The role of implicit attitudes towards food and ... - ResearchGate

3.5.2. Implicit attitudes towards food
In a second model, ABMI change at follow up was the dependent variable, and the change in attitude towards
unhealthy food (RT), towards healthy food (RT), towards unhealthy food (PE), towards healthy food (PE), ABMI at the
end of the treatment, age and sex were entered as independent variables. The model accounted for only 8% of the
variance, and was not significant, F(7, 18)=1.22 ns (see Table 5).
3.5.3. Self-reported attitudes towards physical activity
In a third model, ABMI change at follow up was the dependent variable, and the change in attitude towards
sedentary activity, towards moderate intense PA, towards high intense PA, ABMI at the end of the treatment, age and
sex were entered as independent variables. The model accounted for only 3% of the variance, and was not significant, F
(6, 18)=1.10 ns. (see Table 6).
3.5.4. Self-reported attitudes towards food
In a fourth model, ABMI change at follow up was the dependent variable, and the change in attitude towards
unhealthy food, towards healthy food, ABMI at the end of the treatment, age and sex were entered as independent
variables. The model accounted for 14% of the variance, and was not significant, F(5, 18)b1 (see Table 6).
4. Discussion
M. Craeynest et al. / Eating Behaviors 9 (2008) 41–51
This manuscript presented a longitudinal study, investigating whether implicit and self-reported food and
exercise attitudes changed during a six month inpatient treatment for youth obesity and at a one year follow up.
Further, it was examined whether this change explained the variance in overweight change during treatment and at
follow up.
A first finding was that the youngsters lost weight during the treatment, that seemed not to be regained at follow up.
This lack of weight regain is in contrast with what is often found (e.g., Braet et al., 2003, 2004). However, the finding of
the present study should be interpreted with caution, as it is based on a very restricted and selective sample. As the
dropout youngsters reported at baseline that they liked more unhealthy food and liked less healthy food than the
remaining group, it can be assumed that especially the youngsters that regained weight after treatment, dropped out or
could not be contacted at follow up. Another possibility may be that the participants further lost weight after the
six months of treatment that was regained at follow up.
The self-reports revealed more favourable attitudes towards healthy food and physical activity than towards
unhealthy food and sedentary activities. This pattern was quite stable over time. Further, a change in self-reported
attitudes was not related to decrease in overweight during treatment and at follow up. Possibly, demand
characteristics leading to self-presentation strategies may have played a role (see Schwarz, 1999), but this pattern
can also reflect a gap between a positive attitude towards health practices and the intention to effectively perform
health behaviour. Moreover, it should be noted that the attitudes were assessed when the treatment had already
started.
Of particular interest was the change in implicit food and physical activity attitudes during treatment, and the
relation with decrease in overweight. At baseline, the participants had positive attitudes towards both healthy and
unhealthyfood,whichwasalsofoundinthetotalgroupsampleasdescribedinCraeynest et al. (2005).However,this
mean effect disappeared in a longitudinal study design. Nevertheless, some specific changes in implicit attitude
towards food and physical activity seemed to be related to the decrease in overweight during treatment and at follow
up. More specifically, it was found that the decrease in overweight at the end of the treatment was related to
becoming more positive towards healthy food during therapy. This pattern seems in line with studies that applied the
Transtheoretical Model of behavioural change (Prochaska & DiClimente, 1983) on fruit and vegetable consumption,
which found that increasing the perception of the benefits of the consumption of fruit and vegetables is a crucial
factor for the move towards a higher behavioural stage (e.g., Cullen, Bartholomew, Parcel, & Koehly, 1998; Greene
et al., 2004). Therefore, it may be assumed that emphasizing the benefits of healthyfoodiselementaryinthe
treatment of childhood obesity. Further, a more negative attitude towards high intense physical activity and towards
moderate intense physical activity seemed to be predictive for respectively decrease in overweight at the end of the
treatment and at follow up. At first sight, these effects are not in line with the expectations. Nevertheless, they can
also indicate that the youngsters who lost much weight are fed up with being intensively physical active. However,
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