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Mishina K, Kronström K, Heinonen E, Sourander A. Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study. Eur Child Adolesc Psychiatry 2024; 33:2605-2614. [PMID: 38168825 PMCID: PMC11272674 DOI: 10.1007/s00787-023-02327-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.
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Affiliation(s)
- Kaisa Mishina
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.
- INVEST Research Flagship, University of Turku, Turku, Finland.
| | - Kim Kronström
- Department of Adolescent Psychiatry, University of Turku, Turku, Finland
| | - Emmi Heinonen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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2
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Ganson KT, Nagata JM. Prevalence and correlates of appearance- and performance-enhancing drugs and substances use among a national sample of college students aged 18-30. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1336-1340. [PMID: 35623043 DOI: 10.1080/07448481.2022.2076104] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: To identify the lifetime prevalence and correlates of appearance- and performance-enhancing drugs and substances (APEDS) use among a national sample of US college and university students. Participants: Student participants from the 2020-2021 Healthy Minds Study (N = 7,401; ages 18-30 years). Methods: Lifetime prevalence of five forms of APEDS was estimated. Modified Poisson regression analyses were conducted to determine the sociodemographic correlates of protein and creatine supplement use. Results: Lifetime protein (23.8%) and creatine (7.7%) supplement use were most common among the sample. Older age within young adulthood, male sex, perceiving oneself to be normal weight or somewhat overweight, any athletics participation, and 2-3 or ≥ 5 h/week of exercise were associated with greater likelihood of lifetime protein and creatine supplement use. Conclusions: Awareness and prevention efforts on the potential harms of APEDS use are needed on campuses, particularly among males and those who participate in athletics and high-frequency exercise.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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3
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Anis N, Keski-Rahkonen A, Kaartinen S, Silén Y, Kaprio J, Aaltonen S. Adolescent leisure-time physical activity and eating disorders: a longitudinal population-based twin study. Eat Weight Disord 2024; 29:40. [PMID: 38850337 PMCID: PMC11162369 DOI: 10.1007/s40519-024-01670-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/26/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE High levels of physical activity have been documented in eating disorder patients. Our aim was to examine whether adolescent leisure-time physical activity is prospectively associated with eating disorders in adolescence and young adulthood. METHODS Finnish twins born in 1983-1987 reported their physical activity frequency at ages 12, 14, and 17. A subsample of participants underwent structured, retrospective interviews for eating disorders at the mean age of 22.4 years. Associations between female twins' physical activity and future eating disorders (571-683 twins/wave) were investigated with the Cox proportional hazards model. To illustrate the physical activity similarity of the co-twins in a twin pair, we used cross-tabulation of eating disorder-discordant twin pairs (13-24 pairs/wave). RESULTS After adjusting for several covariates, we found no statistically significant longitudinal association between physical activity and eating disorders. This applied when all eating disorders were combined but also when assessed separately as restrictive and non-restrictive eating disorders. Co-twins' physical activity in adolescence tended to be similar irrespective of their future eating disorder, supporting the results of the regression analysis. CONCLUSION We observed no evidence of adolescent physical activity frequency being prospectively associated with eating disorders in female twins. Further longitudinal studies with larger sample sizes and more detailed physical activity data are needed. LEVEL OF EVIDENCE III, evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Nadja Anis
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland.
| | - Anna Keski-Rahkonen
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
- Department of Physical Medicine and Rehabilitation, HUS Hyvinkää Hospital, P.O. Box 585, 05850, Hyvinkää, Finland
| | - Yasmina Silén
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
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He J, Cui S, Cui T, Barnhart WR, Han J, Xu Y, Nagata JM. Exploring the associations between muscularity teasing and eating and body image disturbances in Chinese men and women. Body Image 2024; 49:101697. [PMID: 38460293 DOI: 10.1016/j.bodyim.2024.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
This study described muscularity teasing in both men and women and explored its associations with eating and body image disturbances in adults from China. A total of 900 Chinese adults (50% women) were recruited online. Correlation and regression analyses were conducted to examine the relationships between muscularity teasing and a battery of measures on eating and body image disturbances. Gender differences in the associations were examined. Men reported more muscularity teasing than women (31.6% men vs. 15.6% women; χ2(1,N = 900) = 31.99, p < .001). Muscularity teasing was significantly and positively correlated with all measures in both men and women. Muscularity teasing explained significant, unique variance in all measures for men and women, except for body fat dissatisfaction in women, beyond covariates (i.e., age, body mass index, and weight teasing). The relationships between muscularity teasing and eating and body image disturbances were generally stronger in men than women. Findings further suggest that muscularity teasing is an important factor related to eating and body image disturbances in men and women, but muscularity teasing might be more detrimental to men's eating behaviors and body image. Future research is needed to further explore the directionality and mechanisms of the links between muscularity teasing and eating and body image disturbances.
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Affiliation(s)
- Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Taipa, Macau, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Jiayi Han
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yinuo Xu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, CA, USA
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Dal Brun D, Pescarini E, Calonaci S, Bonello E, Meneguzzo P. Body evaluation in men: the role of body weight dissatisfaction in appearance evaluation, eating, and muscle dysmorphia psychopathology. J Eat Disord 2024; 12:65. [PMID: 38773673 PMCID: PMC11110325 DOI: 10.1186/s40337-024-01025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/17/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Body image dissatisfaction is a significant concern among men, influencing appearance evaluation, eating behaviors, and muscle dysmorphia psychopathology. However, research on these correlations is notably deficient in men, largely because body image concerns are unevenly distributed between genders. Therefore, this study aims to assess the various dimensions of concerns about body image in men and explore their associations with characteristics such as sexual orientation. METHODS A cross-sectional study was conducted with 251 adult men from fitness centers in the Veneto Region, Italy. Participants completed self-report questionnaires, including the Eating Attitudes Test (EAT-26), the Appearance Schemas Inventory-Revised (ASI-R), and the Muscle Dysmorphic Disorder Inventory (MDDI). Body weight perception and dissatisfaction were evaluated using a Figure Rating Scale (FRS) with 12 male biometric silhouettes. RESULTS Participants were divided into three subgroups based on the experienced levels of body weight dissatisfaction: those who rated a smaller body (BWsmaller), those who rated a larger body (BWlarger) more highly relative to their own estimated body size, and those who reported implicit neutrality with their current weight (BWneu). BWsmaller participants reported higher levels of eating-related concern, while BWlarger participants exhibited higher levels of muscle dysmorphia. Additionally, the BWlarger group showed the highest degree of quantitative perceptual underestimation of their body weight. Sexual orientation was found to have an impact on body weight dissatisfaction, with bisexual men more likely to desire an increase in weight and gay men more likely to desire a decrease. CONCLUSIONS Body weight dissatisfaction significantly impacts appearance evaluation, eating behaviors, and muscle dysmorphia psychopathology in males. Tailored interventions that consider individual differences can support the well-being of men. The study provides useful insight into male body image issues, warranting further exploration to inform effective interventions and promote positive body image and mental health in this population.
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Affiliation(s)
- David Dal Brun
- Department of Linguistic and Literary Studies, University of Padova, Padova, Italy
| | - Elena Pescarini
- Plastic Surgery Unit, San Bortolo Hospital, ULSS 8 Berica, Vicenza, Italy
| | - Sofia Calonaci
- Department of Neuroscience, University of Padova, via Giustiniani 2, Padova, 35128, Italy
| | - Elisa Bonello
- Department of Neuroscience, University of Padova, via Giustiniani 2, Padova, 35128, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, via Giustiniani 2, Padova, 35128, Italy.
- Padova Neuroscience Center, University of Padova, Padova, Italy.
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Nebel-Schwalm MS. Family pressure and support on young adults' eating behaviors and body image: The role of gender. Appetite 2024; 196:107262. [PMID: 38368910 DOI: 10.1016/j.appet.2024.107262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/10/2024] [Accepted: 02/10/2024] [Indexed: 02/20/2024]
Abstract
Families play a key role in establishing eating habits of children, yet whether families continue to influence eating behaviors of young adults remains an open question. It is also not clear whether associations between family variables (i.e., support and pressure) are similar for adult sons and daughters regarding eating pathology. The present cross-sectional study examined family correlates on disordered eating, body satisfaction, and drive for muscularity. The aim was to examine the associations of family support and family pressure with eating pathology, and to determine whether gender moderated the associations. Among 365 undergraduates (Mage = 18.9 years, 62 % Caucasian, 48 % female), neither family pressure nor family support were significantly associated with the drive for muscularity, whereas both were associated with disordered eating, and family pressure was associated with body satisfaction. Gender moderated the relationship of family pressure and body satisfaction (p = 0.03) and, unexpectedly, the relationship of family support and disordered eating (p = 0.02). Contrary to prediction, family pressure had stronger associations with body satisfaction for men (i.e., men had a more robust association (beta = -0.31, p < .001) than women (beta = -0.19, p = 0.004)). For women, the relationship of family support and disordered eating was not significant (beta = 0.07, p = 0.452); but, was significant for men (beta = -0.25, p < .001). These findings suggest that family pressure and support are associated with eating pathology among young adults, and that in some instances the associations were larger for men, thus highlighting the importance of including men in eating pathology research. Pending replication, these results suggest that family attitudes, behaviors, and support may be necessary topics to address when designing prevention programs for young adults.
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Anderson C, Messer M, McClure Z, Liu C, Linardon J. Bidirectional relationships between muscularity-oriented disordered eating and mental health constructs: a prospective study. Eat Disord 2024:1-14. [PMID: 38380888 DOI: 10.1080/10640266.2024.2319947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Muscularity-oriented disordered eating (MODE) is a novel class of eating behaviors characterised by abnormal dietary alterations aimed towards building lean muscle. Although traditionally shown to affect men, emerging evidence suggests that increasingly more women are striving for the muscular and lean ideal, resulting in engagement of MODE behaviors. Prior research examining MODE in women is limited, yet emerging evidence from cross-sectional studies have established associations between MODE and poor mental health indices in this population. However, the temporal order of these associations in women is not yet known. Thus, the current study examined possible bi-directional associations between MODE behaviors and common mental health outcomes (depression, anxiety, loneliness). Adult women completed online study measures at baseline (Time 1 [T1]; n = 1760) and three-month follow-up (Time 2 [T2]; n = 1180). Cross-lagged panel models were computed to test for possible bi-directional relationships between MODE and the relevant mental health constructs. Findings showed that higher MODE levels at T1 significantly predicted increased depressive and anxiety symptoms (but not loneliness) at T2, and loneliness at T1 (but not depression/anxiety) significantly predicted MODE at T2. Effect sizes were small, so findings should be interpreted with this in mind. This is the first study to establish temporal relationships between MODE and mental health outcomes in adult women. Findings suggest that clinicians may benefit from inquiring about MODE behaviors for proper screening, assessment, and intervention, and potentially addressing loneliness to decrease risk of MODE.
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Affiliation(s)
- Cleo Anderson
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Mariel Messer
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Zoe McClure
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Claudia Liu
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jake Linardon
- Center for Social and Emotional Development, Deakin University, Burwood, Victoria, Australia
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Morris CS, Shepherd EA, Ingram PB. Investigating the Validity of the MMPI-3 Eating Concerns (EAT) scale across Men and Women in a University Sample. J Pers Assess 2024; 106:17-26. [PMID: 37092781 DOI: 10.1080/00223891.2023.2195497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 03/09/2023] [Indexed: 04/25/2023]
Abstract
Disordered eating is a major health epidemic that occurs at disproportionate rates among young adults and for which gender plays a major role in symptom presentation. Broadband psychological instruments have historically not included disordered eating as a core scale construct. The recent release of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) offers an opportunity to address this shortcoming through the newly developed Eating Concerns Scale (EAT) for which the existing literature is promising but limited. This study expands research on EAT by investigating its validity and comparing findings across gender. In 345 college students (102 men, 243 women), we examined gender differences between men and women in the EAT scale's structure, item endorsement rates, mean scores, and correlations with measures of body image and eating pathology. Differences emerged in item endorsement rate, scale score elevation rate, and correlation magnitudes. Broadly, findings further support EAT's use in detecting eating pathology and highlight ways in which the EAT scale may not effectively capture masculine expressions of eating pathology, namely binging and purging behaviors. To assess eating pathology more comprehensively, clinicians and researchers should consider including assessments of eating pathology inclusive of masculine eating patterns. Limitations and future research directions are also discussed.
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Affiliation(s)
- Cole S Morris
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
| | | | - Paul B Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas
- Eastern Kansas Veteran Healthcare System, Topeka, Kansas
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Ganson KT, Pang N, Testa A, Jackson DB, Nagata JM. Food insecurity is associated with muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults. Body Image 2023; 47:101628. [PMID: 37738777 DOI: 10.1016/j.bodyim.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
Prior research has documented the association between food insecurity and eating disorders, disordered eating behaviors, and body dissatisfaction. No known research has investigated whether food insecurity is associated with muscle dysmorphia symptomatology, which was the aim of this study. Data from 912 adolescents and young adults in Canada were analyzed. Linear regression analyses were used to determine the association between experiencing past year food insecurity and current muscle dysmorphia symptomatology. Among the sample, 15.7% reported experiencing any food insecurity. In regression analyses, food insecurity was significantly associated with greater overall muscle dysmorphia symptomatology and symptoms of Functional Impairment and Appearance Intolerance. Nearly one in five (18.5%) participants who reported food insecurity were at clinical risk for muscle-dysmorphia. Findings add to the growing literature on the adverse correlates of food insecurity and underscore the need for more research and intervention efforts to address the relationship between food insecurity and muscle dysmorphia symptomatology.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Nelson Pang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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McNaughton M, Hunt DL, O'Brien M, Sugimoto D, Meehan WP, Miller P, Stracciolini A. Sport specialisation and performance-enhancing substance use by young athletes. BMJ Open Sport Exerc Med 2023; 9:e001702. [PMID: 38022758 PMCID: PMC10660423 DOI: 10.1136/bmjsem-2023-001702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives To investigate the association of reported legal performance enhancing substance (PES) use and consideration of banned PES use among sport-specialised and non-sport-specialised young athletes. Methods and design Cross-sectional study of 1049 young athletes enrolled in an injury prevention programme from 2013 to 2020. We used logistic regression modelling to determine the independent association between sports specialisation. We reported (1) legal PES use and (2) consideration of banned PES use after adjusting for the effects of gender, age, having a relative as a coach, unrestricted internet access, use of a weight training regimen, and weeknight hours of sleep. Results The final cohort consisted of 946 athletes with a mean age of 14. 56% were female, and 80% were sport-specialised athletes. 14% reported legal PES use, and 3% reported consideration of banned PES use. No difference was found between sport-specialised athletes who reported legal PES use (OR=1.4; 95% CI 0.81 to 2.43; p=0.23) or consideration of banned PES use (OR=3.2; 95% CI 0.78 to 14.92; p=0.1) compared with non-sport-specialised athletes. Reported legal PES use was more common among athletes who were male, older, used weight training, and slept less. Reported consideration of banned PES use was more common among male and older athletes. Conclusions PES use is not independently associated with sport specialisation in young athletes. Athlete sex, age, training, and sleep patterns are important factors for young athletes to consider in PES use.
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Affiliation(s)
- Michael McNaughton
- Department of Pediatrics, Brown University Hasbro Children’s Hospital, Providence, MA, USA
| | - Danielle L Hunt
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
| | - Michael O'Brien
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - William P Meehan
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Patricia Miller
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
| | - Andrea Stracciolini
- Division of Sports Medicine, Boston Children’s Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Walham, MA, USA
- Department of Orthopaedics, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
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11
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Berengüí R, Castejón MA. Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2910. [PMID: 37958054 PMCID: PMC10649439 DOI: 10.3390/healthcare11212910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait.
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Affiliation(s)
- Rosendo Berengüí
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
| | - María A. Castejón
- Faculty of Education, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
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12
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Hirvelä L, Keski-Rahkonen A, Sipilä PN. Associations of broad eating disorder symptoms with later alcohol problems in Finnish adult twins: A nationwide 10-year follow-up. Int J Eat Disord 2023; 56:1854-1865. [PMID: 37353472 DOI: 10.1002/eat.24013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Eating disorders are associated with subsequent alcohol problems, but it is not known whether this association also extends to broader eating disorder symptoms not captured by clinical diagnoses. We assessed the longitudinal association of broad eating disorder symptoms with alcohol problems in a nationwide twin sample (FinnTwin16). METHODS Finnish women (N = 1905) and men (N = 1449) self-reported their eating disorder symptoms using the Eating Disorder Inventory-2 Bulimia, Drive for Thinness, and Body Dissatisfaction subscales at the mean age of 24.4 years in 2000-2003. A subsample of participants also completed items on drive for muscularity, height dissatisfaction, and muscle-enhancing supplement use. Alcohol problems were assessed 10 years later at the age of 34.1 in 2010-2012 with the Rutgers Alcohol Problem Index. RESULTS Eating disorder symptoms were associated with later alcohol problems (odds ratio per point increase 1.02-1.18). Bulimia showed stronger associations among men than women (p for interaction .012). Drive for muscularity and height dissatisfaction were also associated with later alcohol problems, but supplement use was not. When accounting for baseline alcohol problems, only Bulimia (among women and men) and Drive for Thinness (among men) were significantly associated with later alcohol problems. Bulimia was also significantly associated with later alcohol problems in within-twin-pair analyses among dizygotic twins, but not among monozygotic twins. DISCUSSION In a longitudinal setting, eating disorder symptoms were associated with later alcohol problems. Bulimic symptoms were a stronger risk factor for men than women. These associations may be attributable to baseline alcohol problems, childhood environment and genetic liability. PUBLIC SIGNIFICANCE This study found that both young adult women and men with broad eating disorder symptoms are at a higher risk of alcohol-related problems than those without such symptoms. Men with bulimic symptoms were at a particularly high risk. These findings emphasize the need for better prevention and treatment of disordered eating, body image concerns and alcohol problems for both young adult women and men.
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Affiliation(s)
- Leon Hirvelä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Pyry N Sipilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
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13
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Yager Z, Doley JR, McLean SA, Griffiths S. Goodform: A cluster randomised controlled trial of a school-based program to prevent body dissatisfaction and muscle building supplement use among adolescent boys. Body Image 2023; 44:24-35. [PMID: 36434957 DOI: 10.1016/j.bodyim.2022.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/27/2022]
Abstract
Although body dissatisfaction is common among adolescent boys, few intervention programs specifically developed for boys have been shown to be effective for reducing body dissatisfaction. Our study aim was to evaluate Goodform, a 4-session, teacher delivered intervention program specifically developed for boys to reduce body dissatisfaction and muscle building supplement use. The Goodform program was based on cognitive dissonance, social learning theory, and a social norms approach, and drew from two existing body image intervention programs that have shown promise among males: The Body Project- More than Muscles, and the Athletes Training and Learning to Avoid Steroids Program (ATLAS). A sample of 488 boys in grades 9 and 10 (Mage = 14.81, SDage = 0.51) at nine secondary schools in Australia were randomly assigned to Goodform (n = 244) or control (n = 244) at the school level. Self-reported body image, supplement use, anabolic androgenic steroid (AAS) use, and attitudes around using AAS and muscle building supplements were measured at baseline, post-intervention, and eight-week follow-up. Analyses with multi-level, mixed-effect regression models revealed no changes over time attributable to the intervention. Our results have implications for researchers in the body image and eating disorder prevention fields. Lessons learned in this study can inform future school-based efforts for reducing muscle building supplement use.
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Affiliation(s)
- Zali Yager
- Institute for Health and Sport, Victoria University, Footscray Park, Australia; Body Confident Collective, Australia.
| | - Jo R Doley
- Institute for Health and Sport, Victoria University, Footscray Park, Australia
| | - Siân A McLean
- The Bouverie Centre and Department of Psychology, Counselling, and Therapy, La Trobe University, Melbourne, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
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14
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Parker MN, Lavender JM, Schvey NA, Tanofsky-Kraff M. Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents. Adolesc Health Med Ther 2023; 14:63-85. [PMID: 36860931 PMCID: PMC9969870 DOI: 10.2147/ahmt.s220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).
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Affiliation(s)
- Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
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15
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Ganson KT, Testa A, Rodgers RF, Jackson DB, Nagata JM. Muscle-Building Exercise and Weapon Carrying and Physical Fighting Among U.S. Adolescent Boys. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2566-2584. [PMID: 35546543 PMCID: PMC9850380 DOI: 10.1177/08862605221101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study aimed to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting among adolescent boys. Cross-sectional data from the 2019 Youth Risk Behavior Survey (U.S.) were analyzed (N = 4120). Muscle-building exercise was assessed based on the number of days reported in the past 7 days, recategorized into four levels of engagement (no engagement [0 days], low engagement [1-2 days], moderate engagement [3-5 days], and high engagement [6-7 days]). Three forms of weapon carrying (general, on school grounds, gun carrying) and two forms of physical fighting (general, on school grounds) were assessed. Five logistic regression analyses with adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to determine the association between engagement in muscle-building exercise and weapon carrying and physical fighting, while adjusting for relevant demographic and control variables. Over 75% of participants reported engaging in muscle-building exercise. One in five (19.8%) participants reported any general weapon carrying in the past 30 days, 3.3% reported any weapon carrying at school in the past 30 days, 6.5% reported any gun carrying in the past 12 months, 28.0% reported any general physical fighting in the past 12 months, and 10.7% reported any physical fighting at school in the past 12 months. Logistic regressions showed that, compared to no engagement, participants who reported high engagement of muscle-building exercise had higher odds of general weapon carrying (AOR 2.18, 95% CI 1.54-3.07), gun carrying (AOR 2.12, 95% CI 1.23-3.64), and general physical fighting (AOR 2.07, 95% CI 1.53-2.79). These are novel findings that add to a growing literature related to engagement in muscularity-oriented behaviors among males. Prevention and intervention efforts are needed to ensure that adolescent boys engage in muscle-building exercise in ways that are not harmful and to reduce weapon carrying and physical fighting.
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Affiliation(s)
| | - Alexander Testa
- University of Texas Health Science Center at
Houston, Houston, TX, USA
| | - Rachel F. Rodgers
- Northeastern
University, Boston, MA, USA
- Lapeyronie
Hospital, CHRU Montpellier, France
| | - Dylan B. Jackson
- Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Jason M. Nagata
- University of
California, San Francisco, San Francisco,
CA, USA
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16
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Cleland L, Kennedy HL, Pettie MA, Kennedy MA, Bulik CM, Jordan J. Eating disorders, disordered eating, and body image research in New Zealand: a scoping review. J Eat Disord 2023; 11:7. [PMID: 36650575 PMCID: PMC9847028 DOI: 10.1186/s40337-022-00728-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/25/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prevention and treatment of eating disorders relies on an extensive body of research that includes various foci and methodologies. This scoping review identified relevant studies of eating disorders, body image, and disordered eating with New Zealand samples; charted the methodologies, sample characteristics, and findings reported; and identified several gaps that should be addressed by further research. METHODS Using scoping review methodology, two databases were searched for studies examining eating disorders, disordered eating, or body image with New Zealand samples. Snowball methods were further used to identify additional relevant articles that did not appear in initial searches. Two independent reviewers screened the titles and abstracts of 473 records. Full text assessment of the remaining 251 records resulted in 148 peer-reviewed articles being identified as eligible for the final review. A search of institutional databases yielded 106 Masters and Doctoral theses for assessment, with a total of 47 theses being identified as eligible for the final review. The included studies were classified by methodology, and the extracted information included the study foci, data collected, sample size, demographic information, and key findings. RESULTS The eligible studies examined a variety of eating disorder categories including binge-eating disorder, bulimia nervosa, and anorexia nervosa, in addition to disordered eating behaviours and body image in nonclinical or community samples. Methodologies included treatment trials, secondary analysis of existing datasets, non-treatment experimental interventions, cross-sectional observation, case-control studies, qualitative and mixed-methods studies, and case studies or series. Across all of the studies, questionnaire and interview data were most commonly utilised. A wide range of sample sizes were evident, and studies often reported all-female or mostly-female participants, with minimal inclusion of males and gender minorities. There was also an underrepresentation of minority ethnicities in many studies, highlighting the need for future research to increase diversity within samples. CONCLUSION This study provides a comprehensive and detailed overview of research into eating disorders and body image in New Zealand, while highlighting important considerations for both local and international research.
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Affiliation(s)
- Lana Cleland
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Hannah L Kennedy
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Michaela A Pettie
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.
- Mental Health Clinical Research Unit, Te Whatu Ora, Waitaha, Christchurch, New Zealand.
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17
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Grunewald W, Troop-Gordon W, Smith AR. Relationships between eating disorder symptoms, muscle dysmorphia symptoms, and suicidal ideation: A random intercepts cross-lagged panel approach. Int J Eat Disord 2022; 55:1733-1743. [PMID: 36200702 DOI: 10.1002/eat.23819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Eating disorder (ED) symptoms correlate with suicidality; yet the strength of these relationships in men is unclear. Muscle dysmorphia (MD) symptoms may reflect a more accurate index of body-related concerns for men, as they better target muscularity concerns typical of men. However, no studies have tested a model in which ED/MD symptoms and suicidality are simultaneously examined. We longitudinally tested whether ED/MD symptoms were related to suicidal ideation among a community sample of men. METHODS Men with MD symptoms (N = 272) were recruited to complete three surveys over 6 weeks. A random intercepts cross-lagged panel model tested predictive associations between ED/MD symptoms and suicidal ideation, while disaggregating between/within-person variance. RESULTS ED/MD symptoms were significantly associated with suicidal ideation at the between-subjects level (ED: b = .04; MD: b = .09) and showed significant within-wave covariances with suicidal ideation (ED: b = .02-.04; MD: b = .02-.05). Those who experienced increases in ED symptoms showed increased suicidal ideation at the next wave (b = .32). Those who experienced increases in suicidal ideation showed increases in MD symptoms at the next wave (b = .85). DISCUSSION Results highlight ED symptoms as a potential risk factor for suicidal ideation among men. Further, suicidal ideation predicted MD symptoms. ED symptoms may create intra- and interpersonal distress predicting suicidal ideation. Suicidal ideation may lead to muscle-building behaviors to cope with suicidal thoughts. Clinicians should assess for suicidal ideation among men at risk for MD/EDs, and for MD symptoms among those reporting suicidal ideation. PUBLIC SIGNIFICANCE Eating disorder (ED) symptoms are related to suicidality, but these relationships are understudied among men. Since men report concerns surrounding muscularity, muscle dysmorphia (MD) may be a better ED index for this population. However, little research has investigated relationships between ED symptoms, MD symptoms, and suicidality among men. This study investigated relationships between ED/MD symptoms and suicidality among 272 men. Results may inform clinical assessment, treatment, and classification of MD.
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Affiliation(s)
- William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Wendy Troop-Gordon
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama, USA
| | - April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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18
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He J, Tang C, Song J, Cui T, Barnhart WR, Cui S, Ren Y, Nagata JM. The Muscularity Bias Internalization Scale: Development and initial validation in Chinese adult men. Body Image 2022; 43:326-336. [PMID: 36244184 DOI: 10.1016/j.bodyim.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/05/2022]
Abstract
The present study developed the Muscularity Bias Internalization Scale (MBIS), a measure of muscularity bias internalization, which assesses the extent to which an individual endorses muscularity-based stereotypes and engages in negative self-evaluations due to muscularity. In Study 1, a pool of candidate items was developed. By using exploratory factor analysis (EFA) on a sample of 300 Chinese adult men (Mage = 29.98 years, SD = 7.81), 14 items from the item pool were retained. The 14-item MBIS contained three factors. In Study 2, a second sample of 300 Chinese adult men (Mage = 29.50 years, SD = 7.50) was used to confirm the factor structure of the MBIS, as well as to examine its reliability and validity. Confirmatory factor analysis (CFA) further confirmed the three-factor structure of the MBIS with a good model fit. The MBIS showed high internal consistency reliability and high two-week test-retest reliability. The MBIS also showed good construct validity with measures of drive for muscularity, muscularity-oriented disordered eating, and muscle dysmorphia symptoms. The newly developed MBIS may help understand the role of muscularity bias internalization in the development and maintenance of muscularity-oriented body image and muscularity-oriented disordered eating.
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Affiliation(s)
- Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China.
| | - Chanyuan Tang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Jianwen Song
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China; Department of Educational Psychology, Baylor University, Waco, TX, United States
| | - Tianxiang Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China; Department of Psychology, University of Macau, Macau, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Yaoxiang Ren
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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19
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Sagrera CE, Magner J, Temple J, Lawrence R, Magner TJ, Avila-Quintero VJ, McPherson P, Alderman LL, Bhuiyan MAN, Patterson JC, Murnane KS. Social media use and body image issues among adolescents in a vulnerable Louisiana community. Front Psychiatry 2022; 13:1001336. [PMID: 36405904 PMCID: PMC9669337 DOI: 10.3389/fpsyt.2022.1001336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Widespread concern has been expressed regarding unrealistic body image and adolescent eating disorder promoting content on social media (SM) platforms. Numerous research studies have examined the impact of SM on body image as well as social vulnerability on negative mental health outcomes. Despite this, few previous studies have examined the impact of SM on body image specifically in vulnerable, underserved, or predominantly minority communities. This study examines the impact of SM on body image issues (BII) in adolescents in a public school system where greater than 50% of the students live in impoverished households. In late 2019, high school student leaders in Northwest Louisiana developed a survey alongside Step Forward, a collective impact initiative. Questions investigated adolescent SM use and mental health in Caddo Parish, namely BII. Teachers within Caddo Parish Public School System administered the survey. Out of the 11,248 total high school students in the school system, nearly 50% were sampled for a sample size of 5,070. Hypotheses included: (1) females were more likely to use SM than males, (2) increasing time spent on SM would correlate with females reporting BII, with males remaining largely unaffected, and (3) highly visual social media (HVSM) platforms would be associated with greater reports of BII than non-HVSM platforms. Results showed females were more likely to use SM (p < 0.001) and report BII (p < 0.001) compared to males, while both sexes reported BII with increasing time spent on SM (p < 0.001). A diversity of platforms were associated with increased BII among SM users compared to non-users (p < 0.001): Pinterest, Reddit, Snapchat, TikTok, Twitter, and YouTube. This conclusion is tempered by the omission of race as a variable in the study design, the use of self-report, and the use of an unvalidated instrument. These findings suggest that the harmful association between SM use and BII may transcend culture and socioeconomic status for a broadly deleterious effect on adolescent mental wellbeing.
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Affiliation(s)
- Caroline E. Sagrera
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
| | - Johnette Magner
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
- School of Communication and Media Studies, Louisiana Tech University, Ruston, LA, United States
| | - Jazzlynn Temple
- Caddo Parish Magnet High School, Shreveport, LA, United States
| | - Robert Lawrence
- Caddo Parish Magnet High School, Shreveport, LA, United States
| | | | | | - Pamela McPherson
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
| | - Laura Lane Alderman
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
| | - Mohammad Alfrad Nobel Bhuiyan
- Division of Clinical Informatics, Department of Internal Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
| | - James C. Patterson
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
- Department of Pharmacology, Toxicology and Neuroscience, School of Graduate Studies, Louisiana State University Health Shreveport, Shreveport, LA, United States
| | - Kevin S. Murnane
- Department of Psychiatry and Behavioral Medicine, School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA, United States
- Louisiana Addiction Research Center, Shreveport, LA, United States
- Department of Pharmacology, Toxicology and Neuroscience, School of Graduate Studies, Louisiana State University Health Shreveport, Shreveport, LA, United States
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20
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Galvin J, Evans EH, Talbot CV, Wilson C, Richards G. The associations between autistic traits and disordered eating/drive for muscularity are independent of anxiety and depression in females but not males. PLoS One 2022; 17:e0276249. [PMID: 36251679 PMCID: PMC9576073 DOI: 10.1371/journal.pone.0276249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
Previous research has shown a positive correlation between autistic traits and eating disorder symptoms, and this relationship appears to be independent of co-occurring mental health status. The current study followed a pre-registered analysis plan with the aim to investigate a previously unconsidered factor in the relationship between autistic traits and disorders of eating and body image: the drive for muscularity. Participants (N = 1068) completed the Autism Spectrum Quotient (AQ), Hospital Anxiety and Depression Scale (HADS), Eating Attitudes Test-26 (EAT-26) and Drive for Muscularity Scale (DMS). Positive correlations between AQ and EAT-26 and AQ and DMS were observed. In females, AQ remained significantly correlated with EAT-26 and DMS when controlling for co-occurring anxiety and depression symptoms, but this was not the case in males. These findings demonstrate the moderating role of sex, and the need to consider autistic traits in individuals diagnosed with, or at a heightened risk for, disorders of eating and body image.
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Affiliation(s)
- John Galvin
- Department of Psychology, Birmingham City University, Birmingham, United Kingdom
| | | | | | - Claire Wilson
- School of Education, University of Strathclyde, Glasgow, United Kingdom
| | - Gareth Richards
- Faculty of Medical Sciences, School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
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21
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Layman HM, Keirns NG, Hawkins MA, Nagata JM. Does seeking the brawns impact the brain?: An investigation of muscularity-oriented disordered behaviors and cognitive function. Body Image 2022; 42:307-314. [PMID: 35908297 PMCID: PMC9812210 DOI: 10.1016/j.bodyim.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
Shifts in body-image ideals over the past 30 years towards leaner, muscular bodies have revealed new health behaviors that may be related to cognitive function. This study objective was to investigate prospective associations between a drive for muscularity and/or muscularity-oriented disordered behaviors (MODBs) with cognition. Data were drawn from Add Health, a nationally representative longitudinal cohort dataset. Drive for muscularity and MODB engagement were assessed in emerging adulthood (ages 18-26). Cognition was measured via immediate word recall, delayed-word recall, and number recall at 7-years later (ages 24-32). Analyzes were conducted in 1976 participants with available data. A one-way ANCOVA revealed that those with a drive for muscularity had lower immediate word recall (F(3, 12,819) = 3.845, p = .009) and delayed word recall (F(3, 12,807) = 5.933, p < .001) scores than other weight goal groups adjusting for covariates. Hierarchical linear regressions between individual MODBs and cognitive outcomes showed that legal performance-enhancing substance use (βs = 0.06-0.07, p < .05) and exercise (β = 0.06, p < .05) were positively associated with some cognition scores. Conversely, lifting weights (β = - 0.06, p < .05) and eating different foods than usual (β = - 0.05, p < .05) exhibited negative associations with some of the cognitive outcomes. Future research should be conducted to examine other potential outcomes related to the drive for muscularity and associated MODBs.
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Affiliation(s)
- Harley M. Layman
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America,Corresponding author. (H.M. Layman)
| | - Natalie G. Keirns
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America
| | - Misty A.W. Hawkins
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America
| | - Jason M. Nagata
- Department of Pediatrics, University of California, 550 16th St., San Francisco, CA 94158, the United States of America
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22
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The 'not-so-healthy' appearance pursuit? Disentangling unique associations of female drive for toned muscularity with disordered eating and compulsive exercise. Body Image 2022; 42:276-286. [PMID: 35841701 DOI: 10.1016/j.bodyim.2022.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 05/29/2022] [Accepted: 06/04/2022] [Indexed: 12/22/2022]
Abstract
Today, many women are driven to subscribe to a more athletically oriented appearance ideal hallmarked by muscle tone (referred to as athletic- or fit-looking). However, the constellation of unhealthy eating and exercise behaviors that may accompany the pursuit of toned muscularity among women is not yet well characterized. To address this knowledge gap, our study evaluated the associations among the female drive for toned muscularity and both thinness-oriented disordered eating behaviors (e.g., dietary restriction) and muscularity-oriented disordered eating behaviors (e.g., excessive scrutiny of macro-nutrient values of food), as well as dimensions of compulsive exercise. Participants were 388 Australian undergraduate women who completed an online questionnaire including self-report measures of said constructs. Hierarchical regression models were used to determine whether the drive for toned muscularity accounted for unique variance in eating and exercise behaviors after adjusting for theoretically relevant covariates. Results indicated independent relationships between the drive for toned muscularity and several facets of thinness- and muscularity-oriented disordered eating, as well as compulsive exercise (e.g., exercise rigidity). Our findings further contribute to an emerging literature illustrating that women driven to attain a toned appearance may be vulnerable to engaging in a wide range of maladaptive eating and exercise practices.
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23
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Messer M, Duxson S, Diluvio P, McClure Z, Linardon J. The independent contribution of muscularity-oriented disordered eating to functional impairment and emotional distress in adult men and women. Eat Disord 2022; 31:161-172. [PMID: 35671325 DOI: 10.1080/10640266.2022.2086728] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Muscularity-oriented disordered eating (MODE) refers to a broad cluster of pathological eating patterns driven by the pursuit of muscularity and leanness. Although increasing attention has been devoted towards understanding these symptoms in men, little work has been conducted to understand MODE in women. It is also unclear whether MODE contributes unique variance to functional impairment and emotional distress beyond thinness-oriented disordered eating symptoms. We addressed these gaps in a sample of 1,321 community-based adult women (n = 1136) and men (n = 185). Hierarchical multiple regressions revealed that MODE explained a significant proportion of unique variance in functional impairment in both men and women, even after controlling for traditional thinness-oriented disordered eating symptoms. MODE also contributed unique variance in symptoms of depression and anxiety in women, but not for men. Findings highlight the possible significance of these unique symptoms patterns geared towards the pursuit of muscularity and leanness. MODE symptoms may be a viable target in eating disorder intervention or prevention programs, although further longitudinal research is needed.
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Affiliation(s)
- Mariel Messer
- School of Psychology, Deakin University, Geelong, Vic, Australia
| | - Siahn Duxson
- School of Psychology, Deakin University, Geelong, Vic, Australia
| | - Paige Diluvio
- School of Psychology, Deakin University, Geelong, Vic, Australia
| | - Zoe McClure
- School of Psychology, Deakin University, Geelong, Vic, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, Vic, Australia
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24
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Kathiresan R, Austin SB, Raffoul A, Vargas G. Use of Protein Powders and Muscle-Building Supplements by Young Men in their Drive for Muscularity. Pediatr Rev 2022; 43:353-355. [PMID: 36121420 DOI: 10.1542/pir.2021-005452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA.,Department of Pediatrics, Harvard Medical School, Boston, MA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA
| | - Gabriela Vargas
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA.,Department of Pediatrics, Harvard Medical School, Boston, MA
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Ganson KT, Nagata JM, Vanderlee L, Rodgers RF, Lavender JM, Hazzard VM, Murray SB, Cunningham M, Hammond D. Weight gain attempts and diet modification efforts among adults in five countries: a cross-sectional study. Nutr J 2022; 21:30. [PMID: 35562831 PMCID: PMC9102257 DOI: 10.1186/s12937-022-00784-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent research has emphasized a growing trend of weight gain attempts, particularly among adolescents and boys and young men. Little research has investigated these efforts among adults, as well as the specific diet modifications individuals who are trying to gain weight engage in. Therefore, the aims of this study were to characterize the diet modification efforts used by adults across five countries who reported engaging in weight gain attempts and to determine the associations between weight gain attempts and concerted diet modification efforts. METHODS Cross-sectional data from the 2018 and 2019 International Food Policy Study, including participants from Australia, Canada, Mexico, the United Kingdom, and the United States (N = 42,108), were analyzed. In reference to the past 12 months, participants reported on weight gain attempts and diet modification efforts related to increased consumption of calories, protein, fiber, fruits and vegetables, whole grains, dairy products, all meats, red meat only, fats, sugar/added sugar, salt/sodium, and processed foods. Unadjusted (chi-square tests) and adjusted (modified Poisson regressions) analyses were conducted to examine associations between weight gain attempts and diet modification efforts. RESULTS Weight gain attempts were significantly associated with higher likelihood of each of the 12 forms of diet modification efforts among male participants, and 10 of the diet modification efforts among female participants. Notably, this included higher likelihood of efforts to consume more calories (males: adjusted prevalence ratio [aPR] 3.25, 95% confidence interval [CI] 2.94-3.59; females: aPR 4.05, 95% CI 3.50-4.70) and fats (males: aPR 2.71, 95% CI 2.42-3.03; females: aPR 3.03, 95% CI 2.58-3.55). CONCLUSIONS Overall, the patterns of association between weight gain attempts and diet modification efforts may be indicative of the phenomenon of muscularity-oriented eating behaviors. Findings further highlight the types of foods and nutrients adults from five countries may try to consume in attempts to gain weight.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, 550 16th Street., Box 0110, San Francisco, CA, 94158, USA.
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé Et Société (NUTRISS), Université Laval, Quebec City, QC, Canada
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | - Vivienne M Hazzard
- Sanford Center for Bio-Behavioral Research, Sanford Health, Fargo, ND, USA
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | | | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Nagata JM, Hazzard VM, Ganson KT, Bryn Austin S, Neumark-Sztainerx D, Eisenberg ME. Muscle-building behaviors from adolescence to emerging adulthood: a prospective cohort study. Prev Med Rep 2022; 27:101778. [PMID: 35402151 PMCID: PMC8987401 DOI: 10.1016/j.pmedr.2022.101778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 12/28/2022] Open
Abstract
Muscle-building behaviors in adolescence to emerging adulthood were studied. Starting muscle-building behaviors is common from adolescence to emerging adulthood. Prevalence of any protein powder/shakes use was 55.1% in males and 33.0% in females. Prevalence of any steroids use was 6.7% in males and 5.4% in females. Protein powder consumption was associated with future use of steroids.
This study aimed to identify patterns of change in muscle-building behaviors from adolescence to emerging adulthood and determine what adolescent factors predict new-onset muscle-building behavior in emerging adulthood. Prospective cohort data from a diverse sample of 1,535 participants followed from adolescence (baseline, Mage = 14.4 ± 2.0 years) to emerging adulthood (follow-up, Mage = 22.1 ± 2.0 years) from the population-based EAT 2010–2018 (Eating and Activity over Time) study were analyzed. Changes in muscle-building behavior were identified (starting, stopping, persistent use, or never use). Log-binomial regression models examined adolescent predictors of starting (i.e., new-onset) muscle-building behaviors in emerging adulthood. Prevalence of any use in adolescence (EAT 2010) and/or emerging adulthood (EAT 2018) was 55.1% (males) and 33.0% (females) for protein powder/shakes, 6.7% (males) and 5.4% (females) for steroids, and 19.4% (males) and 6.5% (females) for other muscle-building substances (e.g., creatine, amino acids). In particular, 22.6% (males) and 13.7% (females) started protein powder/shakes, 2.2% (males) and 1.0% (females) started steroid use, and 9.0% (males) and 2.0% (females) started other muscle-building substances during emerging adulthood. Adolescent protein powder/shake consumption was associated with starting steroids/other muscle-building substances use in emerging adulthood in males (adjusted risk ratio [ARR] 2.09, 95% confidence interval [CI] 1.29–3.39) and females (ARR 4.81, 95% CI 2.01–11.48). Adolescent use of protein powders/shakes may lead to a two- to five-fold higher risk of new use of steroids and other muscle-building products in emerging adulthood. Clinicians, parents, and coaches should assess for use of muscle-building behaviors in adolescents and emerging adults and discourage use of harmful products.
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Nagata JM, Hazzard VM, Ganson KT, Hahn SL, Neumark-Sztainer D, Eisenberg ME. Digital technology use and muscle-building behaviors in young adults. Int J Eat Disord 2022; 55:207-214. [PMID: 34904744 PMCID: PMC9023317 DOI: 10.1002/eat.23656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Digital technology use and muscle-building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle-building behaviors remain unknown and this study aimed to address this gap. METHOD Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population-based Eating and Activity over Time 2018 study. Gender-stratified-modified Poisson regression models were used to determine cross-sectional associations between three types of digital technology use (screen time, social media, weight-related self-monitoring apps) and five types of muscle-building behaviors (changing eating, exercise, protein powders/shakes, pre-workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. RESULTS Screen time and social media were either not found to be associated with muscle-building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre-workout drinks in men). In contrast, the use of weight-related self-monitoring apps was positively associated with all muscle-building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13-2.97) and women (PR = 4.43; 95% CI: 1.68-11.68). DISCUSSION While most recreational screen time may represent sedentary behaviors not related to muscle-building behaviors, weight-related self-monitoring apps are highly associated with more muscle-building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle-building substances.
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Affiliation(s)
- Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Samantha L Hahn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marla E Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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28
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Nagata JM, McGuire FH, Lavender JM, Brown TA, Murray SB, Compte EJ, Cattle CJ, Flentje A, Lubensky ME, Obedin-Maliver J, Lunn MR. Appearance and performance-enhancing drugs and supplements (APEDS): Lifetime use and associations with eating disorder and muscle dysmorphia symptoms among cisgender sexual minority people. Eat Behav 2022; 44:101595. [PMID: 35066385 PMCID: PMC9359347 DOI: 10.1016/j.eatbeh.2022.101595] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Appearance and performance-enhancing drugs and supplements (APEDS) are used to enhance muscle growth, athletic performance, and physical appearance. The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among cisgender sexual minority people. METHODS Participants were cisgender sexual minority people (1090 gay men, 100 bisexual plus men, 564 lesbian women, and 507 bisexual plus women) recruited from The PRIDE Study in 2018 who reported lifetime APEDS use and completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Muscle Dysmorphic Disorder Inventory (MDDI). Regression analyses stratified by gender and sexual orientation examined associations of any APEDS use with EDE-Q and MDDI scores. RESULTS Lifetime APEDS use was common across the four groups of cisgender sexual minority people (44% of gay men, 42% of bisexual plus men, 29% of lesbian women, and 30% of bisexual plus women). Protein supplements and creatine supplements were the most commonly used APEDS. Any APEDS use was associated with higher EDE-Q scores on one or more subscales in all sexual minority groups. Further, any APEDS use was associated with higher MDDI Total Scores in all groups; any APEDS use was associated with all MDDI subscale scores in cisgender gay men only. DISCUSSION APEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in sexual minority men and women, thus highlighting the importance of assessing for these behaviors and symptoms among these populations in clinical settings.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0110, San Francisco, CA 94143, USA.
| | - F Hunter McGuire
- The Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA; The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA.
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA; San Diego State University Research Foundation, 5250 Campanile Dr, San Diego, CA 92182, USA.
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA 90033, USA.
| | - Emilio J Compte
- Eating Behavior Research Center, School of Psychology, Universidad Adolfo Ibáñez, Diagonal Las Torres 2640, Santiago, Peñalolén, Región Metropolitana, Chile; Research Department, Comenzar de Nuevo Treatment Center, Avenida Humberto Lobo 1001, Del Valle, 66220 San Pedro Garza García, N.L., Mexico.
| | - Chloe J Cattle
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0110, San Francisco, CA 94143, USA.
| | - Annesa Flentje
- Department of Community Health Systems, University of California, San Francisco, 2 Koret Way San Francisco, CA 94143, USA; Alliance Health Project, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 1930 Market Street, San Francisco, CA 94102, USA; The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Dr, Palo Alto, CA 94304, USA.
| | - Micah E Lubensky
- Department of Community Health Systems, University of California, San Francisco, 2 Koret Way San Francisco, CA 94143, USA; The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Dr, Palo Alto, CA 94304, USA.
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Dr, Palo Alto, CA 94304, USA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305, USA; Department of Epidemiology and Population Health, Stanford University School of Medicine, 150 Governor's Lane, HRP Redwood Building, Stanford, CA 94305-5405, USA.
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, 300 Pasteur Dr, Palo Alto, CA 94304, USA; Department of Epidemiology and Population Health, Stanford University School of Medicine, 150 Governor's Lane, HRP Redwood Building, Stanford, CA 94305-5405, USA; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Palo Alto, CA 94304, USA.
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MacIntyre RI, Heron KE, Howard LM, Symons Downs D. Gender and Black-White Race Differences in Young Adult Exercise Dependence Prevalence and Associated Disordered Eating. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:680-688. [PMID: 32809923 DOI: 10.1080/02701367.2020.1767757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
Purpose: Exercise dependence, an unhealthy preoccupation with exercise that results in physiological and psychological symptoms, may be particularly prevalent among college students given sociocultural exercise and body ideals in this population. Yet few studies have examined this phenomenon in diverse college samples. The aims of the present study were to examine gender and Black-White race differences in the prevalence of exercise dependence and associated disordered eating. Method: Undergraduates (N = 839) completed online measures of exercise dependence and disordered eating. Chi square tests were used to test for differences in prevalence, and linear regression was used to examine race and gender moderating effects on the exercise dependence-disordered eating association. Results: More men reported exercise dependence symptoms than women. More White participants reported symptoms than Black participants. Of the four gender and race combinations examined, White men had the highest proportion and Black women the lowest proportion experiencing symptoms. Gender, but not race, moderated the exercise dependence-disordered eating association. Conclusions: Although more men experience exercise dependence symptoms, women experience stronger associations between exercise dependence symptoms and disordered eating. The number of students who reported exercise dependence symptoms underscores the need for further research in this population and the development of culturally sensitive interventions.
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Affiliation(s)
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology
- Old Dominion University
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30
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Messer M, McClure Z, Norton B, Smart M, Linardon J. Using an app to count calories: Motives, perceptions, and connections to thinness- and muscularity-oriented disordered eating. Eat Behav 2021; 43:101568. [PMID: 34543856 DOI: 10.1016/j.eatbeh.2021.101568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/06/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
The number of people counting calories through apps is increasing, yet concerns have been raised that this could trigger symptoms of eating disorders. Although associations between calorie tracking and eating disorder symptomatology have been identified, further research is needed to understand motives for, and the perceived impact of, using a calorie tracking app. This study addressed these gaps with data collected from 1357 adults. A high percentage of participants (n = 964; 71%) had used a calorie tracking app; 531 participants (39%) reported currently using a calorie tracking app. Prior users reported higher levels of thinness- and muscularity-oriented disordered eating than non-users. Those using a calorie tracking app for weight-control/shape reasons were more likely to report that the app had contributed to several eating disorder symptoms (i.e., food preoccupation, all-or-none thinking around food, food anxiety, purging behaviours) than those using an app for health/disease prevention reasons. Engaging in a calorie tracking app for weight/shape reasons was associated with higher perceived helpfulness of calorie tracking app ratings and higher symptom severity. Findings suggest that underlying motives may be important to consider in research investigating the use of calorie tracking apps, as well as for health professionals working with clients engaging in these dietary monitoring tools.
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Affiliation(s)
- Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
| | - Zoe McClure
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Bethany Norton
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Melanie Smart
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
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31
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Roche C, Trompeter N, Bussey K, Mond J, Cunningham ML, Murray SB, Lonergan A, Mitchison D. Gender compatibility and drive for muscularity among adolescent boys: Examining the indirect effect of emotion regulation difficulties. Body Image 2021; 39:213-220. [PMID: 34500425 DOI: 10.1016/j.bodyim.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
The drive for muscularity continues to be a prominent concern among adolescent boys. However, it is unknown how gender compatibility (gender typicality and gender contentedness) relates to this pursuit. The present study sought to examine the link between gender compatibility and drive for muscularity among male adolescents, and whether this is partially accounted for by emotion regulation difficulties. Participants were 903 male adolescents, aged 11-19 years, who completed self-report measures as part of the EveryBODY study. Using path analysis, a proposed mediation model was assessed, testing an indirect pathway of gender compatibility and drive for muscularity through emotion regulation difficulties. Findings showed an indirect pathway between gender compatibility and drive for muscularity through emotion regulation difficulties. That is, boys who were more content with their male gender and believed they were typical of their gender reported fewer emotion regulation difficulties and, in turn, exhibited a lower drive for muscularity. Findings support theoretical perspectives integrating masculinity and muscularity in boys, in that those who feel less compatible with their masculinity could be susceptible to developing a greater drive for muscularity to regulate distress deriving from perceptions of not being sufficiently masculine. This study sets the groundwork for future longitudinal studies.
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Affiliation(s)
- Claudia Roche
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
| | | | - Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, CA, United States
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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Siegel JA, Huellemann KL, Calogero RM, Roberts TA. Psychometric properties and validation of the Phenomenological Body Shame Scale - Revised (PBSS-R). Body Image 2021; 39:90-102. [PMID: 34217949 DOI: 10.1016/j.bodyim.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022]
Abstract
Body shame is a common experience among women yet a challenging phenomenon to operationalize, and measures of body shame often fail to capture its embodied aspects. In this article, we examined the structural and psychometric properties of an existing measure of body shame that was developed by Fredrickson et al. (1998) to assess the motivational and behavioral components of feeling body shame. Across three studies, women participants completed the Phenomenological Body Shame Scale (PBSS) and measures of theoretically related constructs in counterbalanced order via online survey platforms. The results demonstrate evidence of construct validity for an abbreviated, 8-item measure of phenomenological body shame (PBSS-R). In Study 1 (n = 341 community women), we evaluated and confirmed the scale's structural validity as a unidimensional measure. In Study 2 (n = 204 college women), we demonstrated positive associations between the PBSS-R and negative body image attitudes and behaviors, and negative associations with self-compassion, supporting the scale's external validity. In Study 3 (n = 235 community women), the PBSS-R explained variance in intuitive eating and happiness above theoretically related measures of self-objectification and body shame, supporting the scale's incremental validity. We recommend use of this abbreviated measure to assess the more embodied and less evaluative features of body shame in women.
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Affiliation(s)
- Jaclyn A Siegel
- Western University, Department of Psychology, London, ON, Canada.
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Nagata JM, Peebles R, Hill KB, Gorrell S, Carlson JL. Associations between ergogenic supplement use and eating behaviors among university students. Eat Disord 2021; 29:599-615. [PMID: 32129729 PMCID: PMC7483647 DOI: 10.1080/10640266.2020.1712637] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ergogenic supplements to improve athletic performance are commonly used among college athletes, but little is known about their association with eating disorder symptoms. The objective of this study was to examine associations between ergogenic supplement use and disordered eating attitudes and behaviors among university students, and to compare differences by sex. Undergraduate students from 10 top-ranked National College Athletics Association (NCAA) Division I colleges completed an online survey on supplement use, athletic activities, and eating attitudes and behaviors. Among 1633 university students, males (38.9%) reported higher rates of current supplement use than females (15.2%) (p < .001). In linear regression models adjusting for athletic status and body mass index, current supplement use was associated with higher Eating Disorders Examination-Questionnaire (EDE-Q) Global, Shape Concern, and Restraint scores in both males and females. Supplement use was associated with driven/compelled exercise (OR 2.00, 95% CI 1.33-2.99) in males and diuretic (OR 6.39, 95% CI 2.02-20.22) and diet pill use (OR 3.07, 95% CI 1.79-5.27) in females. Results suggest ergogenic supplement use is common in undergraduates and associated with disordered eating attitudes and behaviors. Clinicians should screen for disordered eating behaviors particularly in young adults who use ergogenic supplements.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Rebecka Peebles
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Katherine B Hill
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sasha Gorrell
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Jennifer L Carlson
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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Cunningham ML, Rodgers RF, Pinkus RT, Nagata JM, Trompeter N, Mitchison D, Murray SB, Szabo M, Lavender JM. Factor structure and psychometric properties of the Muscularity-Oriented Eating Test in university women in Australia. Int J Eat Disord 2021; 54:1956-1966. [PMID: 34661291 DOI: 10.1002/eat.23621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Toned muscularity continues to emerge as a salient aspect of women's body image. However, there is a dearth of research investigating the potentially maladaptive eating practices and related cognitions that accompany the drive for muscularity in women. This may be attributable to the limited empirical and clinical attention previously given to muscularity-oriented disordered eating and, accordingly, the lack of validated measures assessing these concerns. To address this knowledge gap, our study aimed to provide a preliminary evaluation of the factor structure and core psychometric properties of a recently developed measure of muscularity-oriented disordered eating, the Muscularity-Oriented Eating Test (MOET), in university women in Australia. METHOD Participants included 419 university women who completed the 15-item MOET and other self-report measures for validity evaluation as part of an online survey. Data from split-half samples were used to undertake an exploratory factor analysis and subsequent confirmatory factor analysis. RESULTS Factor analytic results supported a briefer (12-item), one-factor scale in this sample of university women. The internal consistency reliability and validity (convergent and discriminant) of this 12-item unidimensional MOET was supported. DISCUSSION Our study provides preliminary support for this modified MOET as a psychometrically sound self-report measure of muscularity-oriented disordered eating in university women in Australia, providing a useful tool for understanding maladaptive eating behaviors and cognitions concomitant to the pursuit of muscularity in this population.
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Affiliation(s)
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Rebecca T Pinkus
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Metis Foundation, San Antonio, Texas, USA
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Ganson KT, Nagata JM, Lavender JM, Rodgers RF, L Cunningham M, Murray SB, Hammond D. Prevalence and correlates of weight gain attempts across five countries. Int J Eat Disord 2021; 54:1829-1842. [PMID: 34415082 DOI: 10.1002/eat.23595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the prevalence and correlates of weight gain attempts in a pooled sample of adults aged 18 and older from Canada, Australia, the United Kingdom, the United States, and Mexico. METHOD Data collected during 2 years (2018 and 2019) of the International Food Policy Study (N = 42,108) were analyzed. Unadjusted 12-month prevalence of weight gain attempts was estimated based on body mass index (BMI; kg/m2 ), weight perception, country, survey year, and sex. Logistic regression analyses were estimated to determine the sociodemographic correlates (age, race/ethnicity, education, BMI, weight perception, weight perception accuracy, and self-rated mental health) of weight gain attempts among the pooled sample stratified by sex. RESULTS Men (10.4%) were significantly more likely than women (5.4%) to report weight gain attempts (p < .001). Nearly one in five (17.1%) men with a BMI in the "normal" range (≥18.5 to <25.0) reported weight gain attempts. Among both men and women, minority group identity was associated with higher odds, while older age and higher BMI category were associated with lower odds, of reporting weight gain attempts. Country differences over the two survey years showed the prevalence of weight gain attempts in 2019 (vs. 2018) was higher among women in Australia (p < .05) and men in the United States (p < .01). DISCUSSION Weight gain attempts are more common among men, compared to women, across five countries, potentially reflecting the global salience of the pursuit of a muscular body.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, Maryland, USA.,Metis Foundation, San Antonio, Texas, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | | | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Glazer KB, Ziobrowski HN, Horton NJ, Calzo JP, Field AE. The Course of Weight/Shape Concerns and Disordered Eating Symptoms Among Adolescent and Young Adult Males. J Adolesc Health 2021; 69:615-621. [PMID: 34074590 PMCID: PMC8429109 DOI: 10.1016/j.jadohealth.2021.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE Male weight concerns tend to focus on shape and muscularity as opposed to a desire for thinness and remain underdetected by conventional eating disorder assessments. We aimed to describe the longitudinal course of weight concerns and disordered eating behaviors among males across adolescence and young adulthood. METHODS We used prospective assessments of 4,489 U S. males, aged 11 to 18 years at baseline of analyses, in the Growing Up Today Study. We assigned mutually exclusive classifications of behaviors consistent with bulimia nervosa (BN), binge eating disorder (BED), purging disorder (PD); high levels of concern with thinness and/or muscularity; and use of muscle-enhancing products. We estimated the probability of maintenance, resolution, or transition to different weight concerns and/or disordered eating behaviors across consecutive survey waves. RESULTS Less than 1% of participants met full or partial criteria for BN, PD, or BED at baseline. One-quarter (25.4%, n = 1,137) of males reported high weight concerns during follow-up; nearly all these cases (93.7%, n = 1,065) had high muscularity concerns. The most common transition in concerns or behaviors involved the addition of muscularity concerns to a preoccupation with thinness. Eleven percent of participants used muscle-building products during follow-up. Multi-year product use (23.0% [standard deviation 1.0%] of males who used products) was more common than maintenance of bulimic behaviors (3.0% [.7%] of BN/PD, 10.5% [1.2%] of BED cases). CONCLUSIONS Integrating muscularity concerns and product use into health promotion and screening tools may improve prevention and early detection of harmful body image and weight control among adolescent and young adult males.
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Affiliation(s)
- Kimberly B. Glazer
- Department of Population Health Science & Policy and the Blavatnik Family Women’s Health Research Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, New York, USA
| | - Hannah N. Ziobrowski
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, Massachusetts, USA
| | - Nicholas J. Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts, USA
| | - Jerel P. Calzo
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts,Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Alison E. Field
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S121, Floor 2, Providence, Rhode Island, USA,Department of Pediatrics, Warren Alpert Medical School, Providence, Rhode Island, USA
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Nattiv A, De Souza MJ, Koltun KJ, Misra M, Kussman A, Williams NI, Barrack MT, Kraus E, Joy E, Fredericson M. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part 1: Definition and Scientific Basis. Clin J Sport Med 2021; 31:335-348. [PMID: 34091537 DOI: 10.1097/jsm.0000000000000946] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/23/2021] [Indexed: 02/02/2023]
Abstract
ABSTRACT The Male Athlete Triad is a syndrome of 3 interrelated conditions most common in adolescent and young adult male endurance and weight-class athletes and includes the clinically relevant outcomes of (1) energy deficiency/low energy availability (EA) with or without disordered eating/eating disorders, (2) functional hypothalamic hypogonadism, and (3) osteoporosis or low bone mineral density with or without bone stress injury (BSI). The causal role of low EA in the modulation of reproductive function and skeletal health in the male athlete reinforces the notion that skeletal health and reproductive outcomes are the primary clinical concerns. At present, the specific intermediate subclinical outcomes are less clearly defined in male athletes than those in female athletes and are represented as subtle alterations in the hypothalamic-pituitary-gonadal axis and increased risk for BSI. The degree of energy deficiency/low EA associated with such alterations remains unclear. However, available data suggest a more severe energy deficiency/low EA state is needed to affect reproductive and skeletal health in the Male Athlete Triad than in the Female Athlete Triad. Additional research is needed to further clarify and quantify this association. The Female and Male Athlete Triad Coalition Consensus Statements include evidence statements developed after a roundtable of experts held in conjunction with the American College of Sports Medicine 64th Annual Meeting in Denver, Colorado, in 2017 and are in 2 parts-Part I: Definition and Scientific Basis and Part 2: The Male Athlete Triad: Diagnosis, Treatment, and Return-to-Play. In this first article, we discuss the scientific evidence to support the Male Athlete Triad model.
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Affiliation(s)
- Aurelia Nattiv
- Division of Sports Medicine and Non-Operative Orthopaedics, Departments of Family Medicine and Orthopaedic Surgery, University of California Los Angeles, Los Angeles, California
| | - Mary Jane De Souza
- Department of Kinesiology, Penn State University, University Park, Pennsylvania
| | - Kristen J Koltun
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andrea Kussman
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Nancy I Williams
- Department of Kinesiology, Penn State University, University Park, Pennsylvania
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, California; and
| | - Emily Kraus
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | | | - Michael Fredericson
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
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Kvaløy K, Sandsgård-Hilmarsen E, Eik-Nes TT, Bratberg GH. Underestimation of Overweight and Health Beneficial Outcomes in Two Adolescent Cohorts in Norway - The HUNT Study. J Adolesc Health 2021; 69:82-89. [PMID: 33288462 DOI: 10.1016/j.jadohealth.2020.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/30/2020] [Accepted: 10/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Underestimating overweight may prevent efforts toward reducing weight, but simultaneously benefit mental health and well-being. The magnitude of underestimation of overweight and obesity in adolescents is largely unknown, and so is to what extent this underestimation is associated with dieting behaviors, mental distress, and life satisfaction. As overweight has become more common during the past decades, associations between body size underestimation and mental health may have changed. METHODS Overweight (iso-body mass index, iso-BMI ≥25) adolescents (aged 13-19 years) who participated in The Young-HUNT1 (1995-97, n = 1,338) or The Young-HUNT3 (2006-08, n = 1,833) surveys were included. Being overweight, but perceiving oneself as average-weighted or underweighted was defined as underestimation. Results were based on clinical examinations and self-report questionnaires. Multivariable logistic regression models were used to examine associations between body size underestimation, dieting behaviors, and symptoms of anxiety, depression, and life satisfaction. RESULTS Among adolescents with overweight and obesity (iso-BMI ≥25), the prevalence of obesity (iso-BMI ≥30), body size underestimation, and having symptoms of anxiety and depression had increased from the first survey to the next. At both time points, body size underestimation was more common among boys than girls. In 2006-08, body size underestimation was negatively associated with symptoms of anxiety and depression in both sexes, and overall associated with higher life satisfaction equally over time. Dieting behavior was negatively associated with underestimation of body size. CONCLUSIONS Body size underestimation in adolescents with overweight/obesity has become more prevalent and a phenomenon associated with less dieting, better life satisfaction and mental health in both boys and girls.
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Affiliation(s)
- Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
| | - Eli Sandsgård-Hilmarsen
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine Tetlie Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway; Stjørdal Community Mental Health Centre, Nord-Trøndelag Hospital Trust, Stjørdal, Norway
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Seekis V, Bradley GL, Duffy AL. How is Trait Self-Compassion Used During Appearance-Related Distress by Late Adolescents and Emerging Adults With Positive or Negative Body Image? A Qualitative Study. JOURNAL OF ADOLESCENT RESEARCH 2021. [DOI: 10.1177/07435584211011471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Having a positive body image contributes to adolescents’ and emerging adults’ psychological well-being. One approach to protecting one’s body image from appearance threats involves adopting a self-compassionate perspective. This study explored how six different facets of trait self-compassion are used by late adolescents and emerging adults to cope with appearance-related distress. Following Institutional Review Board approval, in-depth interviews were conducted with 16 female and 14 male undergraduates ( Mage = 18.77 years, SD = 1.77 years) who reported either positive or negative body image and high or low self-compassion. Adopting a descriptive/confirmative approach, data were analyzed via an a priori coding system based on the six facets of self-compassion. Only one self-compassion facet, self-kindness, was reportedly used to counteract body-related distress, and only by those with a positive body image. Most participants with negative body image engaged in self-judgment, with some expressing a fear of self-kindness. Despite being acknowledged by all, the facet of common humanity was not used for appearance-related affect regulation. Participants showed limited practice of the mindfulness facet. Together, the findings show that scope remains for achieving reductions in body image distress, and corresponding gains in resilience, through self-compassion interventions.
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Affiliation(s)
- Veya Seekis
- Griffith University, Gold Coast, Queensland, Australia
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Gewirtz O'Brien JR, Sim L, Narr C, Mattke A, Billings M, Jacobson RM, Lebow J. Addressing Disparities in Adolescent Eating Disorders: A Case Report of Family-Based Treatment in Primary Care. J Pediatr Health Care 2021; 35:320-326. [PMID: 33516619 DOI: 10.1016/j.pedhc.2020.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/23/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
Eating disorders typically have a protracted course, marked by significant morbidity. Male adolescents and adolescents of color are at risk of delayed care. Primary care providers are well-positioned to identify eating disorders early and initiate treatment. This case report describes an adaptation of Family-Based Treatment delivered by a primary care provider to an Asian-American male adolescent from an immigrant family with restrictive anorexia nervosa. The adolescent achieved full-weight restoration and remission of his anorexia through treatment in primary care. Embedding eating disorder treatment within primary care could improve detection, engagement, and retention in treatment among young people from diverse backgrounds.
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Examining the impact of weight bias on the association between exercise identity and maladaptive exercise behaviors. Eat Behav 2021; 41:101503. [PMID: 33836341 DOI: 10.1016/j.eatbeh.2021.101503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Though exercise behaviors are typically viewed as health-promoting, certain forms of exercise (i.e., excessive exercise, unhealthy muscle-building behaviors) are considered maladaptive and are associated with negative physical and psychological outcomes. Psychosocial factors may put people at greater risk for engaging in maladaptive exercise. Based on deviance regulation theory, weight bias was examined as a potential moderator of the association between exercise identity and both excessive exercise and muscle-building behaviors. DESIGN The current study is a secondary analysis of a larger data set investigating associations between athletic identity, exercise behaviors, and disordered eating behaviors. Hypotheses were examined using moderation testing in multiple linear regression. MAIN OUTCOME MEASURES Participants (N = 225, 50.2% female) completed the Eating Pathology Symptoms Inventory as a measure of maladaptive exercise. RESULTS Controlling for sex, age, athlete status, and body mass index, weight bias moderated the association between exercise identity and both excessive exercise and muscle-building behaviors. Among individuals with high exercise identity, higher weight bias was associated with increased maladaptive exercise behaviors. CONCLUSION Individuals with higher exercise identity and higher weight bias may be at greatest risk of engaging in maladaptive exercise. Preventive interventions for maladaptive exercise behaviors may consider targeting exercise identity and weight bias.
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Ganson KT, Murray SB, Mitchison D, Hawkins MAW, Layman H, Tabler J, Nagata JM. Associations between Adverse Childhood Experiences and Performance-Enhancing Substance Use among Young Adults. Subst Use Misuse 2021; 56:854-860. [PMID: 33726612 PMCID: PMC11385237 DOI: 10.1080/10826084.2021.1899230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Adverse childhood experiences (ACEs) are associated with negative health outcomes, yet their associations with performance-enhancing substance (PES) use are unclear. This study aimed to determine whether ACEs predict greater use of legal and illegal PES in young adults. METHODS We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (n = 14,322), Waves I (1994-1995) and III (2001-2002). ACEs included childhood sexual abuse, physical abuse, two neglect indicators, and cumulative ACEs. Legal (e.g. creatine monohydrate) and illegal (e.g. non-prescription anabolic-androgenic steroids; AAS) PES use was assessed. RESULTS Sexual abuse had the greatest effect and predicted higher odds of legal PES use (men: adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.06-2.59; women: AOR 3.74, 95% CI 1.63-8.59) and AAS use (men: AOR 8.89, 95% CI 5.37-14.72; women: AOR 5.73, 95% CI 2.31-14.18). Among men, a history of physical abuse (AOR 3.04, 95% CI 2.05-4.52), being left alone by a parent/guardian (AOR 2.33, 95% CI 1.50-3.60), and basic needs not being met (AOR 3.47, 95% CI 2.30-5.23) predicted higher odds of AAS use. Among women, basic needs not being met (AOR 2.94, 95% CI 1.43-6.04) predicted higher odds of AAS use. Among both men and women, greater number of cumulative ACEs predicted higher odds of both legal and illegal PES use. CONCLUSIONS ACEs predict greater PES use among young adults. Clinicians should monitor for PES use among those who have experienced ACEs and provide psychoeducation on the adverse effects associated with PES use.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Harley Layman
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, College of Arts and Sciences, University of Wyoming, Laramie, Wyoming, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Mikhail ME, Klump KL. A virtual issue highlighting eating disorders in people of black/African and Indigenous heritage. Int J Eat Disord 2021; 54:459-467. [PMID: 33180348 PMCID: PMC7956059 DOI: 10.1002/eat.23402] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 12/13/2022]
Abstract
While eating disorders affect people from all racial/ethnic backgrounds, research has traditionally focused on eating disorders in white populations. In this virtual issue, we present a collection of 14 articles previously published in the International Journal of Eating Disorders highlighting eating disorders in people of black/African and Indigenous heritage. Featured articles examine the prevalence and presentation of disordered eating in black and Indigenous populations; access to care and treatment experiences for black and Indigenous people; and environmental stressors, such as acculturative stress and discrimination, that may contribute to disordered eating in these populations. Future directions for inclusive research with people of black/African and Indigenous heritage are discussed, including reporting participant demographics, examining differences in risk factors and treatment outcomes across race/ethnicity, and partnering with black and Indigenous communities to produce culturally sensitive research attuned to the needs and priorities of these populations.
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Affiliation(s)
- Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Neumark-Sztainer D, Wall MM, Levine A, Barr-Anderson DJ, Eisenberg ME, Larson N. Yoga practice among ethnically/racially diverse emerging adults: Associations with body image, mindful and disordered eating, and muscle-enhancing behaviors. Int J Eat Disord 2021; 54:376-387. [PMID: 33277727 PMCID: PMC8436956 DOI: 10.1002/eat.23421] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study explores cross-sectional associations between yoga and body image, mindful eating, disordered eating, and muscle-enhancing behaviors among a population-based sample of ethnically/racially diverse emerging adults. METHOD An ethnically/racially diverse population-based sample of 1,568 emerging adults (18-26 years) completed surveys as part of EAT 2010-2018 (Eating and Activity over Time). Models were adjusted for sociodemographic characteristics and body mass index (BMI). RESULTS Practicing yoga at least 30 min/week was reported by 12.7% (n = 210) of the sample. Yoga practitioners had higher levels of mindful eating than those not practicing yoga. Although effect sizes were small, yoga practitioners were more likely than non-yoga practitioners to use steroids (3.8 vs. 0.7%, p < .001, h = 0.22) or protein powder/shakes (35.1 vs. 25.3%, p < .010, h = 0.21) to increase their muscle size/tone. Body satisfaction, unhealthy weight control behaviors, and binge eating tended to be similar among yoga practitioners and non-yoga practitioners. There was a significant interaction between BMI and yoga in predicting body satisfaction with a trend toward a positive impact among yoga practitioners at higher BMI values. Interactions between yoga practice and all body image attitudes and behaviors across gender and ethnicity/race were not statistically significant. DISCUSSION Young people from diverse ethnic/racial backgrounds who practice yoga are more likely to engage in mindful eating but have equal or elevated levels of unhealthy body image attitudes and behaviors as compared to non-yoga practitioners. Further research should explore how yoga is best taught and practiced to ensure that it is beneficial for body image and related behaviors.
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Affiliation(s)
- Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melanie M Wall
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | | | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Kelly NR, Kosty D, Guerricabeitia L, Guidinger C, Williamson G. Evaluating components of existing theories for loss of control eating in a sample of young racially/ethnically diverse men. Body Image 2020; 35:63-70. [PMID: 32877842 DOI: 10.1016/j.bodyim.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 01/23/2023]
Abstract
The current study evaluated components of existing theoretical models for loss of control (LOC) eating in young men. The link between body image concerns, including concerns with fat and muscularity, and LOC eating frequency was evaluated in 1109 ethnically/racially diverse men (18-30y). Dietary restraint, compulsive exercise, and emotion dysregulation were evaluated as putative mediators. Body mass index (BMI) and race/ethnicity were examined as moderators. Participants completed online surveys. Path analyses in Mplus tested indirect paths using the bias-corrected bootstrap method. Higher body fat concerns were directly linked to LOC eating frequency and indirectly linked through greater dietary restraint, compulsive exercise, and emotional dysregulation (ps<.01). The link among fat concerns, restraint, and LOC eating frequency was moderated by body mass, such that this association was particularly strong for men with a low-to-average BMI relative to those with a high BMI (p < .001). Higher muscularity concerns were not directly linked to LOC eating frequency but were indirectly linked through greater emotion dysregulation (p < .001). Body image concerns are associated with LOC eating in young men. The pathways to LOC eating may differ depending on the nature of men's body image concerns (muscularity vs. thinness). Prospective data are needed to verify these findings.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States.
| | - Derek Kosty
- The Prevention Science Institute, University of Oregon, United States
| | | | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
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Abstract
PURPOSE OF REVIEW To review the recent literature on eating disorders, disordered eating behaviors (DEB), and body image dissatisfaction among sexual and gender minority populations, including, but not limited to, gay, lesbian, bisexual, and transgender people. RECENT FINDINGS Overall, eating disorders, DEB, and body dissatisfaction are common among sexual and gender minority populations. Lifetime prevalence for anorexia nervosa (1.7%), bulimia nervosa (1.3%), and binge-eating disorder (2.2%) diagnoses are higher among sexual minority adults compared with cisgender heterosexual adults in the United States. Lifetime prevalence of eating disorders by self-report of a healthcare provider's diagnosis are 10.5% for transgender men and 8.1% for transgender women in the United States, including anorexia nervosa (4.2 and 4.1%) and bulimia nervosa (3.2 and 2.9%), respectively. DEB may be perpetuated by minority stress and discrimination experienced by these individuals. Body dissatisfaction may be a core stressor experienced by transgender people; gender dysphoria treatment has been shown to increase body satisfaction. A particular clinical challenge in caring for transgender youth with eating disorders is the standard use of growth charts based on sex. SUMMARY Novel research demonstrates that sexual and gender minorities with eating disorders have unique concerns with regards to disordered eating and body image.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ganson KT, Mitchison D, Murray SB, Nagata JM. Legal Performance-Enhancing Substances and Substance Use Problems Among Young Adults. Pediatrics 2020; 146:peds.2020-0409. [PMID: 32868471 PMCID: PMC7461208 DOI: 10.1542/peds.2020-0409] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Legal performance-enhancing substance(s) (PES) (eg, creatine) are widely used among adolescent boys and young men; however, little is known about their temporal associations with substance use behaviors. METHODS We analyzed prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I to IV (1994-2008). Logistic regressions were used to first assess adolescent substance use (Wave I) and use of legal PES (Wave III) and second to assess use of legal PES (Wave III) and subsequent substance use-associated risk behaviors (Wave IV), adjusting for potential confounders. RESULTS Among the sample of 12 133 young adults aged 18 to 26 years, 16.1% of young men and 1.2% of young women reported using legal PES in the past year. Adolescent alcohol use was prospectively associated with legal PES use in young men (odds ratio 1.39; 95% confidence interval [CI] 1.13-1.70). Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, including binge drinking (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.71), injurious and risky behaviors (aOR 1.78; 95% CI 1.43-2.21), legal problems (aOR 1.52; 95% CI 1.08-2.13), cutting down on activities and socialization (aOR 1.91; 95% CI 1.36-2.78), and emotional or physical health problems (aOR 1.44; 95% CI 1.04-1.99). Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems (aOR 3.00; 95% CI 1.20-7.44). CONCLUSIONS Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University
of Toronto, Toronto, Ontario, Canada
| | - Deborah Mitchison
- Translational Health Research Institute, School of
Medicine, Western Sydney University, Sydney, New South Wales, Australia;,Department of Psychology, Macquarie University,
Sydney, New South Wales, Australia
| | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences,
University of Southern California, Los Angeles, California; and
| | - Jason M. Nagata
- Division of Adolescent and Young Adult Medicine,
Department of Pediatrics, University of California, San Francisco, San
Francisco, California
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48
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Cunningham ML, Nagata JM, Frederick D, Rodgers RF, Lavender JM, Szabo M, Murray SB. Who's the 'bigger' man? Parsing the relationships between masculinity and men's muscularity dissatisfaction. Body Image 2020; 34:94-100. [PMID: 32659680 DOI: 10.1016/j.bodyim.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 02/08/2023]
Abstract
Muscularity dissatisfaction is documented to be a pervasive phenomenon among men. While previous studies have examined theoretically relevant predictors of muscularity dissatisfaction, such as adherence to traditional masculine norms, to the best of our knowledge we are not aware of empirical research that has assessed how perceived discrepancies in one's level of masculinity may also be associated with these concerns. Therefore, the objective of this study was to determine whether perceived deficits in masculinity bear predictive utility over and above adherence to traditional masculine norms in the context of muscularity dissatisfaction. An online survey that included measures assessing the aforementioned constructs was completed by 390 university and community adult men. A hierarchical regression analysis showed that while adherence to masculine norms was associated with increased muscularity dissatisfaction, masculine role discrepancy (and attendant stress) were particularly strong predictors of muscularity dissatisfaction. Our findings make a novel contribution to the male body image literature by demonstrating the relative importance of perceived discrepancies in masculinity, and related stress, in the context of muscularity dissatisfaction. Pending replication in relevant clinical samples using prospective designs, this study provides preliminary evidence that masculine role discrepancies may be promising targets to help allay muscularity concerns among men.
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Affiliation(s)
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, USA
| | - David Frederick
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, Montpellier, France
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA; The Metis Foundation, San Antonio, USA
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, USA
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Abstract
PURPOSE OF REVIEW Body image is a crucial part of adolescent development for teens all over the world. Studies show that negative body image impacts many aspects of adolescent health and that anticipatory guidance about body image is important at the annual health maintenance exam visit. Weight bias is closely tied to body image and is associated with negative health effects as well; research shows weight bias is a problem throughout healthcare. The purpose of this review is to discuss influencing factors on adolescent body image and to explore interventions to promote positive body image. RECENT FINDINGS Research shows that adolescent body image is shaped by media influence, athletics and personal relationships. Studies have also begun to show that negative and positive body image are separate entities, and that overall health outcomes seem to be better in adolescents with positive body image. In thinking about intervention, there are ways to promote positive body image in the provider--patient interaction, within the school and community, in healthcare education, and at the societal level. SUMMARY Body image is an incredibly important aspect of adolescent health, and clinicians should be aware of ways to help promote positive body image in adolescents.
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50
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Abstract
PURPOSE OF REVIEW To review the recent literature on eating disorders and disordered eating behaviors among adolescent boys and young men, including epidemiology, assessment, medical complications, treatment outcomes, and special populations. RECENT FINDINGS Body image concerns in men may involve muscularity, and muscle-enhancing goals and behaviors are common among adolescent boys and young men. Recent measures, such as the Muscularity Oriented Eating Test (MOET) have been developed and validated to assess for muscularity-oriented disordered eating. Medical complications of eating disorders can affect all organ systems in male populations. Eating disorders treatment guidance may lack specificity to boys and men, leading to worse treatment outcomes in these population. Male populations that may have elevated risk of eating disorders and disordered eating behaviors include athletes and racial/ethnic, sexual, and gender minorities. SUMMARY Eating disorders and disordered eating behaviors in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating. Treatment of eating disorders in boys and men may be adapted to address their unique concerns.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- School of Social Work, Simmons University, Boston, MA, USA
| | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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