Body ideals in women after viewing images of typical and healthy weight models

Body Image Among Sexual and Gender Minorities: An Intersectional Analysis

Body image is consequential for overall well-being and has a complex relation to gender. Sexual and gender minority (SGM) individuals develop body image amid intersecting systems of oppression, such as sexism, cisnormativity, heteronormativity, and gender binary pressures. This study used an intersectionality framework to examine how various aspects of gender identification (cis/trans, binary/nonbinary, woman/man identification) related to body image differences among SGM individuals. We also assessed whether identification with conventionally masculine and feminine personality traits predicted body image. We used one-way and two-way ANOVAs and linear regressions to analyze two indicators of body image (body appreciation and drive for muscularity) in a sample of 643 SGM individuals (148 sexual minority (SM) cis women, 171 trans women, 121 SM cis men, 43 trans men, 160 nonbinary individuals). Results implicated cisnormativity as an influential and hierarchical force for body image, although woman/man and binary/nonbinary identification also played roles in group differences. With a few exceptions, masculine but not feminine trait identification significantly predicted body appreciation and drive for muscularity, indicating a complicated association with overall body image. These findings underscore the value of an intersectional lens for analyzing how broad social forces may manifest in individual-level body image for SGM individuals.

Experimental research on non-idealized models: A systematic literature review

Current literature on non-idealized models seems to offer mixed evidence on whether such models generate a positive body image and increase advertising effectiveness. To closely investigate this claim, we conducted a systematic review to summarize the empirical findings on the effects of non-idealized models on body image, well-being, and advertising outcomes among men and women. To contextualize these results, we also synthesized (1) the conceptualization of a non-idealized body size (i.e., labelling and operationalization), (2) the message accompanying the model (i.e., medium type and marketing intent), and (3) individual traits of participants tested as potential moderators. Three databases in different disciplines (i.e., ProQuest Psychology, Communication and Mass Media Complete, and Web of Science) were searched, and 86 unique studies were included in the review. While most studies found positive or null effects of non-idealized models on body image, well-being, and advertising outcomes, a small number of studies obtained negative results. These inconsistent findings could be explained by the large variety of labels and unclear operationalizations identified within our review. The conclusions of this review call for a clearer definition and measurement of non-idealized models.

Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries

BACKGROUND

Body weight may be a risk factor for anxiety; however, there is a scarcity of studies on this association in older adults especially from low and middle income countries (LMICs). Therefore, we investigated the association between body mass index (BMI) and anxiety symptoms among adults aged ≥ 50 years from 6 LMICs.

METHODS

Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analyzed. The BMI was based on measured weight and height and was categorized as: < 18.5 kg/m² (underweight), 18.5-24.9 kg/m² (normal weight), 25.0-29.9 kg/m² (overweight), 30.0-34.9 kg/m² (obesity class I), 35.0-39.9 kg/m² (obesity class II), and ≥ 40 kg/m² (obesity class III). Anxiety symptoms referred to severe/extreme problems with worry or anxiety in the past 30 days. Multivariable logistic regression analysis was conducted.

RESULTS

Data on 34,129 individuals aged ≥ 50 years (mean age 62.4 years, SD 16.0 years; 52.1% female) were analyzed. Overall, compared to normal weight, only underweight was significantly associated with anxiety symptoms (odds ratio, OR = 1.56; 95% confidence interval, CI = 1.26-1.95). Obesity class III (vs. normal weight) was associated with significantly increased odds for anxiety symptoms (OR = 4.15; 95%CI = 1.49-11.59) only among males.

CONCLUSION

In this large representative sample of older adults from LMICs, underweight was associated with anxiety symptoms in males and females. Class III obesity was associated with anxiety symptoms only in males. Future studies to shed light on the reason why severe obesity was associated with anxiety symptoms only among males in LMICs are needed.

Body Image Software Programs

The assessment of body image has evolved in recent decades through the development of various software programs. However, it is not yet known whether this technological advance has resulted in refined evidence or whether this assessment development has been extensively applied in the field. This study reviewed the body image software programs developed and applied from 2000 to 2020. Searches were systematically conducted in four scientific databases. A total of 35 articles were selected, and 13 body image software programs were identified. The main features comprising the variability of the software were the pattern of body stimuli presentation (avatars x real body x body drawings) and the procedures of body image manipulation (whole body adjustment x adjustment of separate body parts). Heterogeneity was prevalent among the studies reviewed and prevented a favorable conclusion regarding the use of software compared to other body image assessment strategies.

The Real Ideal: Misestimation of Body Mass Index

In Western cultures, the ideal body for women is thin and toned. Idealization of thinness has led many women to desire bodies with an underweight body mass index (BMI). The present study investigated women's knowledge of BMI, particularly relating to their own body ideals, to determine whether women knowingly idealize bodies categorized as “underweight.” In August 2020, one-hundred and forty-seven US women aged 18 to 25 completed two online tasks in a repeated-measures design. First, participants estimated the BMIs of a series of bodies. Then, participants selected representations of their own and ideal bodies from a figure rating scale and estimated the BMIs of their selections. Participants generally mis-estimated the BMI of bodies, but did so to a greater extent when viewing bodies as an extension of their own, i.e., following the figure rating scale task. Further, if participants selected an underweight or overweight ideal body, they were likely to estimate this body was within a “normal” weight BMI range, demonstrating that women who idealize underweight–or overweight–bodies do so unknowingly. These findings suggest misperceptions of women's own ideal body size are often greater than misperceptions of other bodies, potentially driving the tendency to idealize underweight bodies.

A Qualitative Inquiry into the Eating Behavior and Physical Activity of Adolescent Girls and Boys in Indonesia

BACKGROUND

Despite the rising double burden of malnutrition, adolescent nutrition has received little attention in Indonesia. Eating and physical activity behaviors established in adolescence are known to track into adulthood and may contribute to chronic diseases in later life. This study aimed to explore the eating behaviors and physical activity of Indonesian adolescents, and their influencing factors.

METHODS

The study, designed as a qualitative study, was conducted in 2 selected districts in Indonesia: Klaten and Lombok Barat. Data were collected through immersion, open and informal discussions, and participant observations with 302 adolescent girls and boys.

RESULTS

The eating and physical activity behaviors of adolescent boys and girls are influenced by contextual changes in their family lifestyles and environment. The adolescents in this study only conflate physical activity with participation in sport. Even when a wider view of physical activity is cast, their level of physical activity remains low, especially for adolescent girls. Adolescents and their families generally eat 3 meals a day, with schools an important source of food for adolescents. Adolescents skip breakfast at home, and breakfast and lunch are usually purchased and eaten at school. Fewer families cook and families rarely eat together due to increasingly busy lives, increased mobility, and digital connectivity.

CONCLUSIONS

The rapid contextual shifts taking place in Indonesia influence the home, school, and peer environment to shape eating behaviors and physical activity among adolescent boys and girls. Gender-responsive multicomponent school-based interventions have the potential to serve as an important entry point for influencing adolescent nutrition.

Body Image and Voluntary Gaze Behaviors towards Physique-Salient Images

The purpose of this study was to explore body image correlates of voluntary consumption of physique-salient media. A secondary aim was to assess changes in affect following media consumption. Young adult men (n = 47; mean age = 20.2 years) and women (n = 87; mean age = 19.5 years) were discretely exposed to images of same-sex models with idealized- and average-physiques while completing an irrelevant computer task. Voluntary gaze at the images was covertly recorded via hidden cameras. Participants also completed measures of affect before and after the computer task. Measures of body-related envy, body appreciation, and self-perceptions of attractiveness, thinness, and physical strength were completed. Men and women did not differ in how often nor for how long they looked at the images overall, but body image variables were differentially associated with their voluntary gaze behaviors. For men, higher body-related envy and lower body appreciation were correlated with more looks at the average-physique model. Although women reported higher body-related envy than men, envy and body appreciation were not significant correlates of gaze behaviors for women. Both men and women experienced a general affective decrease over time, but only for men was the change in negative affect associated with their time spent looking at the ideal-physique image. Overall, these findings suggest that body-related envy and body appreciation influence how men choose to consume physique-salient media, and that media consumption may have negative consequences for post-exposure affect. Body image factors appear to be more strongly associated with behavior in men, perhaps because men are generally less often exposed to physique-salient media and, in particular, to average-physique images.

The ever-changing ideal: The body you want depends on who else you're looking at

The body positivity movement-celebrating bodies beyond the thin ideal-has gained traction on social media. In an online study of North American women, we aimed to determine how ideal body perceptions shift based on the presentation of more diverse body types. In Study 1, women (n = 115, aged 19-75) responded to arrays of bodies ranging from primarily small to primarily large bodies, selecting the body closest to their ideal body. Results showed that the BMI of the ideal body increased as the body sizes in the array increased. Participants were also less likely to select an underweight ideal when viewing larger bodies. In Study 2, women responded to arrays with either primarily small (n = 132, aged 20-68) or primarily large (n = 130, aged 20-75) bodies. Results suggested that ideal body perceptions only shifted around current societal standards, and not to extremes. The participants presented with the larger-bodied arrays were more likely to select a normal weight ideal body than those who saw the smaller-bodied arrays. Results suggest ideal body size is malleable, and shifting toward a more diverse perception of the ideal body is achievable with increased exposure beyond the thin ideal.

Weight and social comparison: Does the weight of a stranger affect a person's perception of their own weight?

Research suggests that social context affects individuals’ perception of their own weight. Using face-to-face interviews as the social context, we analyze the effect of interviewers’ (N = 90) body mass index on respondents’ (N = 3068) self-perceived weight level. Respondents reported a higher weight level when the interviewer had a higher body mass index (absolute social comparison). Female respondents reported a lower weight level if interviewers had a higher body mass index than they did (relative social comparison). Results suggest that weight perception reflects both absolute and relative social comparison, especially among women. Future research should consider causation and self-selection when studying social context and body image.

Approach and avoidance: Relations with the thin body ideal in women with disordered eating behavior

Recent research suggests that automatic cognitive biases are linked to body dissatisfaction and disordered eating behavior. However, little is known about automatic action tendencies in the field of body image research. The aim of the present study was to examine approach and avoidance biases toward the thin body ideal and normal weight bodies and whether these are pronounced in individuals showing disordered eating behavior. Participants were divided into a group with disordered eating behavior (n = 55) and without disordered eating behavior (n = 45). To assess approach and avoidance tendencies, the Approach-Avoidance Task was used during which the participants were instructed to approach or avoid thin and normal weight body pictures. Our results indicated faster push than pull movements towards thin and normal weight body pictures. However, participants with and without disordered eating behavior did not differ with regard to their reactions. Furthermore, we found positive associations between the avoidance of normal weight body pictures and perceived pressure to confirm to media ideals. Future research is warranted to replicate our findings and to extend our knowledge on approach and avoidance biases toward body pictures in patients suffering from eating disorders.

Pornography use in sexual minority males: Associations with body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life

OBJECTIVE

We examined two hypotheses regarding the potential association of pornography use with body image-related and eating disorder-related psychopathology among sexual minority males (i.e. non-heterosexual males). Our primary hypothesis was that pornography use would be associated with males' body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life impairment; our secondary hypothesis was that the type of pornography, namely, professional versus amateur pornography, which contains idealised and non-idealised (i.e. regular) bodies, respectively, would moderate these associations.

METHODS

A sample of 2733 sexual minority males living in Australia and New Zealand completed an online survey that contained measures of pornography use, body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life.

RESULTS

Almost all (98.2%) participants reported pornography use with a median use of 5.33 hours per month. Multivariate analyses revealed that increased pornography use was associated with greater dissatisfaction with muscularity, body fat and height; greater eating disorder symptoms; more frequent thoughts about using anabolic steroids; and lower quality of life. Effect sizes for these associations were uniformly small. Neither relationship status nor genital dissatisfaction was associated with pornography use. The association between pornography use and thoughts about using anabolic steroids was stronger for viewers of professional pornography than viewers of amateur pornography.

CONCLUSION

The findings suggest that the use of pornography is weakly associated with body dissatisfaction and related variables and that the type of pornography (amateur vs professional) viewed may be a moderating factor in some cases. Within the limits of a cross-sectional study design, these findings may have implications for clinicians who treat individuals with eating disorders, body dysmorphic disorder, anabolic-androgenic steroid dependence and related concerns.

Familial transmission of a body-related attentional bias - An eye-tracking study in a nonclinical sample of female adolescents and their mothers

Background

Previous research indicates that body image disturbance is transmitted from mother to daughter via modeling of maternal body-related behaviors and attitudes (indirect transmission) and via maternal body-related feedback (direct transmission). So far, the transmission of body-related attentional biases, which according to cognitive-behavioral theories play a prominent role in the development and maintenance of eating disorders, has not been analyzed. The current eye-tracking study applied the concepts of direct and indirect transmission to body-related attentional biases by examining body-related viewing patterns on self- and other-pictures within mother-daughter dyads.

Methods

Eye movements of N = 82 participants (n = 41 healthy female adolescents, mean age 15.82 years, SD = 1.80, and their mothers, mean age 47.78 years, SD = 4.52) were recorded while looking at whole-body pictures of themselves and a control peer. Based on fixations on self-defined attractive and unattractive body areas, visual attention bias scores were calculated for mothers and daughters, representing the pattern of body-related attention allocation. Based on mothers’ fixations on their own daughter’s and the adolescent peer’s body, a second visual attention bias score was calculated, reflecting the mothers’ viewing pattern on their own daughter.

Results

Analysis of variance revealed an attentional bias for self-defined unattractive body areas in adolescents. The girls’ visual attention bias score correlated significantly with their mothers’ bias score, indicating indirect transmission, and with their mothers’ second bias score, indicating direct transmission. Moreover, the girls’ bias score correlated significantly with negative body-related feedback from their mothers.

Conclusions

Female adolescents show a deficit-oriented attentional bias for one’s own and a peer’s body. The correlated body-related attention patterns imply that attentional biases might be transmitted directly and indirectly from mothers to daughters. Results underline the potential relevance of maternal influences for the development of body image disturbance in girls and suggest specific family-based approaches for the prevention and treatment of eating disorders.

Perceived barriers to achieving a healthy weight: a qualitative study using focus groups at public and private schools in Guatemala City

BACKGROUND

Overweight prevalence among Guatemalan girls is higher in public than in private schools. Little is known about adolescent girls' perceptions of the right ways to achieve a healthy weight. This study examines public and private school adolescent girls' perceptions of a "healthy weight," and barriers and facilitators to achieving it.

METHODS

We conducted 4 focus groups in public and private schools in Guatemala City with girls from 13 to 15 years old. The discussion guide included open-ended questions and activities aimed at examining perceptions of "healthy weight" and barriers and motivators to achieving it within the school environment. Focus groups were audio-recorded and transcribed. Data analyses followed established methods of content analysis.

RESULTS

Twenty-eight girls (private school, n = 12; public school, n = 16) of ages ranging from 13.1 to 15.9 years (median, 14, IQR, 13.6-14.9) participated in the study. Girls identified images of thin and fit women as healthy. They cited healthy eating and physical activity as ways to achieve a healthy weight. Within the school environment, barriers to maintaining a healthy weight included a lack of healthy food options and the prioritization of sports for boys over girls. In public schools, facilities were less than optimal; in private schools, girls' access to facilities was limited. Public school girls stated that their uniforms were inappropriate for exercising.

CONCLUSION

Our findings support the need to provide more healthy food options in Guatemalan schools. In addition, physical activity for girls should be promoted and facilities made available for their use.

Associations Between Anxiety Disorder Diagnoses and Body Mass Index Differ by Age, Sex and Race: A Population Based Study

Background:

Few large studies have examined correlations between anxiety and body mass index (BMI) by gender or racial groups using clinical data.

Objective:

This study aimed to determine associations between diagnosed anxiety disorders and BMI, and evaluate whether observed associations varied by demographic characteristics.

Method:

Data from the Rochester Epidemiology Project (REP) data linkage system were analyzed to examine associations between anxiety disorders and BMI among adults ages 18-85 residing in Olmsted County, MN in 2009 (n=103,557). Height and weight data were available for 75,958 people (73%). The international classification of underweight, overweight, and obesity by BMI was used.

Results:

Population consisted of 56% females, 92.8% White individuals, with median age of 46 years. When adjusted for age, sex, and race, we observed a U-shaped association between anxiety and BMI group. Underweight and obese individuals were more likely to have an anxiety diagnosis compared to normal weight individuals. Stratification by sex yielded a U-shaped association between anxiety and BMI only in women. Stratification by race showed a U-shaped association between anxiety and BMI only in the White population. Anxiety was significantly associated only with obesity in the Black population. Anxiety was not associated with a BMI category in Asian or Hispanic groups. Among elderly group, there is inverse correlation between anxiety and obesity.

Conclusion:

Our results suggest that anxiety may have heterogeneous associations with BMI in the population. Further research on potential mechanisms contributing to these findings will help direct efforts in anxiety and obesity management across diverse population groups.

Short-term effects of media exposure to the thin ideal in female inpatients with an eating disorder compared to female inpatients with a mood or anxiety disorder or women with no psychiatric disorder

OBJECTIVE

Previous research demonstrated that the exposure to media portrayals of the thin body ideal negatively affects body satisfaction and mood of healthy women and thus represents a sociocultural risk factor for the development of eating disorders. However, at present, it is not known whether negative effects of the thin ideal are pronounced in eating-disordered patients.

METHOD

Female inpatients with a current diagnosis of anorexia nervosa (N = 36), bulimia nervosa (N = 32), or mood or anxiety disorder (N = 31), and women with no current psychiatric diagnosis were randomly assigned to exposure to magazine pictures depicting the thin female body ideal or landscape scenes in two experimental phases (leafing through a magazine followed by instructed imagination of a picture from the magazine). The groups were compared on measures of body satisfaction and mood that were collected before and after the two phases.

RESULTS

Leafing through a fashion magazine was not associated with negative effects on body satisfaction or mood in all groups. Imagining the thin ideal resulted in a decrease in body satisfaction and a decrease in positive mood. We found no diagnosis-specific effects indicating no stronger negative impact of the thin ideal on eating-disorder patients.

DISCUSSION

Given the lacking differences between eating-disordered patients and controls, these findings underline the importance of future research to enhance our understanding of what happens when patients are exposed to external or internal stimuli of media images of the thin ideal. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:708-715).

Enhancing inhibitory learning to reduce overeating: Design and rationale of a cue exposure therapy trial in overweight and obese women

The prevalence of overweight and obesity has increased substantially over the last decades. Weight loss attempts in overweight individuals are common, though they seldom result in successful long-term weight loss. One very promising treatment is food cue exposure therapy, during which overweight individuals are repeatedly exposed to food-associated cues (e.g., the sight, smell and taste of high-calorie foods, overeating environments) without eating in order to extinguish cue-elicited appetitive responses to food cues. However, only few studies have tested the effectiveness of cue exposure, especially with regards to weight loss. For exposure treatment of anxiety disorders, it has been proposed that inhibitory learning is critical for exposure to be effective. In this RCT, we translated techniques proposed by Craske et al. (2014) to the appetitive domain and developed a novel cue exposure therapy for overeating aimed at maximizing inhibitory learning. The current RCT tested the effectiveness of this 8-session cue exposure intervention relative to a control intervention in 45 overweight adult (aged 18-60) females at post-treatment and 3-month follow-up, of which 39 participants completed the study. Weight loss, eating psychopathology, food cue reactivity, and snacking behaviour were studied as main treatment outcomes, and mediators and moderators of treatment effects were studied. The presented study design represents an innovative effort to provide valuable clinical recommendations for the treatment of overeating and obesity.

Suicidal ideation in underweight adults who attempt to lose weight: Korea national health and nutrition examination survey, 2007-2012

BACKGROUND

Being underweight has been related to health risks. However, little is known about the relationship between suicidal ideation and attempting to lose weight. This study was conducted to examine if there is an association between suicidal ideation and attempting to lose weight among underweight adults.

METHODS

A cross-sectional study of 1,122 underweight adults (range, 19 to 69 years) was conducted based on the Korea National Health and Nutrition Examination Survey, 2007-2012. We examined suicidal ideation, doctor-diagnosed depression, depressive mood, stress, physical activity, health-related behavior, comorbidity, and socioeconomic status by weight loss attempts. Logistic regression analysis was performed to examine the association between suicidal ideation and weight loss attempts. The following covariates were controlled for: age, sex, physical activity, alcohol problem, marital status, education, income, occupation, self-perception of body image, chronic disease, and body mass index.

RESULTS

There were 101 subjects in the weight loss attempt group and 1,021 in the non-attempt group. The attempt group had a higher risk of suicidal ideation (odds ratio [OR], 2.47; 95% confidence interval [CI], 1.35 to 4.53) and depressive symptoms (OR, 2.17; 95% CI, 1.19 to 3.98). After depressive symptoms were added to the covariates, the risk of suicidal ideation was also significant (OR 2.11, 95% CI: 1.03 to 4.35). The two groups did not significantly differ in doctor-diagnosed depression and stress.

CONCLUSION

Weight loss attempts were associated with suicidal ideation in underweight Korean adults.

Body region dissatisfaction predicts attention to body regions on other women

The proliferation of "idealized" (i.e., very thin and attractive) women in the media has contributed to increasing rates of body dissatisfaction among women. However, it remains relatively unknown how women attend to these images: does dissatisfaction predict greater or lesser attention to these body regions on others? Fifty healthy women (mean age=21.8 years) viewed images of idealized and plus-size models; an eye-tracker recorded visual attention. Participants also completed measures of satisfaction for specific body regions, which were then used as predictors of visual attention to these regions on models. Consistent with an avoidance-type process, lower levels of satisfaction with the two regions of greatest reported concern (mid, lower torso) predicted less attention to these regions; greater satisfaction predicted more attention to these regions. While this visual attention bias may aid in preserving self-esteem when viewing idealized others, it may preclude the opportunity for comparisons that could improve self-esteem.

Do these norms make me look fat? The effect of exposure to others' body preferences on personal body ideals

In this study we examined the influence of normative body ideals in the form of perceived peer preferences on personal body ideals and body dissatisfaction Participants (N=146 female college students) were exposed to the purported preferences of peers representing either relatively thin or heavy body ideals. Along with the normative body ideal manipulation, the gender of the purported peers was manipulated. Participants then selected their ideal for their own body and body dissatisfaction was measured. Women selected a thinner personal body ideal in the thin norm condition than in the heavy norm condition. This effect was seen irrespective of the gender of the purported peers. Body dissatisfaction was not influenced by the manipulation. The malleability of body image and the influence of social factors on ideal body size are discussed.