Prospective health associations of drive for muscularity in young adult males

Exploring the associations between muscularity teasing and eating and body image disturbances in Chinese men and women

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.

Associations of broad eating disorder symptoms with later alcohol problems in Finnish adult twins: A nationwide 10-year follow-up

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.

Muscularity teasing and its relations with muscularity bias internalization, muscularity-oriented body dissatisfaction, and muscularity-oriented disordered eating in Chinese adult men

Despite increasing research on weight teasing and other forms of appearance teasing, muscularity teasing, which occurs when an individual is victimized due to low muscularity, has not yet received research attention. Given the solid evidence of positive relations between weight teasing and thinness-oriented body dissatisfaction and disordered eating, we aimed to tap into muscularity teasing and examine its relations with muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating (e.g., rigid dietary rules for enhancing muscularity). A sample of 500 Chinese men, aged 18 - 62 years, were recruited online, and they competed questionnaires assessing muscularity teasing, muscularity bias internalization, muscularity-oriented body dissatisfaction, and muscularity-oriented disordered eating. Correlation analyses showed that muscularity teasing was significantly related to muscularity bias internalization (r = 0.55, p < .001), muscularity-oriented body dissatisfaction (r = 0.50, p < .001), and muscularity-oriented disordered eating (r = 0.38, p < .001). Structural equation modelling indicated that muscularity bias internalization and muscularity-oriented body dissatisfaction, as concurrent mediators, fully mediated the relationships between muscularity teasing and muscularity-oriented disordered eating. Findings extend existing knowledge in appearance teasing research to encompass muscularity teasing in order to better understand the etiology of muscularity-oriented body dissatisfaction and muscularity-oriented disordered eating.

Internalisation of stereotyped body appearance standards and body dissatisfaction in adolescent boys: Moderating role of sports participation

The aim of this study was to test the moderating role of sport participation in the mediation model of media pressures, internalisation of appearance ideals and body dissatisfaction in adolescent boys. Five hundred and seventy adolescent boys (mean age 17.2 ± 0.45; range 15-19 years) participated in the cross-sectional study. Adolescents completed a questionnaire consisting of measures of attitudes towards sociocultural pressures on appearance, body dissatisfaction and sport participation (participation in achievement sport, leisure exercising and non-participation in any sports). Sports participation moderated the associations between the internalisation of stereotyped appearance ideals and body dissatisfaction. In athletes, the effect of internalisation of thin body ideals on body dissatisfaction was not significant, while the effect of internalisation of muscular/athletic body ideals was negative. In leisure exercisers, the effect of internalisation of muscular body ideals on body dissatisfaction was not significant, yet internalisation of thin body ideals had a significant effect on body dissatisfaction. The strongest associations between appearance ideals internalisation and body dissatisfaction were found in adolescent boys who reported no participation in sports. Sports participation might be an effective tool in decreasing the negative effect of internalisation of stereotyped appearance ideals on adolescent boys' body image.

Muscle dysmorphia symptomatology among a national sample of Canadian adolescents and young adults

The aim of this study was to describe muscle dysmorphia (MD) symptomatology among a large, diverse, and national sample of adolescents and young adults in Canada. Data from the Canadian Study of Adolescent Health Behaviors (N = 2256) were analyzed. MD symptomatology was assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Men (mean [M] = 33.9, standard deviation [SD] = 8.6) reported significantly greater overall MD symptomatology compared to women (M = 30.1, SD = 7.3) and transgender/gender non-conforming (TGNC; M = 31.5, SD = 7.6) participants. Similarly, the prevalence of clinical MD risk was also highest among men (25.7 %). In regression analyses, participants who identified as South Asian (B 1.97, 95 % confidence interval [CI] 0.41, 3.52) or Middle Eastern (B 2.92, 95 % CI 0.50,5.35), compared to White participants, or identified as gay or lesbian (B 2.65, 95 % CI 1.19, 4.10), compared to heterosexual participants, had greater MD symptomatology. Findings are the first to describe the MD symptomatology among Canadian adolescents and young adults. Health care and public health professionals should be aware of the overall high occurrence of MD symptomatology in this sample, and future research is needed to continue to describe MD among Canadian young people.

Eating and Body Image Disturbances in Adolescence and Substance Use Throughout Young Adulthood: Findings from the Australian Temperament Project

We investigated whether eating and body image disturbances in mid-adolescence were associated with substance use in young adulthood. Participants (n = 1566) completed the drive for thinness, bulimic behavior, and body dissatisfaction subscales from the Eating Disorder Inventory during adolescence (15–16 years), and reported frequencies of substance use (tobacco, cannabis, binge drinking, other illicit substances) across young adulthood (19–20, 23–24, and 27–28 years). Adolescent body dissatisfaction was associated with a 10% increase in the rate of binge drinking and tobacco smoking, with effects being of similar magnitude in men and women, and across young adulthood. The association between bulimic behavior and tobacco smoking was strongest in the earlier years of young adulthood (19–20 years). Relationships between cannabis use, bulimic behavior, and body dissatisfaction were evident in men only. Findings highlight important targets for prevention programs, as well as focused monitoring efforts to identify individuals at risk of later substance use.

Anabolic-Androgenic Steroid Use: Patterns of Use among a National Sample of Canadian Adolescents and Young Adults

Background

Androgenic-anabolic steroid (AAS) use is relatively common among international recreational and community samples and is associated with several deleterious side effects and health consequences that have not been studied recently among a large Canadian sample. Therefore, the purpose of this study was to assess and describe characteristics of AAS users compared to non-AAS users among a national sample of Canadian adolescents and young adults.

Methods

Data from 2,774 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Participants were recruited via social media advertisements and completed the survey online. Survey items measured sociodemographics, AAS use, AAS side effects, motives for AAS use, AAS administration, body satisfaction, other illicit substance use, mental health, and violence involvement.

Results

Among the overall sample, 1.6% of participants reported lifetime AAS use, with the majority of users being White, heterosexual males. Most users strived to gain weight, with main motives for AAS use including increased muscularity and strength, and improved appearance. Most AAS users were satisfied with their body compared to non-users. Approximately one in five users had AAS dependence and experienced multiple adverse side effects. Few differences between users and non-users in self-reported mental health were found.

Conclusion

Findings indicate that AAS use among a community sample of Canadian adolescents and young adults is an important health issue, particularly given the relatively high occurrence of AAS dependence and adverse side effects reported by users. Findings support the need for education and intervention efforts from healthcare professionals. Further investigations among Canadian AAS users may provide more insight regarding the unique supports these individuals require.

Psychometric Evaluation of the Drive for Muscularity Scale and the Muscle Dysmorphic Disorder Inventory among Brazilian Cisgender Gay and Bisexual Adult Men

Despite high levels of muscularity concerns among sexual-minority men, most of the existing literature on the drive for muscularity and muscle dysmorphia focuses on heterosexual men and has mainly been conducted in Western and English-speaking regions. The present study aimed to evaluate the psychometric properties of the Drive for Muscularity Scale (DMS) and the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian cisgender gay and bisexual adult men who were 18-50 years old. We evaluated the factor structure of both measures using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory (CFA; n = 705) factor-analytic approach, which supported the original three-factor structure of the MDDI and resulted in a reduced two-factor solution with 13 items for the DMS. Convergent validity was supported through associations of the DMS and the MDDI with eating disorder symptoms, body-ideal internalization, self-objectification beliefs and behaviors, and body appreciation measures. Additionally, we found good internal consistency, and test-retest reliability of both measures. Results support the validity and reliability of the DMS and the MDDI in Brazilian cisgender gay and bisexual adult men and will support future studies exploring these constructs in Brazilian sexual-minority men.

Body image and associated factors among sexual minority men: A systematic review

Research suggests that the risk of body image concerns among sexual minority men is high. Recent work has increasingly examined body image in relation to psychological, interpersonal, and behavioral constructs, but these findings have yet to be consolidated and critically examined to identify potential risk and protective factors. The present study sought to systematically review and synthesize published findings on body image among sexual minority men. A total of 136 articles published between January 2011 and March 2022 were included. Sexual minority men were generally reported to have more negative body image compared to heterosexual men, yet findings varied across body image constructs. In correlational work, body image was often examined in relation to disordered eating, mental health, internalization of appearance ideals, objectification, sexual behavior and relationships, gay community identification and discrimination, and health concerns (e.g., HIV, AIDS). Robust relationships emerged among body image and stigma variables, including internalized homophobia and harassment related to LGBTQ+ presentation and intersecting minority identities. Sociocultural, objectification, and minority stress theories were employed to interpret findings and to delineate future directions grounded in intersectional approaches. Additional work focused on the role of stigma and discrimination in the development of these concerns across the lifespan is needed.

Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls

Body dissatisfaction is distressing and a risk factor for adverse consequences including eating disorders. However, data pertaining to the prevalence of body dissatisfaction in adolescence, a key period for its emergence, are lacking. This is a substantial barrier to tailored assessment and early intervention. This study addresses this gap and provides the prevalence of body dissatisfaction and associations with depressive symptoms and body change strategies. Adolescent boys (n = 367; Mage = 12.8, SD = 0.7) and girls (n = 368; Mage = 12.7, SD = 0.7) completed measures of body dissatisfaction and depressive symptoms with established cut-off levels. They also completed measures of dietary restraint and strategies to increase muscle size. Of boys and girls, 37.9% and 20.7%, respectively experienced moderate, and 6.8% and 19.6% experienced clinically significant body dissatisfaction, with higher rates among girls than boys and among adolescents aged 13 and 14 than aged 12. More than one-quarter of boys (26.70%) and one-third of girls (33.15%) reported subthreshold depressive symptoms or possible, probable or major depressive episodes. Girls revealed a higher prevalence of possible-, probable-, or major depressive episode than boys. Relative to those with no or low body dissatisfaction, adolescents with clinically significant body dissatisfaction were 24 times more likely to also report possible-, probable-, or major depressive episodes. Among boys and girls, clinically significant body dissatisfaction was associated with higher levels of dietary restraint and engagement in strategies to increase muscle size. Greater attention to identification and early intervention for body dissatisfaction is needed, especially for girls.

The associations between autistic traits and disordered eating/drive for muscularity are independent of anxiety and depression in females but not males

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.

Eating Disorders in Children and Adolescent Males: A Peculiar Psychopathological Profile

(1) Background: Eating Disorders (EDs) are severe psychiatric disorders with high rates of mortality, multiple medical and psychiatric comorbidities associated, and often chronic illness. Historically, EDs are among the most gendered of psychiatric illnesses, and male presentations have been perceived as rare and unusual. This perception resulted in the systematic underrepresentation of males in research on Eds, and as consequence, in a scarcity of research investigating clinical and psychological features in this population. (2) Methods: The present study aims to evaluate clinical and psychopathological features in a sample of 287 children and adolescents, 27 males and 260 females with EDs, in order to identify similarities and differences. (3) Results: Males were younger than females, with similar medical and clinical conditions, but a different distribution of typology of EDs in middle childhood and middle adolescents. The Eating Disorders Inventory-3, TAS-20 for alexithymia and CDI for depressive symptoms' profiles are similar, while males showed higher scores at the global indexes of Symptom Checklist 90-Revised test in early adolescence. (4) Conclusions: Results suggest gender-specific similarities and differences in clinical and psychological features in children and adolescent males, which may require specific diagnosis and treatment.

Associations between Self-Objectification and Lifestyle Habits in a Large Sample of Adolescents

The aim of the present study was to test associations between self-objectification and health-related lifestyle habits in a large sample of adolescents. In 2019–2020, a large sample of adolescents (n = 1402, 40.4% boys) participated in the survey and, as a part of a larger study, filled in questionnaires on self-objectification and lifestyle. Self-objectification was assessed using the Self-Objectification Questionnaire (SOQ). The lifestyle questionnaire had three batteries: eating attitudes and behaviors, dietary habits, and questions on harmful behaviors together with time spending patterns: sedentary lifestyle and physical activity. The ages ranged from 15–19 years with a mean age of 16.97 ± 0.46 years. Self-objectification (SO) was associated with a less healthy lifestyle: more frequent dieting and unhealthy eating habits in girls, skipping breakfast, and a lower number of meals per day. Adolescent boys and girls with higher SO demonstrated more frequent smoking and alcohol consumption until they felt dizzy and more frequent consumption of soft drinks, energy drinks, and fast foods. Girls with higher SO demonstrated lower perceived physical activity and longer duration of internet browsing for non-educational purposes. The results of the present study inform healthy lifestyle promotion programs for adolescents, suggesting that including psychoeducation about self-objectification, body functionality, and positive embodiment might be an effective strategy.

Associations between muscle-building exercise and alcohol use behaviors among adolescent boys: Results from the 2019 Youth Risk Behavior Survey

BACKGROUND AND OBJECTIVES

To explore the association between muscle-building exercise (MBE) and alcohol use behaviors among adolescent boys.

METHODS

Data from the 2019 Youth Risk Behavior Survey (N = 4120) were analyzed using multiple logistic regressions.

RESULTS

A greater number of days of MBE in the past week was associated with higher odds of four alcohol use behaviors, including recent alcohol use and binge drinking.

DISCUSSION AND CONCLUSIONS

Findings extend prior research showing relationships between team sports participation and alcohol use behaviors.

SCIENTIFIC SIGNIFICANCE

This study is the first to examine associations between MBE and alcohol use behaviors among adolescent boys.

Validation and measurement invariance of the muscularity-oriented eating test among Brazilian men and women

OBJECTIVE

The Muscularity-Oriented Eating Test (MOET) is a 15-item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three-week test-retest reliability, and convergent validity in a community sample of Brazilian men and women.

METHOD

After the back-translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating behaviors, and exercise dependence.

RESULTS

Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one-factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω = .84; α = .83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test-retest reliability for both men (ICC = .96; p < .001) and women (ICC = .92; p < .001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating, and exercise dependence.

CONCLUSION

This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity-oriented disordered eating in Brazilian adults, allowing for future cross-cultural studies in this field.

PUBLIC SIGNIFICANCE

The Muscularity-Oriented Eating Test (MOET) is a measure of muscularity-oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity-oriented disordered eating in Brazilian adults.

Muscle-building behaviors from adolescence to emerging adulthood: a prospective cohort study

•

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, M_age = 14.4 ± 2.0 years) to emerging adulthood (follow-up, M_age = 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.

Untangling the associations between generalized anxiety and body dissatisfaction: The mediating effects of social physique anxiety among collegiate men and women

Researchers disagree on which types of anxiety influence body dissatisfaction and how gender (cisgender men vs. cisgender women) may impact these associations. Specifically, little is known about how generalized anxiety and social physique anxiety combine to predict body dissatisfaction in men and women. The purpose of the present study was to explore a moderated mediation model in which the relationships between generalized anxiety and body dissatisfaction (drive for thinness and drive for muscularity) were mediated by social physique anxiety and moderated by gender. Data from 423 U.S. college students (n = 259 women) were analyzed using multigroup structural equation modeling. Generalized anxiety was positively associated with social physique anxiety, and this association was significantly stronger for men than for women. Neither social physique anxiety nor generalized anxiety were associated with drive for muscularity. Social physique anxiety was positively and significantly associated with drive for thinness equally for men and women and emerged as a significant mediator. These results highlight gender differences/similarities in body image and suggest drive for thinness and social physique anxiety may have a common factor of generalized anxiety. When helping clients who suffer with body dissatisfaction, clinicians and researchers may wish to focus on generalized anxiety (and not just social physique anxiety).

Symptoms of disturbed eating behavior risk: Gender and study factors in a cross-sectional study of two Norwegian medical schools

BACKGROUND

Studies about medical student's stress associated with disturbed eating behavior are scarce.

OBJECTIVES

To study the explanatory role of curricular factors and distress in disturbed eating behavior among medical students and whether this varies according to gender, study stage, curriculum model, study stress and mental distress.

METHODS

The cross-sectional sample surveyed consisted of Norwegian medical students at two faculties with different curricular models (traditional and integrated). The total response rate was 64% (1044/1635). We tested differences in disturbed eating behavior symptoms (EDS) and their correlates using stepwise linear regression analysis.

RESULTS

In total, 18.3% were cases of disturbed eating behavior symptoms, including 23.5% of female and 5.6% of male participants. Disturbed eating behavior symptoms were independently associated with the medical school stress factors "medical school is cold and threatening" (β = 0.07, p = .041), "worries about work and competence" (β =0.15, p < .001) and "worries about finances and accommodation" (β = 0.07, p = .018), in addition to female gender (β = 0.30, p < .001), mental distress (β = 0.17, p < .001), and body mass index (β = 0.28, p < .001). The variables explained 28.9% of the variance in disturbed eating behavior symptoms, and medical school stress contributed 9%. "Worries about work and competence" was more important among the female students.

CONCLUSIONS

Nearly one in five female medical students in the current sample reported symptoms of disturbed eating behavior. The symptoms were associated with medical school stress factors, mental distress, and body mass index.

Role of parental confirmation in body dissatisfaction and body change behaviors among college men

To examine how the components of confirmation (i.e., acceptance and challenge) from mother and father have an indirect effect on college men's body dissatisfaction through self-concept, and if body dissatisfaction, in turn, is related to body change behaviors. Participants: College men (N = 237) aged 18-25 from two large universities completed an online survey. Methods: Structural equation modeling was conducted to test hypothesized mediation model. Results: Maternal acceptance had negative indirect effects on body dissatisfaction through self-concept, and body dissatisfaction, in turn, was positively related to body change behaviors. Mother challenge emerged as a near-significant direct and positive predictor of muscularity enhancement behaviors. None of the paternal variables significantly contributed to the model. Conclusions: Mother acceptance may contribute to sons' positive view of self and their appearance, potentially reducing the likelihood of their engagement in body change behaviors. Intervention can target parent-child communication and enhancement of college men's self-concept.

Underestimation of Overweight and Health Beneficial Outcomes in Two Adolescent Cohorts in Norway - The HUNT Study

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.

Trends in Eating Habits and Body Weight Status, Perception Patterns and Management Practices among First-Year Students of Kaunas (Lithuania) Universities, 2000-2017

Students' transition from high school to university is accompanied by lifestyle changes. This study aimed to assess trends in students' body weight status, perception, management practices and eating habits from 2000 to 2017. Three cross-sectional surveys were carried out among the first-year students of five Kaunas (Lithuania) universities in 2000, 2010 and 2017. The self-administered questionnaires were filled in during lectures. Altogether, 3275 students aged 20.0 (1.5) years participated in the survey. The prevalence of self-reported overweight increased among male students from 11.3% in 2000 to 24.3% in 2017 and female students from 5.2 to 9.6%. The intake frequency of fruits, vegetables and cereals increased, and red meat decreased. At a normal BMI, more female than male students perceived themselves as being 'too fat' (19.4% and 8.8% in 2017), while more male than female students perceived themselves as being 'too thin' (37.2% and 4.5% in 2017). More females than males were dissatisfied with their weight, worried about gaining weight and tried to lose weight. Weight-management practices were associated with body weight, self-perception, dissatisfaction, worries about weight gain and eating behaviours. Our study highlights the need for interventions to increase the accuracy of weight perception and to promote the appropriate weight-management methods, addressing gender differences.

Intimate partner violence and muscularity-building behavior in latino sexual minority men

Intimate partner violence (IPV) has been associated with increased prevalence of eating disorders. In men, disordered eating is often related to the muscularized ideal. Sexual minority men (SMM; e.g., gay, bisexual, etc.) are at higher risk for eating disorders and Latino SMM may be at particularly high risk; however, IPV and eating pathology has yet to be examined in this population. Therefore, the aim of this study is to elucidate the association between IPV and muscularity-related dissatisfaction and muscularity-oriented behavior in Latino SMM. Participants were 81 Latino SMM. Thirty participants (37% of the sample) met the cutoff score for experiencing IPV in the past month. In bivariate analyses, IPV was associated with muscularity-oriented behavior, but not muscularity-related dissatisfaction. In multivariable analyses, IPV was negatively associated with muscularity-related dissatisfaction with a small effect size and positively associated with muscularity-oriented behavior with a large effect size. It may be that SMM engage in muscle building behavior to increase self-esteem, regulate affect, or better physically protect themselves from their abusive partner. Future research should investigate motivation for muscle building behavior in individuals experiencing IPV.

Validación del Cuestionario de Actitudes Socioculturales sobre la Apariencia (SATAQ-4) en población colombiana

El deseo de cumplir estándares modernos estéticos corporales no alcanzables afecta la salud mental, debido a que las personas internalizan los ideales de belleza y aceptan las presiones sociales acerca de la apariencia corporal incluso por encima de su bienestar. El objetivo del presente estudio instrumental fue evaluar las propiedades psicométricas del Cuestionario de actitudes socioculturales sobre la apariencia (SATAQ-4) en población colombiana, para lo cual se utilizó una muestra estratificada no aleatorizada conformada por 214 personas -138 mujeres y 76 hombres-, con un promedio de edad de 25.13 años (DE = 7.66). Se retomó la versión en español del instrumento validado en Argentina, que fue evaluada por jueces expertos para realizar la adaptación lingüística y que se aplicó a una muestra piloto antes de la aplicación definitiva, hecha bajo las normas éticas exigidas. Se realizó el análisis de las condiciones psicométricas desde la teoría de respuesta al ítem, mediante el modelo Rasch, y por medio del software WINSTEPS. Los resultados indican que la versión en español cumple las condiciones psicométricas adecuadas en las cinco dimensiones que componen el instrumento (.72-.94); y que el grado de dificultad y de habilidad alcanzan valores de ajuste apropiados, lo que indica que el cuestionario cuenta con adecuadas condiciones psicométricas y mantiene su estructura interna original. En conclusión, la versión final de esta adaptación del SATAQ-4 puede ser utilizada en población de similar procedencia, a fin de evaluar el efecto de los aspectos socioculturales en la satisfacción con la imagen corporal.

Who's the 'bigger' man? Parsing the relationships between masculinity and men's muscularity dissatisfaction

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.

Eating disorders in adolescent boys and young men: an update

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.

The impact of the COVID-19 pandemic on eating disorder risk and symptoms

The current COVID-19 pandemic has created a global context likely to increase eating disorder (ED) risk and symptoms, decrease factors that protect against EDs, and exacerbate barriers to care. Three pathways exist by which this pandemic may exacerbate ED risk. One, the disruptions to daily routines and constraints to outdoor activities may increase weight and shape concerns, and negatively impact eating, exercise, and sleeping patterns, which may in turn increase ED risk and symptoms. Relatedly, the pandemic and accompanying social restrictions may deprive individuals of social support and adaptive coping strategies, thereby potentially elevating ED risk and symptoms by removing protective factors. Two, increased exposure to ED-specific or anxiety-provoking media, as well as increased reliance on video conferencing, may increase ED risk and symptoms. Three, fears of contagion may increase ED symptoms specifically related to health concerns, or by the pursuit of restrictive diets focused on increasing immunity. In addition, elevated rates of stress and negative affect due to the pandemic and social isolation may also contribute to increasing risk. Evaluating and assessing these factors are key to better understanding the impact of the pandemic on ED risk and recovery and to inform resource dissemination and targets.

Drive For Muscularity in Male Adolescents: The Role of Psychological Factors (Self-Esteem, Maladaptive Perfectionism, and Interpersonal Sensitivity)

Background: Concerns about body image among male adolescents has become increasingly prevalent, leading to a need for muscularity. It is well known that psychological factors play a role in the development of these concerns. Objectives: The aim of the current study was to predict the drive for muscularity based on psychological factors, including self-esteem, maladaptive perfectionism, and interpersonal sensitivity. Methods: This cross-sectional study was conducted in 2019. Using a convenience sampling method, 150 adolescent male students from district 14 of Tehran, Iran, were selected to participate in the study. Data was collected by utilizing the following measures: drive for Muscularity scale, Rosenberg Self-Esteem scale, Almost Perfect scale-revised, and Interpersonal Sensitivity measure. Data were analyzed using the Pearson correlation coefficient and the Enter Regression method. Results: High scores in the Drive for Muscularity scale were significantly associated with higher levels of maladaptive perfectionism, interpersonal sensitivity, and lower levels of self-esteem. Moreover, the results of the multiple regression analysis revealed that predivariables could explain 52% in the variance of the drive for muscularity. Conclusions: Findings indicated that the psychological factors investigated in this study were risk factors for masculinity among adolescents. We suggest that clinicians take these factors into account in order to make preventive and therapeutic programs more effective.

The Role of Body Image, Disordered Eating and Lifestyle on the Quality of Life in Lithuanian University Students

Purpose. The present study aimed to explore the associations between body image concerns (BI), disordered eating (DE), health-related lifestyle, and the different domains of the quality of life (QoL) in a Lithuanian sample of student-aged men and women. Methods. A mixed-gender sample of students (N = 1850, 58.8% were women, average age 21.6 ± 5.0 years) completed a series of questionnaires, including health-related lifestyles, BI, DE, and QoL. A series of simultaneous multiple linear regression analyses were conducted. Mediation analyses were performed to estimate the size of the total, direct, and indirect effects of variables in the models. Results. The analysis of the linear regressions demonstrated that the positive trait of body areas satisfaction was associated with the significantly enhanced QoL in all domains in both genders (for men β = 0.29-0.34; for women β = 0.26-0.33; p < 0.001). DE was associated with a poorer psychological QoL domain in women only (β = -0.07; p = 0.047). The drive for muscularity was associated with a lower QoL in men (β = -0.06-(-0.141); p < 0.05). Body areas satisfaction mediated the associations between body mass index and psychological and physical QoL in both genders (TLI (Tucker Lewis Index) = 0.975; CFI (comparative fit index) = 0.997; RMSEA (Root of the Mean Square Error) = 0.053). Conclusions. Positive traits of BI play essential roles in the QoL of student-aged women and men. The present study adds empirical evidence emphasizing the importance of integrating education about positive body image while implementing healthy lifestyle and QoL promotion programs in student-aged men and women.

Predictors of muscularity-oriented disordered eating behaviors in U.S. young adults: A prospective cohort study

OBJECTIVE

To determine adolescent predictors of muscularity-oriented disordered eating behaviors in young men and women using a nationally representative longitudinal sample in the United States and to examine differences by sex.

METHOD

We used nationally representative longitudinal cohort data collected from baseline (11-18 years old, 1994-1995) and 7-year follow-up (18-24 years old, 2001-2002) of the National Longitudinal Study of Adolescent to Adult Health. We examined adolescent demographic, behavioral, and mental health predictors of young adult muscularity-oriented disordered eating behaviors defined as eating more or differently to gain weight or bulk up, supplements to gain weight or bulk up, or androgenic anabolic steroid use at 7-year follow-up.

RESULTS

Of the 14,891 included participants, 22% of males and 5% of females reported any muscularity-oriented disordered eating behavior at follow-up in young adulthood. Factors recorded at adolescence that were prospectively associated with higher odds of muscularity-oriented disordered eating in both sexes included black race, exercising to gain weight, self-perception of being underweight, and lower body mass index z-score. In addition, participation in weightlifting; roller-blading, roller-skating, skate-boarding, or bicycling; and alcohol among males and depressive symptoms among females during adolescence were associated with higher odds of muscularity-oriented disordered eating in young adulthood.

CONCLUSIONS

Interventions to prevent muscularity-oriented disordered eating behaviors may target at-risk youth, particularly those of black race or who engage in exercise to gain weight. Future research should examine longitudinal health outcomes associated with muscularity-oriented disordered eating behaviors.

Examination of Actual and Ideal Body-Related Characteristics and Body-Related Pride in Adult Males

Body image concerns are becoming more prevalent in males. Discrepancies between actual and ideal body muscularity and thinness have been studied from a pathological perspective whereby perceiving the body as discrepant from an internalized ideal is associated with body dissatisfaction, negative emotions, and harmful body-altering behaviors. It is unclear if agreement among actual and ideal self-perceptions is associated with positive emotion in males. The present study examined the associations between actual and ideal congruence and discrepancies in muscularity and thinness, and two facets of pride (i.e., authentic and hubristic pride) in male adults. Participants (n = 294; M_age = 34.80 years; M_BMI = 27.31 kg/m²) completed a cross-sectional self-report survey. Results from polynomial regressions indicated that actual and ideal self-perceptions of muscularity and thinness were significant predictors of both authentic (R² = .37 and .20) and hubristic pride (R² = .33 and .19), respectively. Response surface values demonstrated that extremely high or low scores that were congruent for muscularity (a₂ = .35 and .40) and thinness (a₂ = .18 and .18) perceptions were associated with higher reports of authentic and hubristic pride. These findings demonstrated that congruence in actual and ideal self-perceptions contribute to feelings of pride, suggesting interventions that promote actual and ideal self-perception congruence may be important for fostering positive emotional experiences in males.

The effects of internalized shame and self-blame on disordered eating and drive for muscularity in collegiate men

PURPOSE

The purpose of the present study was to explore the relative contributions of self-blame and internalized shame to variability in disordered eating and drive for muscularity scores in collegiate men.

METHOD

One hundred and sixty-eight male college students in the Rocky Mountain region of the USA completed valid and reliable self-report survey measures: the Drive for Muscularity Scale, the Internalized Shame Scale, the Shame and Guilt Eating Scale to assess self-blame, and the Eating Attitudes Test. Cross-sectional data were analyzed through descriptive, correlation, and regression statistics.

RESULTS

Men who reported higher levels of self-blame, r = 0.39, p < 0.001, and internalized shame, r = 0.38, p < 0.001, also reported higher levels of eating disorder symptomology. Similarly, men who scored higher on internalized shame, r = 0.20, p < 0.01, reported higher scores on drive for muscularity. Regression analyses revealed that internalized shame was the sole contributor to variability in drive for muscularity scores, β = 0.20, p < 0.01, whereas both self-blame, β = 0.27, p < 0.001, and internalized shame, β = 0.24, p < 0.001, contributed to scores on disordered eating attitudes and behaviors in men.

CONCLUSIONS

Our study was the first to examine how internalized shame and self-blame relate to drive for muscularity and disordered eating in collegiate men. Our results suggest that both self-blame and internalized shame may contribute to disordered eating in men. Additionally, internalized shame appears to relate to drive for muscularity in men. Clinicians may wish to consider how they approach treatment given the potential contributions of internalized shame and self-blame to disordered eating in their male clients.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Drive for muscularity behaviors in male bodybuilders: a trans-contextual model of motivation

BACKGROUND

The drive for muscularity behaviors are very common in male athletes, especially in male bodybuilders. Studies have related drive for muscularity behaviors to body dissatisfaction, eating disorders and muscle dysmorphia.

METHODS

This study applied the trans-contextual model of motivation to the drive for muscularity behaviors of male bodybuilders at risk of developing muscle dysmorphia. The relationships between self-determination theory constructs and drive for muscularity behaviors, via the theory of planned behavior variables (i.e., attitude, subjective norm, perceived behavioral control, and intention) were examined. A total of 175 Swiss male bodybuilders (M _age = 27.34; SD _age = 7.53) completed measures on motivation for sport, theory of planned behavior variables, and drive for muscularity behaviors. They practiced bodybuilding from three to 24 h per week (Mhours per week = 6.59; SDhours per week = 3.45) and had done so for 7.19 years on average (SDnumber of years = 6.91). Using bootstrapped maximum likelihood estimation with the AMOS 7.0 program, a series of confirmatory factor analyses was performed on each subscale and a series of path analyses was performed to determine the final model.

RESULTS

The fit indices of the final model were satisfactory: χ² (11) = 13.81; p = .244; TLI = .98; CFI = .99; RMSEA = .04. The model explained 29% of the variance of drive for muscularity behaviors. The final path analysis supported the motivational sequence, with autonomous motivation for sport showing a positive, significant and indirect association with the drive for muscularity behaviors via perceived behavioral control and intention to gain muscle mass, and controlled motivation for sport showing a positive association with the drive for muscularity behaviors both directly and via attitude and intention to gain muscle mass.

CONCLUSIONS

It was concluded that the trans-contextual model of motivation applies only partially to the drive for muscularity behaviors in male bodybuilders.

PERSPECTIVE

The motivational mechanisms explaining the development of drive for muscularity behaviors might be better understood through complementary analyses of motivational profiles. Such investigations would guide the design of programs to lower the risks associated with these behaviors.