Hourglass Body Shape Ideal Scale and disordered eating

The relationship between racial/ethnic identification and body ideal internalization, hair satisfaction, and skin tone satisfaction in black and black/white biracial women

Eurocentric physical characteristics, including a thin, tall physique, long straight hair, and fair skin, typify Western beauty standards. Past research indicates that for Black women, greater identification with one's racial/ethnic culture may buffer against internalizing Eurocentric beauty standards, specifically the thin ideal. Black/White Biracial women often experience different appearance pressures from each of their racial identity's sociocultural appearance ideals. Unfortunately, body image research is limited among Bi/Multiracial individuals. Participants were recruited online via Prime Panels, a high-quality data recruitment service provided by CloudResearch. Participants, M(SD)Age= 34.64 (12.85), self-reported their racial/ethnic identification, thin and thick/curvy ideal internalization, and hair and skin tone satisfaction. Using linear regression analyses, we assessed whether racial/ethnic identification buffered against monoracial Black (n = 317) and Black/White Biracial (n = 254) women's thin ideal internalization. Additionally, we assessed whether stronger racial/ethnic identity was associated with stronger thick/curvy ideal internalization and hair and skin tone satisfaction. Supporting hypotheses, greater racial/ethnic identification was associated with higher thick/curvy ideal internalization and hair and skin tone satisfaction among both Black and Biracial women. Contrary to hypotheses, greater racial/ethnic identification was not associated with lower thin ideal internalization in either group. Our results stress the need to use racially and culturally sensitive measurements of body image.

The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice

White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.

Intersecting gender identity and racial/ethnic inequities in eating disorder risk factors, symptoms, and diagnosis among U.S. college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

INTRODUCTION

There are documented inequities in eating disorders (EDs) by gender and race/ethnicity, yet, little is known about population-level prevalence of ED risk factors, symptoms, and diagnosis at the intersection of diverse gender and racial/ethnic identities.

METHODS

Data from the Healthy Minds Study 2015-2019 (N = 251,310 U.S. university students) were used in a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Participants were nested in 35 intersectional strata given by all combinations of 5 gender and 7 racial/ethnic categories. Multilevel logistic models with participants at level 1 and intersectional strata at level 2 were used to estimate stratum-specific predicted prevalence estimates for self-reported thin-ideal internalization, ED symptoms, and ED diagnosis. The variance partition coefficient (VPC) was calculated to quantify the contextual effect of the strata.

RESULTS

There was considerable heterogeneity in the predicted prevalence of our ED outcomes across the strata (e.g., .3%-18.3% for ED diagnoses). There were large disparities in all three outcomes, with transgender participants of color having a higher predicted prevalence than expected based on the additive effects of gender and race/ethnicity. Moderation by race/ethnicity was also apparent, such that racial/ethnic disparities were wider within the cisgender groups relative to the transgender groups. VPCs indicated that ~10% of the total variance in ED outcomes was due to intersectionality between gender and race/ethnicity, over and above variance due to individual-level differences.

CONCLUSION

Findings suggest that gender and racial/ethnic disparities in EDs are interrelated, underscoring the need to develop preventive interventions centering health equity.

PUBLIC SIGNIFICANCE

Despite evidence that sexism, racism, and cissexism (i.e., anti-transgender prejudice) can impact EDs risk, little research examines the social patterning of EDs at the intersection of diverse gender and racial/ethnic identities. Using data from a sample of 250,000 U.S. university students, this study found that gender and racial/ethnic disparities in eating disorder risk are interrelated, highlighting the need to develop health equity centered preventive interventions.

Cultural adaptation of an integrated eating disorders prevention and healthy weight management program

BACKGROUND

Both eating disorder (ED) prevention and weight management interventions often focus on the thin ideal. Yet, many Black and Latina women do not view thinness as their body ideal. This study used focus groups to investigate the influence of race, ethnicity, and culture on appearance ideals and inform the cultural adaptation and integration of two established programs addressing EDs and weight management: the Body Project, and Healthy Weight Interventions.

METHODS

White (n = 10), Black (n = 14), and Latina (n = 6) women participated in racially and ethnically homogenous focus groups.

RESULTS

Thematic analysis identified several themes, including: (1) diverse beauty standards across groups, (2) lack of acknowledgement of racialized beauty standards in prevention and cultural appropriation, (3) culturally-specific impacts of standards, (4) harm of appearance-related comments, (5) limitations of available resources, (6) stigma/minimization of mental health, (7) barriers to inclusive programming, and (8) facilitators of inclusive programming.

CONCLUSIONS

Results suggested that current programs' emphasis on thinness limit their relevance for women of color, and perpetuate the misconception that EDs primarily affect White women. Findings highlight the need for culturally responsive prevention.

Resistance and empowerment against racism: A preregistered study of associations with body appreciation and body acceptance by others in racialised minority adults in the United Kingdom

Research on body image and racism has largely focused on how individual experiences of racism are associated with detrimental body image outcomes. However, research has not yet examined how resistance and empowerment against racism (REAR) - a repertoire of proactive strategies aimed at preventing or challenging racism both at the individual and collective levels - shape positive body image outcomes. Here, 236 women and 233 men who identified as belonging to racialised minority groups in the United Kingdom completed the REAR Scale - which measures REAR along four dimensions - as well as measures of body appreciation and body acceptance by others. Correlational analyses indicated significant inter-correlations between nearly all REAR domains and body image-related variables in men, whereas relationships in women were largely non-significant. Linear model analyses indicated that greater leadership for resistance against racism was significantly associated with higher body appreciation in women and men. Greater interpersonal confrontation of racism was significantly associated with both body appreciation and body acceptance by others in men, but not in women. These results suggest that REAR may play a role in shaping body image-related outcomes in people of colour, but that these effects are also be shaped by the intersection of gender and race.

Through Thick and Thin: Exposure to Instagram Advertisements and Willingness to Engage in Appearance-Altering Practices

Instagram is increasingly used in advertising, yet little is known about the unintended consequences of Instagram advertising on women's and girls' body image. Also largely unexplored is if and how curvy models (large breasts and buttocks, wide hips, and small waist) used in this advertising affect women's and girls' body image. We drew on social comparison and cultivation theories to explore if exposure to thin and curvy models through Instagram advertising is associated with late-adolescent girls' willingness to take action to be thinner or curvier, respectively. Two mediation models examined the mechanisms through which any such effects occur. A sample of 284 17-19 year old girls completed self-administered online questionnaires. Results revealed that exposure to thin and curvy models was positively associated with willingness to take action to be thinner and curvier, respectively. These associations were mediated by thin/curvy body preference (model 1), and by thin/curvy body preference, upward physical appearance comparisons, and body dissatisfaction (model 2). Results suggest that although exposure to different body types may be associated with different types of unhealthy (body-altering) actions, the processes underlying these effects are similar. This research highlights possible cultural shifts toward more diverse body ideals and informs tailored body concern interventions and media literacy programs.

Do Weight Perception Transitions in Adolescence Predict Concurrent and Long-Term Disordered Eating Behaviors?

PURPOSE

Perceiving one's weight as "overweight" is associated with disordered eating in adolescence. Yet, it is unknown whether weight perceptions change during adolescence, or whether these weight perception transitions predict disordered eating. This study aims to: (1) characterize weight perception transitions from early to late adolescence among a population-based sample and (2) examine whether weight perception transitions in adolescence predict concurrent and future disordered eating into young adulthood.

METHODS

Eating and Activity in Teens and Young Adults (N = 1,414) survey data were used to examine correlates of weight perception transitions from early (Mage = 14.9 ± 1.6 years) to late adolescence (Mage = 19.4 ± 1.6 years). Adjusted generalized estimating equations were used to determine whether weight perception transitions in adolescence predicted concurrent and future disordered eating in emerging adulthood (Mage = 25.2 ± 1.6 years) and young adulthood (Mage = 31.0 ± 1.6 years).

RESULTS

Weight perceptions were stable from early to late adolescence for 77.2% of adolescents, whereas 15.5% transitioned to perceiving their weight as "overweight" and 7.3% stopped perceiving "overweight" in late adolescence. Perceived "overweight", especially in late adolescence, was associated with higher concurrent and long-term disordered eating up to 10 years later. For example, the predicted prevalence of binge eating in young adulthood among individuals who perceived their weight as "overweight" throughout adolescence was 20.1% compared to 6.6% for those who never perceived their weight as "overweight" in adolescence.

DISCUSSION

Adolescent weight perception was relatively stable in this population-based sample. However, weight perception transitions that involved perceiving "overweight", particularly in late adolescence, were associated with long-term higher risk of disordered eating.

Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents

Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).

Measuring positive breast experience: Development and psychometric evaluation of the Breast Appreciation Scale (BrAS)

Existing measures of women's breasted experiences have focused on negative experiences, which de-centres women's meaning-making and relationships with their breasts. To rectify this, we developed a novel measure of women's positive breasted experiences, the Breast Appreciation Scale (BrAS), and examined the psychometric properties of this novel measure across four studies. Study 1, with 307 United Kingdom women, led to the extraction of a 9-item, unidimensional model of BrAS scores that showed adequate composite reliability and 4-week test-retest reliability. Study 2, with 297 United Kingdom women, showed that the unidimensional model of BrAS scores had adequate fit and evidenced convergent, concurrent, discriminant, and incremental validity. Study 3, with 295 women from the United Kingdom, provided additional support for factorial validity and concurrent validity, and additionally provided evidence of known-groups validity insofar as mothers had greater breast appreciation than non-mothers. Study 4 showed that the BrAS was scalar invariant across women from Australia, the United Kingdom, and the United States (N = 573) and provided additional evidence of concurrent validity. Based on these results, we conclude that the BrAS is a psychometrically valid measure of women's positive breasted experiences that can be utilised in future research.

Development and validation of a measure of curvy ideals internalization

Several sociocultural female body ideals exist - thin, muscular/athletic, and, more recently, curvier ideals, which research specifically suggests are more prevalent among Black women. Two validated measures assess women's desire for curvier bodies, but neither assess certain facets of curvy ideals (e.g., thick vs. slim-thick) separately. We developed and validated the Curvy Ideals Internalization (CII) Scale, to be used alone or alongside existing measures of appearance ideal internalization. Focus groups among racially/ethnically diverse women informed initial items. A sample of 897 White (37.1%), Black (34.2%), and biracial Black and White (28.7%) U.S. women completed the initial 37-item CII to determine factor structure, narrow the item pool, and examine validity and reliability. A separate sample (N = 366) of U.S. Black, White, and biracial women completed the CII to confirm the factor structure. The final CII has eleven items, with factors assessing thick/curvy ideal internalization and facets of slim-thick ideal internalization: thin waist and large breast size. The CII has adequate internal consistency, test-retest reliability, construct validity, and factorial validity. The CII is appropriate for use among Black, White, and biracial women to assess internalization of curvier body ideals and needs to be validated in more diverse samples.

Prospective relationships between skin color satisfaction, body satisfaction, and binge eating in Black girls

Although it has been demonstrated that (a) body dissatisfaction and internalization of societal appearance standards contribute to disordered eating and (b) that internalization of societal appearance standards leads to decreased skin color satisfaction among Black women, it has not been established whether skin color dissatisfaction contributes to disordered eating among Black women or girls. The objective of the present study is to determine the influence of skin color satisfaction as a potential predictor for binge eating, and its effect through body image in Black girls during the vulnerable developmental period of adolescence. Using data from ten annual measurements in 1213 Black girls across ages 10-19, we sought to determine whether skin color satisfaction predicts Binge Eating Disorder (BED) risk and symptoms using pre-registered logistic and multilevel models. We found that lower skin color satisfaction at ages 13 and 14 significantly predicted greater odds of BED and lower skin color satisfaction at all ages predicted greater BED symptoms. Body satisfaction mediated the relationship between skin color satisfaction and BED symptoms. Our results suggest that skin color dissatisfaction is a novel component of body image for Black girls that is also related to binge eating.

A complex conceptualization of beauty in Latinx women: A mixed methods study

Latinx women face a myriad of unique pressures to meet unrealistic standards of beauty that are not captured in the dominant, Eurocentric framework of beauty and body image in the U.S. The majority of the extant body image literature represents the experiences of White women and overlooks salient body areas that women of color may experience dissatisfaction with. The present researchers employed a convergent-parallel mixed methods design to examine demographic differences as well as the lived experiences of Latinx women's relationship with beauty and their bodies. Quantitative results from 118 participants revealed that Latinx women with an annual income< 60k (54.2%) reported a higher discrepancy between their actual and ideal buttock size compared to Latinx women with an annual income> 60k (45.8%). Furthermore, a thematic analysis revealed four emergent themes that reflected the unique perceptions and lived experiences of 98 Latinx women's experiences with body image. Findings may assist clinicians working with Latinx women, as they will be able to better understand and integrate relevant cultural aspects of body dissatisfaction when working with Latinx clients.

Body image and internalization of appearance ideals in Black women: An update and call for culturally-sensitive research

Extant research on body image supports sociocultural theories emphasizing the internalization of societal pressures to attain the thin-ideal, as well as other White or Eurocentric ideals that are predominant in mainstream media. While earlier research suggests that Black women are less likely to report body dissatisfaction and thin-ideal internalization compared to women of other racial backgrounds, recent studies argue that most measures of body image and appearance ideals may not be accurate assessments of body dissatisfaction for this population. In this paper, we summarize the literature over the past two decades on body image and appearance ideals among cisgender Black girls and women and discuss the applications of well-established sociocultural theories of body dissatisfaction. We additionally highlight existing gaps in culturally-sensitive theory and assessment tools and consider the benefits of applying intersectionality-informed research. We lastly propose future directions in research, assessment, and intervention to develop more culturally-sensitive approaches to identifying, assessing, and addressing body dissatisfaction among Black girls and women. This paper encourages researchers to apply culturally-sensitive and intersectionality-informed theory to improve efforts in assessing early warning signs of body dissatisfaction and developing effective interventions for this population.