Associations of parents' self, child, and other "fat talk" with child eating behaviors and weight

Raising Confident Girls: A pragmatic school-based trial of a body image and parenting program for mothers of adolescent girls

This study evaluated Raising Confident Girls (RCG), delivered to mothers of Year 8 students (mean age 12.8-years) who were receiving the classroom-based Dove Confident Me (DCM) program. RCG is an interactive, multi-session intervention designed to improve body image in mothers in order to enhance their capacity to parent and role model this to their daughters. A pragmatic non-randomised controlled trial involved delivery of the program to mothers (n = 69) over three, 2-hour seminars in evenings, compared with a comparison group (n = 51). The study took place at an independent all-girls secondary school in Australia. Multilevel mixed modelling analyses compared pre- and post-test scores on standardized scales. Mothers who participated in the program had significantly higher scores on primary outcome variables of body esteem and body appreciation compared to the comparison group at post-test. Further, participation significantly improved mother's knowledge, confidence, and skills for parenting, and improved role modeling of positive body image. Mothers were well engaged, with low attrition rates, and rated the program highly. The RCG program was effective and engaging for mothers, offering deeper insight into improving parental engagement in body image interventions delivered within the school context.

Adolescent-perceived parent-child negative body talk and disordered eating: Evidence for behavior-specific affective mediators

INTRODUCTION

This study examined the mediating role of general negative affect and body-specific negative affect between the association between negative body talk occurring within the mother-daughter relationship and restrained and disinhibited disordered eating.

METHODS

Adolescent girls (N = 100; Mage = 14.25; 49.5% White) completed self-report measures of general negative affect (depression and anxiety), body-specific negative affect (body dissatisfaction), and perceptions of the frequency that negative body talk occurred in interactions with their mother (initiated by the mother or daughter) as part of a cross-sectional study. While the same set of questionnaires was administered to both mothers and daughters, only the data reported by the daughters were analyzed and included in this study. Data were gathered in the Ann Arbor/Ypsilanti area of Michigan, USA, around the year 2015.

RESULTS

Path analysis showed that general negative affect, but not body-specific negative affect, mediated the association from mother-daughter negative body talk to disinhibited eating behaviors (emotional and external eating). Conversely, body-specific negative affect, but not general negative affect, mediated the association from negative body talk to restrained eating behaviors.

CONCLUSIONS

Our findings suggest there are distinct affective mechanisms that mediate the relationship between mother-daughter negative body talk and restrained versus disinhibited eating behavior. Future work should continue to explicate the role of general and body-related negative affect in different eating behaviors.

Examining parents' experiences and challenges of feeding preschool children with avid eating behaviour

Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child's food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents' experiences in this context. This study aimed to explore parents' experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N = 15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children's avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, 'Have they got worms? Children's insatiable hunger', captures parents' interpretation of the complex ways in which avid eating behaviour manifests. Theme two, 'Parenthood as a duty', illustrates how parents' perceived responsibilities shape their feeding practices. Theme three, 'Lifelong habits', captures parents' use of responsive feeding practices to support children's healthy relationship with food. Theme four, 'Picking battles', captures the structure- and coercive-based feeding strategies commonly used to manage children's avid eating. This novel study provides an in-depth understanding of the complex ways that children's avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.

Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing

OBJECTIVES

To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices.

STUDY DESIGN

Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest.

RESULTS

Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later.

CONCLUSIONS

Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.

Parents and caregivers as key players in the prevention and identification of body image concerns and eating disorders among early adolescents

Early adolescence (ages 11-14 years) is a key period for the emergence of body image and eating concerns, and early identification and access to treatment are imperative for positive outcomes. Despite research identifying this critical developmental period, few prevention resources are available for early adolescents. Parents are key players for this age group and important socializing agents. As such, they are well positioned to help youth access resources or support where needed. However, programs to position and involve parents as interventionists are lacking. Our aims are two-fold. First, we review the evidence for the effectiveness of parents as body image interventionists and the existing data regarding parental needs. Second, we provide directions for future research and outline a framework for empowering parents as interventionists, identifying key domains in which parents may play a role in addressing body image and eating concerns among early adolescents. Based on the extent literature, these domains include facilitating engagement with or co-utilizing intervention content to decrease body image and eating concerns in at-risk children, which may also help to increase parents' effectiveness in their efforts to support youth. In addition, parents may deliver content to decrease or reverse risk-factors and early symptoms, or disrupt the early disorder phase of illness. To date, parents constitute an underutilized resource in eating disorder and disordered eating prevention, and efforts should be made to increase the evidence-based strategies to leverage their relationship with at-risk children.

Associations between parent-adolescent health-related conversations and mealtime media use among Hispanic families

INTRODUCTION

Whereas parents play an important role in shaping the home environment, it is unknown whether health-related parent-adolescent conversations may be associated with different health-promoting parenting practices, such as limiting adolescent mealtime media use in Hispanic families.

METHOD

For this cross-sectional analysis, Hispanic parents (n = 344; 40.4 ± 6.6 years; 89.2% female) of sixth- to eighth-grade adolescents self-reported the frequency of having health- or weight-related conversations with their adolescent child, and the frequency of adolescent mealtime media device use. Spearman's rank correlations were used to assess whether parent-adolescent health-related conversations are associated with mealtime media device use by adolescents.

RESULTS

Over 75% of parents reported having conversations about healthy eating and being physically active at least a few times per week. Fewer parents reported having frequent weight-related conversations. Frequency of mealtime media use was low, except for television/movie watching (only 30% of parents reported their child rarely/never watching television during family meals). Having conversations related to the adolescent weighing too much was correlated with the mealtime use of television (r = .207; p < .001), cellphones (r = .134; p = .018), and headphones for music listening (r = .145; p = .010). Conversations about exercising to lose weight were correlated with television/movie watching during mealtimes (r = .129; p = .035).

DISCUSSION

Findings suggest the co-occurrence of less health-promoting parenting behaviors, such as focusing on weight-related conversations and allowing the use of media devices during mealtimes. Focusing on health- rather than weight-related parent-adolescent conversations and implementing mealtime media use rules may have the potential to shape a home food environment which ultimately could improve an adolescent's overall health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parent-Adolescent Weight Communication: Parental Psychosocial Correlates Among a Diverse National Sample

Parental communication about body weight with their children is common across diverse families. The current study investigates how parents' feelings about their own bodies, beliefs about body weight, history of weight stigma, and weight-related characteristics contribute to the degree to which they talk about weight - both negatively and positively - with their adolescent children. The study sample was comprised of U.S. parents (N = 1936) from diverse racial/ethnic backgrounds with children aged 10-17 years old. Parents completed an online survey with measures assessing their frequency of engaging in negative and positive weight communication with their children, along with several relevant psychosocial factors (i.e. body satisfaction, experienced weight stigma, associative stigma, body appreciation, beliefs about weight controllability, weight bias internalization). Study findings paint a complex picture, including some psychosocial factors (e.g. weight bias internalization) that are related to both more frequent negative and positive weight communication. Notably, higher levels of associative stigma were related to more frequent negative parental weight comments, and less frequent positive weight socialization. Findings can inform healthcare professionals in raising parents' awareness about how their personal beliefs and feelings about their own weight and their child's weight can contribute to how they engage in communication about weight with their children.

An Examination of Parental Weight Stigma and Weight Talk Among Socioeconomically and Racially/Ethnically Diverse Parents

Parental communication about body weight can influence children's emotional well-being and eating behaviors. However, little is known about the role of parental self-stigma concerning weight and social position variables (ie, race/ethnicity, income, and gender) in weight communication. This study examined how parents' self-stigmatization for their own weight (ie, weight bias internalization) and self-stigmatization for their child's weight (ie, affiliate stigma) relates to weight talk frequency with their children, and whether these associations vary across parental race/ethnicity, income, and gender. Parents (n = 408) completed a cross-sectional, online survey about their weight communication and self-stigmatization. Linear regression was used to examine the relationships among these variables, including interactions between the stigma variables and social position variables in predicting weight talk. Higher levels of weight bias internalization and affiliate stigma were strongly associated with increased parental weight talk frequency; parents who endorsed higher levels of internalized bias about their own weight expressed greater affiliate stigma for their child's weight, regardless of demographic characteristics or weight status. Associations between the stigma variables and weight talk outcomes were stronger among fathers and parents of higher income. Findings highlight the importance of considering weight stigma variables in parental weight communication research.

Associations among parents' internalized weight bias, negative child-focused body talk, and feeding behaviors

OBJECTIVE

Parents' negative body talk about children (negative weight/shape comments) and internalized weight bias (application of negative weight-based stereotypes to oneself) are associated with children's maladaptive eating behaviors, but mechanisms are poorly understood. Conceptually, parental behaviors and attitudes may translate to implicit and explicit concerns about their child's weight and influence parents' feeding practices. These associations are underexplored in the literature.

METHOD

242 parents (59.4% mothers) completed a one-time assessment that included measures of internalized weight bias, negative body talk, and feeding practices. Parents also completed assessments about one of their children, of any weight status (age range 5-15 years; 40% daughters).

RESULTS

Parents' internalized weight bias was positively associated with concern about their child's weight and restriction of their child's diet. Parents' negative body talk towards their child was positively associated with concern about their child's weight and shape, restriction of their child's diet, and monitoring of their child's diet. Relative to internalized weight-bias, negative body talk had a stronger correlation with parents' concern about child weight and monitoring of child's diet. Correlations did not vary by child gender or weight category.

DISCUSSION

Parents' internalized weight bias and negative body talk about their child were associated with their feeding practices across child gender and weight categories, with correlations in the small to medium range. Thus, children of all genders and weights may be vulnerable to enacted weight bias. Future studies should examine whether addressing parents' internalized weight bias and communication in family-focused interventions improves feeding practices and child well-being.

Parental Reasons for Engaging in or Avoiding Weight Talk With Children

Parental weight talk with children can have negative consequences; yet, it is not well understood why parents engage in it and if demographic differences exist. Utilizing the extant qualitative literature, we developed two scales to quantitatively examine parental reasons for engaging in and avoiding weight talk. An Internet sample of 408 US parents (64% mothers; 34% White, 33% Black, and 32% Hispanic/Latinx) completed the scales. Parents cited concern for their child's health as a primary reason for weight talk, whereas avoidance stemmed from not wanting their child to be weight-obsessed. White and Hispanic vs. Black parents, and parents with experienced weight stigma, were more likely to cite personal struggles with body weight as reasons to both engage in and avoid weight talk. Fathers vs. mothers were more likely to cite protecting their child from weight-based bullying as a reason for weight talk. Understanding these parental motivations can inform health interventions.

Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity

PURPOSE OF REVIEW

To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth.

RECENT FINDINGS

Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research. Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.

An exploration of how adolescents experience and reason their parents' comments on their weight, shape, and eating

INTRODUCTION

Disordered eating among adolescents is of increasing concern given associated physical and mental health sequelae. Cognitions underlying disordered eating are formed in childhood and adolescence. Parents are a significant presence during this period, so it is critical to understand how they influence their adolescent's eating cognitions and behaviors.

METHODS

Qualitative analysis using interpretative phenomenological analysis (IPA) methodology was employed to consider the lived experiences of 10 Australian adolescents (14-19 years), 60% female, as they engaged with their parents in a range of weight, shape, and eating communications.

RESULTS

Our inductive IPA revealed three key themes representing adolescents' experiences and meaning-making: Parents as Influencers-adolescents acknowledged parents are influencers (objects) within a wider context of community and cultural norms (symbols) and can be protective for peer influence on body image ideals; Expression and Perception-the "what" (weight-talk as an object) and the "how" (objects as independent influences) of gendered parental communication related to health and fitness ideals and illustrated diverse interpretations of both verbal and non-verbal expression; and Fertile Soil and Maturity-the adolescent's characteristics and context influence perceptions of communication, a fear of deviating from norms, and an overarching focus on being "healthy" yet not always knowing what that was. Perception of bidirectional communication also offered valuable insights into potential dangers through family loyalty and in-group permissions.

CONCLUSIONS

Findings highlight implications for the nuanced influence of parental communication and illustrate the pivotal role of parents within the bioecosystem of adolescent development.

Weight- and Health-focused Conversations in Racially/Ethnically Diverse Households With and Without a Child with Overweight/Obesity

Studies indicate parent conversations focused on child weight, shape, or size are associated with unhealthy child weight and weight-related behaviors, whereas health-focused conversations are not. Little research has examined what these types of conversations sound like, how parents respond to them, and whether households with or without a child with overweight/obesity approach these conversations differently. This study used qualitative data to identify the weight- and health-focused conversations occurring in racially/ethnically diverse households. Children ages 5-7 and their families (n=150) from six racial/ethnic groups (i.e., African American, Hispanic, Hmong, Native American, Somali, White) participated in this mixed-methods study. Results showed that parents from households with and without a child with overweight/obesity engaged in similar weight- and health-focused conversations (qualitative themes = focus on growth; health consequences of having overweight/obesity; focus on dietary intake and physical activity; being direct about weight, shape or size; mixing weight- and health-focused conversations). In addition, findings showed that parents also engaged in different types of weight- and health focused conversations depending on whether the household had a child with overweight/obesity (qualitative themes = weight-based teasing; critiquing own weight) or without overweight/obesity (qualitative themes = differences in body shape and size are the norm; focus on modeling rather than talking). Results may be useful for informing public health interventions and for health care providers working with parents regarding weight- and health-focused conversations occurring in home environments of diverse children.

Associations between Parents' Body Weight/Shape Comments and Disordered Eating Amongst Adolescents over Time-A Longitudinal Study

Parents are key influencers of adolescents' attitudes on weight, shape, and eating, and make more positive than negative comments, with negative comments most impactful. This study examined prospective unique associations of parental positive and negative comments in a community sample of adolescents with paediatric psychosocial quality of life (PED-QoL), Eating Disorder Weight/Shape Cognitions (EDEQ-WS), BMI percentile, and Psychological Distress (K10) scales. Data were from 2056 adolescents from the EveryBODY study cohort. Multiple regressions were conducted for the impacts of parental positive and negative comments on four dependent variables at one year after controlling for their stage of adolescence (early, middle, late). Multiple imputation and bootstrapping were used for handling missing data and violations of normality. Results indicated that positive maternal comments on eating were associated with increased EDCs and better quality of life at one year. Paternal positive weight shape comments were associated with a decrease in psychological distress, but positive eating comments saw a decrease in quality of life. Findings highlight the nuances of parental comments and how these are perceived and interpreted, and could alert health care workers and family practitioners who have weight, shape, and eating conversations to be aware of the potential influence of their communication.

An integrative model of weight stigma, body image, and physical activity in adolescents

Negative weight-related experiences and internalized weight stigma have been associated with poorer body image and reduced physical activity in adolescents. However, exploring body image and physical activity as discrete weight stigma outcomes fails to consider the theoretically- and empirically-supported covariation between the two. The present study tested a novel integrated model of the associations among negative weight-related experiences and internalized weight stigma (via weight-related distress), body image (shame, authentic pride, body appreciation), and physical activity. Canadian adolescents (N = 311, M_age ± SD = 16.00 ± 1.01, 75.5% girls) completed a cross-sectional self-report survey. A structural equation model with maximum likelihood robust estimation was tested. Higher negative weight-related experiences were indirectly associated with poorer body image (i.e., higher shame; lower authentic pride and appreciation) through higher weight-related distress. Authentic pride was associated with moderate-to-vigorous physical activity. Higher negative weight-related experiences were indirectly associated with lower physical activity through higher weight-related distress and lower body-related authentic pride. These findings elucidate targetable individual mechanisms and larger systems that could improve body image and foster physical activity among adolescents who encounter negative weight-related experiences and internalized weight stigma.

"Look beyond the weight and accept me": Adolescent perspectives on parental weight communication

Critical weight communication between parents and their adolescent children is prevalent and harmful. However, research on adolescent perspectives about parental weight communication is limited. The present mixed-methods study aimed to address this gap using inductive thematic analysis of 1743 adolescents' (M_age=14.61 years, SD_age=2.48) preferences regarding parental weight communication in response to an open-ended prompt, and quantitative analyses to examine age, gender, race/ethnicity, and weight-related differences in subthemes. In their responses, adolescents articulated 1) whether and 2) how parental weight communication should-or should not-occur, and 3) what these conversations should entail. We identified 15 subthemes across these categories-the endorsement of which often varied by adolescents' demographic and anthropometric characteristics. For example, some adolescents (especially cisgender girls and transgender/gender diverse adolescents) preferred that their parents talk about weight less often (n = 184), while others (especially multiracial/ethnic or Hispanic/Latinx adolescents) hoped that, if parents were to discuss weight with them, they do so in a manner that was compassionate and respectful (n = 150). Across most subthemes, adolescents described adverse responses (e.g., feeling insecure, embarrassed, or hurt) when parents discussed their weight in non-preferred ways. Collectively, findings can inform interventions to promote more supportive health-focused communication in families.

Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives

BACKGROUND

Little is known about parent and adolescent motivations for engaging in weight communication.

OBJECTIVES

To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management.

METHODS

Independent samples of parents (N = 1936) and unrelated adolescents (N = 2032) completed questionnaires assessing their agreement with different reasons they engage in, or avoid, parent-adolescent weight communication, using 7-point Likert scales (strongly-disagree to strongly-agree).

RESULTS

Parents, irrespective of sex, race/ethnicity, and child's weight status, expressed stronger motivations for engaging in weight communication in order for their child to feel good about his/her weight and body size compared to being motivated because a health professional raised their child's weight as a concern. Adolescent motivations for weight communication with parents stemmed from health concerns and worry about their weight; avoidance stemmed from feeling embarrassed, upset, or not wanting to obsess about weight. Differences emerged across sex and race/ethnicity but were most pronounced by weight status and weight management.

CONCLUSION

Parents and adolescents have different motivations for engaging in or avoiding weight communication. Protecting adolescents' emotional wellbeing and body esteem are viewed as reasons for both engaging in or avoiding weight communication.

A Comprehensive Examination of the Nature, Frequency, and Context of Parental Weight Communication: Perspectives of Parents and Adolescents

Research suggests that many parents make comments about their child’s weight, which is associated with negative adolescent health outcomes. Gaps in this literature include an underrepresentation of fathers, limited knowledge regarding positive versus negative parental weight comments and differences across race/ethnicity, and adolescent preferences for parental weight communication. The present study addressed these research gaps through a comprehensive investigation of two diverse samples of U.S. parents (n = 1936) and adolescents (n = 2032), who completed questionnaires about their experiences and perspectives of parental weight communication. Positive weight comments from parents were more frequent than negative comments, though both were commonly reported across sex, race/ethnicity, and weight status. In general, boys, fathers, Latino/a parents and adolescents, and adolescents with a high BMI and/or engaged in weight management reported more frequent parental weight-talk. Parent–adolescent weight communication occurred both in-person and digitally, and across daily life contexts. Although the majority of parents communicated positive messages of body diversity and respect, 44% and 63% of adolescents said they never want their mothers and fathers, respectively, to talk about their weight. Adolescents were offered circumstances that would increase their comfort level in having these conversations. Findings have implications for health professionals working with families to promote supportive health communication at home.

Exploring associations between positive and negative valanced parental comments about adolescents' bodies and eating and eating problems: a community study

BACKGROUND

Adolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one's weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons' and daughters' psychological distress and eating disorder cognitions (EDCs).

METHODS

A representative mixed-sex sample of 2204 Australian adolescents (12-19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours.

RESULTS

Correlation analyses revealed that adolescents' reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs.

CONCLUSIONS

Overall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years. Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.

Spread of gambling abstinence through peers and comments in online self-help chat forums to quit gambling

Habit formation occurs in relation to peer habits and comments. This general principle was applied to gambling abstinence in the context of online self-help forums to quit gambling. Participants in this study, conducted between September 2008 and March 2020, were 161 abstinent and 928 non-abstinent gamblers who participated in online self-help chat forums to quit gambling. They received 269,317 comments during their first 3 years of forum participation. Gamblers had an increased likelihood of 3-year continuous gambling abstinence if they had many peers in the forums. However, they had a decreased likelihood of gambling abstinence if they received rejective comments from the forums. Based on these results, online social network-based interventions may be a new treatment option for gamblers.

Weight Bias and Stigma: Impact on Health

Weight bias and stigma exist in a variety of realms in our society (media, education, employment, and health care), and unfortunately many view it as a socially acceptable form of discrimination. Patients with obesity often avoid scheduling appointments for health promotion visits and routine care due to perceived weight bias and stigma from their health care provider. Within the health care setting, it is important that health care providers strategically focus on reducing obesity bias and provide high-quality obesity management. People-first language should be used and waiting rooms and examination rooms should be accommodating to people of all sizes.

Cross-cultural adaptation of the Fat Talk Questionnaire for Brazilian Portuguese language

OBJECTIVE

To perform the cross-cultural adaptation of the Fat Talk Questionnaire into Brazilian Portuguese with focus on adolescent girls.

METHODS

The steps taken in this research were: conceptual and item equivalence, semantics, operational. The conceptual and item equivalence was performed by researchers in the field of Nutrition and body image; semantics involved translators fluent in English and Portuguese (n=3) and experts (n=19) in body image and eating behavior. Step 3 included 32 female adolescents (15 and 18 years), who answered the translated and adapted version to assess comprehension by the target audience.

RESULTS

Of the 14 items, six were considered adequate by the experts and 3 items required minimal language adjustments. Five items needed broader changes for cultural and idiomatic adaptation. The back-translation was approved by the original authors. The average response time by the adolescents was 3.5 minutes, with no queries.

CONCLUSION

The scale was translated and adapted to Brazilian Portuguese aimed at female adolescents, showing satisfactory results in the translation process, conceptual, semantic and operational equivalence. Analyses of external validity, measurement equivalence and reproducibility were also required.

"It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference

Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.

Parental feeding practices and children's disordered eating among single parents and co-parents

OBJECTIVE

Some parental feeding practices are associated with pediatric disordered eating and weight status. Existing research, however, has focused on maternal feeding practices in co-parent households. Single parents and fathers are notably understudied in this area. The current study examined associations of parental feeding practices with child disordered eating behaviors and weight, and compared associations between single mothers and fathers with a matched sample of co-parenting mothers and fathers.

METHOD

Parents (N = 524) of youth between 5 and 16 years completed an online survey that included measures of parental feeding practices and unhealthy eating/weight-related parenting practices. Co-parents were matched to each single parent based on gender, race, ethnicity, education level, age, and BMI.

RESULTS

Single parents reported significantly greater concern about their child's weight, eating and shape, and reported engaging in more restraint and restriction of their child's eating, as well as having more perceived responsibility of their child's eating than caregivers in co-parent households. Children of single parents were significantly more likely to engage in secretive eating.

DISCUSSION

Associations between single parents' feeding practices and child weight and disordered eating parallel the broader literature. There were differences between single mothers and fathers and co-parenting mothers and fathers, particularly in their report of their unhealthy eating/weight-related parenting practices. Such differences may influence children's longer-term eating behaviors and weight status. Further research on single-parent households is needed, including longitudinal and epidemiological studies.

"It really presents a struggle for females, especially my little girl": Exploring fathers' experiences discussing body image with their young daughters

Body dissatisfaction in children, particularly young girls, is a growing concern around the world. The home environment can have a strong influence on children's well-being, and parents may contribute to their children's positive or negative body image development. Nearly all research on parent influence on body image has focused on mothers, leaving fathers' attitudes and experiences poorly-understood. To address this gap in the literature, we interviewed 30 fathers (Mage = 40.30; SD = 7.48) of girls between the ages of 5 and 10 about the conversations they have with their daughters regarding body image. Through thematic analysis, we identified three primary themes: barriers to effective communication, combatting negative influences, and strategies for discussing body image. Fathers recognized the importance of talking about body image with their daughters, yet many did not feel confident or competent to do so effectively. They engaged in a variety of strategies to combat adverse cultural influences and encourage self-expression, character development, and mental and physical health in their daughters. However, messages about health were sometimes conflated with messages about thinness or food restriction. Implications for families and future research are discussed.

Prevalence of Parental Comments on Weight/Shape/Eating amongst Sons and Daughters in an Adolescent Sample

Reports suggest that 12–76% of adolescents have experienced parental comments regarding their weight/shape and/or eating behaviours. Parents may engage in conversations about weight/shape and eating out of concern, even without any ill intent; however, the associations of these comments with subsequent problematic psychosocial and eating behaviours are evidenced. Therefore, an in-depth understanding of the content and prevalence of such comments is needed. To date, adolescent-reported prevalence estimates have not included differentiation between mother or father and sons or daughters, nor have they considered eating-focussed comments. This study considered the prevalence of positive and negative parental commentary regarding weight/shape and eating with a focus on parental origin. A total of 2287 Australian male and female adolescents participated via a self-report survey. Adolescents reported frequent positive comments on weight/shape and on eating, most commonly maternal positive comments on weight/shape (78%; 95% CI 77–80). Daughters reported significantly more maternal comments on weight/shape (positive and negative) as well as more negative eating comments from mothers than did sons. Sons reported significantly more negative weight/shape comments from fathers than did daughters. Some negative comments increased significantly with age. These findings support a notable prevalence of reported parental weight/shape and eating comments directed at their offspring, particularly from mothers.

Disentangling Associations of Children's Sports Participation and Compulsive Exercise With Parenting Practices and Child Disordered Eating Behavior

PURPOSE

Exercise can enhance health and well-being. Exercise can also, when it is highly driven and compulsive, reflect eating disorder psychopathology. The present study examined associations of compulsive exercise and youth athletics with child disordered eating behaviors (overeating, binge eating, and secretive eating) and with parenting practices related to eating and weight, including how parents talk to their children about weight.

METHODS

Participants were parents (N = 875) who completed an online cross-sectional survey. Parents reported whether their child was an athlete and how often their child exercised in a "driven" or "compulsive" way to control their weight. Four groups were compared: child athletes with compulsive exercise (Group AE: n = 34, 3.9%), athletes without compulsive exercise (Group A: n = 314, 35.9%), nonathletes with compulsive exercise (Group E: n = 40, 4.6%), and nonathletes without compulsive exercise (Group X: n = 487, 55.7%).

RESULTS

There was a significant, graded association of eating/weight-related parenting: parents of Group E children had the most negative eating/weight-related parenting, followed by parents of Group AE children, followed by both noncompulsive exercise groups (Group A and Group X). Parents reported significantly more "fat talk" in both compulsive exercise groups (Group AE and Group E) than noncompulsive exercise groups (Group A and Group X). Significantly more youth had regular disordered eating behaviors (overeating, binge eating, and secretive eating) in compulsive exercise groups (Group AE and Group E) compared with noncompulsive exercise groups (Group A and Group X).

CONCLUSIONS

Overall, relatively few youth were categorized as engaging in compulsive exercise. However, compulsive exercise, particularly among nonathletes, was consistently associated with both disordered eating behaviors and eating/weight-related parenting practices. Stronger associations emerged for compulsive exercise than child athletics.

Fat talk frequency in high school women: Changes associated with participation in the Body Project

The Body Project is an evidence-based eating disorder prevention program that aims to prevent the onset of eating disorders by challenging the thin-ideal and promoting body acceptance through dissonance-based activities. One of the key program targets is fat talk, the self-deprecating communication about dissatisfaction with one's weight and shape. Fat talk, family fat talk, and weight concern are associated with body image disturbance and eating disorder development, especially in adolescent girls. Despite this, there is a gap in the research that specifically evaluates the extent to which participation in the Body Project changes fat talk frequency. In the current study, we examined change in fat talk frequency, family fat talk frequency, and weight concern among high school-aged women who participated in the peer-led Body Project. A total of 112 female students completed baseline assessments and 105 participants completed the post-intervention assessment measures for an 94 % response rate. The majority of participants (83 %) identified as Caucasian/White and ages ranged from 15 to 18 years of age. Results found that participation in the Body Project was associated with decreases in self-reported fat talk frequency, family fat talk frequency and weight concern. We discuss possible explanations for these findings and future research directions.

Associations of parental feeding practices and food reward responsiveness with adolescent stress-eating

Rates of adolescent obesity have continued to rise over the past decade. As adolescence is an important time for developing eating habits that endure into adulthood, more information is needed about the potentially modifiable family- and individual-level factors that influence the development of common overeating behaviors such as stress-eating during adolescence. In this study, we conducted secondary data analyses to evaluate how parental feeding practices and adolescents' food reward responsiveness related to adolescents' stress-eating during a laboratory test meal. Participants were 90 healthy adolescents (50% female), 12-17 years of age (M = 14.3, SD = 1.7 years), at risk for excess weight gain (BMI percentile M = 92.7, SD = 7.5). Parental feeding behaviors were assessed with parent-report on the Child Feeding Questionnaire-Adolescent Version. Adolescents' relative reward value of food was measured with a behavioral task. Stress-eating was assessed as total energy intake from a buffet lunch meal after adolescents participated in the Trier Social Stress Test adapted for adolescents. Results revealed that parental concern about their child's weight (t = 2.27, p = .02) and adolescents' relative reward value of food (t = 2.24, p = .03) were related to greater stress-eating, controlling for BMI standard score, age, sex, and general perceived stress. Parental restriction was not related to stress-eating in this sample (p = .21). These findings suggest that parental attitudes about their adolescent's weight and adolescents' own internalized responsiveness to food as a reward may play a role in propensity to engage in overeating in response to stress.

Impacto de práticas parentais de peso e dieta na imagem corporal de adolescentes do sexo feminino

RESUMO Objetivo Avaliar as práticas parentais de peso e alimentação e sua relação com a insatisfação da imagem corporal em adolescentes. Métodos As análises referem-se aos dados de base de um ensaio clínico randomizado previamente realizado com 270 adolescentes do sexo feminino de escolas públicas de São Paulo que participaram do Programa New Moves Brasil durante os anos de 2014 e 2015. Dados antropométricos, nível econômico, insatisfação com a imagem corporal, autoestima e práticas parentais sobre a ótica das adolescentes quanto à alimentação e corpo foram coletados. Um modelo de regressão logística múltipla foi conduzido para avaliar a influência das variáveis sobre a insatisfação com a imagem corporal das adolescentes. Resultados Adolescentes que estavam acima do peso tinham média/baixa autoestima, sofriam provocações relativas ao peso e faziam menos refeições em família tiveram associação com a insatisfação com a imagem corporal. Na análise de regressão, somente o comentário sobre o peso da filha foi considerado como um fator de risco, e esse deixa de existir quando há o convívio de ambos os pais com as filhas. Em relação à influência do pai, no modelo de convivência familiar, ele pode ser tanto um modelo positivo, na influência de escolhas saudáveis, quanto negativo, ao fazer provocações sobre peso e o incentivar fazer dietas. Conclusões Práticas parentais relacionadas ao peso e alimentação são consideradas de risco para o desenvolvimento de uma insatisfação com a imagem corporal e consequente predisposição a problemas relacionados ao peso.

"No seconds for you!": Exploring a sociocultural model of fat-talking in the presence of family involving restrictive/critical caregiver eating messages, relational body image, and anti-fat attitudes in college women

In line with sociocultural models of parental influence on body image, we examined the relationship between recall of restrictive/critical caregiver eating messages (RCEM) and current frequency of disclosing self-disparaging fat talk among family in 335 undergraduate women (M_age = 19.4; SD = 1.53; range = 18-27). Additionally, two forms of relational body image (i.e., perceived body acceptance by others, external body image shame) and anti-fat attitudes were tested as potential explanatory pathways. RCEM were positively related to current frequency of self-directed fat talk in the family context. All three proposed mediators helped explain this relationship, with external body image shame demonstrating the largest observed effect. Findings suggest frequent recollections of caregivers' implied weight-stigmatizing comments surrounding eating may contribute to more frequent self-denigrating body talk with family members at present via both positive and negative dimensions of relational body image and endorsed explicit weight bias. Theoretical and practical implications are discussed.

Leading by example: Development of a maternal modelling of positive body image scale and relationships to body image attitudes

The aims of this study were to develop a measure, the Role Modelling of Body Image (Attitudes and Behaviors) Questionnaire (RMBI-Q), to determine maternal perceptions of their body image role modelling in front of their children, and to evaluate how role modelling differs with demographic characteristics to identify characteristics of mothers who may require assistance in being a positive role model. Participants were a community-based sample of 887 mothers who provided demographic information and completed the RMBI-Q, Body Appreciation Scale (BAS-2), and a measure of dietary restraint (DEBQ) in an online questionnaire. Exploratory factor analysis revealed one 7-item factor for the RMBI-Q. Confirmatory factor analysis revealed that removal of an item was necessary for model fit, and thus, a 6-item version of the RMBI-Q was evaluated. Good internal consistency, test-retest reliability, content validity, and convergent validity were found. Higher scores on the RMBI-Q correlated with greater maternal body appreciation and lower dietary restraint. More positive role modelling was reported by mothers with lower body mass index and younger children. The RMBI-Q is useful for assessing maternal modelling of positive behaviors that may improve children's body image. Findings highlight avenues for body image interventions for mothers.

Confident body, confident child: Evaluation of a universal parenting resource promoting healthy body image and eating patterns in early childhood-6- and 12-month outcomes from a randomized controlled trial

OBJECTIVE

To evaluate Confident Body, Confident Child (CBCC), a universal parenting resource designed to promote positive body image and healthy eating patterns in children aged 2-6 years, at 6- and 12-months follow-up.

METHOD

A four-arm randomized controlled trial with 345 parents was conducted. Group (A) received the CBCC resource pack + workshop, (B) received the CBCC resource pack only, (C) received a nutrition booklet and (D) received no interventions until all questionnaires were completed (i.e., waitlist control). Measures of parenting variables relevant to child body image and eating patterns, and parent-report of child weight, were administered at baseline, 6-weeks post-intervention (results reported previously), and 6- and 12-months follow-up.

RESULTS

Mixed effects modeling comparing group averages over time revealed that significant group differences on measures of knowledge, parenting intentions and the parental feeding practice of weight restriction were still present at 12-months follow-up, though the remaining measures showed no significant differences between groups over time. The two CBCC groups reported more positive and less negative outcomes than the nutrition booklet active control.

DISCUSSION

The CBCC program achieved sustained improvements in some parenting variables at 12-months, suggesting its value as an effective parenting intervention. Changes to the intervention design, such as the addition of a follow-up parent workshop, however, would likely increase its efficacy.

Parents have both implicit and explicit biases against children with obesity

Weight bias (negative attitudes towards individuals with obesity) has been widely observed, but not examined in parents. In this study, we measured parents' (N = 658; 74.2% female) explicit and implicit weight bias against children with obesity. Many parents (n = 612; 93%) endorsed some moderate explicit weight bias. Fathers had greater explicit bias than mothers and parents with overweight/obesity had less bias than those with healthy-weight. Other parent/child variables (i.e., parent age, child sex, child weight, child age) were not significantly associated with explicit bias. Parents also demonstrated implicit weight bias. No parent or child variables were significantly associated with implicit bias. Parents may contribute, among many others, to the stigmatizing environment experienced by youth with overweight/obesity, which has been associated with negative child psychosocial functioning and health. Clinical research into strategies to reduce parental weight bias against children with obesity or increase children's resilience to weight discrimination is needed to improve children's health and well-being.