افزایش وزن، غذایی خویشتن داری، و غذا خوردن اختلال در سال اول دانشگاه

Abstract Objective The aims of the study were to assess whether women during the first year of college experience (1) significant weight gain; (2) a prospective relation between dietary restraint and weight gain; (3) an increase in disordered eating; and (4) a prospective relation between dietary restraint or concern about the Freshmen 15 (i.e., weight gain of 15 lbs during the freshman year of college) and disordered eating. Method Participants were 336 female students in their first year of college who completed questionnaire measures of Body Mass Index (BMI), eating disorder pathology, dietary restraint, body image, and self-esteem. Results Participants' mean weight gain was approximately 3 lbs (1.5 kg), and among those who gained weight, the mean gain was 7.32 lbs (3.3 kg). Dietary restraint in September did not predict weight change in April, but participants who lost weight reported significantly greater dietary restraint than those participants who gained weight. Eating disorder symptoms increased significantly from September to April. Dietary restraint, concern about the “Freshman 15”, and self-esteem in September uniquely predicted EDE-Q Weight and Shape Concern subscale scores in April. Discussion Female students in their first year of college gain a small but significant amount of weight, and weight gain was mostly unrelated to dietary restraint. Disordered eating increases during the first year of college and, is predicted by prospective dietary restraint and concerns about weight gain.

Extreme weight and shape concerns are implicated in the development of dieting and disordered eating behaviors, which can ultimately lead to clinical eating disorders (Garner, 1997 and Stice, 2002a). The transition to college is considered a high-risk period for the development of eating disorders (Striegel-Moore, Silberstein, & Rodin, 1986), given the notably high rates of dieting, body dissatisfaction, and disordered eating among college students (Heatherton, Nichols, Mahamedi, & Keel, 1995), the association between stress and eating disorder symptoms (Freeman and Gil, 2004 and Sassaroli and Ruggerio, 2005), and the typical onset of Bulimia Nervosa in late adolescence and early adulthood, and Anorexia Nervosa in mid-late adolescence (American Psychiatric Association, 1994). One prospective study, however, found that although body dissatisfaction increases from the senior year of high school to the first year of college, disordered eating symptoms and attitudes are established before college (Vohs, Heatherton, & Herrin, 2001). A belief that may perpetuate women's preoccupation with their weight and shape, especially during the transition to college, is the “Freshman 15” — the notion that college freshmen gain 15 lbs (6.8 kg) during their first year on campus. First year female students who are extremely concerned about their appearance may try to avoid this dreaded phenomenon by resorting to dieting or other extreme eating or exercise behaviors. Despite the seeming commonality of this belief, there are few empirical studies that document its validity. One study by Hodge, Jackson, and Sullivan (1993) found that there was no significant difference in weight among women from the beginning of the first year of college as compared with six months later. The majority of women remained the same weight during this time, and among those that gained weight, the weight gain averaged 7 lbs (3.2 kg), not 15 lbs. Graham and Jones (2002) found support for these results, showing no weight gain among freshmen during their first year of college. In this study, concern about the Freshmen 15 was related to thinking about weight gain, poor body image, categorizing self as overweight, and being at risk for disordered eating. These findings suggest that being worried about the well-known Freshmen 15 phenomenon may contribute to negative attitudes towards weight. In another small sample of college women, Megel, Wade, Hawkins, Norton and Sandstrom (1994) found that the average weight gain was only 2.5 lbs (1.1 kg) during the freshman year, similar to the mean gain of 1.73 kg during the transition from high school to college (Vohs et al., 2001). Anderson, Shapiro, and Lundgren (2003) reported a mean, significant weight gain of 1.7 kg from beginning to end of freshman year, with the majority of participants (61%) remaining within 2.3 kg of their baseline weight, 33% gaining more than 2.3 kg, and 7% losing more than 2.3 kg. Most of the weight gain occurred in the first semester and stabilized in the second semester. Notably, the proportion of participants classified as overweight or obese increased markedly by the end of the first semester, from 15.6% to 25.2% as overweight, and from 5.2% to 6.7% as obese. Similarly, Levitsky, Halbmaier, and Mrdjenovic (2004) reported a mean, significant weight gain of 1.9 kg over the course of the first semester of college. Together these studies, conducted with primarily Caucasian samples, indicate that the amount of weight gained during the freshman year may be modest but significant, especially for individuals who become overweight or obese during that time period. This risk of becoming overweight or obesity may be increased for individuals who are already at elevated weights, as research indicates that high normal weight status in childhood predicts onset of adult overweight or obesity (Field, Cook, & Gillman, 2005), and that a steeper increase in BMI over time is observed for children with a higher baseline relative weight (Rzehak & Heinrich, 2006). Another factor implicated in the risk for overweight and obesity is ethnicity, as prevalence is disproportionately high among Black, Latina, and Native-American women compared with non-Hispanic White women in the United States. The recent increase in obesity among adolescents is especially evident among non-Hispanic Blacks and Mexican-Americans (Zametkin, Zoon, Klein, & Munson, 2004). Examination of ethnic differences shows that nearly half of African-American college students are overweight or obese, gain more weight during college, and report worse dietary habits (DiGioacchino, Topping, & Sargent, 2001). Prospective research with individuals aged 18–30 indicates that weight gain is greatest among African-Americans and among less educated individuals (Burke & Bild, 1996). Unfortunately, none of the studies described above assessing weight gain in the freshman year report on potential differences across ethnic groups in weight gain or BMI. One factor that predicts prospective weight gain in a number of studies is dieting (Neumark-Sztainer et al., 2005, Stice et al., 1999 and Stice et al., 2005). Dieting has also been shown to be a consistent risk factor for binge eating and other disordered eating behaviors (Neumark-Sztainer et al., 2005, Stice, 2002a and Stice, 2002b), and it has been posited that dieting may produce weight gain by inducing binge eating (Field et al., 2003 and Stice et al., 1999). For example, Field et al. (2003) found that dieting adolescents gained significantly more weight over three years than non-dieting adolescents and dieters were significantly more likely to binge eat. Lowe et al. (2006) examined the relation between multiple types of dieting and weight gain in college freshmen, but found that no self-report measures of dietary restraint predicted weight gain, which was a mean of 2.1 kg over the course of freshman year. However, participants who said that they were currently dieting to lose weight (n = 7) gained twice as much weight (5.0 kg) as former dieters (2.5 kg) and three times as much weight as never dieters (1.6 kg). The authors suggest that dieting indicates proneness to weight gain and, therefore dieters would be expected to gain more weight prospectively, although they noted having a small sample of self-labeled dieters. It should be noted also that assessment of dietary restraint has been the subject of recent debate (see Stice et al., 2006 and Van Strien et al., 2006). Contrary to previous evidence that self-report measures of dietary restraint negatively correlate with self-reported caloric intake (e.g., Laessele et al., 1989, Stice, 2001 and van Strien et al., 1986), recent unobtrusive observational data suggest that these self-report measures are uncorrelated with actual caloric intake (Stice, Fisher, & Lower, 2004). Therefore, it remains unclear whether measures of dietary restraint, designed to assess dietary behaviors to produce weight loss and maintenance, assess intentions to restrict intake, rather than intake itself. The first objective of this study was to assess whether there is significant weight gain among women in the first year of college and whether there is differential weight gain across ethnic groups. The second purpose was to examine the prospective relation between dietary restraint and weight gain. The third purpose was to assess whether eating disorder symptoms increase during the first year of college and whether dietary restraint or concern about the Freshmen 15 at the beginning of the year is related to eating disorder symptoms reported at the end of the year. As part of this objective, the accuracy of self-reported weight was evaluated by comparing actual weight to self-reported weight in a subsample of participants. This step was essential given the research showing that although people are generally accurate at self-reporting their weight, dieters under-report their weight to a greater degree than non-dieters (McCabe et al., 2000 and Shapiro and Anderson, 2003), and the finding that dieters tend to gain more weight (Lowe et al., 2006). Additionally, overweight and obese adolescents have shown greater bias in self-reported weight than normal/underweight individuals (Elgar, Roberts, Tudor-Smith, & Moore, 2005).