Mediating role of body-related shame and guilt in the relationship between weight perceptions and lifestyle behaviours

Emotion in Motion: Weight Bias Internalization, Exercise Avoidance, and Fitness-Related Self-Conscious Emotions

Weight bias internalization (WBI), the process of internalizing negative attitudes and stereotypes towards overweight individuals, significantly impacts self-worth and health behaviors, such as exercise avoidance. In the current study, we focused on the mediating role of fitness-related self-conscious emotions, particularly shame and guilt. A cross-sectional study involving 150 self-described overweight Dutch women (age M = 49.63 ± 10.72) was conducted online. Participants completed measures assessing weight bias internalization, exercise avoidance, and body/fitness-related self-conscious emotions. Data were analyzed using linear regression and mediation analysis, controlling for age, BMI, and exercise frequency. The results show that weight bias internalization, guilt-free shame, and shame-free guilt uniquely predict exercise avoidance. Guilt-free shame partially mediated the relationship between weight bias internalization and exercise avoidance, indicating that increased internalized weight bias led to higher levels of guilt-free shame, which in turn contributed to exercise avoidance. Shame-free guilt did not act as a unique mediator. These findings underscore the importance of addressing weight bias internalization and fitness-related self-conscious emotions, particularly guilt-free shame, in interventions targeting exercise avoidance among overweight individuals. Strategies promoting self-compassion and reducing shame may prove beneficial in improving exercise behaviors and overall well-being.

Mindful monitoring and accepting the body in physical activity mediates the associations between physical activity and positive body image in a sample of young physically active adults

Introduction

The study aimed to extend research on the possible mechanisms that explain the associations between physical activity (PA), mindfulness during PA and positive body image. In the present study, we tested the mediating role of state mindfulness during PA in the association between PA and trait body appreciation. We also explored the moderating roles of sex and body mass index (BMI) in these associations.

Methods

In total, 759 students participated in the study but after applying the inclusion criteria 539 questionnaires were approved for analysis, with a mean age of 23.3 ± 7.2 years (49.7% were women). Study participants completed the online survey, which included sociodemographic details, PA data, the State Mindfulness Scale for Physical Activity 2 (SMS-PA-2) and the Body Appreciation Scale 2 (BAS-2).

Results

Monitoring and accepting the body during exercise mediated the association between PA and body appreciation. BMI moderated the association between accepting the body during exercise and body appreciation: for heavier individuals with BMI > 24.99 kg/m2, the associations between accepting the body during exercise and body appreciation were higher (B = 0.53, p < 0.001) compared to those whose body weight was in the normal range (B = 0.21, p < 0.001).

Conclusion

Strengthening mindfulness and promoting mindful body acceptance during exercise might enhance a positive body image, especially in individuals with a higher BMI.

Body-related emotions and subsequent physical activity behaviour: An ecological momentary assessment

Body-related shame and guilt are theorized to be time-varying affective determinants of physical activity, yet research has predominantly relied on self-report measures of physical activity and between-person associations. To address these limitations, the present study used ecological momentary assessment to examine within- and between-person associations between body-related shame and guilt, and subsequent time spent in moderate-to-vigorous physical activity (MVPA) measured by continuously worn accelerometers. University students (n = 98; 79.6% female; mage = 19.45) were prompted 49 times over seven days to report body-related shame and guilt, and wore activPAL accelerometers to monitor movement behaviours. Higher levels of within-person body-related guilt, but not shame, were associated with increased subsequent time spent in MVPA. Contrary to existing literature, neither body-related shame nor guilt demonstrated a significant association with average levels of MVPA between individuals. These findings support theoretical propositions that body-related guilt may impact engagement in physical activity in daily life.

Longitudinal Associations Between Body-Related Self-Conscious Emotions and Weight Control Status During Adolescence

PURPOSE

Half of adolescents are trying to change their weight and body-related self-conscious emotions may influence these intentions. We estimated associations between body-related shame, guilt, embarrassment, envy, authentic pride, and hubristic pride and weight control status (trying to maintain, lose, or gain weight) throughout adolescence in girls and boys.

METHODS

Six annual cycles of self-administered questionnaires were collected from age 12-17 in the Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study (n = 776). Average associations over all cycles were estimated with generalized estimating equations to describe the relationship between emotions (predictors) and weight control status (outcome). To explore the impact of changes in emotions on weight control status, fixed effects logistic regressions were used. Separate models were conducted for each emotion and for boys and girls.

RESULTS

On average, boys and girls with higher scores for negative emotions (shame, guilt, embarrassment and, exclusively among girls, envy) had higher odds of trying to lose weight. Higher scores for positive emotions (authentic and hubristic pride) were associated with lower odds of trying to lose weight among girls. Higher scores for authentic pride were associated with trying to gain weight among boys. Girls with increases in any of the negative emotions presented higher odds of trying to lose weight. Girls with increases in hubristic pride had increased odds of trying to maintain weight.

DISCUSSION

Body-related self-conscious emotions may be promising healthy-weight intervention targets as they represent important predictors of weight control status, particularly in girls.

Body image self-conscious emotions get worse throughout adolescence and relate to physical activity behavior in girls and boys

Body image is a commonly-reported factor perpetuating declines in physical activity levels during adolescence. However, the evidence is predominantly qualitative, cross-sectional, and focused on girls. Furthermore, the affective dimension of body image has been overlooked compared to the perceptual (e.g., misrepresentations of body size) and cognitive (e.g., dissatisfaction) dimensions. Affective body image includes a range of self-conscious emotions including guilt, shame, envy, embarrassment, and authentic and hubristic pride. This study examined (i) body-related self-conscious emotions over time, and (ii) associations between body-related emotions and physical activity over five years during early-to-mid adolescence. Potential gender differences were also explored. Self-report data for this study were collected once a year over 5 years as part of the MATCH study. The main analyses involved mixed-effects modeling. Participants (n = 776, 55.8% girls) initially aged 12.6 (SD = 0.6) years who provided data on at least one occasion were included in the analysis. Girls reported higher body-related guilt, shame, envy, and embarrassment than boys, and boys reported higher hubristic pride than girls. Over five years from early to mid-adolescence, body-related shame, guilt, envy, and embarrassment significantly increased for boys and girls, authentic pride did not change, and hubristic pride increased for girls only. Controlling for gender and puberty status, body-related guilt, shame, and embarrassment were negatively, and body-related authentic and hubristic pride were positively, associated with physical activity over time. Body-related envy was not significantly related to physical activity. These findings suggest that adolescents express greater negative body-related self-conscious emotions over time. Since these were negatively related to physical activity, interventions focused on reducing negative body-related emotions and enhancing positive body-related emotions may be valuable in adolescence to help curb declining physical activity.

Feasibility of a Theory-Based, Online Tailored Message Program to Motivate Healthier Behaviors in College Women

We aimed to test the feasibility of an online survey and tailored message program in young women. Recruited from college campuses, women (n = 189) completed an online survey assessing preference for and behaviors toward diet and physical activity as well as theory-based influencers of these behaviors (knowledge/information, motivation, and confidence). Health messages were tailored to the participant’s survey responses and learning style to address misconceptions and motivate or reinforce healthy physical activity and dietary behaviors. Most women reported the survey as relevant (92%) and useful for reflecting on their health (83%), with survey responses variable in level of nutrition and physical activity knowledge, motivation, and confidence. Each woman received four tailored messages—most reported the messages as relevant (80%) and learning new information (60%). Across all messages, nearly half of the participants (~48%) reported willingness to try or maintain healthier behaviors and confidence in their ability. Body size discrepancy and dietary restraint had small effects message responses of information learned, and the motivation and confidence in trying healthier behaviors. In summary, these data support the feasibility of this online tailored message program. The college women found the tailored message program acceptable and useful to motivate healthier behaviors. The findings provide direction for behaviorally focused interventions to improve dietary and physical activity behaviors.

A qualitative investigation of the need for and feasibility of weight loss programs on university campuses

BACKGROUND

Despite the public health significance of overweight and obesity, weight management has remained a low priority for health-related programming on university campuses.

OBJECTIVE

Investigate the need for and feasibility of implementing university-based weight loss programs.

METHODS

The Practical, Robust Implementation and Sustainability Model (PRISM) was used as a framework. Semi-structured individual interviews were conducted with fifteen university staff and students from two large U.S. universities in the Northeast and Mid-Atlantic. Interviews aimed to assess readiness, preferences, characteristics, barriers and facilitators in each of the four adapted PRISM domains: (1) Organizational and Recipient (Student) Perspectives on the Intervention, (2) Recipient (Student) Characteristics, (3) Internal Environment (organizational characteristics and infrastructure), and (4) External Environment. Verbatim transcriptions were analyzed using inductive and deductive thematic analyses. Themes were extracted as outlined by Consensual Qualitative Research.

RESULTS

Participants supported university-based weight loss programs, but recognized barriers of resources, coordination across entities, and competing health issues taking priority for school programming. Campus built environment and students' busy schedules were identified as barriers to maintaining healthy weight and participation in weight loss programs. Recommendations included designing weight loss programming with a positive and holistic approach, minimizing weight-stigma, ensuring support from university leaders and students, and securing external funding.

CONCLUSIONS

The identified themes provide recommendations for universities looking to develop and implement weight loss programming.

Relationships between self-management strategies and physical activity and diet quality in women with polycystic ovary syndrome

OBJECTIVE

To determine the relationships of self-management strategies and physical activity (PA) and diet quality in women with PCOS.

METHODS

An online cross-sectional study involving women (n = 501), 18-45 years in the general Australian community with a self-reported PCOS diagnosis. The self-management and lifestyle behaviour questionnaires were completed between August 2017 and March 2018.

RESULTS

Implementation of PA related self-management strategies increased the odds of meeting PA recommendations [Odds ratio (OR): 2.929 (95%CI: 2.172, 3.951), p < 0.001] but had no association with body mass index (BMI) [OR: 0.-0.984 (95%CI: -1.010, 0.959), p = 0.217] nor perception of self weight [OR: 1.382 (95% CI: 0.700, 2.725), p = 0.352]. Nutrition related self-management strategies were inversely associated with BMI [OR: - 0.115 (95%CI: -7.159, -0.980), p = 0.010] but had no association with diet quality [OR: 0.183 (95%CI: -2.328, 2.800), p = 0.855], energy intake [OR: - 0.092 (95%CI: -1204.443, 527.496) p = 0.438] or weight [OR: - 0.034 (95%CI: -4.020, 1.930), p = 0.491].

CONCLUSIONS

PA self-management strategies were associated with meeting PA recommendations. Nutrition strategies were associated with lower BMI but not diet quality, energy intake or weight in women with PCOS.

PRACTICE IMPLICATIONS

Other behaviour change determinants (e.g. education, skills and self-efficacy) should be considered when designing a PCOS lifestyle programme in conjunction with self-management strategies.

Can Assessing Physical Activity Liking Identify Opportunities to Promote Physical Activity Engagement and Healthy Dietary Behaviors?

Improving our understanding of what physical activities are enjoyed and the factors that are associated with physical activity liking can promote participation in regular physical activity. We aimed to study physical activity (PA) liking in college women by modelling interactions between body size perception and dietary behaviors on PA liking, and by examining discrepancies between PA liking versus engagement on body size perception and dietary behaviors. Women (n = 251; 74% white) utilized an online survey to report their level of liking for PA types (scored into a PA liking index) and frequency of PA participation. They also reported their perceived body size, level of dietary restraint, and frequency of consuming foods (scored into a diet quality index). In multivariate analyses, a greater perceived body size was directly associated with lower PA liking and indirectly through greater dietary restraint but lower diet quality. Healthiest dietary behaviors were reported by women who both liked and engaged in PA. Women who reported high PA liking but low PA participation reported a higher dietary restraint and lower diet quality. These findings support the empowerment of women across all body sizes to identify physical activities that they enjoy. Health promotion efforts should encourage women to couple physical activity liking and engagement with a healthy level of dietary restraint and consumption of a healthy diet.

Overestimation of body weight and its association with parental, teacher and peer support: evidence from the Israeli Health Behaviours in Schools survey

OBJECTIVE

To investigate the association between family, teachers and peer support patterns on gaps in adolescent's weight perceptions.

DESIGN

A cross-sectional, school-based survey collected information on weight and height, weight perception, socio-economic and family characteristics and social support. Principal component analysis (PCA) was performed to capture social support patterns (SSP). Multivariable logistic regression was used to model adolescent weight perception, including SSP adjusted for demographic variables.

SETTING

The 2014 Israeli Health Behaviours in School-Aged Children (HBSC) survey.

PARTICIPANTS

Adolescents aged 11-18 years (n 7563).

RESULTS

In total, 16·1 % of the boys and 10·7 % of the girls were overweight or obese. Most participants perceived their size accurately. Body size was underestimated by 25·6 % of the boys and 15·1 % of the girls, while 15·2 % of the boys and 27·7 % of the girls overestimated their body size. PCA generated three SSP accounting for 81·9 % of the variance in social support. Female sex and higher SES increased odds of overestimating body size. Students in the top quartile (Q4 v. Q1-Q3) of family support and teacher support were less likely to overestimate their body size. Good parental communication reduced the odds of body size overestimation in middle school students. Male sex and higher family support increased odds of underestimation.

CONCLUSIONS

Significant support from parents and teachers was associated with accurate weight perceptions; thus, support skills may be amenable to intervention. Efforts should be made to educate adolescents on healthy weight.

Internalized weight stigma and the relationship between weight perception and negative body-related self-conscious emotions

Individuals who perceive themselves as "overweight" experience higher negative body-related self-conscious emotions than those who do not. Theoretical and empirical evidence suggests internalized weight stigma may be an important mediator of the relationship between weight perception and self-conscious emotions. Overcoming common measurement limitations and sampling limitations, the present study investigated whether gender moderates the associations among weight perceptions, internalized weight stigma, and negative body-related self-conscious emotions in 104 young adults (64 % women). Individuals who perceived themselves as too heavy (52 %) experienced higher body-related shame and guilt compared to those who perceived themselves as about right. Internalized weight stigma mediated these associations in women but not men, such that perceiving oneself as too heavy was associated with higher internalized weight stigma, which was associated with higher body-related shame and guilt in women. Results underscore the importance of internalized weight stigma as a potential target for intervention among women of diverse weight statuses who are prone to experiencing body-related shame and guilt.