An etiological model of disordered eating behaviors among Brazilian women

My mother, sisters, and I: Investigating the role of female family members in body dissatisfaction and disordered eating behaviours among young Middle-Eastern women

The global rise in body dissatisfaction and disordered eating concerns is apparent; however, limited research in Middle-Eastern populations gives an incomplete understanding of these concerns. The present study recruited 377 young women aged 18 to 25 years from the Middle-East for an online survey to determine how female family members may contribute to body dissatisfaction and disordered eating behaviours. Guided by the Tripartite Influence Model, we investigated the relationships between appearance pressures and fat talk, from mothers and sister(s), in predicting body dissatisfaction, and in turn, disordered eating symptomatology (restriction and bulimia), as mediated by appearance comparisons and internalisation of the thin-ideal. Overall, greater appearance pressures and fat talk from mothers and sister(s) were associated with body dissatisfaction and disordered eating symptomatology. Greater reported closeness in mother-daughter relationships, but not sister relationships, was associated with less perceived appearance pressure and fat talk by mothers, and lower appearance comparisons, body dissatisfaction and bulimia symptomatology. Finally, participants perceived greater appearance pressure from their mothers than their sister(s), but there was no difference in their perceived levels of fat talk. Findings demonstrate the applicability of a subsection of the Tripartite Influence Model in a non-Western and understudied population, namely in young Middle-Eastern women.

Variables that explain disordered eating behaviors among women: the mediating role of body dissatisfaction

PURPOSE

To analyze the role of body dissatisfaction in the relationships of sociocultural influences, depression, and anxiety with disordered eating behaviors (DEB) in a sample of female Mexican university students.

METHODS

A nonrandom sample of 526 female Mexican university students aged 18 to 25 years completed the Questionnaire of Influence on the Aesthetic Model of Body Shape (CIMEC-26), the Hospital Anxiety and Depression Scale (HADS), the Body Shape Questionnaire (BSQ-8D) and the Eating Attitudes Test (EAT-26).

RESULTS

Through the mean model (χ2/df (5, n = 526) = 7.298, p = .199; NFI = .996; CFI = .999; RMSEA = .030; SRMR = .011), body dissatisfaction was found to mediate the relationships of influence of advertising, influence of social models and anxiety with DEB (restrictive dieting and bulimia). The variable with the most direct effect on restrictive dieting and bulimia was the influence of advertising. Body dissatisfaction partially mediated this relationship, as the influence of advertising had a significant direct effect on restrictive dieting and bulimia. The final model of direct and indirect effects explained 43% and 22% of the variance in restrictive dieting and bulimia, respectively.

CONCLUSION

The present study showed that body dissatisfaction partially mediated the relationships between influence of advertising, influence of social models, and anxiety with DEB among women. Thus, these variables should be taken into account in prevention and intervention programs targeting BED.

LEVEL V

Evidence obtained from a cross-sectional descriptive study.

LEVEL V

Evidence obtained from a cross-sectional descriptive study.

Weight stigma is a predictor of disordered eating in Brazilian college students during the COVID-19 pandemic: A 16-month cohort follow-up

This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.

Weight stigma and disordered eating behaviors during the COVID-19 pandemic: the mediating role of weight gain concern and psychological distress

OBJECTIVES

The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight.

METHODS

A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest.

RESULTS

Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status.

CONCLUSIONS

Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating.

LEVEL OF EVIDENCE

Level V, cross-sectional study.

The mother-daughter-sister triad: The role of female family members in predicting body image and eating behaviour in young women

Familial influence, specifically from mothers and sisters, may impact the development of body dissatisfaction and disordered eating in young women. Guided by the Tripartite Influence Model, the present study recruited 422 young Australian women for a survey to determine how appearance pressures and fat talk, exhibited by mothers and sisters, and mediational mechanisms (comparisons and internalisation), are associated with body dissatisfaction, and in turn, disordered eating symptomatology. We also explored differences in perceived ratings of mother versus sister appearance pressures and fat talk. Findings were in the hypothesised directions. Greater appearance pressures and fat talk from mothers and sisters was associated with greater body dissatisfaction, restriction and bulimic behaviours. Furthermore, appearance pressures from mothers and sisters was related to young women's likelihood of engaging in appearance comparisons and thin-ideal internalisation, which was associated with body dissatisfaction, and in turn, disordered eating symptomatology. Finally, participants perceived more appearance pressures from their mothers than their sisters, and perceived their mothers to exhibit greater fat talk than their sisters. The findings extend previous research in an important and novel way by investigating individual agents of female familial influence in addition to the role of fat talk in predicting body dissatisfaction and disordered eating.

Body, eating, and exercise comparison orientation measure (BEECOM): Cross-cultural adaptation and psychometric properties among Brazilian female university students

The Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) is an instrument that aims to quantify behaviors related to social comparison, specifically comparisons related to the body, eating and exercise, and was originally developed using a nonclinical population of American university women. The objective of this study was to perform a cross-cultural adaptation and verify the psychometric qualities of the BEECOM for young Brazilian adult women aged 18-35 years. In the present study, the cross-cultural adaptation of the instrument was performed through its translation, back-translation and evaluation by the target population. The instrument proved to be easy to understand among young women. Then, the psychometric qualities of the instrument were evaluated using a sample of 716 women (M_age = 22.47 ± 3.10). Exploratory and confirmatory factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. The BEECOM presented an invariant measurement across white vs. nonwhite and physically active vs. non-active individuals. In addition, the instrument showed adequate reliability and convergent validity. In conclusion, the BEECOM is a useful tool to evaluate social comparison behaviors related to eating disorders and body image in young Brazilian female adults, enabling further research on these constructs and supporting the development of preventive strategies.

Socio-cultural power of social media on orthorexia nervosa: An empirical investigation on the mediating role of thin-ideal and muscular internalization, appearance comparison, and body dissatisfaction

As social media continues to penetrate users' daily lives, concerns about its negative impact on body image issues and eating disorders are becoming focuses of research. It remains unclear whether social media should be held responsible for promoting orthorexia nervosa-a problematic and extreme fixation on healthy eating. The present study draws on socio-cultural theory and tests a social media-based model in the context of orthorexia nervosa to enhance knowledge of social media's influence on body image issues and orthorectic eating tendencies. The socio-cultural model was tested using structural equation modeling based on responses from a German-speaking sample (n = 647). The results indicate that social media users' involvement with health and fitness accounts is associated with higher orthorectic eating tendencies. Thin-ideal and muscular internalizations mediated this relationship. Interestingly, body dissatisfaction and appearance comparison were not mediators, which can be attributed to the characteristics of orthorexia nervosa. Higher involvement with health and fitness accounts on social media was also related to higher appearance comparisons. The results highlight the powerful influence of social media on orthorexia nervosa and the relevance of socio-cultural models in investigating the mechanisms underlying this influence.

Validation of the Arabic version of the Muscle Dysmorphic Disorder Inventory (Ar-MDDI) among Lebanese male university students

BACKGROUND

To date, the vast majority of research on disordered eating symptomatology and body image disturbances from the Arab world have been performed exclusively among women; and mainly used thinness-oriented measures that are not sensitive to detect muscularity-oriented symptoms, which are more evident in males. Therefore, the objective of our study was to validate the Arabic version of the Muscle Dysmorphic Disorder Inventory (Ar-MDDI), in order to make it accessible for Arabic-speaking populations.

METHODS

Using a snowball sampling technique, men university students (n = 396) from multiple universities in Lebanon filled the survey in this cross-sectional designed study (January-May 2022). A soft copy of the questionnaire was created using google forms software, and sent to participants through the different social media platforms such as Facebook, Instagram, and WhatsApp. We used the Muscle Dysmorphic Disorder Inventory to assess Muscle Dysmorphia, along with the Big Three Perfectionism Scale to assess perfectionism and Eating Attitude Test (EAT) to evaluate the inappropriate eating attitudes. To explore the factor structure of Ar-MDDI, we computed a principal-axis Exploratory Factor Analysis (EFA) with the first split-half subsample using the FACTOR software. We used data from the second split-half to conduct a Confirmatory Factor Analysis (CFA) using the SPSS AMOS v.29 software. Pearson correlation test was used to test the convergent and divergent validity of the Ar-MDDI scale with the other scores included in the study.

RESULTS

The results of the EFA revealed three factors, which explained 57.68% of the common variance: Factor 1 = Appearance intolerance, Factor 2 = Drive for size, and Factor 3 = Functional impairment. The CFA fit indices of the three-factor model of the Ar-MDDI scale showed good results. Moreover, 254 (64.1%) of the participants had inappropriate eating attitudes (EAT scores ≥ 20). Indices suggested that configural, metric, and scalar invariance was supported according to eating attitudes. No significant difference between participants with appropriate versus inappropriate eating attitudes in terms of functional impairment, drive for size and appearance intolerance. Perfectionism scores correlated positively with the Ar-MDDI, which suggests divergent validity.

CONCLUSION

Our findings revealed that the validation of the Arabic scale yielded excellent properties, preliminarily supporting its use for the assessment of muscle dysmorphia among Arabic-speaking university men. This would hopefully allow for its timely detection and management in Arab clinical settings and encourage cross-cultural research on this topic.

Body image as a global mental health concern

Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.

Cyberbullying victimization and disordered eating behaviors: The mediating roles of self-compassion and self-objectification

Previous studies have demonstrated the correlations between cyberbullying victimization and disordered eating behaviors in adolescents, however, limited attention has been paid to the long-term effects and underlying mechanisms, and studies focused on young adults are scarce. This study explored the association between cyberbullying victimization and disordered eating behaviors and the underlying mechanisms in a sample of young adults using a longitudinal design. A total of 955 Chinese young adults completed the Cyber Victim Subscale of the Cyber Victim and Bullying Scale, the Self-surveillance Subscale of the Objectified Body Consciousness Scale, the Self-compassion Scale-Short Form, and the Dutch Eating Behaviors Questionnaire three times with a 3-months interval. The results indicated that cyberbullying victimization was positively correlated with emotional eating and external eating after six months, but not with restrained eating. Moreover, self-compassion and self-objectification mediated the associations between cyberbullying victimization and the three kinds of disordered eating behaviors, however, in different ways. In the associations of cyberbullying victimization with restrained eating and external eating, the independent mediating effect of self-objectification and the serial mediating effect were significant, while in the association between cyberbullying victimization and emotional eating, only the independent mediating effect of self-compassion was significant. The findings indicated that the relations between cyberbullying with different kinds of disordered eating behaviors might have different mediation mechanisms, which sheds light on the prevention and intervention for disordered eating behaviors associated with cyberbullying in the future.

Pathways from sociocultural and objectification constructs to body satisfaction among women: The U.S. Body Project I

Objectification theory proposes that widespread sexualization causes women to engage in surveillance of their appearance. We integrated this concept into a model with constructs from the tripartite influence model, which proposes that body dissatisfaction is a result of internalizing cultural notions of thin ideal beauty that stem from family, peer, and media appearance-related pressures. We tested this model with an online sample of 6327 adult women. Specifically, we tested whether these pressures predicted increased thin-ideal and muscular-ideal internalization, leading to greater body surveillance, and in turn lower appearance evaluation and body image quality of life. Structural equation modeling supported many aspects of the model. Family, peer, and media pressures related to higher thin-ideal internalization, which related to higher body surveillance and lower appearance evaluation. Peer and media pressures related to higher muscular-ideal internalization, which related to lower appearance evaluation. However, muscular-ideal internalization was not related to body image quality of life. An indirect relationship emerged between thin-ideal internalization and body image outcomes via body surveillance. Body mass index (BMI) moderated several of these model paths. Findings highlight the value of this integrated sociocultural model, and of BMI as an important moderating factor when examining objectification and tripartite influence models.

Validation of the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian Women

Despite high levels of body dissatisfaction and an increasing drive for muscularity among Brazilian women, most of the existing literature on muscle dysmorphia focuses on men and has mainly been conducted in Western and English-speaking regions. As a result, one of the most widely used assessment tools for symptoms of the disorder, the Muscle Dysmorphic Disorder Inventory (MDDI), has not yet been evaluated in Brazilian women-an at-risk population. In the present study, we perform a psychometric evaluation of the Brazilian Portuguese translation of the MDDI in a sample of 515 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach, which supported the original three-factor structure of the measure. Additionally, we found good internal consistency, convergent validity, and test-retest reliability of the measure. Collectively, these results support the use of the measure in Brazilian women and provide a foundation to expand the literature in this population.

Internalization of body shape ideals and body dissatisfaction: A systematic review and meta-analysis

OBJECTIVE

The present meta-analysis summarizes existing evidence on the relationship between the internalization of body shape ideals (IBSI) and body dissatisfaction.

METHOD

Pooled effect sizes (r) were computed using a random-effects model. The robustness of the results was examined using influence analyses. Potential predictors of effect heterogeneity were examined using subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined using the three-parameter selection model (3PSM).

RESULTS

A total of 141 effect-sizes from 78 studies (N = 39,491) were retrieved. Results revealed medium (r = .25; muscular/athletic-ideal internalization) to very large (r = .43, general attractiveness-ideal internalization; and r = .45, thin-ideal internalization) relationships, all these being largely similar in male and female individuals.

DISCUSSION

IBSI and body dissatisfaction were strongly linked: (a) in younger individuals (general attractiveness-ideal internalization); (b) when IBSI was operationalized in terms of endorsement rather than mere awareness of appearance ideals; (c) in studies of lower methodological quality (muscular/athletic-ideal internalization); and (d) when IBSI was assessed using instruments involving social comparisons. Given the largely cross-sectional nature of data included in this meta-analysis, further testing in prospective and experimental studies is needed to confirm hypotheses about causality of observed associations. Such findings would have impact for prevention and intervention studies.

Translation and validation of the Brazilian version of the Physical Appearance Comparison Scale-Revised in college women

Brazilian women are known to present high levels of physical appearance concerns, and data suggest they often compare themselves with others. Nevertheless, there is no validated instrument to systematically assess appearance comparisons in the Brazilian population. Thus, this study aimed to translate the Physical Appearance Comparison Scale-Revised (PACS-R) into Brazilian Portuguese and evaluate its factor structure, internal consistency, and convergent validity in Brazilian college women. The translated version into Brazilian Portuguese of the PACS-R was completed by 832 Brazilian college women and its factor structure was examined through exploratory and confirmatory factor analyses, internal consistency through McDonald's omega, and convergent validity through its associations with measures of eating disorder symptoms, internalization of appearance ideals, appearance-related sociocultural pressures, body satisfaction, and self-esteem. The results suggested an 11-item single-factor scale. The Brazilian Portuguese PACS-R showed adequate internal consistency and was significantly associated with all measures of convergent validity in the expected direction, indicating its adequate convergent validity. The Brazilian Portuguese PACS-R might be useful in the investigation of the appearance comparison among women in Brazil, as also in the study of body image and eating disorders.

Does the tripartite influence model of body image and eating pathology function similarly across racial/ethnic groups of White, Black, Latina, and Asian women?

The tripartite influence model suggests that appearance pressures from family, peers, and the media contribute to thin-ideal internalization, which leads to increased body dissatisfaction and subsequent eating disorder pathology. The tripartite influence model was initially developed and tested among primarily White samples, and emerging research suggests racial/ethnic differences in mean levels of particular model constructs. Consequently, the model's appropriateness for understanding eating disorder risk in racial/ethnic minorities warrants investigation to determine its usefulness in explicating eating disorder risk in diverse populations. Participants in the current study were White (n = 1167), Black (n = 212), Latina (n = 203), and Asian (n = 176) women from five geographically disparate college campuses in the United States. Participants completed the Sociocultural Attitudes Towards Appearance Questionnaire-4, the Multidimensional Body-Self Relations Questionnaire - Appearance Evaluation Subscale, and the Eating Disorder Examination-Questionnaire. Analysis of variance was used to compare mean levels of each construct across racial/ethnic groups. Multigroup structural equation modeling was used to assess the appropriateness of the tripartite influence model for each racial/ethnic group, and to examine differences in the strength of the model pathways across groups. There were significant mean level differences across groups for most model constructs. However, results indicated similar model fit across racial/ethnic groups, with few differences in the strength of model pathways. Findings suggest that although some groups report lower levels of proposed risk factors, the sociocultural risk processes for eating pathology identified through the tripartite influence model are similar across racial/ethnic groups of young adult women. Such information can be used to inform culturally-sensitive interventions.

An exploration of the tripartite influence model of body image in Lithuanian sample of young adults: does body weight make a difference?

PURPOSE

The present study aimed to test the sociocultural Tripartite Influence Model (TIM) that helps to explain the associations between the sociocultural pressures to achieve stereotyped body ideals and disordered eating in young Lithuanian women and men of different body mass.

METHODS

A mixed-gender sample of students (n = 1850, 58.8% female, the mean age of men was 20.4 (SD = 3.1) years, of women 22.4 (SD = 5.8) years) filled in series of questionnaires including the social attitudes towards appearance, body image, disordered eating and drive for muscularity. Mediation analyses were performed to estimate the size of total, direct, and indirect effects of variables in the models.

RESULTS

For women of different body weight, the TIM model was fully replicated. For men of normal weight, internalization of the muscular/athletic ideal, drive for muscularity and greater investment towards appearance mediated the relationships between peers' pressures and disordered eating. For overweight men, internalization of the thin and muscular/athletic ideals, poorer body image mediated associations between pressure from the peers and disordered eating. However, the internalization of the muscular/athletic ideal and the greater appearance evaluation mediated the associations between sociocultural pressures and disordered eating for overweight and obese men.

CONCLUSION

The TIM was replicated in women of different body weight. However, internalization of the thin/low fat ideal was not relevant for men of normal body weight and internalization of the muscular ideal had different outcomes for men of different body mass index. The implications of the results for practice are discussed.

LEVEL OF EVIDENCE

V, Cross-sectional descriptive study.

Psychological Risk Factors for the Development of Restrictive and Bulimic Eating Behaviors: A Polish and Vietnamese Comparison

The aim of this paper is to identify psychological factors which are culture specific or common predictors for restrictive and bulimic behaviors towards eating for young women raised in different cultures. The study included 661 young women from Poland (n = 233) and Vietnam (n = 428). Subjects filled-in the Eating Disorders Inventory (EDI-3) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and body measurements were collected to calculate anthropometric indices. Women form Vietnam were less satisfied with their appearance than were their Polish peers, but Vietnamese showed a lower level of preoccupation with being overweight and fear of obesity. Intercultural differences indicate that Vietnamese women show greater intensities for psychological variables, connected with restrictive and bulimic eating behaviors, verified in the research model: low self-esteem, personal alienation, interpersonal insecurity, interpersonal alienation, emotional dysregulation, interoceptive deficits, perfectionism and asceticism, and anxiety.

Revisiting the relationship between body dissatisfaction and eating disorder symptoms in Chinese adolescents: the mediating roles of regulatory emotional self-efficacy and depression symptoms

PURPOSE

Even though many studies have investigated the relationship between body dissatisfaction and eating disorder symptoms, the relationship is still far from being clear, especially about what factors that could potentially mediate such relationship. This study aimed to examine the direct pathway in the relationship between body dissatisfaction and eating disorder symptoms, and possible mediation pathways between the two via regulatory emotional self-efficacy and depression symptoms.

METHODS

A sample of 654 adolescents from central China completed questionnaires for a set of study variables. Modeling analysis was conducted that examined the direct pathway between body dissatisfaction and eating disorder symptoms, and the mediating roles of regulatory emotional self-efficacy and depression symptoms between these two constructs. Multi-group modeling analysis was conducted to assess model invariance across gender and age groups.

RESULTS

The results showed that, in addition to the direct pathway between body dissatisfaction and eating disturbances, regulatory emotional self-efficacy and depression symptoms partially mediated the relationship between these two constructs. Results of multi-group invariance analysis showed that the mediation model was consistent across gender and age groups.

DISCUSSION

These results indicated that management of regulatory emotional self-efficacy and appropriate intervention for depression could potentially buffer against the negative impact of body dissatisfaction on eating disorder symptoms. Finally, some potential clinical implications are discussed, and possible preventions for eating disorder symptoms are suggested.

LEVEL OF EVIDENCE

V, Cross-sectional descriptive study.

Sociocultural pressure: a model of body dissatisfaction for young women

The aim of the study was to verify the influence of pressure from sociocultural agents on dissatisfaction with face and body in young women mediated by the internalization of the lean and muscular body and to identify the contribution of individual characteristics to this model. A total of 612 university female students participated of study. The students completed the Portuguese versions of the Sociocultural Attitudes Towards Appearance Questionnaire-4 and of the Body Area Scale-Revised and a sociodemographic questionnaire. A hypothetical model was constructed using structural equation modeling to test the relationship between the variables. The model fit and the significance of the hypothetical paths were verified. The results provide evidence that the greater the pressure of sociocultural agents and the internalization of the lean body, the more women were dissatisfied with body and face appearance. The media contributed to a greater internalization of the muscular body, which reduced the body dissatisfaction. The practice of physical activity and a higher economic level contributed to a greater internalization of the muscular body, which reduced body dissatisfaction. A higher economic level also influenced the internalization of the lean body and increased the dissatisfaction with face and body. A higher body mass index contributed to a greater pressure from sociocultural agents, greater internalization of the lean body, and greater dissatisfaction with body and face. The relationships identified in the model can contribute to the development of strategies aimed at reducing body dissatisfaction and eating disorders in the population, such as body acceptance.

The effects of fitspiration images on body attributes, mood and eating behaviors: An experimental Ecological Momentary Assessment study in females

Through an experimental Ecological Momentary Assessment (EMA) design, we assessed the effects of fitspiration images (relative to neutral) on body image, mood and disordered eating and whether trait body dissatisfaction, thin-ideal internalization and pressures from the media, family and peers moderated these effects. After completing trait-based measures, 85 women were prompted via a mobile application 6 times daily for 7 days to view an image (fitspiration or neutral) and report on state levels of perceived pressures to attain an idealized physique, satisfaction with various body attributes, mood and eating behavior. When participants were exposed to fitspiration images, their perceived pressure to attain an idealized physique was significantly higher than after exposure to the control images. This effect was most pronounced for women experiencing pressure from the media. Furthermore, fitspiration images lowered the extent to which women felt that idealized physiques were attainable, and decreased satisfaction with current fitness. There were no significant effects on mood and disordered eating. Exposure to fitspiration content predicted only a few adverse outcomes in terms of negative body attributes and perceived pressures to attain a similar physique, suggesting that its content is not as detrimental as initially believed, but further research is needed.

Disordered eating and body change behaviours: support for the Tripartite Influence Model among Brazilian male university students

The Tripartite Influence Model posits that sociocultural influences mediated by internalization and social comparison are predictors of disordered eating and body change behaviours. This study aimed to test the Tripartite Influence Model among Brazilian male university students, which has not been tested yet. 707 undergraduate students of the five Brazilian regions, completed measures of sociocultural influences, internalization, social comparison, body and muscularity dissatisfaction, disordered eating and body change behaviours. Structural equation modelling analyses showed good model-fitting. Parental influence was related to internalization, while peer influence with social comparison. Media influences were related to both internalization and social comparison. Internalization and social comparison are mediating variables that are related to body dissatisfaction and muscularity dissatisfaction. Finally, muscularity dissatisfaction was associated with body change behaviours.

Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa

Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome–gut–brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.

Body image and disordered eating in older women: A Tripartite Sociocultural model

Evidence suggests that body image concerns and disordered eating exist in women even at older ages. Few studies have examined the factors that are related with body image and eating concerns in this age group. In particular, the roles of sociocultural influences and thin-ideal internalization remain unclear. In the present study, we tested a modified tripartite sociocultural model of body image and disordered eating behaviors in a sample of 222 women aged 60 to 75 years, using structural equation modeling. After adjustment, a model similar to that observed in young women was a good fit to the data. Perceived pressure from the media revealed a direct relationship with body image concerns, as well as an indirect relationship mediated by thin-ideal internalization. Peer pressure was directly associated with body image concerns, and thin-ideal internalization was associated with dieting. In older women, pressure to conform to appearance ideals, in particular from the media, may impact the internalization of appearance ideals and body image concerns that might, in turn, increase disordered eating. The usefulness of sociocultural models for framing body image and eating concerns in older women implies that similar prevention interventions to those used in younger women could be adapted to fill a gap in available resources for this group.

Strategies for eating and body change among Brazilian women and men

OBJECTIVES

Our study was conducted to adapt the Body Image and Body Change Inventory (BIBCI) for Portuguese; to evaluate the BIBCI's psychometric properties in samples of university students; to calculate the prevalence of strategies for eating and body change among students; and to evaluate the impact of demographic, social, and anthropometric characteristics on the BIBCI subscales.

METHODS

798 students (women = 63%) answered the Portuguese translation of the BIBCI and answered a demographic questionnaire. All analyses were performed separately for women and men. The BIBCI's psychometric properties were estimated using confirmatory factor analysis. Mean scores were calculated for each BIBCI subscale. A multivariate regression model was tested to evaluate the impact of demographic, social, and anthropometric characteristics on mean BIBCI subscale scores.

RESULTS

The psychometric properties of the BIBCI were adequate in the samples analyzed. The BIBCI subscales scores did not differ according to sex. According to the cut-off points adopted, most of the students were classified in the very low category of the BIBCI subscales. For women, characteristics such as self-reported eating assessment, economic class, physical activity level, and work were significant. For men, only physical activity level was significant.

CONCLUSION

The Portuguese translation of the BIBCI was presented and its psychometric properties were found to be adequate in the samples analyzed. The models identified significant characteristics that can be used in intervention protocols for preventing inappropriate behaviors in relation to body image and eating.

Body Dissatisfaction, Restrictive, and Bulimic Behaviours Among Young Women: A Polish-Japanese Comparison

The growing number of women, who are characterized by restrictive and bulimic behaviours towards their own body is observed especially in countries influenced by Westernalization. However, there is a lack of cross-cultural studies in this area. The main aim of the present study was to examine the psychological and socio-cultural risk factors for eating disorders in Polish and Japanese women. A cross-sectional research study was conducted among 18- to 29-year old Polish (n = 89) and Japanese (n = 97) women. The variables were measured using the Sociocultural Attitudes Towards Appearance Scale SATAQ-3, and the Eating Disorders Inventory EDI-3. The descriptive and comparative statistics, Spearman's rho, and the stepwise regression analysis were used. The global internalization of socio-cultural standards of body image proved to be a significant predictor of Body Dissatisfaction among Polish and Japanese women. The main analysis showed a significant relation between the Drive for Thinness and Interoceptive Deficits in the group of Japanese women, as well as a correlation between Drive for Thinness and Asceticism in the group of Polish women. The obtained results could improve the prevention aimed the dysfunctional eating behaviours. However, the cultural nuances need to be considered in understanding the risk factors for eating disorders.

Socio-Cultural Standards Promoted by the Mass Media as Predictors of Restrictive and Bulimic Behavior

Research lacks in verifying the nature of the relationship between mass media pressure, body image, and the risk of unhealthy eating behaviors. This study aimed to investigate whether the internalization of sociocultural norms, perceived pressure or searching for information about body image promoted by the mass media directly affect restrictive and bulimic behavior toward eating, through the mediating role of body image and physical appearance variables. The research hypotheses were that (1, 2) body image, the pressure and the internalization of sociocultural norms are significant predictors of unhealthy eating behavior among women and men; and (3) the variables related to body image play the role of the mediating variable between the impact of socio-cultural standards of body image promoted by the mass media and unhealthy eating behavior. The sample comprised 514 Polish men and women, aged 16 to 63 old (men M=24.35; SD=13.53; women M=24.77; SD=7.61), with average Body Mass Index (BMI). Assessment comprised the Sociocultural Attitudes Toward Appearance Scale (SATAQ-3), Eating Disorders Inventory (EDI 3), The Multidimensional Body-Self Relations Questionnaire (MBSRQ-AS), and the author's survey questionnaire. The descriptive and comparative statistics, and a path analysis (structural equations modeling) were applied. The statistical analysis showed that the variables related to body image do not play the role of intermediary variables. The pressure of sociocultural standards of body image and physical appearance had the strongest and most direct effect on the development of restrictive eating behavior and appeared to negatively affect body image in women. The search of information on body image in the mass media had the strongest and most direct impact on the development of bulimic eating behavior among women. However, only the global internalization of sociocultural standards of body image and physical appearance had a significant and direct effect on the development of bulimic eating behavior in men. Moreover, the internalization of athletic body shape standards had the strongest and most positive impact on some aspects of body image in this group. No sociocultural variables showed a direct impact on restrictive behavior among studied men. BMI had a positive and direct impact on individual body part satisfaction. These results may help improve prevention of eating disorders and dysfunctional eating behavior.

Is the Drive for Muscularity Scale a valid and reliable instrument for young adult women?

There is a lack of psychometric studies on scales aiming to evaluate the drive for muscularity in women. This study aimed to test whether the Drive for Muscularity Scale (DMS) yielded reliable and valid scores for assessing the drive for muscularity construct in young adult women. A cross-sectional study was conducted among 242 Brazilian adult women. Exploratory factor analysis, convergent validity, estimated internal consistency, and test-retest reliability of the DMS's scores were examined. The results of the exploratory factor analysis upheld the original unidimensional structure of the DMS for Brazilian women. The scale presented a significant but weak association with body mass index and risk behaviors for eating disorders. Adequate internal consistency and 2-week test-retest reliability were found. Future psychometric analyses (convergent and discriminant validity) of the DMS are encouraged to further our understanding of drive for muscularity in women, especially to confirm its unidimensional factor structure. Future research avenues also include examining the reliability and validity of the DMS's scores among women from various cultures.

[Tripartite Influence Scale (TIS) applied to university students: validation study and application]

The Tripartite Influence Scale (TIS) is used to assess the influence of social and family factors on individuals' body image. However, little evidence has been presented on the validity of the TIS construct. The study aimed to estimate the psychometric indicators in TIS and identify the degree of influence of the media, parents, and peers on body image in university students, considering different characteristics. University students of both sexes participated. The psychometric indicators in TIS were assessed for each sex using confirmatory factor analysis. Mean scores were calculated for each TIS factor. Prevalence rates for degree of influence were presented. A multivariate regression model was built to verify the relationship between target characteristics and TIS factor scores. The sample included 791 university students (63.2% women) 18 to 40 years of age. TIS did not initially display a good fit to the samples and was therefore refined. After refinement, the scale showed adequate validity and reliability for women and men. Significant differences were observed in the mean scores between women and men, and in the prevalence rates the majority of the students were in the low category. Work, consumption of food supplements for body changes, age, body mass index, self-rated diet, and level of physical activity were significantly related to TIS factors. Women were generally more influenced than men by the media and peers. Characteristics identified as related to TIS can be relevant for inclusion in clinical and research protocols.

Prospective predictors of body dissatisfaction, drive for thinness, and muscularity concerns among young women in France: A sociocultural model

The aim of this study was to explore a prospective sociocultural model of the influence of media, peers, and partners on body dissatisfaction, drive for thinness, and muscularity concerns in a sample of young women in France. A sample of 192 undergraduate women with a mean age of 20.97 years (SD = 2.69) completed a questionnaire at two time-points, 12 months apart, assessing media and interpersonal influences, appearance comparison, body dissatisfaction, drive for thinness, and muscularity concerns. The final model highlighted that media and interpersonal influences (from peers and romantic partners) were associated over time with increased body dissatisfaction, drive for thinness, and muscularity concerns one year later, via appearance comparison. Sociocultural influences towards both thinness and muscularity may contribute to increases in body image concerns and risky body change behaviors in young women in France.