Athletic-ideal and thin-ideal internalization as prospective predictors of body dissatisfaction, dieting, and compulsive exercise

Experiences of body image in the gender non-binary community: A qualitative analysis

Body image concerns are prevalent within transgender communities - many transgender people engage in disordered eating to suppress or accentuate secondary sex characteristics and reduce gender dysphoria. However, this research has mostly been conducted with binary transgender people. Here, we examine how non-binary people experience and relate to their bodies. Semi-structured one-on-one interviews were conducted with 13 gender non-binary individuals living in Australia. Photo elicitation techniques were utilised, and the transcribed interview data were analysed using reflexive thematic analysis. Six themes were identified: Expansive Understandings of Body Image, Body Image can be Linked to Gender Dysphoria, Cultivating a Preferred Body can Lead to Gender Euphoria, Appreciating Diversity in Non-Binary Body Ideals, The Androgynous Body Ideal is not Universally Accepted, and Experiencing the Body as Functional rather than Aesthetic. The present findings highlight the diversity of experiences of body image for non-binary people. The non-binary concept of body image was found to be expansive, stressing various physical attributes involved in social gender recognition and physiological sources of gender dysphoria. Some participants valued gender-affirming medical intervention, others were accepting of their bodies as they are, attributing their body confidence to the process of affirming their non-binary gender.

Higher orthorexia tendency among female fashion models: an empirical international study

PURPOSE

Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on assessing whether female models are more prone to report orthorexia nervosa signs and symptoms than non-models.

METHODS

Female fashion models (n = 179, mean age: 25.9 SD = 4.40 years) and an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years) were selected by snowball sampling. Participants filled out an online survey containing anthropometric questions and the 18-item Eating Habits Questionnaire.

RESULTS

According to BMI, fashion models were underweight (mean BMI = 18.1 SD = 1.68) while control participants' BMI was in the normal range (mean = 22.1 SD = 4.23, p < 0.001). On all three of Eating Habits Questionnaire subscales fashion models showed significantly higher average value (Knowledge subscale: M = 2.42 among models versus M = 2.08 in the control group, p < 0.01, Cohen's d = 0.52; Problems subscale: M = 1.93 among models versus M = 2.61 in the control group, p < 0.01, Cohen's d = 0.49; Feelings subscale: M = 3.20 among models versus M = 2.96 in the control group, p < 0.01, Cohen's d = 0.38). Orthorexic tendencies were reported by 35.1% of the models versus 20.2% of controls.

CONCLUSION

Fashion models are at risk for the development of eating disorders. Even though not yet included in the DSM-5, the assessment of orthorexia nervosa among fashion models seems to be important. It is suggested to take appropriate measures to prevent the spread of disordered eating habits among models as they can lead to the development of anorexia nervosa or bulimia nervosa.

LEVEL OF EVIDENCE

Level III, well-designed cohort study.

Social media behaviors and body type ideals predict weight loss and food tracking behaviors among recreational climbers

Introduction

Elite and recreational climbers may be at risk for disordered eating, low energy availability (LEA), and increased injury as a result. Social media use among athlete and non-athletes can lead to body image disturbances resulting in unhealthy weight loss practices exacerbating LEA and injury risk. Therefore, the objective of this study was to examine relationships between social comparative behaviors on social media, body type ideals and outcomes, and health behaviors among adult recreational climbers.

Methods

Participants (n = 324) were adult recreational climbers from the U.S. (29.30 ± 9.99 years old and 50% female). Participants answered a 66-item questionnaire comprised of demographics, climbing characteristics, social media behaviors, body type ideals, training and nutrition-seeking behaviors, and weight and food tracking behaviors.

Results

Most participants (78.7%) indicated strength-to-weight ratio was important for climbing performance. Many participants perceived they could perform better at rock climbing if their body proportions were different (59.3%). These body type ideals were found to be significant predictors of performing weight loss and food-tracking behaviors (all p < 0.001). Higher amounts of social comparative behaviors on social media and social physique anxiety independently and significantly predicted attempting weight loss to improve climbing ability (p < 0.001 and p = 0.001 respectively). Those who followed climbing influencers, used Instagram frequently for training and nutrition information, perceived they could perform better at rock climbing if their body proportions were different, or were female and college-aged had significantly higher mean social comparative behavior scores (all p < 0.01).

Discussion

This study expands on prior work with elite climbers by providing a possible explanation for how climbing-related body type ideals and certain social media behaviors can perpetuate negative body image and compensatory behaviors among a general climbing population. Because unhealthy weight management behaviors can lead to injury and health disturbances, broad education programming and social media campaigns should be developed to shift body ideals and nutrition behaviors among recreational climbers.

Communicating Extremity: Fitness Efficacy and Standards Relate to Using Extreme Imagery and Messaging to Create Fitness-Related Media

Health-related social media increasingly competes with other forms of health communication for public attention. To advance understanding of the genesis of health-related social media communicating extreme fitness standards, we investigated women's creation of fitspiration, social-media content combining fitness images with effortful messages. In a pre-registered study, we hypothesized that creating extreme fitspiration content would relate positively to fitness fantasizing and to exercise self-efficacy, fitness perfectionism, physical activity, thin- and muscular-ideal internalizations, and self-objectification. Undergraduate women (N = 277) created their own fitspiration content by selecting from fitness images and messages that varied in extremity. Fitness fantasizing related positively to creating more extreme fitspiration. When controlling statistically for all other individual-difference variables, exercise self-efficacy and perfectionistic strivings emerged as key variables associated with creating extreme fitspiration content. Results suggest that women who are confident and strive toward challenging goals may create fitspiration content that communicates extreme standards. This work has implications for understanding a potential disconnect between fitspiration creators and consumers, which may illuminate ways to promote healthy fitness communications online.

Exploring the role of mindfulness on obligatory exercise among young athletes: mediating roles of obsessive passion and cognitive state anxiety

Introduction

In the current trend toward youthfulness and age reduction in competitive sports, the issue of obligatory exercise among young athletes is becoming more severe. This not only affects their physical and mental health but also hampers their future prospects in the sports world. While delving into the impact of mindfulness on the issue of obligatory exercise among young athletes, it reveals the mediating role of obsessive passion and cognitive state anxiety.

Methods

This study is a cross-sectional research that employs convenience and snowball sampling methods. We selected 403 young athletes from several universities and high-level sports teams in the central-southern region of China as valid samples and used AMOS v.23 to construct a structural equation model to validate the hypotheses.

Results

The research findings indicate a significant positive correlation between obsessive passion, cognitive state anxiety, and obligatory exercise. Furthermore, obsessive passion and cognitive state anxiety mediate the relationship between mindfulness and obligatory exercise. This implies that young athletes can better regulate their emotional state during training, manage training loads sensibly, and avoid issues with obligatory exercise through mindfulness training.

Discussion

In conclusion, to enhance the cognitive levels of young athletes and reduce their obligatory exercise behaviors, national sports authorities and coaching teams should develop reasonable mindfulness training programs for athletes and encourage their participation in mindfulness training.

Examining compulsive exercise as a risk factor for eating disorder symptoms in first-year college students using a latent change score modeling approach

OBJECTIVE

Research suggests that both compulsive exercise and eating disordered behaviors increase during college. Despite strong cross-sectional associations between compulsive exercise and eating disorders, it is unknown if compulsive exercise is a variable risk factor for eating disorders or simply a correlate. It was hypothesized that increases in compulsive exercise would significantly and prospectively predict increases in overall number of eating disorder symptoms over the study period.

METHOD

A total of 265 first year college students who did not meet criteria for a full or subthreshold eating disorder diagnosis at Time 1 (age M = 18.15; SD = 0.42; 122 female [46%] at Time 1) completed reports of compulsive exercise and eating disorder symptoms via online questionnaires at four timepoints over the 9-month 2021-2022 academic year (76% retention rate). Hypotheses were tested using a bivariate latent change score model.

RESULTS

Hypotheses were not supported. Change in compulsive exercise did not predict change in number of eating disorder symptoms. Change in number of eating disorder symptoms also did not predict change in compulsive exercise.

CONCLUSIONS

Compulsive exercise did not emerge as a variable risk factor for the development of eating disorder symptoms among first year college students. The relationship between these behaviors should be investigated at different developmental timepoints, such as early adolescence, and potential third variables that may explain the observed co-occurrence should be explored.

PUBLIC SIGNIFICANCE

This study investigated whether increases in compulsive exercise predicted increases in number of eating disorder symptoms among first year college students. Compulsive exercise did not significantly predict number of eating disorder symptoms. Additional research is warranted to clarify the relationship between compulsive exercise and eating disorder symptoms.

Preventing eating pathology among elite adolescent ballet dancers: a pilot trial of the Athlete Body Project

Adolescent ballet dancers are commonly recognized as aesthetic athletes who are at higher risk for body dissatisfaction, disordered eating, and eating disorders. Although athletic participation can generally protect against negative mental and physical health outcomes, idealization of a body ideal specific to ballet can confer unique vulnerability for eating pathology. Despite this known vulnerability, rigorous efforts to prevent eating pathology among young dancers are lacking. Previously, we reported on a trial of the Female Athlete Body Project adapted for professional female ballet dancers. The current study tested a subsequent adaptation, the Athlete Body Project (ABP), tailored for younger dancers, including a version for boys. This non-randomized, uncontrolled pilot trial tested ABP among boys and girls in two elite ballet schools (N = 23), formatted in-person and via video-conferencing. Program delivery met benchmarks for feasibility and acceptability across gender and delivery formats, and dancers provided positive qualitative feedback. Overall results suggest the potential of ABP in intervening on pre-post eating pathology and body appreciation, and significantly decreasing drive for muscularity among young ballet dancers. Taken together, this pilot work addresses a gap in the field and advances the needed development of eating disorder prevention programming for young, high-risk aesthetic athletes.

Testing general sociocultural and coach-related appearance pressures as the factors associated with disordered eating in competitive female athletes participating in various sports

The aim of the present study was to test the sociocultural Petrie and Greenleaf's (2007) model of disordered eating (DE) in competitive female athletes. Specifically, we tested a model of general sociocultural and coach-related pressures towards body weight and appearance of female athletes as the factors associated with athletes' DE through the mediators such as internalization of appearance ideals and overweight preoccupation. 515 athletes participated in this study. The mean age of the sample was 19.0 ± 5.9 years. Athletes were provided with study measures on general sociocultural and coach-related appearance and body weight pressures, internalization of appearance ideals, overweight preoccupation and DE. Path analyses showed that general sociocultural pressures were associated with DE directly and through internalization of appearance ideals and overweight preoccupation. Pressures from coaches were associated with DE through overweight preoccupation and through the internalization of appearance ideals and overweight preoccupation. The models were invariant across body weight sensitivity in sports and age groups. These results inform DE prevention for female athletes. It is important to increase resistance to sociocultural pressures and pressures from coaches in DE prevention programmes for female competitive athletes of all ages and participating in sports irrespective of sports group (weight-sensitive or less weight-sensitive).

Identifying methods used to manage weight and shape by first year university students: A qualitative analysis

OBJECTIVE

To identify current strategies used by first-year university students to lose weight, maintain weight, or change their body shape.

METHODS

First-year university students (n = 661) completed an open-ended, web-based survey. Cross-sectional data were analyzed qualitatively using a reflexive thematic approach to identify strategies used to lose weight, maintain weight, or alter body shape/composition. Thematic maps were constructed for each weight- and shape-related goal.

RESULTS

Four main types of strategies were used to achieve all three weight or shape-related goals among first-year college students: changes in diet, changes in exercise, self-monitoring, and disordered eating. One behavioral strategy observed across all weight-related goals was prioritizing protein consumption, including protein gained from supplementation. However, there were also differences in strategies by weight- or shape-related goal. For example, only participants aiming to lose or maintain weight reported mindful strategies for monitoring diet. Individuals aiming to alter body composition reported heterogeneity in goal-related intentions, targeting specific body parts through exercise, and extensive supplement use.

CONCLUSIONS

First-year college students use a variety of strategies to manage their weight and shape. Some strategies were observed across goals, whereas others are specific to the weight- or shape-related goal. More research is needed to understand the impacts, both positive and negative, of using the strategies identified in the present study.

Exploring longitudinal relationships between fitness tracking and disordered eating outcomes in college-aged women

OBJECTIVE

A growing body of research, primarily cross-sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness-tracking smartphone applications ("apps") or wearable devices ("wearables") and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college-aged women, as well as to determine whether the individual-level risk factors of pre-existing eating concerns, perfectionism, and rumination about food moderated the relationship.

METHOD

N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self-report measures.

RESULTS

At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next-day levels for any of the outcome measures. Within-day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time.

DISCUSSION

These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted.

The female athletic ideal - Friend or foe? Fit, thin, and athletic body ideals and their associations with women's body image

The internalization of body ideals is a critical predictor of body image and health behaviors. Thin and athletic ideal internalization in women need to be elucidated. The aims of the current study included: (i) describing the endorsement of thin and athletic body ideals among women and (ii) examining group differences in negative and positive self-conscious emotions and body image. Participants (N = 392 women; Mage = 25.6, SD = 5.3 years) were assigned to Fit Ideal (n = 110), Thin Ideal (n = 83), Athletic Ideal (n = 55), and Low Internalization (n = 144) groups based on scores for thin and athletic internalization. Three multivariate analyses of variance were conducted to examine Body Ideal group differences on negative appearance and fitness self-conscious emotions, and positive self-conscious emotions and body image. The Athletic Ideal and Low Internalization groups generally scored lower on negative self-conscious emotions and higher on positive self-conscious emotions and body image in comparison to the Fit and Thin Ideal groups (Cohen's d =.35 to 1.15). Results suggest that differing levels of thin and athletic internalization may intersect uniquely with women's body-related self-conscious emotions and positive body image and thus may have distinct effects on women's health and behavior.

Bidirectional relationships between muscularity-oriented disordered eating and mental health constructs: a prospective study

Muscularity-oriented disordered eating (MODE) is a novel class of eating behaviors characterised by abnormal dietary alterations aimed towards building lean muscle. Although traditionally shown to affect men, emerging evidence suggests that increasingly more women are striving for the muscular and lean ideal, resulting in engagement of MODE behaviors. Prior research examining MODE in women is limited, yet emerging evidence from cross-sectional studies have established associations between MODE and poor mental health indices in this population. However, the temporal order of these associations in women is not yet known. Thus, the current study examined possible bi-directional associations between MODE behaviors and common mental health outcomes (depression, anxiety, loneliness). Adult women completed online study measures at baseline (Time 1 [T1]; n = 1760) and three-month follow-up (Time 2 [T2]; n = 1180). Cross-lagged panel models were computed to test for possible bi-directional relationships between MODE and the relevant mental health constructs. Findings showed that higher MODE levels at T1 significantly predicted increased depressive and anxiety symptoms (but not loneliness) at T2, and loneliness at T1 (but not depression/anxiety) significantly predicted MODE at T2. Effect sizes were small, so findings should be interpreted with this in mind. This is the first study to establish temporal relationships between MODE and mental health outcomes in adult women. Findings suggest that clinicians may benefit from inquiring about MODE behaviors for proper screening, assessment, and intervention, and potentially addressing loneliness to decrease risk of MODE.

Automatic pro-thin/anti-fat biases can develop without previous visual exposure to body shapes

Endorsement of the thin beauty ideal increases risk for future body dissatisfaction and eating disorders among women. Visual-based media is theorized to be a central pathway through which the thin ideal is internalized. This internalization process results in formation of automatic pro-thin and anti-fat attitudes. However, it is often difficult to separate the contribution of visual-based media and other forms of communication in the creation of such attitudes. Using a novel auditory implicit association test, we show that women with congenital blindness with no previous exposure to body shapes develop automatic pro-thin and anti-fat attitudes to the same extent as sighted women. This result was replicated in studies conducted in two countries involving a combined total of 62 women with blindness and 80 sighted women. Results suggest that internalization of the thin ideal can occur without visual exposure to images of the thin beauty ideal or visual exposure to one's own body.

An exploration and comparison of #BodyPositivity and #BodyNeutrality content on TikTok

TikTok, one of the most popular visual social media platforms, has been criticized for perpetuating and glorifying eating disorders. In response, content focused on body positivity (loving your body) is growing on TikTok. However, body positivity content on other social platforms promotes positive body image but also perpetuates unrealistic beauty ideals. Body neutrality (deemphasizing the focus on the body's appearance) is an alternative concept that could portray less harmful content, but has yet to be explored. Therefore, the purpose of this study was to explore and compare the content under #BodyPositivity and #BodyNeutrality on TikTok. One hundred and fifty TikToks under each hashtag were downloaded. A thematic analysis of the TikToks was conducted. Three themes were generated that captured content across both hashtags, with only minor differences in content between the two: (1) Resisting societal ideologies (with subtheme: Normalizing insecurities), (2) (Re)producing disordered content (with subtheme: Toxic (body) positivity promotes the need for neutrality), and (3) Social critique. Within the themes, there was the promotion of body positivity through self-love and body acceptance, but also content that continued to emphasize standard beauty ideals and the thin-ideal. Certain TikToks provided educational content that explained the roots of the #BodyPositivity movement and what #BodyNeutrality means as a potentially more realistic approach to body acceptance. Findings suggest that #BodyNeutrality may provide a safer space for individuals online, and future research should assess the impact of such TikToks on those viewing them to assess body and eating attitudes and behaviours.

Internalization of body image as a potential mediator of the relationship between body acceptance by others and intuitive eating

OBJECTIVE

To investigate the role of internalization of body image ideals as a potential mediator between perceived body acceptance and intuitive eating among college students.

PARTICIPANTS/METHOD

168 undergraduates completed the Body Acceptance By Others Scale (BAOS), Sociocultural Attitudes Toward Appearance Questionnaire-3 (SATAQ-3; Internalization-Total and -General, -Athletic subscales), and Intuitive Eating Scale (IES).

RESULTS

Internalization-Total mediated the relationship between BAOS and IES (b=.19, p<.001). Internalization-General was a significant mediator of the BAOS-IES relationship (b=.14, p=.006), while Internalization-Athletic was not (p=.993). Post-hoc analyses stratified by gender followed similar patterns, aside from a negative but nonsignificant relationship between Internalization-Athletic and IES in men (b=-.16, p=.650).

CONCLUSIONS

These data suggest that internalization of general (i.e., thin) body image ideals may be more destructive to body satisfaction and adaptive eating styles in college students than athletic-ideal internalization. More research is needed to examine the role of athletic-ideal internalization on body image and eating behaviors.

Anxiety, body dissatisfaction, and exercise identity: Differentiating between adaptive and compulsive exercise

OBJECTIVE

Little is known about psychosocial variables that may be differentially associated with compulsive exercise versus adaptive exercise. The current study simultaneously examined associations of exercise identity, anxiety, and body dissatisfaction with both compulsive and adaptive exercise behaviors and investigated which construct may account for the most unique variance in compulsive and adaptive exercise. Hypotheses were that: 1) body dissatisfaction, anxiety, and exercise identity would be significantly associated with compulsive exercise and 2) exercise identity would be significantly associated with adaptive exercise.

METHOD

A total of 446 individuals (50.2 % female) completed reports of compulsive exercise, adaptive exercise, body dissatisfaction, exercise identity, and anxiety via an online survey. Multiple linear regression and dominance analyses were used to test hypotheses.

RESULTS

Exercise identity, body dissatisfaction, and anxiety were all significantly associated with compulsive exercise. Only exercise identity and anxiety were significantly associated with adaptive exercise. Dominance analyses suggested that exercise identity accounted for the largest proportion of variance in compulsive (Dominance R² = 0.27) and adaptive exercise (Dominance R² = 0.45).

CONCLUSION

Exercise identity emerged as the strongest predictor of both compulsive and adaptive exercise. The simultaneous presence of exercise identity, body dissatisfaction, and anxiety may contribute to high risk for engagement in compulsive exercise. Incorporating exercise identity into established eating disorder preventions and treatments may contribute to the reduction of compulsive exercise behaviors.

Normative body image development: A longitudinal meta-analysis of mean-level change

This meta-analysis synthesized longitudinal data on mean-level change in body image, focusing on the constructs of body satisfaction and dissatisfaction, body esteem, perceived attractiveness, valuation, self-objectification, and body shame. We searched five databases and accessed unpublished data to identify studies that assessed body image at two or more time points over six months or longer. Analyses were based on data from 142 samples representing a total of 128,254 participants. The age associated with the midpoint of measurement intervals ranged from 6 to 54 years. Multilevel metaregression models examined standardized yearly mean change, and the potential moderators of body image construct, gender, birth cohort, attrition rate, age, and time lag. Boys and men showed fluctuations in overall body image with net-improvements between ages 10 and 24. Girls and women showed worsening body image between ages 10 and 16, but improvements between ages 16 and 24. Change was greatest between ages 10 and 14, and stabilized around age 24. We found no effect of construct, birth cohort, or attrition rate. Results suggest a need to revise understandings of normative body image development: sensitive periods may occur somewhat earlier than previously believed, and body image may show mean-level improvements during certain age ranges.

The Mediating Role of Eating Attitudes in Sociocultural Attitudes toward the Body in Predicting Obligatory Exercise among Young People: A Polish and Chinese Comparison

The main aims of this study were to determine which sociocultural predictors of obligatory exercise are universal for young men or women and which are specific to particular cultural conditions (Polish or Chinese culture) and to examine the mediating role of eating attitudes. A cross-sectional study was conducted among Poles (n = 259) and Chinese (n = 208) aged 18 to 30. Descriptive and comparative statistics, Spearman's rho, and multiple regression analysis were used. The main analyses showed that Internalization-Athlete was a common positive direct predictor of obligatory exercise among young Polish and Chinese women; Information and Internalization-Athlete were only specific direct positive predictors of obligatory exercise in young Chinese men; some variables in eating attitudes mediated the development of obligatory exercise in young Polish and Chinese men and women and indicated that there were cross-cultural differences. In understanding obligatory exercise among young people, attention should be paid to their sociocultural attitudes toward the body and eating, and cultural and gender differences need to be considered.

One size does not fit all: Exploring how the five-factor model facets predict disordered eating behaviours among adolescent and young adult males and females

There is a wealth of research that has highlighted the relationship between personality and eating disorders. It has been suggested that understanding how subclinical disordered eating behaviours are uniquely associated with personality can help to improve the conceptualization of individuals with eating disorders. This study aimed to explore how the facets of the Five-Factor Model (FFM) predicted restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building among males and females. An online survey assessing disordered eating behaviours, FFM and general psychopathology was completed by 394 females and 167 males aged between 16 and 30 years. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the FFM facets, body dissatisfaction and age predicted behaviour. The results indicated that each of the six disordered behaviours were predicted by a unique pattern of thinking, feeling and behaving. Considerable differences between males and females were found for each path model, suggesting differences between males and females in the personality traits that drive disordered eating behaviours. It was concluded that it is important to take personality into account when treating males and females who engage in disordered eating behaviours.

Athlete-specific risk factors for the development of disordered eating behaviors in first-year college athletes

OBJECTIVE

The current study tested whether proposed sport-related risk factors for disordered eating behaviors were associated with increases in disordered eating over first-year college athletes' first four months of collegiate sport participation.

PARTICIPANTS

Participants included a sample of first-year college athletes (N = 59, 45% female) from a Division I National Collegiate Athletics Association (DI) university.

METHOD

This follow-up study tested whether 1) wearing a uniform that emphasizes body concerns, 2) participating in a lean sport, and 3) perceived pressure for thinness from coaches and teammates would lead to increases in weight/shape concerns and disordered eating behaviors over the first four months of collegiate sport participation.

RESULTS

Wearing a uniform that emphasizes body concerns and perceived coach pressure for thinness predicted increases in weight/shape concern. Both teammate and coach pressure for thinness predicted increases in restrained eating behaviors.

CONCLUSION

Findings suggest that there are identifiable, athlete-specific risk factors for the development of disordered eating behaviors among first-year college athletes.

Internalization of athletic body ideal as a mediating variable between family influence and body image of young women. A cross-cultural study of polish, Italian, and Ukrainian women

Introduction

Our aim was to analyze the strength of the family's influence on the internalization of the ideal of an athletic figure and, consequently, on the multifactorial image of the body, from the perspective of intercultural differences.

Methods

A total of 488 healthy women aged 19-26; of Polish (154), Ukrainian (228), and Italian (106) took part in the study. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ 69) were used to measure athletic ideal internalization and family pressure. The body image of Ukrainian, Polish, and Italian women depends both on the degree of internalization the ideal of an athletic figure and influence of the family.

Results and Discussion

The research also suggests significant differences between the three populations, which may suggest cultural differences between young women living in Eastern, Central, and South European countries.

Sociocultural predictors of obligatory exercise in young men: A Polish-Chinese comparison

Background

Obligatory exercise has been shown to have negative physical and mental effects on exercisers and is more prevalent among young people. However, there is limited research on obligatory exercise among young men. Social comparison theory offers a novel perspective to explore the relationship between sociocultural factors and obligatory exercise among young men, which offers an opportunity to understand potential factors contributing to obligatory exercise among young men across different cultures.

Method

We recruited a purposive sample of young people aged 18-30 from Poland (n=79) and China (n=194). Participants completed self-report measures including the Sociocultural Attitudes Toward Appearance Questionnaire3, Inventory of Physical Activity Objectives, and Obligatory Exercise Questionnaire. In the data analysis stage, we examined the strength of the relationships between the independent variables and the dependent variable through multiple regression analysis, and tested the role of the mediating variables.

Results

The main analyses revealed that Internalization-Athlete was a common direct predictor of obligatory exercise for both Polish and Chinese young men; that there were direct sociocultural predictors of obligatory exercise that were only used in relation to Polish or Chinese young men; and that social adaptation goals for motivation for physical activity mediated the development of obligatory exercise for Polish and Chinese young men, and that there were cross-cultural differences.

Conclusion

Attention should be paid to their attitudes towards the idea of a muscular and athletic body and socially adapted physical activity motivations when understanding young men's obligatory exercise, while also considering cross-cultural differences.

#fitspiration: a comparison of the sport-related social media usage and its impact on body image in young adults

BACKGROUND

Following and posting sport-related content on social media is wide-spread among young people. To date, little is known about the interdependence between sport-related social media use and the thereby perceived personal body image.

METHODS

We conducted an online survey (N = 285) to examine how social media influences the sport-related body image.

RESULTS

In general, social media are frequently used for sport (n = 136, 47.7%). Resistance training correlated significantly with several motives of sport-related use of social media, and thus, represents the strong online presence of athletic sports. Less correlations could be found in team or other sports. Regarding the perception of body image, it was found that the group of rejecting (negative) body image significantly correlated with the emulation of social media mediated sport-related beauty and body ideals (r = 0.63, p = 0.001), as well as with increased body dissatisfaction when viewing sport-related posts on social media (r = 0.590, p = 0.001). Perceived social pressure and comparison were found to be mediators of the prevailing influence of social media usage.

CONCLUSIONS

These results reveal the importance of taking a closer look at socially shaped beauty and body ideals, especially in sport-related contents, striving for more educational campaigns such as Body Positivity and, above all, filtering information. Finally, future research is needed to gain deeper insight into young persons' usage behavior of social media and its impact on the individual's body image. Trial Registration The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (01/24/2022).

Psychometric properties of the Chinese version of the Female Muscularity Scale among Chinese young women

PURPOSE

The Female Muscularity Scale (FMS) was specifically developed for assessing drive for muscularity in women. The current study aimed to translate the FMS into Chinese (FMS-C) and examine its psychometric properties among Chinese young women.

METHODS

Based on standard procedures, the FMS was translated into Chinese. By using the psych and lavaan packages on R version 4.0.3, the current study examined the factor structure, reliability, and convergent and incremental validity of the FMS-C with a sample of 517 Chinese women college students ([Formula: see text]= 18.86 years).

RESULTS

Results showed a 2-factor structure including attitudes and behaviors of the FMS-C. The internal consistency reliability (Cronbach's α) was .91 for the total FMS-C scale and .89 and .88 for the Attitudes and Behaviors subscales, respectively. Results also revealed evidence for good convergent and incremental validity of the FMS-C.

CONCLUSION

Findings suggest that the FMS-C can be a useful tool to measure both attitudes and behaviors underlying drive for muscularity and muscle tone concerns among Chinese young women.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Compulsive Exercise, Exercise Identity, and Coping Styles

Abstract. Compulsive exercise occurs among the general exercise population and is associated with adverse mental and physical health outcomes. The current study explored compulsive exercise behavior regarding coping styles and its relationship to identity to improve our understanding of compulsive exercise among the general exercise population. A community sample of 1,209 adults (aged 18 – 89) with varied exercise levels completed an online survey. We examined the relationships between engagement and disengagement coping styles (as assessed by the Coping Strategy Inventory) and exercise identity (Exercise Identity Scale) with compulsive exercise (Compulsive Exercise Test) using correlation, regression, and moderation analyses. Emotion-focused engagement (β = .075, p < .01) and emotion-focused disengagement (β = .212, p < .001) coping styles significantly predicted compulsive exercise, as did exercise identity (β = .514, p < .001). Coping styles did not moderate the relationship between exercise identity and compulsive exercise behaviors. The results indicate that both adaptive and maladaptive emotion-based coping styles are associated with greater compulsive exercise behavior.

Thin, muscular, and fit-ideals: Prevalence and correlates in undergraduate women

Objective: The current study aimed to compare endorsement of the muscular- and thin-ideals alone, as well as simultaneous endorsement of both as representative of the fit-ideal and examine potential negative correlates of each type of ideal internalization. Participants: Participants were 300 female undergraduate students. Methods: Participants completed measures of internalization of the thin- and muscular-ideals, body dissatisfaction, body checking, and body avoidance. Results: Analyses revealed that approximately 24.9% of participants endorsed scores in the upper quartile on thin-ideal internalization, and 27.4% of participants fell in the upper quartile of muscular-ideal internalization, while 10.3% endorsed high internalization of both ideals. Analyses revealed that individuals endorsing only the thin-ideal reported significantly higher levels of body dissatisfaction and body avoidance than those endorsing the fit-ideal. Conclusions: Overall, findings suggested that thin- and muscular-ideal internalization present different patterns of association depending on whether an individual endorses one or both of these body ideals.

Investigating engagement in maladaptive and adaptive exercise behaviors before and during COVID-19

PURPOSE

Evidence suggests that the coronavirus (COVID-19) pandemic has resulted in increased mental health concerns (e.g., anxiety) and there is ample discussion of how the pandemic has resulted in increases in weight control strategies (e.g., maladaptive exercise behaviors). It remains unclear, however, if maladaptive exercise behaviors are on the rise among non-clinical samples. The objective of this study was to examine college students' engagement in exercise behaviors (both adaptive and maladaptive) before and during COVID-19.

METHOD

This study compared reports of compulsive exercise, weight and shape exercise, and positive and healthy exercise in two separate samples recruited from a large southeastern university. Sample 1 was collected pre-COVID-19 (August 2019-February 2020) and Sample 2 was collected during COVID-19 (August 2020-April 2021). Case-control matched samples were generated for this study (N = 144; 52.1% male). Three separate analysis of covariance models tested the differences between (1) adaptive exercise; (2) compulsive exercise; and (3) weight and shape exercise in pre- and during COVID-19 samples, controlling for sex.

RESULTS

Individuals in the during COVID-19 sample reported significantly more compulsive exercise (p < .001), weight and shape exercise (p < .001), and adaptive exercise (p < .001) compared to individuals in the pre-COVID-19 sample. Effects were of medium to large sizes.

CONCLUSION

Consistent with reports from the research literature and popular press, the current study observed that both adaptive and maladaptive exercise were higher among college students during COVID-19 compared to pre-COVID-19.

LEVEL OF EVIDENCE

Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Does seeking the brawns impact the brain?: An investigation of muscularity-oriented disordered behaviors and cognitive function

Shifts in body-image ideals over the past 30 years towards leaner, muscular bodies have revealed new health behaviors that may be related to cognitive function. This study objective was to investigate prospective associations between a drive for muscularity and/or muscularity-oriented disordered behaviors (MODBs) with cognition. Data were drawn from Add Health, a nationally representative longitudinal cohort dataset. Drive for muscularity and MODB engagement were assessed in emerging adulthood (ages 18-26). Cognition was measured via immediate word recall, delayed-word recall, and number recall at 7-years later (ages 24-32). Analyzes were conducted in 1976 participants with available data. A one-way ANCOVA revealed that those with a drive for muscularity had lower immediate word recall (F(3, 12,819) = 3.845, p = .009) and delayed word recall (F(3, 12,807) = 5.933, p < .001) scores than other weight goal groups adjusting for covariates. Hierarchical linear regressions between individual MODBs and cognitive outcomes showed that legal performance-enhancing substance use (βs = 0.06-0.07, p < .05) and exercise (β = 0.06, p < .05) were positively associated with some cognition scores. Conversely, lifting weights (β = - 0.06, p < .05) and eating different foods than usual (β = - 0.05, p < .05) exhibited negative associations with some of the cognitive outcomes. Future research should be conducted to examine other potential outcomes related to the drive for muscularity and associated MODBs.

The 'not-so-healthy' appearance pursuit? Disentangling unique associations of female drive for toned muscularity with disordered eating and compulsive exercise

Today, many women are driven to subscribe to a more athletically oriented appearance ideal hallmarked by muscle tone (referred to as athletic- or fit-looking). However, the constellation of unhealthy eating and exercise behaviors that may accompany the pursuit of toned muscularity among women is not yet well characterized. To address this knowledge gap, our study evaluated the associations among the female drive for toned muscularity and both thinness-oriented disordered eating behaviors (e.g., dietary restriction) and muscularity-oriented disordered eating behaviors (e.g., excessive scrutiny of macro-nutrient values of food), as well as dimensions of compulsive exercise. Participants were 388 Australian undergraduate women who completed an online questionnaire including self-report measures of said constructs. Hierarchical regression models were used to determine whether the drive for toned muscularity accounted for unique variance in eating and exercise behaviors after adjusting for theoretically relevant covariates. Results indicated independent relationships between the drive for toned muscularity and several facets of thinness- and muscularity-oriented disordered eating, as well as compulsive exercise (e.g., exercise rigidity). Our findings further contribute to an emerging literature illustrating that women driven to attain a toned appearance may be vulnerable to engaging in a wide range of maladaptive eating and exercise practices.

"Eat clean, train mean, get lean": Body image and health behaviours of women who engage with fitspiration and clean eating imagery on Instagram

The present study examined the relationship between posting or viewing fitspiration and clean eating imagery in relation to body image, disordered eating, and compulsive exercise among women. Participants (269 women aged 18-30 years) who posted and/or viewed fitspiration, clean eating or travel imagery on Instagram completed an online cross-sectional questionnaire. Results showed engaging with fitspiration and clean eating material (either posting or viewing) was significantly positively associated with increased levels of compulsive exercise and athletic-ideal internalization. However, only viewing (not posting) fitspiration and clean eating content was significantly related to thin-ideal internalization and disordered eating symptomatology. Athletic-ideal internalization mediated the relationships between posting fitspiration/clean eating and disordered eating symptomatology and compulsive exercise. Both thin-ideal internalization and athletic-ideal internalization mediated the relationship between viewing fitspiration/clean eating material and disordered eating and compulsive exercise. Overall, the findings suggest that viewing fitspiration and clean eating content on Instagram is negatively associated with thin-ideal internalization and disordered eating symptomatology, however the same relationships do not exist for people who frequently post these types of material. The mediational pathways provide a nuanced understanding of how engaging with fitspiration and clean eating material on social media influences female users' body image and health behaviour.

Validation of the Muscle Dysmorphic Disorder Inventory (MDDI) among Italian Women Practicing Bodybuilding and Powerlifting and in Women Practicing Physical Exercise

Studies pertaining to muscle dysmorphia (MD) have concentrated the most on males. However, a new body ideal for women is emerging: a very toned, athletic body with flat, smooth muscles. The emphasis on the level of muscularity represents a contribution to the growth of MD symptoms in women. The aim of this study was to evaluate the factorial structure and psychometric properties of the muscle dysmorphic disorder inventory (MDDI) in two samples of physically active Italian women. One-hundred and sixty-five women practicing non-competing bodybuilding/powerlifting and 353 women practicing physical exercise completed the MDDI and measures of features associated with MD. Findings of the confirmatory factor analysis showed a three-factor structure with acceptable fit and invariant across groups. Omega coefficients revealed adequate internal consistency for all the scales and for the total score of the MDDI. Furthermore, convergent and divergent validity as well as retest reliability emerged to be good. MDDI represents a reliable measure of MD symptoms in physically active Italian women.

What Brings Young Adults to the Yoga Mat? Cross-Sectional Associations Between Motivational Profiles and Physical and Psychological Health Among Participants in the Project EAT-IV Survey

Objectives: This study examines motivations for yoga and identifies unique motivational profiles among a sample of young adult yoga practitioners. This study further determines how young adult yoga practitioners' motivational profiles associate with physical health behaviors and psychological factors. Subjects/Setting: Survey data were drawn from the fourth wave of a large, population-based study (Project EAT-IV; Eating and Activity in Teens and Young Adults). Design: Latent class analysis (LCA) was used to identify motivational profiles among Project EAT-IV participants practicing yoga (n = 297; mean age: 30.8-1.7 years; 79.7 % female). Cross-sectional associations between latent motivational profiles, physical health behaviors, and psychological factors were determined with unadjusted and adjusted (gender, race/ethnicity, and body mass index) general linear models. Results: Across motivational profiles, most young adult yoga practitioners were motivated by enhanced fitness and stress reduction/relaxation. Additional motivations for yoga clustered by appearance (desire to change body appearance or weight) or mindfulness (desire to increase present moment awareness) underpinnings. The LCA characterized motivational profiles as "Low Appearance, Low Mindfulness" (Class 1; n = 77), "Low Appearance, High Mindfulness" (Class 2; n = 48), "High Appearance, Low Mindfulness" (Class 3; n = 79), and "High Appearance, High Mindfulness" (Class 4; n = 93). Having a profile with high mindfulness and low appearance motivations (Class 2) was associated with higher body satisfaction in comparison to the other classes (p < 0.001). Relative to Class 2, those with low mindfulness motivations (Class 1; Class 3) reported less total physical activity (p = 0.002) and those with high appearance motivations (Class 3; Class 4) reported higher compulsive exercise scores (p = 0.002). Conclusions: In this sample, high mindfulness and low appearance motivations for yoga appeared optimal for physical and psychological health. Cross-sectional findings suggest that young adult yoga practitioners' mind-body health may be supported by motivational underpinnings that emphasize yoga's internal (mindfulness) rather than external (appearance) benefits.

The Thin Ideal and Attitudes towards Appearance as Correlates of Exercise Addiction among Sporty People during the COVID-19 Pandemic

The stress and anxiety caused by the coronavirus pandemic (COVID-19) have exacerbated body image concerns. A society that perpetuates the attempt for a perfect and thin appearance represents a fertile ground for the development of exercise addiction (EA). This cross-sectional study aims to explore EA during the second wave of the pandemic (October−December 2020) and to examine the independent influence of both time spent on moderate and vigorous physical activities and body image variables (i.e., drive for leanness and sociocultural attitudes toward appearance) on EA. A sample of Italian sporty people (N = 194; 48.5% females; Mage = 25.91 ± 6.32) was surveyed using the Exercise Addiction Inventory, the Drive for Leanness Scale, the Sociocultural Attitudes Towards Appearance Questionnaire, and the Global Physical Activity Questionnaire. A total of 82% of the sample were symptomatic of and 11.3% were at risk of EA. Hierarchical regressions revealed an association between the time spent on vigorous physical activities and levels of EA (p < 0.05). Moreover, body image variables were positively related to EA, explaining an additional 11% of variance (p < 0.05). Results showed the importance of considering and addressing body image factors to investigate and dampen the risk of EA among sporty people.

The independent contribution of muscularity-oriented disordered eating to functional impairment and emotional distress in adult men and women

Muscularity-oriented disordered eating (MODE) refers to a broad cluster of pathological eating patterns driven by the pursuit of muscularity and leanness. Although increasing attention has been devoted towards understanding these symptoms in men, little work has been conducted to understand MODE in women. It is also unclear whether MODE contributes unique variance to functional impairment and emotional distress beyond thinness-oriented disordered eating symptoms. We addressed these gaps in a sample of 1,321 community-based adult women (n = 1136) and men (n = 185). Hierarchical multiple regressions revealed that MODE explained a significant proportion of unique variance in functional impairment in both men and women, even after controlling for traditional thinness-oriented disordered eating symptoms. MODE also contributed unique variance in symptoms of depression and anxiety in women, but not for men. Findings highlight the possible significance of these unique symptoms patterns geared towards the pursuit of muscularity and leanness. MODE symptoms may be a viable target in eating disorder intervention or prevention programs, although further longitudinal research is needed.

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.

The effect of physical appearance perfectionism and social comparison to thin-, slim-thick-, and fit-ideal Instagram imagery on young women's body image

Body image research to date has examined the impact of thin- and fit-ideal media on women's body image, however cultural trends in Western media have recently shifted towards a curvier body type called slim-thick, which is characterized by a large butt and thighs and small waist and flat stomach. We experimentally examined the impact of forced social comparison to slim-thick-, thin-, and fit-ideal imagery on women's body image relative to a control condition, and whether physical appearance perfectionism moderated these findings. Participants were 402 female undergraduate students. Results revealed that comparison to body-ideal imagery resulted in greater weight and appearance dissatisfaction and less overall body satisfaction, relative to the control condition. Those exposed to slim-thick imagery experienced more weight and appearance dissatisfaction and less body satisfaction than those in the thin-ideal condition. Physical appearance perfectionism moderated these results, such that women who reported moderate or high levels of physical appearance perfectionism experienced greater weight and appearance dissatisfaction and lower body satisfaction in the slim-thick condition, than in the thin-ideal, fit-ideal, or control conditions. It was concluded that drive to achieve body ideals is shifting to a slim-thick body, which maybe more detrimental to women's body image than thin-ideal imagery.

Gender differences in eating disorder-related intrusive thoughts

The present study aimed to examine gender differences in the experience of eating disorder-related intrusive thoughts (EDITs; i.e., frequency, content, emotional consequences, & control strategies). In addition, differences in the experience of EDITs across those atrisk of developing an eating disorder and those who are not atrisk were investigated. Six hundred and seventy-one adults completed self-report measures assessing the experience of EDITs, disordered eating attitudes and behaviours, and body dissatisfaction. It was found that females experienced EDITs more frequently and with higher levels of distress compared with males. With regard to control strategies, females tended to use distraction and thought suppression, whereas males were likely to do nothing in response. Participants in the at-risk group experienced EDITs more frequently, with higher distress, and responded by using obsessive-compulsive rituals or doing what the intrusion dictated significantly more than non-risk participants. Relationships between body dissatisfaction and EDITs related to bodily appearance were found to be stronger for men, whereas women revealed a stronger relationship between disordered eating and purging EDITs. The findings of this study support the growing literature regarding EDITs as a distinct clinical feature of eating disorders, and the developing evidence base regarding intrusive thoughts as a transdiagnostic mechanism.

The Relationship between Obligatory Exercise and Eating Attitudes, and the Mediating Role of Sociocultural Attitudes towards Appearance during the COVID-19 Pandemic

A strong sociocultural context could affect an individual's aesthetic standards. In order to achieve a socially recognized ideal appearance, obligatory exercisers might increase dieting behavior when exercise actions are disturbed, thereby placing the individual at risk of eating disorders. The current study mainly examined the relationship between obligatory exercise and eating attitudes during the COVID-19 pandemic, and considered the mediating role of externalized sociocultural attitudes towards appearance between the two. A total of 342 participants (175 females, 167 males) from various regions of China were invited to fill out the questionnaires including the Obligatory Exercise Questionnaire, the Sociocultural Attitudes Toward Appearance Questionnaire-3, and the Eating Attitudes Test. In total, 51.5% of the participants presented symptoms of an obligatory exercise behavior. Among them, males, young adults, and the participants with lower BMI had higher OEQ scores, whereas females and young adults had higher EAT-26 scores. Meanwhile, 9.4% of the participants might have had an eating disorder. The OEQ score was positively correlated with the EAT-26 total score as well as SATAQ-3 'Pressures' and 'Information' subscales. In addition, the EAT-26 total score was positively correlated with the SATAQ-3 'Pressures' and 'Information' subscales. Externalized sociocultural attitudes towards appearance served as a mediator between obligatory exercise behavior and eating attitudes, and the mediation effect accounted for 56.82% of the total effect. Obligatory exercise behavior may have an indirect effect on eating attitudes through sociocultural attitudes towards appearance. Given the sociocultural information and pressures, in order to maintain or pursue an ideal appearance, many people tend to keep a pathological diet. Thus, forming a positive and healthy social aesthetic orientation is beneficial in helping obligatory exercisers to develop reasonable eating habits.

A review of sex differences in the mechanisms and drivers of overeating

Disordered eating is often associated with marked psychological and emotional distress, and severe adverse impact on quality of life. Several factors can influence eating behavior and drive food consumption in excess of energy requirements for homeostasis. It is well established that stress and negative affect contribute to the aetiology of eating disorders and weight gain, and there is substantial evidence suggesting sex differences in sub-clinical and clinical types of overeating. This review will examine how negative affect and stress shape eating behaviors, and how the relationship between the physiological, endocrine, and neural responses to stress and eating behaviors differs between men and women. We will examine several drivers of overeating and explore possible mechanisms underlying sex differences in eating behavior.

Protective and Risk Factors in Exercise Addiction: A Series of Moderated Mediation Analyses

For a minority of individuals, exercise may become excessive and lead to an addictive behaviour. To better understand the processes by which exercise could become an addiction, the present study examined the risk and protective factors of exercise addiction among regular exercisers, by investigating the role of drive for thinness, bulimia, body dissatisfaction, body image concerns, and self-esteem. A sample of 319 Italian regular exercisers (M_age = 30.78 years, SD = 11.98) completed the Italian versions of the Exercise Addiction Inventory, Eating Disorder Inventory-3 Referral Form, Body Image Concern Inventory, and Rosenberg Self-Esteem Scale. Data were analyzed by implementing a series of moderated mediations. Drive for thinness, bulimia, and body dissatisfaction were positively associated with exercise addiction. An indirect path was found in each of these relationships, which included the mediation of body image concerns, as well as a significant moderation of self-esteem in the associations between drive for thinness, bulimia, body dissatisfaction, and the mediator. High self-esteem appeared to be a protective factor. The higher the level of self-esteem, the less indirect the effects of thinness drive, bulimia, body dissatisfaction, and body image concerns were on exercise addiction. Such findings contribute to a better understanding concerning the risk and protective factors of excessive exercise, and may have important practical implications in structuring interventions to reduce risk of developing exercise addiction, as well as orienting future research.

Compulsive exercise and mental health challenges in fitness instructors; presence and interactions

BACKGROUND

Some physically active people exercise compulsively, which can be associated with several mental health challenges. Fitness instructors are considered important role models for an active, healthy lifestyle; yet little is known about their exercise motives and mental health. The aim of this study was to examine the presence of compulsive exercise and mental health challenges, and their interaction, in fitness instructors.

METHODS

A total of 270 fitness instructors from Norwegian fitness clubs were recruited for this cross-sectional study. Inclusion criteria were operating as instructors within the current year and understanding Norwegian language. Data were collected by an electronic questionnaire and included demographic information, hours of classes instructed and of personal physical activity, Compulsive Exercise Test (CET), Symptom Check List - 10 (SCL-10), Beck Depression Inventory (BDI), and Eating Disorder Examination Questionnaire (EDE-Q)).

RESULTS

Females had higher CET scores than males, and 9% of all respondents had CET score above clinical cutoff. Respondents with clinical CET score had higher SCL-10, BDI and EDE-Q global- and subscale scores compared with their counterparts. Although CET was positively and significantly associated with BDI, SCL-10, and EDE-Q, only the latter explained the CET score (ß = 1.23, 99% CI = 0.87, 1.59).

CONCLUSION

About one out of eleven instructors were above clinical CET cut-off, revealing symptoms of compulsive exercise. EDE-Q significantly contributed in a model explaining 43% of the variation of compulsive exercise.

Hourglass Body Shape Ideal Scale and disordered eating

Disordered eating research has long considered the negative consequences of internalizing sociocultural appearance ideals (e.g., thin ideal, muscular ideal). However, the implications of internalizing a curvy or "hourglass" body shape remains unclear. The Hourglass Body Shape Ideal Scale (HBSIS) is a new self-report questionnaire that was developed and evaluated to appropriately measure the extent women subscribe to an hourglass body shape ideal. The measure was administered to a community and undergraduate sample of women via two separate online studies. Study 1 (N = 916) provided support for the factor structure as well as the convergent and discriminant validity of the HBSIS. The HBSIS was correlated with measures of appearance orientation, overweight preoccupation, and disordered eating. HBSIS was associated with disordered eating even after controlling for age, BMI, thin ideal and muscular ideal internalization. Further, higher HBSIS scores were associated with increased likelihood of having clinical levels of disordered eating symptoms. There were no racial and ethnic group differences on HBSIS. Study 2 (N = 195) replicated the factor structure of Study 1, in addition to its convergent and discriminant validity. The HBSIS allows for more precise examination of appearance-ideal internalization, capturing a unique construct understudied within eating pathology literature.

Bigger isn't always better: an exploration of social perception bias against high levels of muscularity in women

Bodybuilding is often considered more appropriate for men than for women. Previous research has shown that knowledge of a target's involvement in bodybuilding influences interpersonal judgments. The present study examined whether this is also the case for women with competitive-type bodybuilder physiques. Participants (N = 263) were shown photographs of women who competed professionally in different categories of bodybuilding (i.e., bikini, figure, and bodybuilding/physique). Participants were then asked to make a series of judgments on the basis of the photos alone. It was found that the degree of muscularity of the targets shaped participants' estimates of perceived outcomes and of the targets' traits in non-bodybuilding domains (e.g., expected positive life outcomes, gender role traits, and sexual orientation). Both men and women apparently considered moderate to high levels of muscularity in women targets as violations of gender norms.

Psychosocial etiology of maladaptive exercise and its role in eating disorders: A systematic review

OBJECTIVE

Although maladaptive exercise (ME) is widely recognized as a clinical feature in transdiagnostic eating disorders, less is known about psychosocial factors that give rise to and perpetuate this behavior. This systematic review aimed to examine the empirical status of this association.

METHOD

We reviewed 46 full text articles examining longitudinal associations between psychosocial variables and ME.

RESULTS

Eighteen studies met full inclusion criteria. Based on our qualitative synthesis, evidence suggests reasonably consistent associations between early concern with weight and shape, and negative affect on later development of ME.

DISCUSSION

Inconsistent and insufficient assessment of ME across a majority of studies underscores caution in interpretation of results, but guides important discussion for future clinical and research efforts.

Body Dissatisfaction, Weight-Related Behaviours, and Health Behaviours: A Comparison Between Australian and Malaysian in Female Emerging Adults

The presence of body dissatisfaction (BD) in non-Western countries is an important area of empirical enquiry. The results reflect collectivistic and individualistic cultures of Malaysians and Australians, respectively, whereby social approval, social acceptance, and cultural values are of high importance to Malaysians compared with the more liberal attitudes of Australians with respect to health behaviours. This study sought to compare: (1) Australian and Malaysian women on BD, thin ideal internalisation, sociocultural influences, problematic weight-related behaviours, and health behaviours; and (2) the degree to which BD is associated with health behaviours (smoking, alcohol consumption, drug use, and sexual behaviours) across the two cultures. Participants were 428 Australian females and 402 Malaysian females aged 18–25 years old. Australians had higher BD, thin ideal internalisation, family and media influences, restrained eating, and poorer health behaviours, while Malaysians had higher peer influence. There was no difference for bulimic behaviours across the two countries. BD was found to have an association with use of drugs, smoking, and sexual behaviours among Malaysian women, but not for Australian participants. The permeation of Western standards of the thin ideal due to increased industrialisation, Westernisation, and modernisation has brought about bulimic behaviours in Malaysian women, similar to that of Australian women.

Factors associated with body image dissatisfaction in adults: a cross-sectional analysis of the ELSA-Brasil Study

The aim of this article is to assess the association between body image dissatisfaction and sociodemographic and health behaviors, according to sex. Data were analyzed for 6,289 women and 5,188 men (35-59 years), participants in the baseline of the Longitudinal Study of Adult Health (ELSA-Brasil), using multinomial regression. The odds of dissatisfaction due to feeling underweight were higher among in women with low schooling and those who only consumed fruit weekly. Moderate physical activity reduced this type of dissatisfaction by 50%. Higher odds of dissatisfaction due to overweight were seen in married women, those who practiced light physical activity, and former smokers. Men with secondary schooling and excessive alcohol consumption showed 50% higher odds of dissatisfaction due to underweight, while light or moderate physical activity increased the odds by 75% and 94%, respectively. Among men, light and moderate physical activity were also associated with increased odds of dissatisfaction due to overweight. These findings corroborate that unhealthy habits and behaviors can influence body image dissatisfaction with different patterns between women and men.

The Effects of Self-Compassion and Self-Esteem Writing Interventions on Women’s Valuation of Weight Management Goals, Body Appreciation, and Eating Behaviors

In this study, we examined the effects of body-focused daily self-compassion and self-esteem expressive writing activities on women’s valuation of weight management goals, body appreciation, bulimic symptoms, and healthy and unhealthy eating behaviors. One-hundred twenty-six women, recruited from the community and a university participant pool ( Mage = 29.3, SD = 13.6), were randomly allocated to one of the three writing conditions: body-focused self-compassion, body-focused self-esteem, or control. Women reflected on a moment within the past 24 hours that made them feel self-conscious about their bodies, eating, or exercise habits (self-compassion and self-esteem conditions) or on a particular situation or feeling that occurred in the past 24 hours (control condition) for 4–7 days. At post-treatment (24 hours after the intervention), women in the self-compassion group demonstrated decreased bulimic symptoms, while women in the self-esteem and control conditions did not. Furthermore, clinically significant changes in bulimic symptoms were associated with being in the self-compassion condition but not in the self-esteem or control conditions. Results suggest that body-focused writing interventions may be more effective in temporarily reducing eating disorder symptoms in women if they focus on harnessing self-compassion. Additional online materials for this article are available on PWQ ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843211013465

Role of Sociocultural Pressures and Internalization of Appearance Ideals in the Motivation for Exercise

This study examined the mediating role of sociocultural pressures (i.e., parental, peer, significant others, and media) and the internalization of appearance ideals (i.e., thin, muscular, attractive) on the relationship of Body Mass Index (BMI) and exercise frequency to exercise motives (i.e., weight management, appearance, positive health). A total of 262 young women, age 18 to 29, participated in the study. Average BMI in this sample was 22.09 (SD = 2.69) and ranged from 18.03 to 31.51, with 15.3% of the sample having a BMI of 25 and above, which qualifies as overweight. Participants completed Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised and Exercise Motivations Inventory-2 (EMI-2) along with some demographic information and questions regarding their exercise habits. The results indicated that women with higher BMI are more motivated to exercise to lose weight, and women who exercise more frequently are motivated by the aspect of positive health. Also, women with higher BMI perceive more sociocultural pressures to obtain a culturally acceptable body. The sociocultural pressures and appearance internalization mediated the relationship between BMI and the frequency of exercise with motives for exercise. The implications and future directions of research are discussed.

Variable Sculpting in Dynamic Definition Body Contouring: Procedure Selection and Management Algorithm

BACKGROUND

Currently, corporal perception has evolved among different ethnic groups and a tendency to change from a slim to an athletic shape has been influenced by geography, culture, race, gender, and social media. Although exercise improves health status, physical appearance does as well in the long term. Patients often opt for an immediate solution for which high-definition (HD) liposculpture has been the best choice. However, they differ on their preference regarding muscular definition.

OBJECTIVES

The authors presented a new therapeutic algorithm for HD liposculpture in harmony with body biotypes and patients' preferences.

METHODS

The authors reported their experience with 1772 consecutive patients, classified according to their body type in endomorph (217), ectomorph (195), and mesomorph (1360), and treated according to our new algorithm. Patients in general good health requesting HD liposculpture were included from June 2013 to September 2019. Pre- and postoperative photographs were taken to evaluate results.

RESULTS

A total of 479 men and 1293 women were analyzed. Age ranged from 23 to 69 years in men and 18 to 57 years in women. Variable-degree HD liposculpture was successfully performed in all cases. Minor complications included port wound dehiscence (1.2%), seroma (4.1%), prolonged bruising (1.5%), and hyperchromia (10.4%). Superficial burns (0.7%), localized infection (0.4%), erratic skin adhesion (1%), and flap necrosis (0.4%) were also reported. A high-satisfaction index was reported in a nonstandardized patient survey.

CONCLUSIONS

The authors' new algorithm helps in the decision-making for HD liposculpture according to variable degrees of muscle definition due to patients' preferences.

LEVEL OF EVIDENCE: 4