Discussion
binge eating disorder, depression, weight loss, eating disorders
REGRESSION
This exploratory study examined the effect of 2 years of CR on perceived body shape and the extent that sex, BMI, changes in body fat percentage, symptoms of depression, food cravings (state), maximal oxygen consumption (VONotably, body fat percentage appeared to be an important contributor to change in the BSQ score. Further, in simple linear regression, changes in depression scores, food cravings, cardiorespiratory fitness, and stress were also correlated with change in BSQ scores. However, in multi-variate models, change in cardiorespiratory fitness and stress, and to some extent, change in food cravings, were not significant predictors. The multi-variate model with the best fit for change in BSQ score at 12 and 24 months, included: change in body fat percentage, change in depression scores, and change in food cravings. As multi-collinearity was a possibility, we reported the Condition Number (CN) for each multi-variate model. All models had a modest CN score (2.51–5.88) suggesting the possibility of multi-collinearity in some model outcomes.The current results confirm the outcomes from Phase 1 of this study, a 6-month study with various calorie restriction groups. In addition, the present analysis confirmed the findings of Dorling et al. who recently noted improvements in perceived body shape with CR during Phase 2 of CALERIE [Over the course of the study, the women tended to have a higher BSQ score (worse body perception) than men. Although the women had greater concern for body shape, the pattern of change in BSQ scores were similar between men and women. Other research suggests that women tend to be more concerned about their body shape than men [Differences in BSQ scores among men and women could potentially be due to societal pressures and expectations. Women are often told directly and indirectly that thin is ideal; men are told that being bigger and muscled is ideal [Change in body fat percentage emerged as important for change in BSQ score at both 12 and 24 months. In short, as body fat was reduced, the BSQ score was lower. These findings are not surprising as the BSQ survey targets feelings of fatness and increased confidence. Additionally, these results provide insight into why some people who are lean might engage in weight loss and restrictive behaviors as body image may improve. Other studies have shown a correlation between the BSQ or similar tests and body composition, BMI and waist measurements [We found that improvements in depression scores (i.e., reduced scores) were modestly correlated with reduced BSQ scores from 0 to 12 and 0–24 months (Food cravings also strengthened prediction of change in BSQ score individually and in multi-variate models. Food cravings has previously been defined as, “frequent, intense desires to consume a particular type of food” [We note that in the present study, change in VOSimilarly, reduction in perceived stress at 24 months was correlated with and independently predicted reduced BSQ scores. Although our study only examined healthy adults without eating disorders, stress could be a trigger for binge eating in individuals with binge eating disorder and may exacerbate poor body dissatisfaction in women with binge eating disorder [