1
|
Wu R, Puhl RM, Lessard LM, Foster GD, Cardel MI. Exploring the interplay of weight-based teasing and sociodemographic factors in adolescent weight bias internalization. J Pediatr Psychol 2024; 49:547-558. [PMID: 38853703 DOI: 10.1093/jpepsy/jsae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVE Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents. METHODS Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics. RESULTS Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing. CONCLUSION Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.
Collapse
Affiliation(s)
- Rui Wu
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, United States
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, United States
| | - Leah M Lessard
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, United States
| | - Gary D Foster
- WW International, Inc, New York, NY, United States
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle I Cardel
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, United States
| |
Collapse
|
2
|
Weinstock M, Thornton LM, Raynor HA, Mazzeo SE, LaRose JG, Caccavale LJ, Tatum KL, Bean MK. Parent involvement approach and changes in eating pathology within an adolescent obesity intervention. Eat Behav 2023; 51:101807. [PMID: 37659210 PMCID: PMC10840818 DOI: 10.1016/j.eatbeh.2023.101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Although adolescents with obesity have heightened risk for eating pathology, the impact of differential parent involvement on eating pathology after obesity treatment is unknown. We examined differences in eating pathology in adolescents whose parents were randomized to distinct interventions within adolescent obesity treatment. METHODS Participants were 82 adolescent/parent dyads (adolescents: 63 % female; 55 % racial/ethnically marginalized) enrolled in TEENS+, a 4-month behavioral weight loss intervention. Parents were randomized to either a parent weight loss treatment (TEENS+PWL) or parent skills training (TEENS+PAC). Adolescents completed the Eating Disorder Examination-Questionnaire with Instructions (EDE-Q-I) and Child Depression Inventory (CDI) at baseline, 4 m, and 7 m. Group differences in eating pathology (global score; eating concern, weight concern, shape concern, restraint) and depression across time points were evaluated with linear mixed models. RESULTS No significant differences were observed between TEENS+PAC and TEENS+PWL in eating pathology or depression, nor were there group by time interactions. Time point differences were observed for all EDE-Q-I and CDI outcomes, except eating concerns; pairwise contrasts revealed a variety of change patterns. Weight and shape concerns decreased from 0 to 4 m; observed reductions were maintained at 7 m. Restraint was highest at 4 m and decreased at 7 m but did not return to baseline. EDE-Q-I global scores significantly declined over time. Depression decreased over time, but a significant difference was only observed between 0 and 7 m. CONCLUSIONS Neither parent intervention yields harm related to eating pathology in adolescents engaged in obesity treatment. Obesity treatment does not appear to have iatrogenic effects on eating pathology in adolescents.
Collapse
Affiliation(s)
- Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica Gokee LaRose
- Department of Health and Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Laura J Caccavale
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina L Tatum
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Melanie K Bean
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
3
|
West CE, Sato AF. Weight and disordered eating among adolescents from low-income backgrounds. Eat Behav 2023; 50:101768. [PMID: 37390518 DOI: 10.1016/j.eatbeh.2023.101768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Abstract
Disordered eating affects youth from varying socioeconomic backgrounds; however, representation of youth from low-income backgrounds within disordered eating research has been limited. The aim of the current study was to examine the association between adolescent weight and disordered eating among a sample of youth from a low-income background and to examine specific socioenvironmental factors that might moderate this association. Adolescents ages 12-17 (N = 73) from a low-income background and their parents/guardians completed self-report questionnaires. Adolescent height and weight were objectively measured to calculate BMI z-score. Adolescent weight was significantly positively associated with global disordered eating (95 % CI [0.26, 0.54]), after controlling for sex. Parental weight concern moderated the association between weight and global disordered eating, F(4, 68) = 18.44, p < .01, such that the relation between adolescent zBMI and disordered eating was no longer significant at low levels of parental weight concern. Structured family meals moderated the association between weight and global disordered eating, F(4, 68) = 11.99, p < .01, such that more frequent meals weakened the association between adolescent zBMI and disordered eating. Findings suggest that higher weight is associated with greater levels of disordered eating among adolescents from a low-income background. In addition, lower levels of parental weight concern and more frequent family meals significantly buffered the association between weight and disordered eating in this at-risk, yet understudied population. Both parental weight concern and family meals present as factors within the family environment that may serve as targets for intervention.
Collapse
Affiliation(s)
- Caroline E West
- Department of Psychological Sciences, Kent State University, Kent, OH, United States of America.
| | - Amy F Sato
- Department of Psychological Sciences, Kent State University, Kent, OH, United States of America; Brain Health Research Institute, Kent State University, Kent, OH, United States of America
| |
Collapse
|
4
|
Bays HE, Gonsahn-Bollie S, Younglove C, Wharton S. Obesity Pillars Roundtable: Body mass index and body composition in Black and Female individuals. Race-relevant or racist? Sex-relevant or sexist? OBESITY PILLARS 2022; 4:100044. [PMID: 37990673 PMCID: PMC10662008 DOI: 10.1016/j.obpill.2022.100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2023]
Abstract
Background Body mass index (BMI or weight in kilograms/height in meters2) is the most common metric to diagnose overweight and obesity. However, a body composition analysis more thoroughly assesses adiposity, percent body fat, lean body mass (i.e., including skeletal muscle), and sometimes bone mineral density. BMI is not an accurate assessment of body fat in individuals with increased or decreased muscle mass; the diagnostic utility of BMI in individuals is also influenced by race and sex. Methods Previous Obesity Pillars Roundtables addressed the diagnostic limitations of BMI, the importance of android and visceral fat (especially among those with South and East Asian ancestry), and considerations of obesity among individuals who identify as Hispanic, diverse in sexual-orientation, Black, Native American, and having ancestry from the Mediterranean and Middle East regions. This roundtable examines considerations of BMI in Black and female individuals. Results The panelists agreed that body composition assessment was a more accurate measure of adiposity and muscle mass than BMI. When it came to matters of race and sex, one panelist felt: "race is a social construct and not a defining biology." Another felt that: "BMI should be a screening tool to prompt further evaluation of adiposity that utilizes better diagnostic tools for body composition." Regarding bias and misperceptions of resistance training in female individuals, another panelist stated: "I have spent my entire medical career taking care of women and have never seen a woman unintentionally gain 'too much' muscle mass and bulk up from moderate strength training." Conclusions Conveying the importance of race and sex regarding body composition has proven challenging, with the discussion sometimes devolving into misunderstandings or misinformation that may be perceived as racist or sexist. Body composition analysis is the ultimate diagnostic equalizer in addressing the inaccuracies and biases inherent in the exclusive use of BMI.
Collapse
Affiliation(s)
- Harold Edward Bays
- American Board of Obesity Medicine, Medical Director / President Louisville Metabolic and Atherosclerosis Research Center Clinical Associate Professor / University of Louisville Medical School, 3288 Illinois Avenue Louisville KY, 40213, USA
| | - Sylvia Gonsahn-Bollie
- American Board of Obesity Medicine, Embrace You Weight & Wellness Founder, Black Physicians Healthcare Network, Council of Black Obesity Physicians Founding Member, 8705 Colesville Rd Suite 103, Silver Spring, MD, 20910, USA
| | - Courtney Younglove
- American Board of Obesity Medicine, Founder/Medical Director: Heartland Weight Loss, 14205 Metcalf Avenue Overland Park, KS, 66223, USA
| | - Sean Wharton
- McMaster University, York University, University of Toronto Wharton Medical Clinic 2951 Walker’s Line, Burlington,Ontario, Canada
| |
Collapse
|
5
|
Dougherty EN, Goldschmidt AB, Johnson NK, Badillo K, Engel SG, Haedt-Matt AA. Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity. Body Image 2022; 40:249-255. [PMID: 35074653 PMCID: PMC8891090 DOI: 10.1016/j.bodyim.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.
Collapse
Affiliation(s)
| | | | | | | | - Scott G. Engel
- Sanford Research,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
| | | |
Collapse
|
6
|
Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, Chen KY, Johannsson E, Guðmundsdottir SL, Arngrimsson SA. Screen Time and Body Image in Icelandic Adolescents: Sex-Specific Cross-Sectional and Longitudinal Associations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031308. [PMID: 35162330 PMCID: PMC8835238 DOI: 10.3390/ijerph19031308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023]
Abstract
Studies of adolescent body image and screen use are mostly limited to girls, and longitudinal data are scarce. We examined cross-sectional and longitudinal associations between these variables in mid-adolescent boys and girls. Data was collected when participants were at age 15 and 17, by questionnaire and objective measurements (n = 152 had complete data). Sex-specific linear regression was used to explore cross-sectional and longitudinal associations of self-reported screen use (total use, and time spent in gaming, TV/DVD/internet-based watching and internet use for communication) and body image, adjusting for vigorous physical activity, symptoms of depression, and body composition. Screen time was negatively associated with body image at both time points, although more strongly at age 15, and for girls only. Gaming and TV/DVD/internet watching was more strongly associated with body image than internet use for communication. Girls with above median screen time at both ages had 14% lower body image score at age 17 than girls with below median screen time at both time points. Our results suggest that screen use is likely to play a role in the development of body dissatisfaction among adolescent females. Limiting screen time may, therefore, help to mitigate body dissatisfaction in adolescent girls.
Collapse
Affiliation(s)
- Soffia M. Hrafnkelsdottir
- Center of Sport and Health Sciences, University of Iceland, 105 Reykjavik, Iceland; (V.R.); (E.J.); (S.L.G.); (S.A.A.)
- Correspondence:
| | - Robert J. Brychta
- Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (R.J.B.); (K.Y.C.)
| | - Vaka Rognvaldsdottir
- Center of Sport and Health Sciences, University of Iceland, 105 Reykjavik, Iceland; (V.R.); (E.J.); (S.L.G.); (S.A.A.)
| | - Kong Y. Chen
- Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (R.J.B.); (K.Y.C.)
| | - Erlingur Johannsson
- Center of Sport and Health Sciences, University of Iceland, 105 Reykjavik, Iceland; (V.R.); (E.J.); (S.L.G.); (S.A.A.)
- Department of Sport and Physical Activity, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | - Sigridur L. Guðmundsdottir
- Center of Sport and Health Sciences, University of Iceland, 105 Reykjavik, Iceland; (V.R.); (E.J.); (S.L.G.); (S.A.A.)
| | - Sigurbjorn A. Arngrimsson
- Center of Sport and Health Sciences, University of Iceland, 105 Reykjavik, Iceland; (V.R.); (E.J.); (S.L.G.); (S.A.A.)
| |
Collapse
|
7
|
Wang Y, Lynne SD, Witherspoon D, Black MM. Longitudinal bidirectional relations between body dissatisfaction and depressive symptoms among Black adolescents: A cross-lagged panel analysis. PLoS One 2020; 15:e0228585. [PMID: 31999799 PMCID: PMC6992219 DOI: 10.1371/journal.pone.0228585] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 01/19/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To assess the variation in body dissatisfaction and depressive symptoms by weight status and the bi-directional relations between body dissatisfaction and depressive symptoms by weight status among Black adolescents. Methods A sample of 153 Black adolescents aged 12–13 years, either overweight/obese (n = 57, 37%) or healthy weight (n = 96, 63%), were recruited and evaluated three times over two years (T1, T2 and T3). Measured weight and height were converted to age and sex-specific BMI z-score; body dissatisfaction was measured with silhouettes, and depressive symptoms were measured with the Beck Depression Inventory (BDI-I). Bidirectional relations were assessed with cross-lagged panel analyses, accounting for stability over time and contemporary correlations. Results Body dissatisfaction was higher among the overweight/obese group than the healthy weight group. No significant differences were found for depressive symptoms by weight status. Among the overweight/obese group, there were bidirectional relations: antecedent body dissatisfaction predicted subsequent depressive symptoms (T1-T2: β = 0.42, SE = 0.11, p<0.001; T2-T3: β = 0.36, SE = 0.09, p<0.001) and antecedent depressive symptoms predicted subsequent body dissatisfaction (T1-T2: β = 0.25, SE = 0.10, p = 0.012; T2-T3: β = 0.17, SE = 0.08, p = 0.045). Among the healthy weight group, there was no relation in either direction. Conclusions Elevated body dissatisfaction among the overweight/obese group supports weight-based stigma as a stressor among Black adolescents. The bidirectional relations between body dissatisfaction and depressive symptoms among the overweight/obese group support the internalization of thinness idea and negative self-appraisal associated with depressive symptoms. Prevention of both body dissatisfaction and depressive symptoms may be mutually beneficial among Black adolescents with overweight/obesity.
Collapse
Affiliation(s)
- Yan Wang
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- * E-mail:
| | - Sarah D. Lynne
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Dawn Witherspoon
- Department of Psychology, University of North Florida, Jacksonville, Florida, United States of America
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- RTI International, Research Triangle Park, North Carolina, United States of America
| |
Collapse
|
8
|
Johnson ER, Affuso O, Levitan EB, Carson TL, Baskin ML. Body image and dissatisfaction among rural Deep South African American women in a weight loss intervention. J Health Psychol 2019; 24:1167-1177. [PMID: 28810419 DOI: 10.1177/1359105317694489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Body image perception may impact health-promoting behaviors as well as knowledge regarding health risks associated with obesity. Our cross-sectional analysis evaluated body image and its association with body mass index among overweight and obese treatment-seeking African American women (N = 409). Differences between current and desired body image were captured using the Pulvers scale. Results indicated the presence of body image dissatisfaction among participants (median = 2.00, interquartile range: 2.00-3.00), with greater dissatisfaction observed at higher categories of body mass index. Additionally, receiver operating curves demonstrated the ability of the Pulvers scale to correctly identify participants classified by body mass index. Further research is needed to identify factors that influence body image perception.
Collapse
|
9
|
Low-Income, African American and American Indian Children's Viewpoints on Body Image Assessment Tools and Body Satisfaction: A Mixed Methods Study. Matern Child Health J 2019; 22:1327-1338. [PMID: 29500785 DOI: 10.1007/s10995-018-2513-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives Pediatric obesity is complicated by many factors including psychological issues, such as body dissatisfaction. Body image assessment tools are used with children to measure their acceptance of their body shape or image. Limited research has been conducted with African American and American Indian children to understand their opinions on assessment tools created. This study investigated: (a) children's perception about body image and (b) differences between two body image instruments among low-income, multi-ethnic children. Methods This study uses mixed methodology including focus groups (qualitative) and body image assessment instruments (quantitative). Fifty-one children participated (25 girls, 26 boys); 53% of children identified as African American and 47% as American Indian. The average age was 10.4 years. Open coding methods were used by identify themes from focus group data. SPSS was used for quantitative analysis. Results Children preferred the Figure Rating Scale (FRS/silhouette) instrument over the Children's Body Image Scale (CBIS/photo) because their body parts and facial features were more detailed. Children formed their body image perception with influence from their parents and the media. Children verbalized that they have experienced negative consequences related to poor body image including disordered eating habits, depression, and bullying. Healthy weight children are also aware of weight-related bullying that obese and overweight children face. Conclusions for Practice Children prefer that the images on a body image assessment tool have detailed facial features and are clothed. Further research into body image assessment tools for use with African American and American Indian children is needed.
Collapse
|
10
|
Perception of Physical Fitness and Exercise Self-Efficacy and Its Contribution to the Relationship between Body Dissatisfaction and Physical Fitness in Female Minority Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061187. [PMID: 29882789 PMCID: PMC6025461 DOI: 10.3390/ijerph15061187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 11/17/2022]
Abstract
Body Dissatisfaction (BD) and low physical self-concept and exercise efficacy have been linked to poor physical fitness levels and adverse health outcomes in children. The purpose of this study was to examine the relationship between BD, physical fitness, exercise self-efficacy, and self-Perception of Physical Fitness (PFP) in Latina and Black female children. Twenty-eight Latina and Black children enrolled in an elementary afterschool program, aged 8–12, completed surveys evaluating body dissatisfaction, exercise efficacy, PFP, and measures of physical fitness. Subjects exhibited moderate but significant inverse relationships between BD and PFP in strength (r = −0.459), agility (r = −0.382), aerobic fitness (r = −0.354), and flexibility (r = −0.461) (p < 0.05 for all). There was a significant negative correlation between exercise efficacy and BD (r = −4.2; p < 0.05). Power (r = 0.51) and flexibility (r = 0.42) were the only physical fitness measures significantly and positively related to children’s PFP (p < 0.05). A significant medium inverse relationship was also found between BD and aerobic fitness scores (r = −0.381; p < 0.05). However, after controlling for exercise efficacy or perception of physical fitness, the relationship between BD and aerobic fitness was not significant (p > 0.05). Findings suggest that positive PFP and positive performance in several physical fitness measures are associated with lower levels of BD in minority female children. Furthermore, evidence suggests exercise efficacy and PFP can mediate the relationship body image and aerobic fitness. These findings suggest that PFP, more so than measured physical fitness, was associated with lower levels of BD in minority female children. These results have important implications for programs designed to improve physical fitness and mental health in minority children.
Collapse
|
11
|
Rodgers RF, Watts AW, Austin SB, Haines J, Neumark-Sztainer D. Disordered eating in ethnic minority adolescents with overweight. Int J Eat Disord 2017; 50:665-671. [PMID: 27987207 PMCID: PMC5459664 DOI: 10.1002/eat.22652] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/20/2016] [Accepted: 11/04/2016] [Indexed: 11/08/2022]
Abstract
High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating.
Collapse
Affiliation(s)
- Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, Boston, USA,Laboratoire de Stress Traumatique, Université Toulouse Paul Sabatier, Toulouse, France
| | - Allison W. Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| |
Collapse
|
12
|
Mölbert SC, Sauer H, Dammann D, Zipfel S, Teufel M, Junne F, Enck P, Giel KE, Mack I. Multimodal Body Representation of Obese Children and Adolescents before and after Weight-Loss Treatment in Comparison to Normal-Weight Children. PLoS One 2016; 11:e0166826. [PMID: 27875563 PMCID: PMC5119783 DOI: 10.1371/journal.pone.0166826] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/05/2016] [Indexed: 12/29/2022] Open
Abstract
Objective The aim of the study was to investigate whether obese children and adolescents have a disturbed body representation as compared to normal-weight participants matched for age and gender and whether their body representation changes in the course of an inpatient weight-reduction program. Methods Sixty obese (OBE) and 27 normal-weight (NW) children and adolescents (age: 9–17) were assessed for body representation using a multi-method approach. Therefore, we assessed body size estimation, tactile size estimation, heartbeat detection accuracy, and attitudes towards one’s own body. OBE were examined upon admission and before discharge of an inpatient weight-reduction program. NW served as cross-sectional control group. Results Body size estimation and heartbeat detection accuracy were similar in OBE and NW. OBE overestimated sizes in tactile size estimation and were more dissatisfied with their body as compared to NW. In OBE but not in NW, several measures of body size estimation correlated with negative body evaluation. After weight-loss treatment, OBE had improved in heartbeat detection accuracy and were less dissatisfied with their body. None of the assessed variables predicted weight-loss success. Conclusions Although OBE children and adolescents generally perceived their body size and internal status of the body accurately, weight reduction improved their heartbeat detection accuracy and body dissatisfaction.
Collapse
Affiliation(s)
- Simone Claire Mölbert
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience, International Max Planck Research School, University Tübingen, Tübingen, Germany
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Dirk Dammann
- Fachkliniken Wangen i.A., Children Rehabilitation Hospital for Respiratory Diseases, Allergies and Psychosomatics, Wangen i.A., Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- * E-mail:
| |
Collapse
|
13
|
Association between body image dissatisfaction and obesity among schoolchildren aged 7–10 years. Physiol Behav 2016; 160:6-11. [DOI: 10.1016/j.physbeh.2016.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 01/27/2016] [Accepted: 03/17/2016] [Indexed: 11/17/2022]
|
14
|
Gowey MA, Stromberg S, Lim CS, Janicke DM. The Moderating Role of Body Dissatisfaction in the Relationship between ADHD Symptoms and Disordered Eating in Pediatric Overweight and Obesity. CHILDRENS HEALTH CARE 2015; 46:15-33. [PMID: 28286355 PMCID: PMC5342252 DOI: 10.1080/02739615.2015.1065745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Identifying factors linked to disordered eating in overweight and obesity (OV/OB) may provide a better understanding of youth at risk for disordered eating. This project examined whether ADHD symptoms and body dissatisfaction were associated with disordered eating. METHODS ADHD symptoms, disordered eating, and body dissatisfaction were assessed in 220 youth ages 7-12 who were OV/OB. RESULTS Multiple linear regressions showed that body dissatisfaction and ADHD symptoms were associated with disordered eating. DISCUSSION Children with ADHD symptoms and OV/OB may be at greater risk for disordered eating when highly dissatisfied with their bodies. Healthcare providers should assess body image and disordered eating in youth with comorbid OV/OB and ADHD.
Collapse
Affiliation(s)
- Marissa A Gowey
- Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA.
| | - Sarah Stromberg
- Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA.
| | - Crystal S Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216, USA.
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA.
| |
Collapse
|
15
|
Considering an affect regulation framework for examining the association between body dissatisfaction and positive body image in Black older adolescent females: does body mass index matter? Body Image 2014; 11:426-37. [PMID: 25079011 PMCID: PMC4250321 DOI: 10.1016/j.bodyim.2014.07.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 07/04/2014] [Accepted: 07/05/2014] [Indexed: 11/23/2022]
Abstract
The present study provided an initial evaluation of an affect regulation model describing the association between body dissatisfaction and two contemporary measures of positive body image among 247 Black college-bound older adolescent females. We further tested whether possessing a higher body mass index (BMI) would strengthen these associations. Self-reported height and weight were used to calculate BMI. Respondents also completed a culturally-sensitive figure rating scale along with assessments of body appreciation and body image flexibility. Results indicated a robust positive association between the two measures of positive body image; BMI was the strongest predictor of both body appreciation and body image flexibility with body size discrepancy (current minus ideal) contributing incremental variance to both models tested. Implications for improving our understanding of the association between positive and negative body image and bolstering positive body image to promote health-protective behaviors among Black young women at this developmental juncture are discussed.
Collapse
|
16
|
Kimber M, Couturier J, Georgiades K, Wahoush O, Jack SM. Ethnic Minority Status and Body Image Dissatisfaction: A Scoping Review of the Child and Adolescent Literature. J Immigr Minor Health 2014; 17:1567-79. [DOI: 10.1007/s10903-014-0082-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
17
|
Fortes LDS, Almeida SDS, Cipriani FM, Ferreira MEC. Inappropriate eating behavior: a longitudinal study with female adolescents. ACTA ACUST UNITED AC 2014; 32:85-91. [PMID: 24676195 PMCID: PMC4182991 DOI: 10.1590/s0103-05822014000100014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 08/28/2013] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the inappropriate eating behaviors (IEB) of female adolescents over a
one-year period. Methods: 290 adolescents aged between 11 and 14 years old participated in the three
research stages (T1: first four months, T2: second four months and T3: third four
months). The Eating Attitudes Test (EAT-26) was applied to assess the IEB. Weight
and height were measured to calculate body mass index (BMI) in the three study
periods. Analysis of variance for repeated measures was used to analyze the data,
adjusted for the scores of the Body Shape Questionnaire and the Brazil Economic
Classification Criteria. Results: Girls at T1 showed a higher frequency of IEB compared to T2
(p=0.001) and T3 (p=0.001). The findings also
indicated higher values for BMI in T3 in relation to T1 (p=0.04).
The other comparisons did not show statistically significant differences. Conclusions: IEB scores of female adolescents declined over one year.
Collapse
|
18
|
Ling FCM, McManus AM, Knowles G, Masters RSW, Polman RCJ. Do children emotionally rehearse about their body image? J Health Psychol 2013; 20:1133-41. [PMID: 24174432 DOI: 10.1177/1359105313507965] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the association between propensity for emotional rehearsal, body image self-perception and weight status in Chinese Hong Kong pre-adolescents. Children 8-12 years of age (n = 278) completed measurement of body mass index, body image and emotional rehearsal. Multinomial regression analyses revealed that body mass index was positively associated with body image dissatisfaction and a significant predictor of body size estimation. However, only body size underestimation was associated with lower rehearsal tendencies. The prevalence of body image dissatisfaction and body size estimation was also reported for this population. Future research is suggested for greater understanding of emotional coping in body image dissatisfaction in young children.
Collapse
|
19
|
Cassidy O, Sbrocco T, Vannucci A, Nelson B, Jackson-Bowen D, Heimdal J, Mirza N, Wilfley DE, Osborn R, Shomaker LB, Young JF, Waldron H, Carter M, Tanofsky-Kraff M. Adapting interpersonal psychotherapy for the prevention of excessive weight gain in rural African American girls. J Pediatr Psychol 2013; 38:965-77. [PMID: 23678135 DOI: 10.1093/jpepsy/jst029] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To obtain focus group data regarding the perspectives of rural African American (AA) girls, parents/guardians, and community leaders on obesity, loss of control (LOC) eating, relationships, and interpersonal psychotherapy for the prevention of excessive weight gain (IPT-WG). METHODS 7 focus groups (N = 50 participants) were moderated and the transcripts analyzed by Westat researchers using widely accepted methods of qualitative and thematic analysis. A session was held with experts in health disparities to elucidate themes. RESULTS Participants understood LOC eating; however, they had culturally specific perceptions including usage of alternative terms. Relationships were highly valued, specifically those between mothers and daughters. IPT-WG program components generally resonated with participants, although modifications were recommended to respect parental roles. Experts interpreted focus group themes and discussed potential barriers and solutions to recruitment and participation. CONCLUSION Findings suggest that adapting IPT-WG may be acceptable to rural AA families. This research is the first step in developing a sustainable excessive weight gain and binge eating disorder prevention program for rural AA adolescents.
Collapse
Affiliation(s)
- Omni Cassidy
- PhD, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Cassidy OL, Matheson B, Osborn R, Vannucci A, Kozlosky M, Shomaker LB, Yanovski SZ, Tanofsky-Kraff M. Loss of control eating in African-American and Caucasian youth. Eat Behav 2012; 13:174-8. [PMID: 22365807 PMCID: PMC3299485 DOI: 10.1016/j.eatbeh.2012.01.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/16/2011] [Accepted: 01/10/2012] [Indexed: 11/21/2022]
Abstract
Loss of control (LOC) eating, a disinhibited eating behavior shown to predict excessive weight gain in youth, has been reported by African-American children and adolescents. Yet, little is known about how LOC-eating manifests in this population. To investigate potential racial differences in LOC-eating, the Eating Disorder Examination was administered to 185 non-Hispanic African-American and Caucasian youth ages 8-17 y. Objective eating was assessed at two test meals during which youth ate ad libitum from a multi-item lunchtime food array. African-American and Caucasian youth reported a similar prevalence of LOC episodes (24.2% vs. 28.9%, p=.75). Yet, accounting for sex, age, fat-free mass, percent fat mass, height, and socioeconomic status, African-Americans consumed more total energy at both laboratory meals (1608±57 kcal vs. 1362±44 kcal; p<.001). Furthermore, African-American youth reporting LOC consumed the most total energy across both meals (1855±104 kcal) compared to African-Americans without LOC (1524±60 kcal), Caucasians with LOC (1278±68 kcal), and Caucasians without LOC (1399±46 kcal; p<.001). Future research is required to examine whether LOC-eating contributes to the high rates of obesity in African-American youth.
Collapse
Affiliation(s)
- Omni L. Cassidy
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20814, USA
| | - Brittany Matheson
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20814, USA
| | - Robyn Osborn
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
| | - Anna Vannucci
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, Bethesda, MD, 20814, USA
| | - Lauren B. Shomaker
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20814, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20814, USA
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences (USUHS), Department of Medical and Clinical Psychology, Bethesda, MD, 20814
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD, 20814, USA
| |
Collapse
|