A Collaborative University Model for Employee Wellness

Abstract

Universities are taking a more active approach in understanding and monitoring employees’ modifiable health risk factors and chronic care conditions by developing strategies to encourage employees to start and sustain healthy behaviors. WellBama, the University of Alabama's signature health and wellness program, utilizes a collaborative model in partnership with select colleges and departments to implement strategies to improve employees’ health status. The program provides onsite health screenings and assessments, timely health advising sessions, assistance in setting and monitoring individual health goals to promote improved health, and preventive examination referrals.     

Freshmen Women and the “Freshman 15”: Perspectives on Prevalence and Causes of College Weight Gain

Abstract

Objective: Freshman weight gain has been assessed using quantitative inquiry, but this qualitative study allowed for an in-depth exploration of freshmen women's experiences surrounding body image, nutrition, and exercise. The purpose of this study was to better understand the impact and explanations for the “Freshman 15.” Participants: Freshmen college women, aged 18 to 19 years. Methods: Participants (N = 235) were initially surveyed about body dissatisfaction. Thirty participants were selected for semistructured interviews (conducted in March 2008) using a criterion-based, multilevel stratified random sampling. Results: Freshmen women reported intense fears about gaining weight. Women most commonly attributed freshman weight gain to newly found food independence, social comparison with peers, and the influence of friends and family. Women frequently cited eating habit changes to explain college weight gain. Conclusions: Comparison among females was framed using Festinger's social comparison theory. Despite being cautious about food, females described freshman weight gain as inevitable.     

The Freshman 15: Is it Real?

Objective: The belief that college students gain 15 Ibs during freshman year is widespread, yet the evidence for this is limited. The authors aimed to determine whether college students gain weight during freshman year. Participants: The authors studied unmarried freshmen living on-campus at a private university in the northeastern United States. Methods: The authors used an online survey to collect information about social behaviors and weight. Results: The authors observed an average weight gain of 2.7 Ibs. About half of the students gained weight, and 15% lost weight. Men gained more weight than did women. Conclusions: Freshman weight gain was 5.5 times greater than that experienced by the general population.     

Eating and Exercise Disorders in Young College Men

Abstract

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.     

Characteristics of the Female Athlete Triad in Collegiate Cross-Country Runners

The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. Objective and Participants: The author's purpose in this study was to examine female cross-country runners' (N = 300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual dysfunction. Methods: The author used measures including the Orientation to Exercise Questionnaire, Calcium Rapid Assessment Method, and questions related to height, weight, exercise time, perceptions of eating disorders, and menstrual status. Previous or current eating disorders were reported by 19.4% of the women, 23.0% had irregular menstrual cycles, and 29.1% had inadequate calcium intake. Results: Those athletes perceiving a previous/current eating disorder scored higher on the Orientation to Exercise questionnaire than did those who did not perceive such. Conclusion: The author recommends educational efforts for the prevention of components of the Female Athlete Triad.     

The Critical Shapes of Body Image: The Role of Culture and Family in the Production of Eating Disorders

Although research has pointed to the influence of culture and family in the etiology of eating disorders, few studies have examined how these influences conjoin in this process. This research explores how the family mediates cultural ideas about thinness and how the family conveys these messages to family members. Using a grounded theory approach, open‐ended interviews were conducted with 32 White, middle‐class women (with and without eating disorders) on the topic of body image and eating problems. In conjunction with this method, qualitative comparative analysis (QCA) was also performed to identify family characteristics, and their specific combinations, that were associated with eating disorders. The findings indicate that a critical family environment, coercive parental control, and a dominating discourse on weight in the household are salient conditions, and their specific configurations are discussed in relationship to current theoretical conceptualizations regarding the influences of culture and family in the production of eating disorders.     

The Relationship Between Romantic Partner Support Styles and Body Image Disturbance

ABSTRACT

American women have long been affected by perceptions of beauty being described as the thin female idealizing standards far below the standards for what is considered the ideal body weight. Women have also been strongly influenced by their partners and the opinions that are expressed. To explore this concept further, 170 females were assessed to determine whether romantic partner social support could be a predictor of female body image and eating disturbances. Of the 117 participants that met full criteria for the project, the measures for figure rating preferences, eating disturbance, and body image dissatisfaction were investigated. Along with these indicators, intimate bonding, self-esteem, stress, general social support, and romantic partner support were also collected. Statistical results supported that higher body image dissatisfaction was inversely related to the perception of lower levels of romantic partner support. In addition, esteem support was predictive of female body image disturbance, with no support style being predictive of female eating disturbance. Therefore, findings in this study highlight that receiving support from a romantic partner and general support from other intimates can be directly related to report levels of body image disturbance and anxiety associated with physical appearance. Results are presented to assist evidence-based practice efforts stressing the need to identify and foster all possible types of supportive communication used within intimate relationships.     

Are there differences in gender,race, and age regarding body dissatisfaction?

ABSTRACT

The purpose of this study was to examine any differences that may exist among demographic variables such as gender, age, and race in regard to internalization of society and media messages leading to body dissatisfaction that may lead to disordered eating behaviors such as preoccupation with weight, dieting, and eating restraint. A total of 324 participants completed the demographic questionnaire, the Multidimensional Body Self Relations Questionnaire, the Sociocultural Attitudes Towards Appearance Questionnaire for women, the Sociocultural Attitudes Towards Appearance Questionnaire-Revised-Male-Version for men, and Rotter’s Internal-External (I-E) Locus of Control Scale. The results of this study found, as predicted, that Caucasians reported higher internalization, higher body dissatisfaction, and higher preoccupation with weight, dieting, and eating restraint than African Americans. This study showed no differences regarding men’s and women’s internalization or body dissatisfaction but did reveal that women reported higher preoccupation with weight, dieting, and eating restraint than men. Regarding age, this study found that age did not predict internalization, body dissatisfaction, or preoccupation with weight, dieting, and eating restraint.     

Energy Drinks,Weight Loss,and Disordered Eating Behaviors

Abstract

Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association–National College Health Assessment II confidentially online during February 2012. Results: This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant. Conclusions: The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss.     

The ‘Freshman 5’: A Meta-Analysis of Weight Gain in the Freshman Year of College

Abstract

Objective: (1) To use the available research to estimate the amount of weight gained by college freshman during their first year of college. (2) To identify potential predictors of freshman weight gain. Methods: A meta-analysis was conducted in November 2008. The analysis focused on articles published in English scientific journals between 1985 and 2008 available on the MEDLINE, Web of Science, and PsycINFO databases and excluded studies of weight change over periods beyond freshman year. Results: Twenty-four studies met the inclusion criteria. Based on a pooled sample of 3,401 cases, mean weight gain was 3.86 (95% confidence intervals [CI] = 3.81–3.91) lbs. Potential contributors to gain were recent dieting, high baseline weight, and psychological stress. Conclusions: The first year of college is a period of vulnerability for weight problems. Further research is needed to better understand freshman weight gain and devise appropriate prevention strategies based on predictors of gain.     

Longitudinal changes in anthropometry and body composition in university freshmen

Objective: We investigated predictors of weight gain in college freshmen. Participants: A longitudinal cohort study followed a representative sample of freshmen (N = 264) from 8/2011 to 6/2012. Methods: Repeated measurements of anthropometry, dual-energy X-ray absorptiometry (DXA), physical activity, and diet were collected. We investigated predictors of 9-month weight gain using regression models. Results: 172 participants completed follow-up: 75% gained >0.5 kg. Mean weight change was +2.3 kg (SD 3.2) and +2.0 kg (SD 3.2) and mean adiposity change was +1.3% (SD 1.6) and +0.7% (SD 2.2) in men and women, respectively. In participants gaining >0.5 kg, weight increased 5.6% and body fat increased 1.6%. Anthropometric change in men occurred in the first semester, while women increased in both semesters. Leaner DXA-defined body composition at baseline was consistently associated with greater weight gain (p-values 0.029–0.049). Conclusions: Freshman weight gain is common and reflects increased adiposity. Leaner body composition at the beginning of college predicted greater weight gain in men and women during the first year of college.     

Behavior Change and the Freshman 15: Tracking Physical Activity and Dietary Patterns in 1st-Year University Women

Objective and Participants: The authors assessed the stability of diet and physical activity and their relationship to weight changes in first-year university women. Methods: They collected anthropometric and body composition data from 101 resident women at the beginning of their first year of college and again at 12 months. The authors obtained physical activity and dietary logs 4 times throughout the year. Results: Caloric intake decreased over 12 months in all participants (p = .01). There was little change in physical activity in participants who lost weight (p = .73, d = .18). Those who gained weight experienced a trend toward decreased physical activity (p = .13, d = .38). A significant Time X Group interaction on physical activity (p = .04) suggests that physical activity patterns differed substantially between individuals who gained weight and those who lost weight. Conclusions: Reduction in physical activity appears to be the defining characteristic in freshman weight gain.     

The College Health Advisor and the College Age Adoptee

Abstract

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

Appropriate Terminology for the Alcohol,Eating, and Physical Activity Relationship

Abstract

“Drunkorexia” merges prior literature identifying positive relationships between (a) alcohol use/abuse and disordered eating/eating disorders, (b) alcohol use/abuse and physical activity, and (c) disordered eating/eating disorders and physical activity. The term, highlighting an individual's proactive and/or reactive weight management behaviors (ie, disordered eating, physical activity) in relation to alcohol consumption, originated in news editorials and has recently gained recognition via use in scholarly publications. The purpose of this commentary is to recommend discontinuing use of the term “drunkorexia” due to (a) inconsistent definitions of drunkorexia across investigations, (b) drunkorexia being a misnomer, and (c) the medical community's lack of recognition/acceptance of drunkorexia. Because the behaviors encompassed by drunkorexia are of concern to researchers and health professionals, future investigations are still warranted. However, until a medically recognized term/phrase is accepted, scholars should utilize more appropriate characterizations such as “weight-conscious drinkers,” “weight management behaviors of drinkers,” or “Eating Disorders Not Otherwise Specified” (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision).     

Eating Disorders and Body Image of Undergraduate Men

Eating disorders and body dissatisfaction among undergraduate men are less documented and researched than are eating disorders and body dissatisfaction among undergraduate women. Objective and Participants: In this study, the authors examined these issues in undergraduate men to identify similarities and differences between this population and undergraduate women. Methods: In a random sample of undergraduates, the authors categorized respondents by gender and by presence or absence of an eating disorder. The authors compared undergraduate men with an eating disorder with (1) undergraduate women with an eating disorder and (2) undergraduate men without an eating disorder. Results: The patterns of responses suggest that undergraduate men with an eating disorder are preoccupied with body shape and tone but not necessarily with losing weight. Conclusions: The authors discuss implications for future prevention as well as clinical and research efforts based on male symptoms within the diagnostic category of bulimia nervosa and eating disorder, not otherwise specified.     

The Freshman 15—A Closer Look

Abstract

Objectives and Participants: Changes in body weight, composition, and size were examined in college freshmen at the beginning (initial, n = 240) and end of fall semester 2007 (n = 214) and the end of spring semester 2008 (n = 205). Methods: Height, weight, body composition, and waist and hip measurements were assessed. Results: Mean weight, body mass index (BMI), absolute and percent body fat all increased significantly over fall semester and the academic year. About 31% of freshmen lost ≥5 lbs. Mean academic year weight gain was 2.6 lbs (entire group) and 6.0 lbs (weight gainers); body fat increased by 4.4 lbs in the weight gainers. A significant correlation (r = .509) was found between weight change and waist circumference change, but not between weight change and waist to hip ratio change. Conclusions: Freshmen weight gain is associated with increases in body fat and waist circumference, which may be troublesome should the trend continue throughout college.     

Examining the impact of social media on mood and body dissatisfaction using ecological momentary assessment

Abstract

Objective: To assess the effects of social media consumption on body dissatisfaction and negative affect using ecological momentary assessment, a method of assessment over time in the participants’ naturalistic environment. Participants: Woman college students (N?=?30) from a large public university participated in the study in Fall 2015. Methods: Participants were contacted via their smartphones five times per day for five days and asked to complete a battery of measures which assessed social media use, body dissatisfaction, and negative affect. Results: Results demonstrated that the number of social media sites visited was a significant predictor of body dissatisfaction while time spent using social media was not. The number of sites visited and time spent on social media were both significant predictors of general negative affect, sadness, and guilt. Conclusions: Results demonstrate the negative impact that social media use can have on body dissatisfaction and negative affect.     

Prevention of shape and weight concerns among college students: An examination of education status variables

Objective: The current study examined whether overlooked aspects of the postsecondary student experience predicted individuals’ body-related concerns, beyond the influence of demographic factors that have upheld explanatory power in past research. Participants: Undergraduate and graduate students (n?=?3,259) took part in the multi-institute Healthy Bodies Study during the 2015 academic year. Method: Participants completed an online survey that assessed their undergraduate/graduate statuses, academic majors, extracurricular involvements, and body-related concerns. Hierarchical multiple regression analyses were run to answer primary study questions. Results: Gender, body mass index (BMI), undergraduate/graduate student status, being a male graduate student, major, and extracurricular activities predicted shape concern (SC), weight concern (WC), and whether these concerns increased since students began at their universities. The addition of the student-specific variables uniquely contributed to the variance in body-related concerns. Conclusions: Further research on the body-related discontent of the identified student groups should be conducted to elucidate potential campus-based treatment targets.     

Understanding Anorexia Nervosa and Bulimia Nervosa from an Attachment Perspective

Using the Attachment History Questionnaire (AHQ), 30 female anorectic and bulimic inpatients were compared to a control group of 31 primarily female social work students to determine the connection between anorexia and bulimia and early childhood attachment relationships. As predicted, the results indicated that the anorectics and bulimics differed significantly from the controls on all four subfactors of the AHQ: secure attachment base (Factor 1), parental discipline (Factor 2), threats of separation (Factor 3), and peer affectional support (Factor 4). Post hoc comparisons between the eating-disordered group and the controls on the fifty-one individual items of the AHQ showed that within Factor 1, the items involving feelings of being unwanted, alone, helpless, and of shame and guilt, clearly and significantly discriminated between groups. Within Factor 3, the item addressing the child feeling responsible for parental happiness produced significance. The results of this study are interpreted in relation to John Bowlby's attachment theory and the clinical implications are discussed.     

Chapter 2: The Business Case for the Integration of Employee Assistance,Work-Life and Wellness Services

SUMMARY

Employee assistance programs (EAP), work-life programs and wellness programs are three commonly provided kinds of interventions that have the goals of reducing healthcare costs, improving employee performance and fostering a healthier workplace culture. The integration of these kinds of programs is a recent trend that has the potential to offer additional synergistic benefits. New studies have linked comprehensive delivery services that support human capital needs with bottom-line financial success of the company. This evidence can be used to make the business case for offering EAP, work-life and wellness services in an integrated capacity. However, while promising, the scientific evidence thus far in this area has methodological limitations and there are critical aspects that require further study.