Image-based dietary assessment (IBDA) may improve the accuracy of dietary assessments, but no formalized training currently exists for skills relating to IBDA. This study investigated nutrition and dietetics students’ and interns’ IBDA abilities, the training and experience factors that may contribute to food identification and quantification accuracy, and the perceived challenges to performing IBDA. An online survey containing images of known foods and serving sizes representing common American foods was used to assess the ability to identify foods and serving sizes. Nutrition and dietetics students and interns from the United States and Australia (n = 114) accurately identified foods 79.5% of the time. Quantification accuracy was lower, with only 38% of estimates within ±10% of the actual weight. Foods of amorphous shape or higher energy density had the highest percent error. Students expressed general difficulty with perceiving serving sizes, making IBDA food quantification more difficult. Experience cooking at home from a recipe, frequent measuring of portions, and having a food preparation or cooking laboratory class were associated with enhanced accuracy in IBDA. Future training of dietetics students should incorporate more food-based serving size training to improve quantification accuracy while performing IBDA, while advances in IBDA technology are also needed.

Summary: The measurement of habitual energy intake remains a challenge in nutrition research. High levels of misreporting, particularly among adults with obesity, have been observed when comparing self‐reported energy intake to energy expenditure assessed via the doubly labeled water technique. Little is known about misreporting in adults with class III obesity (body mass index ≥40 kg/m²). This systematic review assessed the representation of adults with class III obesity in dietary validation studies and the validity of self‐reported dietary energy intake for this group. Studies were included in this review if they: compared self‐reported energy intake assessment method(s) to doubly labeled water, had participants ≥18 years old, and included participants with class III obesity. Fifteen studies met these criteria. Of those, eight included information about the number of participants with class III obesity. Out of 1784 participants across eight studies, 63 (3.5%) participants had class III obesity, compared to 9.2% of US adults with class III obesity. Six studies provided data on validity of energy intake assessment for class III obesity, with five of these showing underreporting. Participants with class III obesity are underrepresented in dietary validation studies. Future research should explore the role of weight status on dietary reporting accuracy.

Background: Weight stigma is a prevalent issue among individuals with overweight and obesity pursuing weight loss; however, few studies have examined this issue in middle‐aged and older adults. Treatment‐seeking populations may also be at risk of disordered eating or excess concern about weight and shape; thus, it is important to evaluate how these parameters may change over the course of a weight loss intervention. Methods: Adults aged 50+ ( n = 83; 60 F, 23 M) completed measures of experiences of weight stigma, weight bias internalization (WBIS‐M), the Eating Disorder Examination Questionnaire (EDE‐Q), and binge eating (BES) at baseline and after completion of a structured 12‐week behavioral weight loss intervention. Results: Forty‐five percent of participants reported previous experiences of weight stigma at baseline through either teasing, unfair treatment, or discrimination. At baseline, the mean WBIS‐M score was 3.37 (SD 1.03). From baseline to post‐intervention, there were decreases (all p < 0.05) in WBIS‐M scores (adjusted mean difference −0.46), scores on the shape concern subscale of the EDE‐Q (adjusted mean difference −0.75), and BES scores (adjusted mean difference −3.75). Scores on the restraint subscale of the EDE‐Q increased by an adjusted mean of 1.77 units. Conclusions: These findings suggest that participating in a structured behavioral weight loss program may have beneficial effects on weight bias, body shape concern, and binge eating, consistent with previous findings in weight management interventions in younger populations. Future work is needed to determine if changes to weight bias internalization and eating behaviors persist during weight loss maintenance.