Explaining rigid dieting in normal-weight women: the key role of body image inflexibility

Explaining the prospective paths from body appreciation to intuitive eating facets: Does body image flexibility serve as a mediator?

Initial evidence suggests that body appreciation prospectively predicts intuitive eating. However, the limited number of longitudinal studies focused solely on girls and women, with a lack of evaluation among men. Furthermore, the underlying mechanisms explaining this relationship remain poorly understood. The present study examined whether body appreciation prospectively predicted intuitive eating facets among women and men in Germany. We also tested whether adaptive affect regulation skills (i.e., body image flexibility) mediated these relationships. We analyzed data from 1436 women and 704 men across three time points: Baseline (T1), 6-month (T2), and 12-month (T3) follow-up, using latent variable path models to assess direct and indirect effects. Among women, T1 body appreciation directly predicted T3 body-food choice congruence. Additionally, body appreciation indirectly predicted unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on hunger and satiety cues at T3 via its effect on T2 body image flexibility. Among men, T1 body appreciation indirectly predicted T3 eating for physical rather than emotional reasons via T2 body image flexibility. Our findings suggest that body image flexibility plays a pivotal role in explaining why individuals who appreciate their bodies are more likely to eat intuitively.

Self-objectification and cosmetic surgery consideration among Chinese young women: The mediating roles of alienation and body image inflexibility

The behavior of undergoing cosmetic surgery is a coping strategy for body-image threats and challenges. Self-objectification is associated with alienation and body image inflexibility, and all of these are associated with stronger cosmetic surgery considerations. This study evaluated the relationship between self-objectification and cosmetic surgery consideration, and whether this relationship was mediated by alienation and body image inflexibility. The participants were 650 Chinese female college students. Serial mediation analysis indicated that the relationship between self-objectification and cosmetic surgery consideration was significantly mediated by alienation followed by body image inflexibility. The total mediating effect value was 0.424, accounting for 57.5% of the total effects. These results suggest that reducing alienation and improving the flexibility of body image can reduce the influence of self-objectification on young women's willingness to undergo cosmetic surgery. These findings provide a basis for intervening or preventing the self-objectified young women's willingness for cosmetic surgery.

Gay Dating Apps Usage, Body Dissatisfaction, and Disordered Eating in Chinese Young Gay Men

There is a paucity of research on the links between gay dating apps usage and body dissatisfaction and disordered eating, especially for muscularity dissatisfaction and muscularity-oriented disordered eating in non-Western contexts. Thus, this study aimed to evaluate the associations between gay dating apps usage, body image inflexibility, body dissatisfaction, and disordered eating with the inclusion of both body fat and muscularity dissatisfaction and both thinness-and muscularity-oriented disordered eating in a sample of Chinese young gay men. A total of 247 Chinese young gay men (mean age: 21.92 ± 2.74 years) were recruited. Gay dating apps usage, body fat dissatisfaction, muscularity dissatisfaction, body image inflexibility, and thinness-and muscularity-oriented disordered eating were evaluated. Pearson correlation and mediation analyses were conducted. Gay dating apps usage was positively correlated with body fat dissatisfaction (r = .20, p = .002), muscularity dissatisfaction (r = .17, p = .006), thinness-oriented disordered eating (r = .21, p < .001), and muscularity-oriented disordered eating (r = .29, p < .001), and these relationships could be mediated by body image inflexibility. Findings support technologically-informed prevention and intervention strategies for eating and body image disturbances in gay men in the Chinese context.

Eating Patterns of Young Women (18–25 y) with Overweight and Obesity: A Preliminary Investigation

Overweight and obesity impact up to 40% of young women in Australia; however, young women are challenging to recruit to research and are rarely the focus of weight loss interventions. This study aimed to examine dietary patterns in young women (18–25 years; BMI > 25 kg/m2). An analysis of participants’ (mean age: 22.6 year; BMI: 32.2 kg/m2) 3-day food records found young women with overweight/obesity consumed a diet characterised by total energy intake of 9174 (2526) kJ/day, with the first meal at 9:12 am (range: 4:30 am–12:40 pm), the last at 10:43 pm (range: 2:40 pm–2:00 am), and an average eating window of 11.5 h. Young women had poor quality diets, which did not meet dietary recommendations for most core food groups, and high intake of refined carbohydrates. They also reported consuming at least one takeaway meal per day and >30% of total energy intake was from discretionary items. The findings showed that young women with overweight or obesity consume most of their energy intake in the afternoons and late into the evenings and have poor-quality diets with high-discretionary intake, each of which have been shown in previous work to be associated with increased weight and risk of metabolic comorbidities. While these findings require further examination in larger groups with both qualitative and longitudinal data collection to verify the impact of these eating patterns on weight maintenance, the eating behaviours identified here may present a suitable target for novel weight loss interventions in young women, who are an understudied population group in need of tailored weight management solutions.

Exploring the links between celebrity worship, body dissatisfaction, and disordered eating among young adult celebrity worshippers in China

Considerable evidence exists on the associations of celebrity worship with body dissatisfaction and disordered eating. However, relevant findings are confined to Western contexts and thinness-oriented body dissatisfaction and disordered eating. Consequently, the relationships of celebrity worship with muscularity-oriented body dissatisfaction and disordered eating are largely underexplored, especially in non-Western countries. Thus, the present study aimed to examine the relationships of celebrity worship with body dissatisfaction and disordered eating in China. A total of 593 young adult celebrity worshippers in China were recruited online. Correlation and mediation analyses were conducted. In contrast to previous findings, celebrity worship was not associated with thinness-oriented body dissatisfaction. However, significant associations were identified between celebrity worship and muscularity-oriented body dissatisfaction for men (r = 0.32, p < .001) and women (r = 0.26, p < .001), thinness-oriented disordered eating for men (r = 0.31, p < .001) and women (r = 0.37, p < .001), and muscularity-oriented disordered eating for men (r = 0.58, p < .001). Body image inflexibility mediated the associations between celebrity worship and disordered eating in men and women. Findings indicate that celebrity worship correlates positively with body dissatisfaction and disordered eating in Chinese young adults.

Is the relationship between BMI and body appreciation explained by body dissatisfaction and body image inflexibility among older adults? A study among older Chinese men and women

A number of previous studies reported a link between body mass index (BMI) and body appreciation; however, many of these studies were conducted in Western countries and addressed younger samples. Older adults, especially in East Asia, remain insufficiently examined. Therefore, the objective of this study was to examine the relationship between BMI and body appreciation and to explore two potential mediators, body dissatisfaction and body image inflexibility, as proposed in a previous meta-analysis. A community-based cross-sectional study was performed among 313 older Chinese men and women (M = 67.90, SD = 7.94). Mediation tests were conducted to examine the roles of body dissatisfaction and body image inflexibility in the relationship between BMI and body appreciation. BMI correlated significantly with body appreciation, body dissatisfaction, and body image inflexibility among older women but did not correlate with body appreciation among older men. Body dissatisfaction and body image inflexibility emerged as significant mediators in the relationship between BMI and body appreciation among older Chinese women. Reducing body dissatisfaction and body image inflexibility may be potential targets for helping older women with high BMI to promote their body appreciation.

Using machine learning to explore core risk factors associated with the risk of eating disorders among non-clinical young women in China: A decision-tree classification analysis

BACKGROUND

Many previous studies have investigated the risk factors associated with eating disorders (EDs) from the perspective of emotion regulation (ER). However, limited research has investigated interactions between co-existing risk factors for EDs, especially in China where research in EDs is underrepresented.

METHODS

This study examined core risk factors related to maladaptive eating behaviors and ER, and how their interactions affect the detection of EDs. Using machine learning, a decision tree model was constructed on a data set of 830 non-clinical Chinese young women with an average age of 18.91 years (SD = 0.95). The total data set was split into training and testing data sets with a ratio of 70 to 30%.

RESULTS

Body image inflexibility was identified as the major classifier for women at high risk of EDs. Furthermore, interactions between body image inflexibility, psychological distress, and body dissatisfaction were important in detecting women at high risk of EDs. Overall, the model classifying women at high-risk for EDs had a sensitivity of 0.88 and a specificity of 0.85 when applied to the testing data set.

CONCLUSIONS

Body image inflexibility, psychological distress, and body dissatisfaction were identified as the major classifiers for young women in China at high risk of EDs. Researchers and practitioners may consider these findings in the screening, prevention, and treatment of EDs among young women in China.

The relationship between body weight and dietary restraint is explained by body dissatisfaction and body image inflexibility among young adults in China

OBJECTIVE

Eating disorders and obesity are commonly recognized as key public health concerns worldwide. Although rates of obesity and disordered eating have traditionally been lower in China than Western countries, these rates are on the rise. As such, interest is growing in identifying mechanisms that may address these conditions. While associations between body weight and dissatisfaction are well established, burgeoning research aims to examine how these factors are related to dietary restraint and body image inflexibility. This study aimed to explore the possible mediation effect of body dissatisfaction and body image inflexibility between body weight (body mass index) and dietary restraint. Furthermore, we explored how these relationships differed across men and women.

METHODS

A sample of 1068 young adults (563 females and 505 males) in China participated in the study. Participants completed the Eating Disorder Inventory and Three-Factor Eating Questionnaire as well as the Body Image-Acceptance and Action Questionnaire.

RESULTS

Results showed that: (1) body dissatisfaction and body image inflexibility fully mediated the relationship between body mass index and dietary restraint; (2) this model fit both genders, although differences were found in the regression coefficients between the mediation model for men and women.

CONCLUSION

These findings support body image dissatisfaction and inflexibility as mediators of the relationship between body weight and dietary restraint, highlighting these as potential mechanisms for treatment.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Global Dieting Trends and Seasonality: Social Big-Data Analysis May Be a Useful Tool

We explored online search interest in dieting and weight loss using big-data analysis with a view to its potential utility in global obesity prevention efforts. We applied big-data analysis to the global dieting trends collected from Google and Naver search engines from January 2004 to January 2018 using the search term “diet,” in selected six Northern and Southern Hemisphere countries; five Arab and Muslim countries grouped as conservative, semi-conservative, and liberal; and South Korea. Using cosinor analysis to evaluate the periodic flow of time series data, there was seasonality for global search interest in dieting and weight loss (amplitude = 6.94, CI = 5.33~8.56, p < 0.000) with highest in January and the lowest in December for both Northern and Southern Hemisphere countries. Seasonal dieting trend in the Arab and Muslim countries was present, but less remarkable (monthly seasonal seasonality, amplitude = 4.07, CI = 2.20~5.95, p < 0.000). For South Korea, seasonality was noted on Naver (amplitude = 11.84, CI = 7.62~16.05, p < 0.000). Our findings suggest that big-data analysis of social media can be an adjunct in tackling important public health issues like dieting, weight loss, obesity, and food fads, including the optimal timing of interventions.

Appearance Comparisons and Eating Pathology: A Moderated Serial Mediation Analysis Exploring Body Image Flexibility and Body Appreciation as Mediators and Self-Compassion as Moderator

Comparing one's body against the bodies of others is related to lower positive body image and higher eating pathology. Underlying mechanisms as well as protective factors of these relationships are yet to be discovered. The present study examined body image flexibility and body appreciation as potential mediators of the association between appearance comparisons and eating disorder psychopathology. Additionally, it was tested whether self-compassion moderates the mediation effects. In an online sample comprising 250 women (M_age = 42.66, SD = 12.24), the inverse relationship between appearance comparisons and body appreciation was mediated by body image flexibility and the positive relationship between appearance comparisons and eating disorder psychopathology was mediated by body image flexibility and serially mediated by body image flexibility and body appreciation, when controlling for body mass index and age. Simple mediations were further moderated by self-compassion, such that indirect effects were attenuated at high levels of self-compassion. Promoting body image flexibility may be one potential target for helping women to engage in less maladaptive and more adaptive ways of treating the body when comparing one's appearance. Building self-compassion may be another potential target that may protect body image flexibility and its correlates in the face of appearance comparisons.

Factors Underlying Food Choice Motives in a Brazilian Sample: The Association with Socioeconomic Factors and Risk Perceptions about Chronic Diseases

This study aimed to evaluate the food choice motives in a sample in Brazil and to identify how socioeconomic characteristics and risk perceptions about chronic diseases and weight gain affect these motives. The Food Choice Questionnaire (FCQ) is an instrument to analyze the motivations for food choice. The FCQ was completed by 525 adult individuals in Brazil. The participants were asked about their perceived risk of gaining weight, developing diabetes, and hypertension. Confirmatory factor analysis led to the rejection of the original FCQ structure, and, after exploratory factor analysis, 30 items of the FCQ were maintained in eight factors: Nutritional Composition, Preparation Convenience, Purchase Convenience, Mood, Sensory Appeal, Health, Price, and Familiarity. Sensory Appeal and Familiarity were, respectively, the most and the least important factors involved in food choices in this sample. A high education level, high income, age, and female sex positively affected FCQ factors (except for the Price factor). On the basis of FCQ scores, we defined five clusters: Health Driven, Practicality Concerned, Shape Concerned, Food Concerned, and Cooking Enthusiasts. In general, individuals were optimistic regarding the risk of developing diabetes, hypertension, and gaining weight, especially those from the Shape Concerned cluster. The differences in food choice motives presented here reinforce the existence of different niches of food consumption. Different types of products can attract specific target groups at the time of choice.

The Re-shaping of Bodies: A Discourse Analysis of Feminine Athleticism

Slender and skinny body ideals have been associated with psychological disorders such as eating disorders. However, the tendency to promote a “healthier” and more athletic female body ideal has received minimal critical attention. This study aims at exploring the underlying conditions for such an athletic ideal through asking: How is the female athletic body constructed in the pseudonymous contemporary women’s fitness magazine, “Xrzise”? We investigated the object of inquiry through a modified version of Parker’s Foucauldian discourse analysis. We analyzed the interviews of four athletic role models in “Xrzise” and identified four discourses: “Neo-liberal discourse,” “Health expertise discourse,” “Discourse of surveillance and control” and “Discourse of emancipation.” The “Neoliberal discourse” constructs the female athletic body as something that the individual woman should strive for by appropriately managing her own resources, abilities and skills. The “Health expertise discourse” constructs the female athletic body through a homeostatic logic where the individual is responsible and healthcare experts have the mandate to intervene in order to maintain good health. The “Discourse of surveillance and control” constructs the female athletic body as an internalized panoptic stance, disciplining women to accept hegemonic beauty ideals. The “Discourse of emancipation” accentuates that the female athletic body is alleviated from a culturally rigid body image and instead improved physical performance and functionality are considered good ends. The results and discussion indicate that the female athletic body is a result of a complex nexus of different discourses associated with the powers of economy, sex differences, institutions, and ideological forces. We have advocated that magazines like “Xrzise” can have covert disciplinary effects hidden by seemingly well-intentioned motives, which can contribute to women’s objectification of their bodies.

Disordered eating attitudes among Iranian university students of medical sciences: The role of body image perception

BACKGROUND

Disordered eating attitudes and behaviors have become an issue of worldwide concern.

AIM

This research was designed to investigate the role of body image satisfaction in the relationship with eating attitudes among students of Qazvin University of Medical Sciences in Iran.

METHODS

In this cross-sectional study, 385 Qazvin university students of medical sciences were recruited by randomized stratified sampling in 2014. The students completed a three-part questionnaire (socio-demographic, Eating Attitudes Test and Body Shape Questionnaire) in their classrooms. We used hierarchical generalized linear models to identify variables significantly associated with Eating Attitudes Test scores.

RESULTS

The mean age of the students was 21.80 ± 2.98 years. Mean scores for the Eating Attitudes Test and Body Shape Questionnaire were 66.75 ± 29.8 and 11.86 ± 10.97 respectively; 18.5% of students had a score of 20 and above (≥ 20) that indicated disordered eating attitudes or as being at risk of eating disorders. In the multiple regression model, the Eating Attitudes Test was related to screening body image dissatisfaction (β = 0.122, P < 0.001). Body mass index was negatively related to the Eating Attitudes Test score (β= -0.488, P < 0.016), and diet was significantly correlated with an increased Eating Attitudes Test score (β = 5.803, P < 0.001).

CONCLUSIONS

The risk of eating disorders is relatively high among Iranian university students. It can be a warning to health policy makers and should be the focus of special attention. In the present study, the most important factor related to abnormal eating attitudes was body image dissatisfaction. Regarding the complexity of the causes of eating disorders, various preventive and therapeutic interventions are necessary to avoid the dissemination in society of an idealized view of excessive thinness and further unfavorable outcomes in college students.

Does the recall of caregiver eating messages exacerbate the pathogenic impact of shame on eating and weight-related difficulties?

PURPOSE

The central role of caregiver eating messages has been recognized on later individual's eating behaviour, body image and weight status. Additionally, shame is a painful emotion also associated with the development and maintenance of body image and eating-related difficulties. The main aim of the present study was to explore the moderator effect of the recall of caregiver eating messages on the associations between external shame, body weight and shape-related concerns, and the adoption of inflexible eating rules.

METHODS

The sample comprised 479 women from the general population, aged from 18 to 60 years, who completed self-report measures.

RESULTS

Results of the correlation analyses showed that early caregiver restrictive/critical eating messages were positively associated with external shame, inflexible eating and overvaluation of body weight and shape. Path analysis results demonstrated a moderator effect of early caregiver critical eating messages on the relationship between external shame and both weight and shape-related concerns and inflexible eating. These results revealed that caregiver restrictive/critical eating messages exacerbated the impact of shame on these psychopathological indices, with the tested model accounting for 19% and 38% of the variance of inflexible eating rules and body weight and shape concerns, respectively.

CONCLUSIONS

These findings seem to suggest important research and clinical implications, contributing to the understanding of disordered eating patterns, and appear to represent a new avenue for the development of prevention and intervention programs. Particularly, these findings support the relevance of targeting caregiver eating-related attitudes and messages in prevention interventions for eating psychopathology.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Trait body image flexibility as a predictor of body image states in everyday life of young Australian women

The present study evaluated whether individuals with varying levels of trait body image flexibility differ in the severity, variability, and correlates of state body dissatisfaction experienced in their daily lives. One hundred and forty-seven women completed a baseline measure of trait body image flexibility, followed by a 7-day ecological momentary assessment phase in which participants self-reported state body dissatisfaction, disordered eating behavior, drive for thinness, and appearance comparisons at 10 semi-random intervals daily. Higher trait body image flexibility predicted lower average scores, less frequent reporting of high state body dissatisfaction, and less variability in their state body dissatisfaction ratings. Individuals with higher trait body image flexibility were also less likely to engage in a range of behaviors and cognitions previously shown to produce body dissatisfaction, including upward appearance comparisons, drive for thinness, binge eating, and dieting. However, few of these state-based relationships involving body dissatisfaction and these related behaviors and cognitions were moderated by trait body image flexibility. Overall, this pattern of findings suggests that body image flexible individuals may have less negative body image because they are less inclined to engage in behaviors and cognitions in their daily lives that encourage negative body image.

A systematic review of the roles of body image flexibility as correlate, moderator, mediator, and in intervention science (2011-2018)

The emergence of body image flexibility into the positive body image nomenclature has innovatively expanded the conceptualization of how individuals may adaptively respond to body image threats. Given the notable growth of interest in researching this construct over nearly the past decade, the present analysis provides a systematic and critical review of evidence examining the roles of body image flexibility as correlate, mediator, moderator, and in intervention research. Results indicated that body image flexibility tended to demonstrate a pattern of relationships with correlates in directions predicted by its conceptualization and showed promise in functioning as both effect modifier and as an explanatory variable in the associations evaluated. Multiple studies demonstrated susceptibility to change following intervention. Although the current state of the literature is bound by notable limitations, the results of this review point to pertinent future steps in advancing the theory and application of body image flexibility scholarship.

Social safeness and disordered eating: Exploring underlying mechanisms of body appreciation and inflexible eating

Feelings of social safeness and connectedness have been associated with adaptive emotion regulation processes and well-being indicators. Further, literature has demonstrated that interpersonal experiences play an important role in the etiology and maintenance of body and eating psychopathology. However, the study of the role of social variables and emotion regulation processes in the engagement in inflexible eating rules and eating psychopathology is still in its early stages. The current study aims to fill some gaps within the literature and explore the mediator role of body appreciation and inflexible eating rules in the link between social safeness and disordered eating. Participants were 253 women, aged between 18 and 50 years old, who completed a series of online self-report measures. Results from the tested path analysis model showed that social safeness holds a significant effect on eating psychopathology, through the mechanisms of body appreciation and inflexible eating rules. Also, results suggested that women who present higher levels of social safeness tend to present a more positive and respectful attitude towards their body and decreased adoption of inflexible eating rules, which seem to explain lower levels of disordered eating behaviours. These findings seem to present empirical support for the development of intervention programs that promote a positive, affectionate and healthy relationship with one's body image, in order to prevent the inflexible adherence to eating rules and disordered eating behaviours.

Recent trends in weight loss attempts: repeated cross-sectional analyses from the health survey for England

BACKGROUND

Public policies and clinical guidelines encourage people to achieve and maintain a healthy weight and societal culture, especially among women who tend to idealise thinness.

OBJECTIVES

To examine trends over time in the prevalence of weight loss attempts in England (1997-2013) and to investigate if the characteristics associated with attempts to lose weight have changed.

METHODS

Observational study using nationally representative data on adults ⩾18 years who participated in the Health Survey for England (HSE) in 1997 (n=8066), 1998 (n=14 733), 2002 (n=8803), 2012 (n=7132) and 2013 (n=7591), with self-reported attempts to lose weight, cardiovascular disease (CVD) events or medications and measured height, weight and blood pressure. Multivariable logistic regression was used to assess the association between weight loss attempts and survey year, socio-demographic variables and health status.

RESULTS

The age-standardised prevalence of weight loss attempts in the English population increased from 39% in 1997 to 47% in 2013. In 2013, 10% of those with BMI <22; 30% with BMI ⩾22 to <25; 53% with BMI ⩾25 to <30; and 76% with BMI ⩾30 were trying to lose weight. The odds of trying to lose weight increased linearly with each year: odds ratio (OR) 1.021 (95% confidence interval (CI) 1.018-1.024) and 1.024 (95% CI 1.008-1.039) after adjustment for changes in BMI and population characteristics. The biggest predictors of weight loss attempts were being in the overweight/obese categories: 5.42 (95% CI 5.05-5.81) and 12.68 (95% CI 11.52-13.96), respectively; and among women: 3.01 (95% CI 2.85-3.18). Having a BMI >25 and a CVD-related condition was associated with only a small increase in the odds of trying to lose weight. There was no evidence that these predictors changed over time.

CONCLUSIONS

More people are making weight loss attempts each year across all BMI categories. Having a health condition that would improve with weight loss was only very modestly associated with an increase in reported weight loss attempts, which reinforces data that suggests people's prime motivation to lose weight is unrelated to health.

The role of memory in the relationship between attention toward thin-ideal media and body dissatisfaction

PURPOSE

This study examined the causal relationship between attention and memory bias toward thin-body images, and the indirect effect of attending to thin-body images on women's body dissatisfaction via memory.

METHOD

In a 2 (restrained vs. unrestrained eaters) × 2 (long vs. short exposure) quasi-experimental design, female participants (n = 90) were shown images of thin models for either 7 s or 150 ms, and then completed a measure of body dissatisfaction and a recognition test to assess their memory for the images.

RESULTS

Both restrained and unrestrained eaters in the long exposure condition had better recognition memory for images of thin models than did those in the short exposure condition. Better recognition memory for images of thin models was associated with lower body dissatisfaction. Finally, exposure duration to images of thin models had an indirect effect on body dissatisfaction through recognition memory.

CONCLUSIONS

These findings suggest that memory for body-related information may be more critical in influencing women's body image than merely the exposure itself, and that targeting memory bias might enhance the effectiveness of cognitive bias modification programs.