Obesity is a significant public health issue in the United States, with over one-third of adults having a BMI ≥30. Young adults aged 18-35 are particularly vulnerable, often experiencing accelerated weight gain, increasing their risk for negative health outcomes. Prevention efforts are crucial, and understanding the factors influencing weight management in this group is essential.
The SNAP Trial: Preventing Weight Gain in Young Adults
The Study of Novel Approaches to Weight Gain Prevention (SNAP) trial investigated behavioral interventions to prevent weight gain in young adults. The trial compared two self-regulatory interventions: Small Changes (SC), which focused on creating a 200 kcal/day deficit, and Large Changes (LC), which aimed to facilitate a pre-emptive weight loss of 5-10 lbs. A control group (C) received self-guided advice.
Self-Weighing and Behavioral Strategies
Both the Large Changes (LC) and Small Changes (SC) conditions in the SNAP trial incorporated regular self-weighing as a key strategy within a self-regulation model. This was intended to guide the use of behavioral strategies selected to prevent weight gain. The LC group was encouraged to make dietary and physical activity changes to achieve a 5-10 pound weight loss over four months. The SC group focused on small adjustments in dietary intake to create a 100 calorie deficit daily and increase energy expenditure through lifestyle changes, aiming for a 200 calorie/day deficit. The control group attended a single session introducing both LC and SC strategies, along with daily weighing as a preventative tool, and were encouraged to choose and implement an approach.
The Role of Weight and Shape Concern (WSC)
Weight and shape concern (WSC) refers to the degree to which body weight or shape is valued as an important part of self-evaluation. While it's often assumed that concern about weight and shape would motivate weight control efforts, high WSC is linked to dysregulated weight-related behaviors and poorer weight control outcomes.
The Impact of WSC on Weight Management Outcomes
A secondary analysis of the SNAP trial explored the relationship between WSC and weight change across treatment conditions. The study aimed to:
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- Evaluate the presence and severity of WSC in a non-eating disordered cohort of young adults.
- Evaluate demographic correlates of WSC and its association with mood and eating variables.
- Evaluate the impact of baseline WSC on weight change across treatment conditions.
The hypothesis was that WSC would interact with treatment condition to predict weight outcomes over the follow-up period.
Study Participants and Procedures
Participants were young adults aged 18-35 with a BMI between 20-30.9 kg/m2 enrolled in the SNAP trial. The sample (n=599) was primarily female (78.3 %) with an average age of 27.7 years and an average BMI of 25.4 kg/m2. Participants were randomly assigned to the Large Changes (LC) condition, the Small Changes (SC) condition, or a minimal contact control condition.
Assessment of Weight and Shape Concern
Weight and Shape Concern was assessed using one item from the Eating Disorders Assessment: "During the past 6 months, has your weight or the shape of your body mattered to how you feel about yourself? Compare this to how you feel about other parts of your life-like how you get along with family and friends, and how you do at your job.” Responses ranged from "not important" to "very important."
Key Findings
- Approximately 22% of participants reported high WSC, 37% reported moderate WSC, and 41% reported low WSC.
- WSC varied by gender, with a higher percentage of women reporting high WSC.
- Individuals with high WSC gained weight in the LC condition but had better weight control outcomes in the SC condition.
- At 24 months, in the LC group, those with high WSC were unable to lose weight compared to those with lower WSC (high WSC: +0.73%, moderate: −2.74%, low: −2.41%).
- In contrast, those with high WSC in the SC group lost weight over 24 months and observed greater reductions than those with lower levels of WSC (high WSC: −2.49%, moderate: −0.60%, low:−0.71%).
Implications
The study suggests that individuals with high WSC may benefit more from interventions that focus on small, manageable changes rather than large, drastic changes. This highlights the importance of tailoring weight management strategies to individual needs and psychological factors.
Social Media and Body Image: A Growing Concern
Social media use is rapidly expanding, particularly among young adults. While social media offers benefits such as increased social interaction and peer support, it also has potential negative impacts on mental health, body image, and eating behaviors.
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The Rise of Image-Based Platforms
Social media use has increasingly shifted toward image-based platforms like Instagram and Snapchat, which disproportionately disseminate content related to appearance and weight loss. Engagement with appearance-focused content can have adverse consequences on body image.
The Impact of Weight Loss Content
Exposure to weight loss content on social media has been associated with lower body appreciation, greater fears of negative appearance evaluation, and more frequent binge eating. The frequent and varied discourse about weight on social media can contribute to body image disturbances and disordered eating behaviors.
The Role of Body Positivity and Body Neutrality
Body positivity attempts to challenge the "thin ideal" by encouraging body acceptance at all shapes and sizes. Body neutrality promotes the belief that the body is worthy of respect regardless of appearance. While some research suggests that exposure to body positive content may be associated with higher body satisfaction, its impact on eating behaviors remains unclear.
Social Media Use and Weight-Change Behaviors in Adolescents
A study investigating the association between screen time, social media use, and weight-change behaviors among adolescents found that greater screen time and social media use were associated with attempts to gain weight, lose weight, and dieting to lose weight.
Key Findings
- Greater total screen time per weekday was associated with attempts to gain weight and lose weight, and dieting to lose weight.
- Use of specific social media platforms was associated with weight-change behaviors.
- The study emphasized that a greater number of hours of screen time per weekday, as well as the use of specific social media platforms, are correlated with varying patterns of weight-change behaviors.
- The higher the number of hours of screen time, the stronger the association with attempts to change one’s weight.
Implications
The findings underscore the international pervasiveness of screen time and social media use correlating with weight-change behaviors among adolescents. This highlights the need for interventions that address the potential negative impacts of social media on body image and eating behaviors.
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SNAP and Obesity: Examining the Effects of Food Assistance Programs
The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program, providing financial resources to support food purchases for low-income individuals and families. However, the relationship between SNAP and obesity is complex and has been the subject of much debate.
The SNAP Debate
Some studies have suggested that SNAP participation may contribute to obesity, while others have found no significant association or even a protective effect. This debate is ongoing, and the evidence remains mixed.
A Study on SNAP and Obesity Among Women
A study examining the effects of SNAP on obesity among women found that the positive effect of SNAP on both obesity and body mass index (BMI) is robust to differing statistical and modeling assumptions.
Text Message Interventions and SNAP Participants
The San Diego County SNAP agency sent monthly texts to SNAP households from October 2020 to February 2021. After the intervention, participants reported a significant increase in knowing where to get information about selecting, storing, and preparing fruits and vegetables; feeling good about participating in SNAP; and thinking the CalFresh program helps them eat healthy.
Implications
SNAP can feasibly provide food and nutrition messages via text to participants. A monthly text campaign was well received by responding participants and improved some measures of their self-reported knowledge, self-efficacy, produce consumption, and perceptions of SNAP participation.