The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up

Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents

BACKGROUND

Few studies have investigated how the plethora of contemporary social media (SM) platforms relate to, and influence eating disorder (ED) pathology, appearance ideals and pressure to conform to these ideals in youth.

METHODS

In this study, 1558 girls (53%) and boys (47%), predominantly within the 16-19 age range, completed an online questionnaire assessing SM use and perceived influence on appearance, ED pathology, internalization of appearance ideals and perceived appearance pressure.

RESULTS

Results showed that ED pathology was common, particularly in girls, and that internalization of body ideals was gender specific, a thin ideal being more prevalent in girls, and a muscular ideal being more common in boys. Results also showed a strong association between ED pathology and perceived pressure to conform to these appearance ideals. One fourth of the participants reported spending four hours or more on SM daily, and 80% of girls reported that SM, particularly Instagram and TikTok, had a negative influence on how they felt about their appearance. These girls had significantly higher levels of ED pathology and reported higher levels of appearance pressure from the media.

CONCLUSION

A clear pattern of associations between photo- and video specific SM platforms, ED pathology, internalization of body ideals and perceived pressure was found in this study. Adolescent girls appeared to be particularly at risk. The results illustrate an imperative need to keep addressing the potential risks of SM use in adolescents, and to continue monitoring the effect of SM on young people's view of themselves, their appearance, and their eating habits. Future studies should attempt to identify aspects of SM use that may be particularly detrimental for girls and boys in their formative years, but also those that may enhance adolescents' satisfaction and appreciation of their body and appearance.

TRIAL REGISTRATION

The study is registered in the Open Science Framework (Identifier: 10.17605/OSF.IO/5RB6P https://doi.org/10.17605/OSF.IO/5RB6P ).

Positive body image: a qualitative study on the successful experiences of adolescents, teachers and parents

Purpose Body image encompasses body-related self-perceptions and personal attitudes. Dissatisfaction with body image during the early stages of adolescence is negatively related to self-esteem and other health problems. A few publications focused on positive body image and directly related to the experiences and interactions of adolescents themselves. To explore positive body image in adolescents and describe the familial and educational factors that contribute to its development.Methods A qualitative study was conducted. Purposive sampling was used, and 9 adolescents, 6 families, and 8 teachers participated in semi-structured interviews, which were then theme analyzed. Results Self-care, body acceptance, confronting messages that attack body image, and the influence of social media have been identified as emerging themes in adolescents' positive body image experiences. Therefore, the pubertal period, family values, fostering, and educational actions as well as media literacy were identified as factors promoting self-esteem and positive body image in the family and educational environment. Conclusions Their parents also expressed aspects such as those that contribute to the development of healthy self-esteem, confidence, and positive body image. Alternatively, the teachers indicated educational activities to work on self-image and self-esteem when faced with situations of concern in the classroom.

How can we help you? A global investigation into girls' body image experiences in sport and intervention preferences

Existing interventions that target the intersection of girls' body image and sports participation are marginally effective, which is, in part, due to methodological limitations pertaining to intervention development (i.e., not theoretically or stakeholder informed). In this research, girls were consulted on their positive and negative body image experiences in sport and their preferences for fostering and remedying these experiences, respectively, in a new intervention. One-hundred and two girls (11-17-years; n = 91) and youth advisory board members (18-35-years; n = 15) from 13 countries participated in semi-structured focus groups and/or surveys. Template analysis of focus group and survey data resulted in 10 first-level themes and three integrative themes, which highlighted factors that both hinder and help girls' body image while playing sport, as well as girls' intervention preferences and cross-national considerations that will eventually impact the adaptation, localisation, and scaling of the intervention. Overall, girls favoured a girl and woman-only, multimodal intervention that upskilled them in appreciating their bodies, while challenging others' harmful behaviours. Stakeholder insights are crucial in creating acceptable, effective, and scalable interventions. Insights from this consultation phase will inform the development of a new scalable, evidence- and stakeholder-informed intervention that aims to foster girls' positive body image and sports enjoyment.

Impact of School-Based Interventions on Pediatric Obesity: A Systematic Review

Childhood obesity is a global public health problem with significant implications for the health and well-being of children. The prevalence of childhood obesity is increasing every decade, making it a recognized public health concern. This systematic review aims to explore and evaluate the impact of school-based interventions on reducing pediatric obesity among school-aged children. A systematic review of literature according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 was conducted. Google Scholar, PubMed, and Cochrane were the databases used. After screening for bias, inclusion and exclusion criteria, and quality, 27 studies were included in the systematic review, and data were synthesized. The results show that physical activity reduces obesity and improves cardiovascular health. The nutritional change reduces the risk of obesity more than physical activity alone. When blended, the two provide the most benefits for participants. Motivation, self-efficacy, and behavioral change could help maintain the improvements. Schools should adopt a blend of physical activity and nutritional change to reduce prevent, reduce, and manage obesity.

The co-creation, initial piloting, and protocol for a cluster randomised controlled trial of a coach-led positive body image intervention for girls in sport

BACKGROUND

Globally, girls disengage from sports at an earlier age and higher rate than boys. This is, in part, due to the unique body image challenges that girls face, relative to their male peers. Existing intervention efforts that aim to reduce girls' negative body image and movement experiences have proven marginally effective, if not ineffective. This paper outlines the co-creation, initial piloting and protocol for a cluster randomised controlled trial of Body Confident Athletes (BCA); an in-person, coach-led intervention that aims to foster positive body image and sports enjoyment among girls.

METHODS

Following co-creation and an initial pilot, a two-armed cluster randomised controlled trial will assess the immediate (post-intervention) and short-term (1-month and 3-month follow-up) impact of BCA on girls' (N = 1,036; 11-17 years old) body image, sports enjoyment, and affect. Sport organisations will be randomly allocated (1:1) into either an intervention or waitlist control condition. Girls and coaches in the intervention condition will complete three 60-minute sessions over three consecutive weeks. The primary outcome will be the immediate change in girls' body esteem, with secondary outcomes assessing the immediate and short-term changes in girls' body appreciation, self-objectification, attuned self-care, sports enjoyment, and affect.

DISCUSSION

This research is the first to utilise an international multi-stakeholder partnership to co-create and evaluate an intervention that addresses the intersection of girls' body image and sport experiences. The theoretical and methodological considerations of this research have led to a feasible intervention and trial protocol, and if proven effective, BCA may assist in reducing the global gender disparity in sports participation.

TRIAL REGISTRATION NUMBER

NCT05594524 , registered 25^th October 2022.

Expanding the social lens: A quantitative study of the developmental theory of embodiment

The developmental theory of embodiment (DTE) is a research-based theory of social factors that shape the experience of embodiment, a construct that is strongly correlated with body esteem and body appreciation. The DTE is anchored in prospective and retrospective qualitative research studies with cisgender girls and women of diverse backgrounds. This paper describes the first comprehensive quantitative study of factors in the social environment the DTE delineates as shaping the experience of embodiment involving a cross-sectional design, among 412 cisgender women. The 13 quantitative social factors correlated positively with the Experience of Embodiment Scale and accounted together for over 60% of its score variance. The findings of significant positive correlations between all social factors and of a large shared variance amongst these factors in a simultaneous multiple regression predicting the experience of embodiment are in line with the DTE and with a multi-level model of causality central to public health perspectives, whereby social structures and positions, such as those related to gender, shape multiple lower-level protective and risk factors. Future studies of the theory should include prospective designs with samples of varied backgrounds along different dimensions of social location.

Validation of the Body Appreciation Scale-2 in cisgender, heterosexual and sexual and gender minority adolescents and sexuality-related correlates

Body dissatisfaction has received considerable scientific attention, while research about positive body image has been neglected, particularly among adolescents. The aims of the present study were to examine (1) the factor structure of the Body Appreciation Scale-2 (BAS-2) in a large sample of cisgender, heterosexual and sexual and gender minority adolescents, (2) measurement invariance across language, gender and sexual orientation-based groups, (3) convergent validity with sexuality-related outcomes and (4) one-year temporal stability. Results of a confirmatory analysis among 2419 adolescents (M_age=14.6 years, SD=0.62; 52.6% girls) corroborated the proposed one-dimensional factor structure of the scale. The BAS-2 demonstrated adequate reliability and one-year temporal stability. The scale was partially invariant across gender and fully invariant across language and cisgender heterosexual and sexual and gender minority adolescents. Boys (cis and trans) had higher levels of body appreciation than girls (cis and trans), while no significant differences were observed between heterosexual and sexual minority adolescents. The BAS-2 correlated positively with sexual satisfaction and sexual body-esteem as well as negatively with sexual distress. Our findings support the validity and reliability of the BAS-2 in French and English for measuring body appreciation in adolescents.

Intervention in professional dance students to increase mental health- and nutrition literacy: A controlled trial with follow up

Introduction

There is a need to change the culture within the art of dance, as it has been associated with injuries and mental health consequences. This study evaluates an intervention designed to increase mental health literacy, enhance nutritional knowledge, reduce symptoms and effects of low energy availability, and strengthen understanding of sports nutrition and recovery strategies, in dance students of mixed genders.

Material and methods

A total of 125 dance students received three workshops, with 39 arts and crafts students serving as references. The results were evaluated by the Eating Disorder Examination questionnaire, the Low Energy Availability in Females questionnaire, the Hopkins Symptom Check List, and questions on mental health literacy, sports nutrition, and recovery knowledge.

Results

Dance students achieved sustained improvements in mental health and nutrition knowledge and temporary improvements in driven exercise (i.e., performing exercise because of a compulsive drive). No other benefits were identified from the intervention.

Conclusion

Our findings indicate the need for an ongoing education program to reduce the occurrence and development of negative mental health outcomes and low energy availability in professional dance students. Such approaches may not only improve the mental health of dance students but also potentially prevent the high frequency of injuries.

Evaluating the Efficacy of a Social Media-Based Intervention (Warna-Warni Waktu) to Improve Body Image Among Young Indonesian Women: Parallel Randomized Controlled Trial (Preprint)

BACKGROUND

Body dissatisfaction is a global issue, particularly among adolescent girls and young women. Effective body image interventions exist but face barriers to scaling up, particularly in lower- and middle-income countries, such as Indonesia, where a need exists.

OBJECTIVE

We aimed to evaluate the acceptability and efficacy of Warna-Warni Waktu, a social media-based, fictional 6-episode video series with self-guided web-based activities for improving body image among young Indonesian adolescent girls and young women. We hypothesized that Warna-Warni Waktu would increase trait body satisfaction and mood and decrease internalization of appearance ideals and skin shade dissatisfaction relative to the waitlist control condition. We also anticipated improvements in state body satisfaction and mood immediately following each video.

METHODS

We conducted a web-based, 2-arm randomized controlled trial among 2000 adolescent girls and young women, aged 15 to 19 years, recruited via telephone by an Indonesian research agency. Block randomization (1:1 allocation) was performed. Participants and researchers were not concealed from the randomized arm. Participants completed self-report assessments of trait body satisfaction (primary outcome) and the internalization of appearance ideals, mood, and skin shade dissatisfaction at baseline (before randomization), time 2 (1 day after the intervention [T2]), and time 3 (1 month after the intervention [T3]). Participants also completed state body satisfaction and mood measures immediately before and after each video. Data were evaluated using linear mixed models with an intent-to-treat analysis. Intervention adherence was tracked. Acceptability data were collected.

RESULTS

There were 1847 participants. Relative to the control condition (n=923), the intervention group (n=924) showed reduced internalization of appearance ideals at T2 (F_1,1758=40.56, P<.001, partial η²=0.022) and T3 (F_1,1782=54.03, P<.001, partial η²=0.03) and reduced skin shade dissatisfaction at T2 (F_1,1744=8.05, P=.005, partial η²=0.005). Trait body satisfaction improvements occurred in the intervention group at T3 (F_{1, 1781}=9.02, P=.005, partial η²=0.005), which was completely mediated by the internalization change scores between baseline and T2 (indirect effect: β=.03, 95% CI 0.017-0.041; direct effect: β=.03, P=.13), consistent with the Tripartite Influence Model of body dissatisfaction. Trait mood showed no significant effects. Dependent sample t tests (2-tailed) found each video improved state body satisfaction and mood. Cumulative analyses found significant and progressive improvements in pre- and poststate body satisfaction and mood. Intervention adherence was good; participants watched an average of 5.2 (SD 1.66) videos. Acceptability scores were high for understandability, enjoyment, age appropriateness, usefulness, and likelihood to recommend.

CONCLUSIONS

Warna-Warni Waktu is an effective eHealth intervention to reduce body dissatisfaction among Indonesian adolescent girls and young women. Although the effects were small, Warna-Warni Waktu is a scalable, cost-effective alternative to more intense interventions. Initially, dissemination through paid social media advertising will reach thousands of young Indonesian women.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05383807, https://clinicaltrials.gov/ct2/show/NCT05383807 ; ISRCTN Registry ISRCTN35483207, https://www.isrctn.com/ISRCTN35483207.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/33596.

A systematic review of interventions aiming to promote positive body image in children and adolescents

Evidence shows interventions can improve positive body image in adult women. This systematic review examined the evidence of efficacy of interventions that aimed to increase positive body image in children and young people aged under 18 years. The authors followed PRISMA guidelines for the review. Searches of CINAHL Plus, Medline, PsychINFO, Wiley Online Library, SCOPUS and grey literature were conducted up to February 2021 and identified 4171 papers. Thirteen studies evaluating 12 interventions, designed for children/adolescents aged 9-18 years, were eligible and evaluated using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. The studies evaluated body appreciation, body-esteem, and embodiment. Studies using cognitive dissonance, peer support, and psychoeducation had evidence of improving body appreciation and body-esteem in adolescent girls. However, evidence of efficacy for younger children and boys was lacking and the studies ranged in methodological quality. Further research should rigorously evaluate positive body image interventions using second-generation measures that assess specific components of positive body image and consider how to promote positive body image in young children and boys.

Components Related to Long-Term Effects in the Intra- and Interpersonal Domains: A Meta-Analysis of Universal School-Based Interventions

The aims of the present meta-analysis were to (1) examine long-term effects of universal secondary school-based interventions on a broad range of competencies and problems and (2) analyze which intervention components were related to stronger or weaker intervention effects at follow-up. Fifty-four studies of controlled evaluations (283 effect sizes) reporting on 52 unique interventions were included. Long-term intervention effects were significant but small; effect sizes ranged from .08 to .23 in the intrapersonal domain (i.e., subjective psychological functioning) and from .10 to .19 in the interpersonal domain (i.e., social functioning). Intervention components were generally related to effects on specific outcomes. Some components (e.g., group discussions) were even related to both stronger and weaker effects depending on the assessed outcome. Moreover, components associated with long-term effects differed from those associated with short-term effects. Our findings underscore the importance of carefully selecting components to foster long-term development on specific outcomes.

PROSPERO registration number: CRD42019137981.

The Healthy Body Image Intervention and Reduction in Eating Disorder Symptomatology and Muscle Building Supplement Use in High School Students: A Study of Mediating Factors

Background

Mediation analysis is important to test the theoretical framework underpinning an intervention. We therefore aimed to investigate if the healthy body image (HBI) intervention's effect on eating disorder (ED) symptomatology and use of muscle building supplements was mediated by the change in risk and protective factors for ED development and muscle building supplement use.

Methods

This study used data from the HBI intervention: a cluster randomized controlled universal intervention aiming to promote positive body image and embodiment and reduce the risk for ED development including 30 schools in Norway. A total of 1,713 (37% boys) participants were included in the analyses. Conditional latent growth curve analyses were performed to test for indirect effects on ED symptomatology and weekly frequency of protein and creatine supplement use measured at the 12-month follow-up via change in the proposed mediators.

Results

In girls, the reduction in ED symptomatology was mediated by positive changes in protective factors (self-esteem and body image flexibility) and reductions in risk factor scores (perceived media pressure and thin appearance internalization). Comparable changes in protective and risk factors among boys played no mediating role.

Conclusion

Interventions aiming to reduce the risk of ED development in girls may benefit from aiming to enhance self-esteem and body image flexibility and reduce perceived media pressure and thin appearance internalization. Future studies should investigate the casual relationship between muscle building supplement use and risk and protective factors for ED development in both girls and boys.

Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students

PURPOSE

The aim of this study was to test the effectiveness of an 8-week classroom education and mindfulness-based physical activity intervention for the promotion of positive body image in female students.

METHODS

A quasi-experimental study was carried out with 110 Lithuanian female students (mean age 21.5 ± 3.5, range 19-35 years). Thirty students voluntarily participated in the intervention programme and 80 students volunteered in the assessment-only control group. The intervention comprised five cognitive behavioural therapy classroom education sessions and mindfulness-based exercise (one exercise workout per week). The intervention group was evaluated with a pre-test and post-test and the control group completed measures at parallel times.

RESULTS

Compared with the control group participants, the intervention group participants reported greater improvements in positive body image and a reduction in body dissatisfaction and drive for thinness and internalisation of stereotyped beauty ideals, with medium to large effects. There were significant time × group interactions for pre-test to post-test changes in internalisation of beauty ideals, body area satisfaction, body dissatisfaction and body appreciation. In all cases, the interaction reflected greater pre-test to post-test changes in the intervention group compared with the control group, whose scores remained stable. A decrease in appearance orientation, overweight preoccupation, disordered eating and physical activity was observed in the control group, but the effect sizes were low.

CONCLUSION

The preliminary findings of this study support the efficacy of cognitive behavioural therapy methods and mindfulness-based exercise intervention aimed to promote positive body image in student-aged women. Future studies should test the efficacy of the introduced programme in larger randomised samples of young women.

LEVEL IV

Evidence obtained from multiple time series with or without an intervention.

Disordered eating through the lens of positive psychology: The role of embodiment, self-esteem and identity coherence

Applying a positive psychology perspective, this study aimed to identify potential intra-individual factors that might protect against the development of disordered eating in a community sample of young women and men (N = 510; 56 % women; M_age = 24.3). Based on existing literature, the study included the general resilience factors of self-esteem and identity coherence as well as two dimensions of positive embodiment (positive body connection and comfort, and agency and functionality). All factors were negatively correlated with disordered eating among women and men. Hierarchical regression analyses indicated that positive embodiment, specifically positive body connection, was a significant predictor of lower degrees of disordered eating symptoms in both women and men, followed by self-esteem. The overall prediction model accounted for 42.6 % in the variation of disordered eating symptoms for women and 23.9 % for men. Prevention and treatment interventions promoting health factors that protect against the development of eating disorders are much needed. The present study informs such efforts by emphasizing the promotion of positive embodiment.

Translation and psychometric evaluation of the Experience of Embodiment Scale in a Swedish community sample of young women and men

This report describes a Swedish translation and psychometric evaluation of the Experience of Embodiment Scale (EES; Piran, Teall, & Counsell, 2020), an instrument for assessing a wide range of positive and negative experiences of living in the body. A community sample (N = 545) of Swedish young women (56%) and men (M_age = 24.4; SD = 0.52) completed the Swedish translation of the EES. To explore its construct validity, participants also completed measures of body esteem, disordered eating, internalization of appearance ideals, drive for muscularity and leanness, body mass index, life satisfaction, self-esteem, and psychological distress. Exploratory factor analyses (performed separately for women and men) revealed structures of the Swedish EES similar to those displayed during the development and first evaluations of the scale in North America. However, among men, the factors of agency and sexual desire combined to form one factor. On total scale level, the Swedish EES showed good internal consistency (McDonald's ω = .95 for women; ω = .94 for men), convergent validity, and incremental validity. Overall, the present findings support the Swedish version of the EES and the EES's cross-national use to assess the construct of embodiment, as well as its use among men.

[The Effects of Programs on Body-Image Improvement in Adolescents: A Systematic Review and Meta-Analysis]

PURPOSE

This study's objective was to investigate the effects of programs that improve adolescents' body image, using a systematic review and meta-analysis.

METHODS

A literature search was performed in eleven electronic databases, using preferred reporting items for systematic reviews and meta-analysis guidelines. Population characteristics, contents of the programs, and measured outcomes were systematically reviewed from 21 selected studies. To estimate the size of the effects, meta-analysis was conducted using Comprehensive Meta-Analysis software.

RESULTS

The contents of the programs that aimed to improve body image included physical, psychological, interpersonal, and sociocultural interventions. Sixteen studies were meta-analyzed to estimate the effect size of body-image improvement programs. Results showed that the program for body-image improvement had significant effects on body satisfaction (effect size [ES] = 0.56, 95% confidence interval [CI] = 0.23 to 0.89), and body dissatisfaction (ES = - 0.15, 95% CI = - 0.23 to - 0.08).

CONCLUSION

The program for body image improvement in adolescents includes a combination of physical, psychological, interpersonal relationship, and socio-cultural dimensions. The program that seeks to improve body image appears to be effective at increasing body satisfaction, and at reducing body dissatisfaction in adolescents. Thus, it is necessary to develop and apply multidimensional programs for adolescents to have a positive body image.

The influence of physical exercise on college students' mental health and social adaptability from the cognitive perspective

BACKGROUND

the relationship between physical exercise (PE) and mental health (MH) had been an important research topic in exercise psychology. With the development of society, the increasingly fierce social competition had put forward higher and higher requirements for college students' social adaptability (SA). As members of the new era, college students were expected to not only have innovative knowledge concept, solid knowledge foundation, and healthy psychology, but also have the ability to adapt to the changes in the environment, know how to get along with others, and deal with problems alone.

OBJECTIVE

this study aimed to evaluate the PE, MH, and SA of college students, and to analyze the internal relationships among PE, MH, and SA.

METHODS

based on questionnaire survey, college students were randomly selected for investigation and the data were statistically processed.

RESULTS

there were significant differences in the MH of students of different genders, majors, grades, and origins. There was a significant difference between the amount of exercise and the MH of college students. The amount of exercise was positively correlated with the MH level of college students, and there was also a positive correlation between PE and MH. The SA of the physical exercisers was average, but the SA of the non-physical exercisers was poor. There was a significant difference between the SA of the physical exercisers and the non-physical exercisers. There were significant differences in the SA between physical exercisers and non-physical exercisers of different genders, majors, grades, and origins. Physical exercisers who participated in team sports were more socially adaptable. There was no significant difference in the SA of physical exercisers of different genders, majors, and origins, and the SA of senior students was stronger.

CONCLUSIONS

PE had a positive effect on college students' MH and social adaptation ability. Colleges and universities could improve their MH and social adaptation ability by arranging appropriate PE.

The Meaning and Factors That Influence the Concept of Body Image: Systematic Review and Meta-Ethnography from the Perspectives of Adolescents

Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among adolescents. This study aimed to understand the meanings and factors that influence the concept of body image through a systematic review and meta-ethnography of qualitative studies from the perspective of adolescents. Ten studies published from 2009–2019 were identified by a search of relevant systematic databases between September and December 2019. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument. The synthesis revealed six themes: self-perception of body image; opinions of friends and colleagues; opinions of family; specific features of the school environment; expectations perceived across the mass-media; and strategies, practices, and self-management of body image. An explanatory model was developed that showed adolescents’ development of body image and the path towards its establishment. In conclusion, these results should be considered to implement strategies to promote a healthy body image in adolescents by community health and mental health nurses.

Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = -0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = -0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = -1.59, p < 0.001) and low (β = -1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

Embodiment: Cultural and gender differences and associations with life satisfaction

Although cultural factors have an important impact on individuals' experiences of living in their bodies, to date no studies have examined cross-cultural or gender differences in individuals' experience of embodiment. This study compared Swedish and Canadian women's experience of embodiment (and other body image related constructs), as well as Swedish men and women's experience of embodiment. Associations between embodiment, body esteem, and life satisfaction in men and women were also examined. Participants were 302 Swedish women, 242 Swedish men, and 216 Canadian women. Results showed that Swedish women had overall more positive experience of embodiment, more positive body esteem, lower thin-ideal internalization and lower levels of disordered eating than Canadian women. In comparison to Swedish men, however, Swedish women had more negative experience of embodiment in some ways, but similar experience of embodiment in other ways. Although associations between embodiment, body esteem, and life satisfaction were strong, embodiment was a better predictor of life satisfaction than body esteem for both men and women. Results are interpreted through the lens of the developmental theory of embodiment and consider cultural differences between Sweden and Canada, as well as Swedish society's both progress and problems in promoting gender equity.

The Norwegian healthy body image intervention promotes positive embodiment through improved self-esteem

We examined both direct and indirect effects of the Healthy Body Image (HBI) intervention on positive embodiment among Norwegian high school students. In total, 2446 12th grade boys (43 %) and girls (mean age 16.8 years) from 30 schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. We tested mediation models using path analysis and found that among several hypothesized mediators, only self-esteem mediated a positive intervention effect on positive embodiment for both boys and girls. A direct effect of the intervention on positive embodiment was only found in girls. The study provides novel findings indicating that health promotion interventions to address a positive embodiment should focus on enhancing adolescent's self-esteem. Serial mediation modeling might reveal more complex explanations of change mechanisms and could further evolve current knowledge.

The experience of embodiment scale: Development and psychometric evaluation

The construct of embodiment captures a broad range of experiences of living in the body. The present program of research involved developing and evaluating a fully structured measure of the experience of embodiment construct, the Experience of Embodiment Scale (EES), via four independent samples of women. Study 1 (N = 92) provided initial support for the internal consistency and convergent validity of the EES. Study 2 (N = 412) involved factor analyses of the EES, leading to the emergence of 6 factors, reflecting different aspects of the experience of embodiment. Further, this study supported the internal consistency of the EES and its subscales, as well as its construct and discriminant validity. As expected, the EES correlated with measures of body- and self-esteem, body connection, sexual assertiveness, among other measures, and did not correlate with the Perfectionism Personal Standards Scale. Study 3 (N = 348) confirmed the factor structure of the scale from Study 2. Study 4 (N = 76) demonstrated that EES scores were stable over a 3-week period. The EES can be used by researchers and clinicians interested in capturing individuals' range of experiences of living in their bodies, both positive and negative.

Adolescent body image: influencing factors and the clinician's role

PURPOSE OF REVIEW

Body image is a crucial part of adolescent development for teens all over the world. Studies show that negative body image impacts many aspects of adolescent health and that anticipatory guidance about body image is important at the annual health maintenance exam visit. Weight bias is closely tied to body image and is associated with negative health effects as well; research shows weight bias is a problem throughout healthcare. The purpose of this review is to discuss influencing factors on adolescent body image and to explore interventions to promote positive body image.

RECENT FINDINGS

Research shows that adolescent body image is shaped by media influence, athletics and personal relationships. Studies have also begun to show that negative and positive body image are separate entities, and that overall health outcomes seem to be better in adolescents with positive body image. In thinking about intervention, there are ways to promote positive body image in the provider--patient interaction, within the school and community, in healthcare education, and at the societal level.

SUMMARY

Body image is an incredibly important aspect of adolescent health, and clinicians should be aware of ways to help promote positive body image in adolescents.

Yoga and the experience of embodiment: a discussion of possible links

The impact of yoga on body image and embodiment has been a recent area of focus in the field of body image and eating disorders. This paper comprises a theoretical discussion of how the practice of yoga can lead to positive ways of inhabiting the body, specifically through the lens of the Developmental Theory of Embodiment. Yoga may enhance the overall experience of embodiment, by having a positive impact on each of its five dimensions: body connection and comfort, agency and functionality, attuned self-care, subjective immersion (resisting objectification), and experience and expression of desires. The article therefore describes examples of teacher-related practices during yoga that can enhance each of these dimensions. Further, yoga teachers can consider the varied protective physical and social factors delineated by the Developmental Theory of Embodiment to facilitate positive embodiment. Future research should explicitly integrate embodiment theory with yoga interventions, as well as measures that assess both possible mechanisms of change and positive ways of living in the body.

Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents

Objectives Body image is widely related to behavioral factors in adolescents and negative levels has been associated to poor physical and mental health. This study analyzed the association of physical activity and sedentary behavior with body dissatisfaction in adolescents. Methods Data from 15,632 adolescents between 11 and 17 years from the Brazilian National Scholar Health Survey - PeNSE 2015 were analyzed. Body dissatisfaction was self-reported. Sedentary behavior was assessed by hours in television (TV) viewing and in overall sitting behaviors. Physical activity was assessed by amount of time in domains of active commuting, physical education classes at school, and physical activities outside the school. Analyses were adjusted by age, ethnicity, body mass index, and scholarity of mother. Results Body dissatisfaction prevalence was 18.5%, being higher in girls than boys (24.2 vs. 12.7%, p < 0.001). Female gender (OR = 2.35), higher age-group (OR = 1.64), high scholarity of mother (OR = 1.43), and had overweight/obesity (OR = 2.38/4.81) were positively related to body dissatisfaction. Higher sedentary time was associated with body dissatisfaction in adolescents when compared to less than 2 h/day of sedentary time (OR varying from 1.45 to 2.14). Physical activity was negatively associated with adolescent body dissatisfaction in all assessed domains, with odds ratio varying from 0.66 to 0.89. Conclusions Body dissatisfaction showed an independent association of with total sedentary behavior (positively) and with different domains of physical activity (negatively) in a large scholar sample of Brazilian adolescents.

Assessing the measurement invariance of a Latin-American Spanish translation of the Body Appreciation Scale-2 in Mexican, Argentinean, and Colombian adolescents

In order to advance in the study of positive body image among different cultures, it is important to create culturally appropriate measures. We examined the psychometric properties of a Latin-American Spanish translation of the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a), specifically assessing measurement invariance using a large sample of 3845 male and female adolescents from Argentina, Mexico, and Colombia. Participants completed the BAS-2, Eating Disorder Inventory-2, Male Body Attitude Scale and the Sociocultural Attitudes Toward Appearance Questionnaire-3. The BAS-2 had a unidimensional factor structure in each of the three samples. We confirmed the structural, metric, and scalar invariance of the scale regardless of gender or country. Adolescents in Argentina had lower body appreciation compared with those in Mexico and Colombia. Overall, females had lower body appreciation than males, with the greatest gender difference found in the Argentinean sample. Our findings strongly support the validity and reliability of this Latin-American translation of the BAS-2 in measuring positive body image in adolescents in Argentina, Mexico, and Colombia.

Does the Healthy Body Image program improve lifestyle habits among high school students? A randomized controlled trial with 12-month follow-up

Objectives

Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits.

Methods

The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models.

Results

The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days.

Conclusions

In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents.

Trial registration: ClinicalTrials.gov ID: PRSNCT02901457. Approved by the Regional Committee for Medical and Health Research Ethics.