51. https://doi.org/10.1037/abn0000219
Stice E, Desjardins CD (2018) Interactions between risk factors in the prediction of onset of eating disorders: exploratory hypothesis generating analyses. Behav Res Ther 105:52–62. https://doi.org/10.1016/j.brat.2018.03.005
Steen SN, Brownell KD (1990) Patterns of weight loss and regain in wrestlers: has the tradition changed? Med Sci Sports Exerc 22(6):762–768
Kiningham RB, Gorenflo DW (2001) Weight loss methods of high school wrestlers. Med Sci Sports Exerc 33(5):810–813
Moore JM et al (2002) Weight management and weight loss strategies of professional jockeys. Int J Sport Nutr Exerc Metab 12(1):1–13
Morton JP et al (2010) Making the weight: a case study from professional boxing. Int J Sport Nutr Exerc Metab 20(1):80–85
Association AP (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, Washington
Dorflinger LM, Ruser CB, Masheb RM (2017) A brief screening measure for binge eating in primary care. Eat Behav 26:163–166. https://doi.org/10.1016/j.eatbeh.2017.03.009
Masheb RM et al (2015) High-frequency binge eating predicts weight gain among veterans receiving behavioral weight loss treatments. Obesity (Silver Spring) 23(1):54–61. https://doi.org/10.1002/oby.20931
Spitzer R, Yanovski S, Marcus M (1993) The questionnaire on eating and weight patterns-revised (QEWP-R). New York State Psychiatric Institute, New York
Barnes RD et al (2011) Comparison of methods for identifying and assessing obese patients with binge eating disorder in primary care settings. Int J Eat Disord 44(2):157–163. https://doi.org/10.1002/eat.20802
Elder KA et al (2006) Comparison of two self-report instruments for assessing binge eating in bariatric surgery candidates. Behav Res Ther 44(4):545–560. https://doi.org/10.1016/j.brat.2005.04.003
Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16(4):363–370
Fairburn C, Cooper Z (1993) The eating disorder examination. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment and treatment. Guilford Press, New York, pp 317–360
Grilo CM et al (2013) Eating disorder examination-questionnaire factor structure and construct validity in bariatric surgery candidates. Obes Surg 23(5):657–662. https://doi.org/10.1007/s11695-012-0840-8
Masheb RM, Grilo CM (2005) Emotional overeating and its associations with eating disorder psychopathology among overweight patients with Binge eating disorder. Int J Eat Disord 1:1. https://doi.org/10.1002/eat.20221
Allison KC et al (2008) The Night Eating Questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome. Eat Behav 9(1):62–72. https://doi.org/10.1016/j.eatbeh.2007.03.007
Schulte EM et al (2015) Current considerations regarding food addiction. Curr Psychiatry Rep 17(4):563. https://doi.org/10.1007/s11920-015-0563-3
Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307
Higgins DM et al (2013) Binge eating behavior among a national sample of overweight and obese veterans. Obesity 21(5):900–903. https://doi.org/10.1002/oby.20160
Bellows BK et al (2015) Healthcare costs and resource utilization of patients with binge-eating disorder and eating disorder not otherwise specified in the Department of Veterans Affairs. Int J Eat Disord 48(8):1082–1091. https://doi.org/10.1002/eat.22427
Sonneville KR et al (2016) Helpful or harmful? Prospective association between weight misperception and weight gain among overweight and obese adolescents and young adults. Int J Obes (Lond) 40(2):328–332. https://doi.org/10.1038/ijo.2015.166
Hazzard VM, Hahn SL, Sonneville KR (2017) Weight misperception and disordered weight control behaviors among US high school students with overweight and obesity: associations and trends, 1999–2013. Eat Behav 26:189–195. https://doi.org/10.1016/j.eatbeh.2017.07.001
Sonneville KR et al (2016) Weight misperception among young adults with overweight/obesity associated with disordered eating behaviors. Int J Eat Disord 49(10):937–946. https://doi.org/10.1002/eat.22565
Funding
This project was supported in part by the Veterans Affairs Health Services Research & Development (CIN 13-407) (HSR&D) Center of Innovation (COIN) Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, West Haven, CT. The content of this research is solely the responsibility of the authors and does not necessarily represent the official views of the VA or the Veterans Health Administration.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Human Studies Subcommittee at the VA Connecticut Healthcare System) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Masheb, R.M., Kutz, A.M., Marsh, A.G. et al. “Making weight” during military service is related to binge eating and eating pathology for veterans later in life. Eat Weight Disord 24, 1063–1070 (2019). https://doi.org/10.1007/s40519-019-00766-w
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DOI: https://doi.org/10.1007/s40519-019-00766-w