Trajectories of Body Dissatisfaction and Dietary Restriction in Early Adolescent Girls: A Latent Class Growth Analysis

Disordered eating in a 10-year perspective from adolescence to young adulthood: Stability, change, and body dissatisfaction as a predictor

INTRODUCTION

Although there are many studies of disordered eating (DE) in adolescence, studies examining the longitudinal stability and change of DE and its longitudinal associations with other factors are still rather scarce. Such studies are important to inform parents and clinicians how stable DE is and to what extent it will go away with increased maturity. Longitudinal studies may also be of help in establishing predictors of long-term problems. The purpose of the present study was to investigate the stability of DE over a 10-year period from early adolescence to young adulthood, and to explore body dissatisfaction as a predictor in a 10-year perspective.

METHODS

Data were taken from a three-wave longitudinal project (SoL) with survey data collected among the students in Grades 7and 8 in a Swedish municipality in 2007 (T1), 1 year later (T2), and in a 10-year follow-up in 2017 (T3). DE was measured by the eight-item version of the Risk Behaviour Related to Eating Disorders (RiBED-8), and a quasi-clinical criterion of six or more critical answers on the RiBED-8 was used to classify DE cases.

RESULTS

Of the girls, 5.8% passed the cutoff for DE at T1, whereas 9.1% did so at T2 and 7.9% at T3. The boys showed markedly lower figures: 0.5% both at T1 and T2, and 1.5% at T3. There was significant individual stability of DE over the 10-year period, with almost 30% of the girls who passed the cutoff for DE at T1 also doing so 10 years later. Body dissatisfaction in early adolescence predicted the incidence of new cases of DE 10 years later, even when controlling for degree of DE in early adolescence. The results also indicate that DE in early adolescence may be a passing phase among adolescents who express relatively high body satisfaction.

CONCLUSIONS

The present results show a complex picture of different individual trajectories of DE, with degree of body satisfaction playing a significant role for the outcome in a 10-year perspective. Body dissatisfaction appears to be a risk factor for the development of new cases of DE, whereas body satisfaction may protect against the continuation of DE into adulthood.

Body talk on social networking sites and restrained eating among adolescents: A test of a multiple mediation model

The present study aimed to examine the link between body talk on social networking sites (SNS body talk) and restrained eating as well as the mediating roles of fear of negative appearance evaluation (FNAE) and body shame in this relationship. Furthermore, the moderating role of gender in the mediation model was also examined. A sample of 1481 Chinese middle and high school students (720 girls, mean age = 15.49 ± 1.84) completed self-reported measures of SNS body talk, FNAE, body shame, and restrained eating. Results showed that SNS body talk was positively associated with restrained eating. FNAE and body shame mediated the association between SNS body talk and restrained eating, separately and serially. Furthermore, gender difference emerged in the path from SNS body talk to body shame and the path from FNAE to body shame. Findings of the present study enrich the literature on social media and body image and eating behaviors, and have important implications for reducing negative body image and disordered eating among adolescents.

Relationship between Attention to Body Shape, Social Physique Anxiety, and Personal Characteristics of Brazilians: A Structural Equation Model

People can develop eating disorders due to excessive body image concerns. The primary objective of this study was to examine the relationship between attention to body shape, social physique anxiety, and personal characteristics in a sample of Brazilians. The secondary objective was to evaluate the correlation of the constructs with the participants' body composition. First, 1795 individuals (70% female; M_age = 25.5 ± 6.6 years) completed the Attention to Body Shape Scale, the Social Physique Anxiety Scale, and a sociodemographic questionnaire. Then, 286 participants (58% female; M_age = 25.3 ± 5.7 years) underwent a bioimpedance exam to identify body composition. Structural equation modeling was used to estimate the relationship between the variables. The greater the attention to body shape, the greater the expectations of negative physical evaluation and the less comfort with physical presentation. Younger age, female gender, consumption of supplements/substances for body change, restrictive diets, physical inactivity, poor self-assessment of food quality, and overweight/obesity were related to negative body concerns. An expectation of negative physical evaluation was positively correlated with body fat and negatively with muscle mass. Comfort with physical presentation was negatively correlated with fat and positively with muscle. These results can support preventive strategies aimed at reducing eating disorders resulting from body image concerns.

The Food and Nutrition Security for Manitoba Youth (FANS) study: rationale, methods, dietary intakes and body mass index

BACKGROUND

Good nutrition and access to healthy foods are essential for child growth and development. However, there are concerns that Canadian children do not have a healthy diet, which may be related to dietary choices as well as lack of access to healthy foods. The FANS (Food and Nutrition Security for Children and Youth) study examined the nutrition and food security status of youth in the province of Manitoba, Canada. This paper describes methods, dietary intakes, and body mass index for the FANS study.  METHODS: This cross-sectional study included 1587 Manitoba grade nine students who completed a self-administered web-based survey. Data was collected on demographic characteristics, dietary intake (24-h recall), food behaviors, food security, and self-report health indicators. Dietary data was compared to national dietary guidelines (Dietary Reference Intakes and Canada's Food Guide). Mean and median nutrient and food group intakes were calculated with corresponding measures of variability. Chi-square tests compared percentage of respondents not meeting key nutrients and food groups. Significant differences in percentage of total servings for each food group were determined by a Kruskal-Wallis test, and differences between different caloric groups were assessed using Dunn's test for post-hoc comparisons.  RESULTS: Half of study respondents were female (50.5%). Median energy intake was higher in males (2281 kcal) compared with females (1662 kcal), with macronutrient distribution of 52%, 16%, and 32% for carbohydrates, protein, and fats respectively. Most participants consumed inadequate fibre (94%), vitamin D (90%), and calcium (73%), while median sodium intakes exceeded recommendations for males but not females. A majority of participants did not meet Health Canada's recommendations for food group servings: Vegetables and Fruit (93%), Milk and Alternatives (74%), Meat and Alternatives (57%) and Grain Products (43%). Other Foods, including sugar sweetened beverages and juice, were consumed by most participants. Higher energy consumers had a greater proportion of food servings coming from Other Foods. 72.1% of students were classified as having a healthy weight and 25% were classified as overweight or obese.

CONCLUSION

Poor dietary intakes and body mass index values indicate an urgent need for policy and program strategies to support healthy eating habits and food awareness in Manitoba youth.

Body awareness mediates the relationship between body mass index and lipid profiles in adolescents

Aim

The purposes of this study were to 1) investigate the relationship between body awareness and anthropometric measurements and lipid profile in adolescents, 2) determine the potential mediating effect of body awareness due to body mass index (BMI) on lipid profiles.

Materials and methods

The study was carried out with 272 volunteer adolescents between the ages of 10-18 who applied to a private nutrition and counseling clinic. Anthropometric measurements of the participants were evaluated including body height body weight, waist and neck, and mid-upper arm circumference. The lipid profile including total cholesterol, high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholestero (LDL-c) and triglyceride was analyzed. A body awareness questionnaire (BAQ), a seven-point Likert-type questionnaire consisting of 18 statements, was administered and questionnaire is interpreted on the total score, and the higher score reflects better body sensitivity. Correlation analysis, linear regression analysis, and path analysis were performed.

Results

Body awareness scores were negatively associated with all anthropometric measurements, namely, BMI, body weight and fat percentage waist and neck and mid-upper arm circumference (all p < 0.05). Body awareness was found to have a negative linear regression relationship with lipid profiles except than HDL-c. The results of path analysis showed that the direct effect of lipid profiles in relation to BMI and the indirect effect of BAQ was statistically significant. This result indicates that body awareness partial mediated the relationship between BMI and lipid profiles.

Conclusion

The research results suggested that increased body awareness is associated body awareness with a lower risk and a decreased body awareness is associated with a higher risk of developing obesity and dyslipidemia.

Can more people be "Happy Being Me"? Testing the delivery of a universal body satisfaction program by clinicians and school staff

The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their first year of secondary school in the UK (Year 7 and after comparisons aged 11-12). HBM is a manualised universal prevention programme which aims to improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptomsStudy 1 tested the effectiveness of HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-intervention which was maintained at follow up. There were no significant changes in risk factors.Study 2 compared clinician (n = 172) and teacher (n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising for wider delivery are discussed.

Mudanças na frequência do consumo de refeições em adolescentes residentes em área de vulnerabilidade social da região metropolitana do Rio de Janeiro, Brasil

Resumo O objetivo deste estudo foi descrever as mudanças na frequência do consumo de refeições de adolescentes residentes na região metropolitana do Rio de Janeiro, em período de 5 anos. Utilizaram-se dados de dois estudos transversais, de base populacional, que foram realizados por meio de visitas domiciliares. Em 2005, a amostra final foi de 1089 domicílios com 511 adolescentes (de 12 a 18 anos), e em 2010 de 1121 domicílios com 314 adolescentes. A frequência do consumo de refeições foi obtida por meio de questionário autopreenchido e a avaliação da adequação de peso dos adolescentes foi realizada com base nos pontos de corte do IMC por sexo e faixa etária. Houve aumento da substituição diária do almoço tradicional por lanche (3,7% para 13,7%) e no consumo do jantar tradicional (62,9% para 72,0%). Os adolescentes com sobrepeso consumiram o desjejum com menor frequência do que aqueles sem sobrepeso (2005: 68,3% vs 79,3% p=0,02, 2010: 59,5% vs 77,4% p=0,03). Conclui-se que houve aumento da substituição diária do almoço tradicional por lanche e no consumo do jantar tradicional no período de 5 anos. Ademais, a prática do desjejum diário se associou com a classificação de IMC nos dois momentos do estudo, de modo que aqueles com sobrepeso consomem o desjejum com menor frequência.

Temperament and psychopathology in early childhood predict body dissatisfaction and eating disorder symptoms in adolescence

Eating disorders (ED) are highly impairing and dangerous conditions that typically onset in adolescence. However, very few prospective studies have examined early childhood risk factors for ED pathology. Given well-established links between temperament and psychopathology, examination of these factors could inform prevention efforts. The current multi-method, multi-informant prospective longitudinal study tested whether laboratory-observed and parent-reported temperament and psychiatric disorders at ages 3 and 6 (N = 609) predict body dissatisfaction at ages 12 and 15 and dimensional symptoms of EDs (anorexia nervosa [AN] and bulimia nervosa [BN]) at age 15 (n = 458) in a community sample. Results indicated that early childhood temperament (positive and negative emotionality, perceptual sensitivity, impulsivity, less shyness) and childhood psychopathology (anxiety, oppositional defiant, attention deficit/hyperactivity, and depressive disorders), predicted body dissatisfaction in adolescence. In addition, childhood perceptual sensitivity and oppositional defiant and depressive disorders predicted AN symptoms. Demographic characteristics (female sex, lower levels of fathers' education, and parental marital status) in childhood predicted body dissatisfaction and AN symptoms. No temperament or psychopathology variables predicted BN symptoms. This study is an important first step toward continuing to identify areas of focus for future research on early childhood risk factors for ED symptoms and body dissatisfaction.

One size does not fit all: Trajectories of body image development and their predictors in early adolescence

Background: Negative body image predicts many adverse outcomes. The current study prospectively examined patterns of body esteem development in early adolescence and identified predictors of developmental subtypes. Methods: 328 girls and 429 boys reported annually across a 4-year period (Mage at baseline = 11.14, SD = 0.35) on body esteem, appearance ideal internalization, perceived sociocultural pressures, appearance comparisons, appearance-related teasing, self-esteem, positive and negative affect, and dietary restraint. We performed latent class growth analyses to identify the most common trajectories of body esteem development and examine risk and protective factors for body image development. Results: Three developmental subgroups were identified: (a) high body esteem (39.1%); (b) moderate body esteem (46.1%); and (c) low body esteem (14.8%). Body esteem was stable within the low trajectory and there were minor fluctuations in the high and moderate trajectories. Greater appearance-related teasing, lower self-esteem, less positive affect, and higher dietary restraint predicted the low trajectory, whereas higher self-esteem and lower dietary restraint best predicted the high trajectory. Conclusions: Low body esteem appears to be largely stable from age 11 years. Prevention programming may be enhanced by incorporating components to address transdiagnostic resilience factors such as self-esteem and positive affect.

The Homeostatic Theory of Obesity: An Empirical Verification of the Circle of Discontent with an Assessment of Its Relationship to Restrained and Uncontrolled Eating among Children and Adolescents

The purpose of the present study was to provide an empirical verification of the Circle of Discontent with an assessment of its relationship to restrained and uncontrolled eating among children and adolescents. This study examined whether our results confirm a new hypothesized model. The total sample comprised 282 children and adolescents (148 girls and 134 boys; 141 participants with normal body weight and 141 with obesity). The mean age was 12.23 years (SD = 2.80), and the average BMI (body mass index) was 23.29 kg/m² (SD = 6.27). The following were used: Positive and Negative Affect Scale for Children, Children’s Body Image Scale, Figure Rating Scale, Three-Factor Eating Questionnaire and Eating Disorders in Youth. The obtained values of the model fit indices proved the goodness of fit. Our findings show that obesity accompanies body dissatisfaction and uncontrolled and restrictive eating. Moreover, the higher the level of restrictive eating, the lower the level of uncontrolled eating. The relationships between body dissatisfaction, negative affect and restrictive eating, as well as that between uncontrolled eating and high-energy consumption, are significant and positive. Other relationships are non-significant. The above-mentioned relationships established in the Circle of Discontent, as well as relationships of restrained and uncontrolled eating with variables described in the circle, were confirmed. Based on our results, preventive strategies and psychological interventions can be created and may include changes in body image, eating behaviors and emotional functioning.

A cluster randomized controlled trial of the SoMe social media literacy body image and wellbeing program for adolescent boys and girls: Study protocol

Youth spend substantial time on social media, which can foster self-critical processes that increase risk of body dissatisfaction, disordered eating, and depressed mood. To date, there have been few investigations of interventions to decrease the negative impacts of social media engagement in adolescent boys and girls. This paper outlines the protocol for a cluster randomized controlled trial (RCT) of a four-lesson social media literacy program that was developed based on pilot results and aims to decrease body dissatisfaction, dietary restraint, and strategies to increase muscles. The RCT will be conducted with grades 7-8 students from Australian secondary schools. Using block randomization, grade levels within schools will be assigned to either the SoMe program (intervention) or health lessons as usual (control). Primary outcomes will be body satisfaction, dietary restraint, and strategies to increase muscles. Secondary outcomes will be self-esteem and depressed mood. Participants will complete assessments on four occasions - baseline, five-weeks post-baseline, and six- and 12-month post-baseline. Analyses will compare outcomes in the intervention compared to the control group. This study will be the first to implement a RCT design to evaluate the impact of a school-based social media literacy program designed to mitigate negative impacts of social media.

Emphasizing the "Cultural" in Sociocultural: A Systematic Review of Research on Thin-Ideal Internalization, Acculturation, and Eating Pathology in US Ethnic Minorities

A large body of research suggests that thin-ideal internalization is a robust predictor of eating pathology in women and, to some degree, in men. Recent research is exploring the relationships between thin-ideal internalization and culture-specific factors that may be salient to women and men who live in the US but are marginalized based on racial or ethnic background, such as acculturation. This systematic review summarizes published articles examining the relationships among thin-ideal internalization, acculturation-related constructs (including assimilation, marginalization, biculturalism, and acculturative stress), and eating pathology in US adults. Following the PRISMA method, 15 empirical studies met inclusion criteria. Although existing literature was sparse and conflicting in large part due to heterogeneity in acculturation measures, results yielded some support for positive correlational relationships between acculturative stress, thin-ideal internalization, and eating pathology for both men and women (in 4 out of 5 relevant studies). Research on other aspects of acculturation (eg, integration, assimilation) is mixed, with some existing research suggesting a positive relationship and other research finding no statistically significant relationship. Future research would particularly benefit from a gold-standard, multidimensional transcultural measure of acculturation to examine how the acculturation process relates to thin-ideal internalization and eating pathology in ethnic and racial minorities in the US.

Fifteen-Year Prevalence, Trajectories, and Predictors of Body Dissatisfaction From Adolescence to Middle Adulthood

Body dissatisfaction is common in adolescence and associated with negative outcomes (e.g., eating disorders). We identified common individual trajectories of body dissatisfaction from mid-adolescence to adulthood, and predictors of divergent patterns. Participants were 1,455 individuals from four waves of Project EAT (Eating and Activity in Teens and Young Adults), a population-based, 15-year longitudinal study. Aggregate body dissatisfaction increased over 15 years, which was largely attributable to increases in weight. Growth mixture modeling identified four common patterns of body dissatisfaction, revealing nearly 95% of individuals experienced relatively stable body dissatisfaction from adolescence through adulthood. Baseline depression, self-esteem, parent communication/caring, peer dieting, and weight-based teasing predicted differing trajectories. Body dissatisfaction appears largely stable from mid-adolescence onward. There may be a critical period for body image development during childhood/early adolescence. Clinicians should intervene upon body dissatisfaction before it becomes chronic, and target depression, self-esteem, parent/child connectedness, and responses to teasing and peer dieting.

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.

Body Esteem among Korean Adolescent Boys and Girls

Establishing a positive body image is a critical factor for adolescents’ physical and mental health as it leads to sustainable individual growth and development throughout their lives. Therefore, possible personality traits need to be examined for their capability as protective factors for a healthy body image. The current study examined how one internal personality trait (self-concept clarity) and three external factors (tripartite influence from media, parents, and peers) are associated with adolescents’ internalization of the thin-body ideal and body esteem in a sample of Korean adolescents (N = 1127). Self-concept clarity was identified as a powerful factor that is positively related with body esteem. The results showed that greater self-concept clarity, lower tripartite influences and thin body internalization were related to greater body esteem. Gender differences were found in the relationships between body esteem and the predictor variables. The implications of the findings and future research directions are discussed.

The Role of Distinct Facets of Perfectionism and Sociocultural Idealization of Thinness on Disordered Eating Symptoms

Introduction: Perfectionism is a multidimensional personality style implicated in risk for disordered eating (DE), yet the types of perfectionism most predictive of DE and how perfectionistic tendencies lead to the development of DE remains less clear. This study aimed to determine the types of perfectionism most strongly associated with DE and whether perceived pressures for thinness and thin-ideal internalization serve as intervening variables that explain associations between perfectionism and DE.

Methods: An ethnically diverse sample of female college students (n = 154–292) completed well-validated self-report questionnaires assessing overall DE symptoms, perfectionism, and two sociocultural factors: pressures for thinness and thin-ideal internalization.

Results: Only perfectionism constructs encompassed under the “maladaptive evaluative concerns” domain were significantly associated with DE. Double mediation models indicated that heightened pressures for thinness and thin-ideal internalization fully mediate perfectionism-DE associations.

Discussion: Results suggest that disorder-specific risk factors related to idealization of thinness may be important for understanding how a transdiagnostic factor, like perfectionism, results in DE.

Ten-year time trends in mental and physical health correlates of weight/shape overvaluation

OBJECTIVE

To investigate the relationships between weight/shape overvaluation, health-related quality of life (HRQoL) and functional role impairment (days out of role [DOR]) in the general population over 11 years.

METHOD

Five cross-sectional surveys of men and women representative of the South Australian population were conducted in 2005, 2008, 2009, 2015, and 2016 (n_total  = 15,140). Data were collected on demographics, overvaluation, HRQoL, DOR, and eating disorder behaviours.

RESULTS

Between 2005 and 2016, the prevalence of moderate overvaluation increased from 18.1% to 40.0%, marked overvaluation from 7.5% to 23.7%, and extreme overvaluation from 3.1% to 9.2% (all p < 0.001). Overvaluation at any level was associated with more DOR in 2005 but not in 2016, and the association between HRQoL impairment and overvaluation weakened over time.

CONCLUSION

Although the population prevalence of overvaluation has increased significantly in the past decade, the impairment associated with it appears to have reduced.

Socio-Demographic Factors and Body Image Perception Are Associated with BMI-For-Age among Children Living in Welfare Homes in Selangor, Malaysia

Considering the double burden of malnutrition in Malaysia, data on malnourished children living in welfare homes are limited. This study aimed to determine the body weight status of children living in welfare homes and its associated factors. A total of 307 children aged 7–17 years old living in 15 selected welfare homes completed a standardized questionnaire, and their body weight and height were measured by trained researchers. There were 54.4% orphans, 23.8% abandoned children, and 21.8% children from problematic families. There were 51.5% boys and 48.5% girls; 52.4% were Malays, followed by 31.3% Indians, 12.7% Chinese, and 3.6% from other ethnic groups. The prevalence of overweight and obesity (23.1%) was higher than the prevalence of thinness (8.5%). In bivariate analyses, socio-demographic factors of age (p = 0.003), sex (p = 0.0001), ethnicity (p = 0.001), and welfare home enrollment status (p = 0.003), and psychological factors of self-esteem (p = 0.003), body shape dissatisfaction (p = 0.0001), and underestimation of body weight status (p = 0.002), were significantly associated with body mass index (BMI)-for-age. In the multiple linear regression analysis, children who were either Malays (β = 0.492) or Chinese (β = 0.678), with a status of being abandoned (β = 0.409), with body shape dissatisfaction (β = 0.457), and underestimated body weight status (β = 0.628) significantly explained 39.7% of the variances in higher BMI-for-age (F = 39.550; p < 0.05). Besides socio-demographic background, the current findings emphasized the importance of incorporating body image perception in an obesity prevention intervention program in welfare homes.

Body image dissatisfaction and dietary patterns according to nutritional status in adolescents

OBJECTIVE

There is a lack of data on the association between body self-perception and eating patterns in Brazil. Thus, this study aimed to explore the relationship between body image dissatisfaction and eating patterns by the anthropometric status in adolescents.

METHODS

A cross-sectional study of 1496 adolescents was conducted. The participants completed the Body Shape Questionnaire. Demographic, anthropometric, and socioeconomic data were collected, as well as information regarding the pubertal development and dietary intake. Logistic regression was performed to evaluate the associations of interest.

RESULTS

Body image dissatisfaction was identified in 19.5% of the adolescents. Three dietary patterns were identified: (1) the Western pattern was composed of sweets and sugars, soft drinks, typical dishes, pastries, fast food, beef, milk, and dairy products; (2) the Traditional pattern was composed of oils, chicken, fish, eggs, processed meat products, cereals (rice, cassava flour, pasta, etc.), baked beans, and bread; and (3) the Restrictive pattern was composed of granola, roots, vegetables, and fruit. Among overweight/obese adolescents, the data indicated a negative association of slight body image dissatisfaction (OR: 0.240 [0.100; 0.576]) and moderate body image dissatisfaction (OR: 0.235 [0.086; 0.645]) with the Western dietary pattern. Additionally, in this group, there was a positive association between high body image dissatisfaction and the Restrictive pattern (OR: 2.794 [1.178; 6.630]).

CONCLUSION

Amongst overweight/obese adolescents, those with slight and moderate body image dissatisfaction were less likely to follow a Western-like dietary pattern when compared with those satisfied with their body image. Additionally, in this group, adolescents with high body image dissatisfaction was more likely to follow a restrictive pattern.

An evaluation of a body image intervention in adolescent girls delivered in single-sex versus co-educational classroom settings

Body dissatisfaction is now recognized as having considerable negative impact on social, psychological, and physical health, particularly in adolescent girls. Consequently, we have developed a six-session co-educational body image intervention (Happy Being Me Co-educational) designed to reduce body dissatisfaction and its risk factors in Grade 7 girls. In addition to evaluating the program's efficacy, we aimed to identify whether girls would benefit equally when it was delivered as a universal intervention to a whole class including both boys and girls (co-educational delivery), or delivered as a selective intervention to girls only (single-sex delivery). Participants were 200 Grade 7 girls from five schools in Melbourne, Australia. Schools were randomly allocated to receive the intervention in single-sex classes (n=74), co-educational classes (n=73), or participate as a no-intervention control (n=53). Girls completed self-report assessments of body dissatisfaction, psychological (internalization of the thin ideal, appearance comparison, and self-esteem) and peer environment (weight-related teasing and appearance conversations) risk factors for body dissatisfaction, and dietary restraint, at baseline, post-intervention, and at 6-month follow-up. Significant improvements in body dissatisfaction and psychological risk factors were observed in the intervention group at post-intervention and these were maintained at follow-up for psychological risk factors. Importantly, no significant differences between universal and selective delivery were observed, suggesting that the intervention is appropriate for dissemination in both modes.

The measurement of media literacy in eating disorder risk factor research: psychometric properties of six measures

BACKGROUND

Evaluation of media literacy-based interventions for the prevention of eating disorder risk is limited by the lack of appropriate measures with established psychometric properties with which to assess change in media literacy. This study aims to fill this gap by examining the psychometric properties and use in eating disorders risk factor research of six measures of media literacy that assess media processing and critical thinking about general media and critical thinking about appearance-focused media.

METHODS

The factor structure, internal consistency, test-retest reliability, and construct validity, including convergent and discriminant validity, were examined in six measures in two samples of early adolescent females. The measures were the Realism Scepticism, Similarity Scepticism, and Desirability Scepticism subscales of the Media Attitudes Questionnaire, the Fake subscale of the Critical Processing of Beauty Images Scale, the Critical Thinking about Media Messages scale, and Critical Thinking about Media Messages - Appearance Focus scale.

RESULTS

The factor structure of the measures was supported with factor analysis. Items from the Media Attitudes Questionnaire loaded on the three subscales Realism Scepticism, Similarity Scepticism, and Desirability Scepticism and items from each of the Fake subscale, Critical Thinking about Media Messages scale and Critical Thinking about Media Messages - Appearance Focus scale loaded on one scale. In addition, scores on the measures were reliable (adequate internal consistency and test-retest reliability) and valid (adequate construct, convergent, and discriminant validity) in early adolescent females. Two exceptions were Realism Scepticism, which had slightly low test-retest reliability, and the Fake subscale, for which support for construct validity was lacking.

CONCLUSIONS

This study provides evidence to support the use of select media literacy measures, particularly the Realism Scepticism subscale and the Critical Thinking about Media Messages scale, in eating disorder risk factor research and the findings will contribute to enhanced evaluation of media literacy-based prevention interventions.