From JNEB
Integrating Psychology and Nutrition
Behavior theory as
it relates to nut-
rition education
and health strate-
gies has always
intrigued me. I be-
lieve that know-
ing why someone
does something
provides insight
in how to strengthen or weaken that
behavior. So, I try to include behavior
theory within my research, teaching,
and outreach programs. However, I
have not really considered mental
health as part of our sphere as nutrition
educators and researchers. Recent arti-
cles in JNEB suggest that perhaps I
should.
I understand the presumed associa-
tion between depression and obesity.
Depression can lead to overeating,
which leads to weight gain and more
depression. But certainly this associa-
tion is not direct or simple and cannot
be generalized. For instance, McCurdy
et al1 found no association between
mothers' body mass index (BMI) and
depressive symptoms as measured
with the Center for Epidemiologic
Studies Depression Scale (a 20-item
questionnaire) in 166 mothers. How-
ever, more than half of the partici-
pants in this sample were Hispanic.
We know from Lynch and Kane's
article2 that cultural and medical
interpretations of body size do not
always align, and overweight or obese
women may not see themselves as
such. While Lynch and Kane's work2
was with African American women,
Hispanic women also have cultural
perspectives on weight that may not
align with medical interpretation.3
In addition to being overweight,
the dieting itself may play a role in
the mental health of overweight
women. For instance, in their system-
atic review, Clifford et al4 found an
association among non-diet inter-
ventions, self-esteem, and depression.
This systematic review included pri-
marily group classes in the com-
munity or worksite. In a different
population, after bariatric surgery for
obesity, Nijman et al5 found that
behavioral motivational nutrition ed-
ucation was successful to alleviating
depressive symptoms in 144 obese
Hispanic Americans. These articles
point to the usefulness of including
non-diet intervention and motiva-
tional counseling techniques when
working with obese adults.
But what do we know about
children, nutrition, and psychological
well-being? Data from a national New
Zealand survey were analyzed by Utter
et al6 concerning adolescent cook-
ing skills and emotional well-being.
Although I believe that self-efficacy
can improve self-esteem by making
one more capable, I had not thought
about self-efficacy in life skills such
as cooking as being associated with
emotional well-being before reading
this article. Also surprising were the
results from Pacanowski et al.7 In their
study on self-weighing by adoles-
cents, they found that self-weighing
was inversely associated with self-
esteem. Although self-weighing can
provide useful feedback on positive
results from weight reduction man-
agement, their study of 1,902 adoles-
cents and young adults discovered
this relationship remained over
10 years of data.
Although there have been reports
of teaching Health at Every Size in
college,8 I have not heard of men-
tal health assessment and nutrition
courses. While in no way replacing
the psychologist or psychiatrist, in-
corporation of more psychological
assessment and positive approaches
may significantly improve our clients'
quality of life.
Karen Chapman-Novakofski,
PhD, RD, LDN
Editor-in-Chief
REFERENCES
1. McCurdy K, Kisler T, Gorman KS, Met-
allinos-Katsaras E. Food- and health-
related correlates of self-reported body
mass index among low-income mothers
of young children. J Nutr Educ Behav.
2015;47:225-233.
2. Lynch EB, Kane J. Body size perception
among African American women. J Nutr
Educ Behav. 2014;46:412-417.
3. Mama SK, Quill BE, Fernandez-
Esquer ME, Reese-Smith JY, Banda JA,
Lee RE. Body image and physical activ-
ity among Latina and African American
women. Ethn Dis. 2011;21:281-287.
4. Clifford D, Ozier A, Bundros J, Moore J,
Kreiser A, Morris MN. Impact of non-
diet approaches on attitudes, behaviors,
and health outcomes: a systematic review.
J Nutr Educ Behav. 2015;47:143-155.
5. Nijamkin MP, Campa A, Nijamkin SS,
Sosa J. Comprehensive behavioral-
motivational nutrition education im-
proves depressive symptoms following
bariatric surgery: a randomized, controlled
trial of obese Hispanic Americans. J Nutr
Educ Behav. 2013;45:620-626.
6. Utter J, Denny S, Lucassen M, Dyson B.
Adolescent cooking abilities and behav-
iors: associations with nutrition and
emotional well-being. J Nutr Educ Behav.
2016;48:35-41.
7. Pacanowski CR, Loth KA, Hannan PJ,
Linde JA, Neumark-Sztainer DR. Self-
weighing throughout adolescence and
young adulthood: implications for well-
being. J Nutr Educ Behav. 2015;47:506-515.
8. Humphrey L, Clifford D, Neyman
Morris M. Health at every size college
course reduces dieting behaviors and
improves intuitive eating, body esteem,
and anti-fat attitudes. J Nutr Educ Behav.
2015;47:354-360.