Body Image in the Context of Eating Disorders

Self-Perceived Oral Health Related to Eating Disorders-A Cross-Sectional Questionnaire Study

OBJECTIVES

To investigate oral problems experienced by patients with eating disorder (ED).

METHODS

A cross-sectional study where ED patients (n = 48) at two Swedish specialised clinics filled out a questionnaire about perceived oral health problems and habits, and specific behaviours related to ED.

RESULTS

The majority exhibited poor eating and drinking habits, f.i. drinking light drinks (63%), and most of them were on medication (71%). The most common problems were hypersensitive teeth (three out of five) and perceived dryness of the mouth (almost four out of five). Likewise, pain in the teeth (38%) and the jaws (46%) was frequent. About one-third had been binge eating and/or vomiting in recent weeks and these behaviours were associated with pain in the teeth and snacking. Almost two out of three participants were concerned about informing their dentist or dental hygienist about their vomiting.

CONCLUSIONS

The ED patients in this study experienced oral problems and exhibited many risk behaviours regarding oral health. Both dental staff and ED staff who meet ED patients should be aware of the risk of oral health problems and preventive measures should be taken.

Preliminary associations of body weight, weight bias, and dietary restriction with eating disorder diagnosis in women experiencing food insecurity

Understanding the co-occurrence of food insecurity and eating disorders is a pressing concern. Several factors have been hypothesized to increase risk for eating disorders in women with food insecurity including dietary restriction, body weight, and weight-related bias, but few studies have tested these factors simultaneously to determine which are associated most strongly with eating disorder status. We tested cross-sectional associations of dietary restriction, current body mass index (BMI), weight suppression (i.e. the difference between current weight and highest weight), and weight bias with eating disorder diagnosis in a sample of 99 self-identified women with current food insecurity (54% White; mean [SD] age = 40.26 [14.33] years). Participants completed two virtual study visits consisting of electronic questionnaires and interviews. A binary logistic regression model was conducted to test relations between the hypothesized correlates and eating disorder diagnostic status in the past 12 months, controlling for age, food insecurity severity, and body dissatisfaction. Higher levels of weight suppression and weight bias, but not current BMI, were significantly associated with the presence of an eating disorder. Contrary to our hypothesis, greater dietary restriction was associated with lower likelihood of eating disorder diagnosis. Results suggest high levels of weight bias and weight suppression characterize women with food insecurity who meet criteria for an eating disorder. Women who experience food insecurity and have lost a relatively great deal of weight and/or hold biases about high weight should be screened for eating pathology in clinical settings.

The Relationship Between Body Image Dissatisfaction, Psychopathological Symptoms, Social Comparisons With Peers and Celebrities, and Self-Compassion in Men

This study aimed to further understand body image among men by examining differences in body dissatisfaction and physical appearance-related comparisons with peers and celebrities, self-compassion, depressive and anxiety symptoms, and explore the relationship between male body image dissatisfaction, self-compassion, and depressive symptoms. The sample comprised 220 Portuguese men aged 18-66 years old, mostly single (78.2%) and with a mean Body Mass Index (BMI) of 24.81. Participants completed online measures assessing depressive and anxiety symptoms, male body dissatisfaction, self-compassion, and social comparison disseminated through social media and online forums. No significant differences were found between the BMI groups regarding anxiety, depression, and self-compassion. Underweight and typical weight groups revealed significantly less male body dissatisfaction (body fat dimension). Participants in the obesity group revealed less positive social comparisons with peers and celebrities. Regression results showed that age, years of education, the muscularity dimension of the male body dissatisfaction, and self-compassion were significant predictors, accounting for 26% of depressive symptoms. Cultivating self-compassionate skills may be helpful for dealing with muscularity dissatisfaction, thus leading to less depressive symptoms.

Eating disorder risks and psychopathological distress in Italian high school adolescents

BACKGROUND

Psychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population.

METHODS

A sample of high school adolescents was enrolled, and demographic and clinical data were collected. Two self-report questionnaires, the Eating Disorder Inventory-3 (EDI-3) and the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD), were administered.

RESULTS

548 adolescents (333 F/215 M; 16.89 ± 0.85 years) were included. Symptoms associated with EDs of clinical or high clinical concern were prevalent in a range of individuals, with percentages varying from 26.82% for body dissatisfaction to 51.83% for Interoceptive Deficits. The findings from the Q-PAD assessment indicated the presence of psychological distress, leading to discomfort or challenging situations requiring potential intervention in a percentage of adolescents ranging from 2.93% for psychosocial risks to 23.77% for anxiety. These percentages showed differences between genders (F > M, p < 0.001). Our study also highlighted an association between symptoms of EDs and lifestyle factors within families. We observed correlations between Q-PAD measures and EDI-3 scores, including a positive correlation between Q-PAD and EDI-3 body dissatisfaction (r = 0.7), Q-PAD interpersonal conflicts and EDI-3 interpersonal problems (r = 0.6) and a negative correlation between Q-PAD self-esteem and well-being and EDI-3 ineffectiveness Composite (r=-0.7).

CONCLUSIONS

a substantial prevalence of ED symptoms and psychological distress among high school adolescents were recorded. These conditions are interrelated, suggesting the importance of addressing them comprehensively. Early detection is essential to improve treatment outcomes and to implement preventive strategies.

Emotional Distress and Body Dissatisfaction: The Mediating Role of Social Media and Emotional Regulation

BACKGROUND

Body dissatisfaction is defined as a negative attitude towards one's body, characterized by emotional disorders. Currently, problematic use of social media seems to be associated with an increase in body dissatisfaction and emotional distress. Therefore, the present study examined the relationship between emotional distress (i.e., depression, anxiety, and stress) and body dissatisfaction, as well as the mediating role of emotional regulation and problematic social media use in this relationship. In addition, the study aims to identify sex differences in the four research variables.

METHODS

Measures of the four variables mentioned above were administered to 2520 participants over 18 (M = 48.35; SD = 16.56, 51% females).

RESULTS

The results reveal that women reported higher levels of emotional regulation, emotional distress, body dissatisfaction, and problematic use of social media. Emotional distress correlated with problematic use of social media, emotion regulation strategies (i.e., rumination and catastrophizing), and body dissatisfaction. The relationship between emotional distress and body dissatisfaction was mediated by the problematic use of social media and emotional regulation.

CONCLUSIONS

These findings underscore the relevance of educating social media users on strategies for emotional regulation. The results highlight the clinical importance of including the emotion regulation approach to a comprehensive understanding of body dissatisfaction.

Personal ideal, cultural ideal and optimal attractiveness: Are these constructs for body size and shape the same or different?

There has been an assumption in the literature that the three concepts of ideal body shape (personal ideal, cultural ideal, and the most attractive body shape) are effectively the same percept. To test this presumption, 554 participants completed either a between- or within-subjects condition using a matrix of 32 bodies varying in two dimensions: muscle and adiposity. Three separate groups of participants were recruited to the between-subjects design and made only one of these judgements, whilst participants in the within-subjects version completed all three of these judgments. These bodies are based on 3D scans of 221 women's bodies and so accurately represent the change in size and shape caused by changing body composition. The participants also completed a set of psychometric questionnaires to index the degree to which external concepts of body image have been internalised. The results show that in both conditions, all three judgements collapse onto the same average preferred body shape, with low adiposity and relatively high muscularity. However, this masked systematic differences in responses between personal ideals and the other body judgements, which may be explained by a difference in how information directly related to oneself is processed relative to more abstract third person judgements.

A Novel Foodstuff Mixture Improves the Gut-Liver Axis in MASLD Mice and the Gut Microbiota in Overweight/Obese Patients

Microbial community control is crucial for maintaining homeostasis of the gut-liver axis in metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we show that supplementation with a mixture of Mexican foodstuffs (MexMix)-Opuntia ficus indica (nopal), Theobroma cacao (cocoa) and Acheta domesticus (crickets)-enriches several beneficial taxa in MASLD mice and overweight/obese humans. Thus, MexMix induces an important prebiotic effect. In mice, a restoration of intestinal health was observed due to the increased short-chain fatty acids (SCFAs) and intestinal crypt depth, Ocln and Cldn1 expression, and decreased Il6 and Tnfa expression. MexMix significantly reduced steatosis in the mice's liver and modified the expression of 1668 genes. By PCR, we corroborated a Tnfa and Pparg decrease, and a Cat and Sod increase. In addition, MexMix increased the hepatic NRF2 nuclear translocation and miRNA-34a, miRNA-103, and miRNA-33 decline. In overweight/obese humans, MexMix improved the body image satisfaction and reduced the fat intake. These findings indicate that this new food formulation has potential as a therapeutic approach to treat conditions associated with excessive consumption of fats and sugars.

The United Kingdom Eating Disorders Genetics Initiative

OBJECTIVE

The United Kingdom Eating Disorders Genetics Initiative (EDGI UK), part of the National Institute for Health and Care Research (NIHR) Mental Health BioResource, aims to deepen our understanding of the environmental and genetic etiology of eating disorders. EDGI UK launched in February 2020 and is partnered with the UK eating disorders charity, Beat. Multiple EDGI branches exist worldwide. This article serves the dual function of providing an in-depth description of our study protocol and of describing our initial sample including demographics, diagnoses, and physical and psychiatric comorbidities.

METHOD

EDGI UK recruits via media and clinical services. Anyone living in England, at least 16 years old, with a lifetime probable or clinical eating disorder is eligible to sign up online: edgiuk.org. Participants complete online questionnaires, donate a saliva sample for genetic analysis, and consent to medical record linkage and recontact for future studies.

RESULTS

As of September 2022, EDGI UK recruited 7435 survey participants: 98% female, 93.1% white, 97.8% cisgender, 65.9% heterosexual, and 52.1% have a university degree. Over half (57.8%) of these participants have returned their saliva DNA kit. The most common diagnoses are anorexia nervosa (48.3%), purging disorder (37.8%), bulimia nervosa (37.5%), binge-eating disorder (15.8%), and atypical anorexia nervosa (7.8%).

CONCLUSION

EDGI UK is the largest UK eating disorders study and efforts to increase its diversity are underway. It offers a unique opportunity to accelerate eating disorder research. Researchers and participants with lived experience can collaborate on projects with unparalleled sample size.

PUBLIC SIGNIFICANCE STATEMENT

Eating disorders are debilitating and costly for society but are under-researched due to underfunding. EDGI UK is one of the largest eating disorder studies worldwide with ongoing recruitment. The collected data constitute a resource for secondary analysis. We will combine data from all international EDGI branches and the NIHR BioResource to facilitate research that improves our understanding of eating disorders and their comorbidities.

"Eat more protein, build more muscle": A grounded theory study of muscle-building behaviors among Canadian adolescents and young adults

Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice.

[Social networks use and risk factors for the development of eating disorders: A systematic review]

OBJECTIVE

Review the available scientific literature on the relationship between the use of social networks and risk factors for the development of eating disorders, such as low self-esteem, body dissatisfaction and/or idealization of thinness, in the Spanish population.

DESIGN

A systematic review of scientific literature published between 2010 and 2022 was carried out.

DATA SOURCES

PubMed, Scopus and Web of Science.

SELECTION OF STUDIES

Only original articles were included, published in Spanish or English, that measured at least one variable of use of social networks and at least one risk factor for eating disorders in the Spanish population.

DATA EXTRACTION

The PRISMA 2009 statement was used as a guide. The quality of selected articles was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

RESULTS

Twelve cross-sectional studies that met the inclusion criteria were identified. Evidence suggests that the use and frequency of use of social networks is significantly associated with body dissatisfaction (p≤0,01), drive for thinness (p≤0,001), and low self-esteem (p≤0,05) in adolescents and young adults in the Spanish population.

CONCLUSIONS

Users of social networks, mainly those based on images, are exposed to factors that could increase their risk of developing an eating disorder.

Effect of body-related information on food attentional bias in women with body weight dissatisfaction

Women with body weight dissatisfaction (BWD) have long-term negative assessments of their body weight, which are often associated with poor eating behavior. In this study, we investigated the effect of body-related information on the food cue processing and attention of women with BWD. Sixty-eight women were recruited and assigned to either a BWD (NPSS-F > 2) (n = 32) or a no body weight dissatisfaction (NBWD) group (NPSS-F < 1) (n = 36). We measured attentional bias to food cues (high- and low-calorie) with a food probe task after exposure to body-related information and recorded eye tracking data. Body-related images were presented prior to a pair of stimulus images (food-neutral or neutral-neutral). Body-related information and food type were repeated measure factors in our study. Our results showed that the first fixation duration bias for high-calorie foods was significantly longer than for low-calorie foods after exposure to overweight cues in the BWD group. Compared with the NBWD group, the BWD group showed longer first fixation duration bias for high-calorie foods after exposure to overweight cues. The direction for high-calorie foods was significantly more often than that for low-calorie foods in the BWD group after exposure to body-related information. Our findings suggest that compared to women with NBWD, women with BWD may be more susceptible to body-related information, resulting in increased attention to high-calorie foods.

Psychedelics in the treatment of eating disorders: Rationale and potential mechanisms

Eating disorders are serious illnesses showing high rates of mortality and comorbidity with other mental health problems. Psychedelic-assisted therapy has recently shown potential in the treatment of several common comorbidities of eating disorders, including mood disorders, post-traumatic stress disorder, and substance use disorders. The theorized therapeutic mechanisms of psychedelic-assisted therapy suggest that it could be beneficial in the treatment of eating disorders as well. In this review, we summarize preliminary data on the efficacy of psychedelic-assisted therapy in people with anorexia nervosa, bulimia nervosa, and binge eating disorder, which include studies and case reports of psychedelic-assisted therapy with ketamine, MDMA, psilocybin, and ayahuasca. We then discuss the potential therapeutic mechanisms of psychedelic-assisted therapy in these three eating disorders, including both general therapeutic mechanisms and those which are relatively specific to eating disorders. We find preliminary evidence that psychedelic-assisted therapy may be effective in the treatment of anorexia nervosa and bulimia nervosa, with very little data available on binge eating disorder. Regarding mechanisms, psychedelic-assisted therapy may be able to improve beliefs about body image, normalize reward processing, promote cognitive flexibility, and facilitate trauma processing. Just as importantly, it appears to promote general therapeutic factors relevant to both eating disorders and many of their common comorbidities. Lastly, we discuss potential safety concerns which may be associated with these treatments and present recommendations for future research.

Parental Pressure on Child Body Image, BMI, Body Image Dissatisfaction Associated with Eating Disorders in School-Age Children in China: A Path Analysis

Background

Children's eating behaviors, body shape and body image cognition may be more susceptible to the influence of their parents, but these influences may be weakened with age. There may be different association pathways between parental pressure on children's body image (PPCBI), body mass index (BMI), body image dissatisfaction (BID) and eating disorders (EDs) among children and adolescents at different developmental stages.

Methods

The stratified cluster sampling method (Stratified by grade, and took the classes as clusters) was used to select 486 students aged 8-15 years in two 9-year schools. Children's body height, weight, testicular volume and breast development were measured. PPCBI, BID, and EDs were investigated using the Appearance-related Social Stress Questionnaire, Body Size Questionnaire (BID-14), and EDI-1 scale, respectively.

Results

The boys before puberty initiation had significantly higher EDs score (182.3±50.8) than girls before puberty initiation (164.1±58.1) (P<0.05). There were significant association pathways of PPCBI→BMI→BID→EDs and PPCBI→BID→EDs in boys before puberty initiation (β=0.035, P<0.01; β=0.059, P<0.01), in boys after puberty initiation (β=0.032, P<0.01; β=0.175, P<0.001), and in girls after puberty initiation (β=0.026, P<0.01; β=0.172, P<0.001). There was a positive association pathway of PPCBI→EDs in boys before puberty initiation (β=0.30, P<0.001) and PPCBI→BID→EDs in girls before puberty initiation (β=0.176, P<0.01).

Conclusion

Parental pressure on children's body image may positively associate with children's eating disorders through BMI and body image dissatisfaction in boys and girls after puberty initiation and directly associate with eating disorders in boys before puberty initiation; however, it may indirectly associate with eating disorders only through BID in girls before puberty initiation.

Emotional regulation and body dissatisfaction: the mediating role of anger in young adult women

Introduction

Emotion regulation difficulties have an important role in the presence of negative self-image. These problems in the self-regulation of emotion could lead to negative emotional processes (such as anger) that can lead to body dissatisfaction. Therefore, the aim of the present study was to examine emotion regulation difficulties than can negatively impact self-image and to understand if anger acts as mediator in the relationship between emotion regulation and body dissatisfaction.

Methods

A cross-sectional study was carried out comprising 565 young adult women aged 18-30 years. The participants were administered the Difficulties in Emotion Regulation Scale (DERS), the State-Trait Anger Expression Inventory 2 (STAXI-2), and the Body Dissatisfaction dimension of the Eating Disorder Inventory-2 (EDI-2). The proposed hypotheses were tested by path analysis in MPlus 8.0.

Results

The results indicated that anger had a positive significant effect on body dissatisfaction as well as the non-acceptance of emotional responses, the lack of emotional awareness, and the lack of emotional clarity. Of all the dimensions of emotional regulation difficulties, impulse control difficulty was the dimension which had a positive significant indirect effect on body dissatisfaction explained by increased anger.

Discussion

The present study suggests the importance of emotion regulation in the prevention of body dissatisfaction. Impulse control difficulty may be the key emotion regulation emotion in explaining the increments of anger that lead to body dissatisfaction. Among young adults, the promotion of positive body image can be promoted by helping this population to self-regulate their anger impulses.

Risk factors of disordered eating in adolescent girls from a community sample: a multidimensional approach

BACKGROUND

Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups.

AIM

1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology.

METHODS

The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used.

RESULTS

Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating.

CONCLUSION

There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.

Examining associations between obesity and mental health disorders from childhood to adolescence: A case-control prospective study

Childhood obesity and mental disorders often co-exist. To date, most of the studies are cross-sectional, involve the assessment of a specific disorder, and rely on self-report questionnaires. This study aimed to provide a comprehensive psychological assessment to examine the concurrent and prospective association between childhood obesity and mental health problems. We compared 34 children with obesity with 37 children with normal weight at baseline, and at a five-year follow-up, to examine the development of mental health disorders from childhood (8-12 years) to adolescence (13-18 years). Both assessments included a clinical interview and self-reported measures of psychosocial and family markers. Findings showed that the obesity group had a higher prevalence of mental disorders, and psychological comorbidity increased in five years. Prospectively, childhood obesity was associated with a psychological diagnosis in adolescence. Moreover, the obesity group displayed higher severity of symptoms at both times. Finally, body esteem contributed to predicting mental health disorders in adolescence regardless of weight status, while eating symptomatology was a specific marker for the obesity group. Therefore, in the management of childhood obesity is suggested to address also psychosocial variables such as weight-related teasing and body esteem, to prevent the onset or development of mental health problems.

Fat talk, old talk, or both? Association of negative body talk with mental health, body dissatisfaction, and quality of life in men and women

BACKGROUND

Little research has investigated the harmful effects of old talk-negative age-related body talk-on mental health and quality of life despite substantial research examining fat talk. Old talk also has only been evaluated in women and in relation to few outcomes. Of note, old talk and fat talk are strongly correlated, suggesting possible overlap in elements that drive negative outcomes. Thus, the primary aim of this study was to investigate the extent that old talk and fat talk contribute to negative mental health and quality of life outcomes when examined in the same model and when interacting with age.

METHODS

Adults (N = 773) ages 18-91 completed an online survey assessing eating disorder pathology, body dissatisfaction, depression, aging anxiety, general anxiety, quality of life, and demographics.

RESULTS

While fat talk and old talk were correlated with almost all outcome variables, fat talk was more commonly significantly associated with poorer outcomes than old talk. Additionally, the relationship between fat talk and old talk with poorer mental health was affected by age in men, but not women.

CONCLUSIONS

Future research is warranted to decipher the individual effects of old talk and fat talk on mental health and quality of life across the adult lifespan.

Individual and Combined Association between Unhealthy Lifestyle Behaviors and Body Weight Dissatisfaction in a Sample of Adolescents from Southern Brazil

The individual and combined association between unhealthy lifestyle behaviors and body weight dissatisfaction in adolescents was investigated. This cross-sectional research used data from 676 students (348 female), aged between 14 and 19 years old (mean of 14.6 years old) from southern Brazil. Unhealthy lifestyle behaviors and body weight dissatisfaction were assessed through a questionnaire. Unhealthy lifestyle behaviors included smoking, excessive alcohol consumption, sedentary lifestyle, and poor diet, and were analyzed as individual factors and as combinations of behaviors. For males, smoking (OR: 2.6; 95% CI: 1.6-4.0) and the combination of smoking/excessive consumption of alcoholic beverages (OR: 2.5; 95% CI: 1.1-5.8) were directly associated with the desire to reduce body weight, whereas the combination of smoking/inadequate diet (OR: 1.3; 95% CI: 1.0-1.6) was associated with the desire to increase body weight. For females, the combinations of inadequate diet/physical inactivity (OR: 1.6; 95% CI: 1.0-2.5) and of smoking/excessive consumption of alcoholic beverages (OR: 1.9; 95% CI: 1.4-2.8) were directly associated with the desire to reduce body weight. The presence of simultaneous unhealthy lifestyle behaviors is associated with bodyweight dissatisfaction in adolescents.

The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men

In this study, we investigated the link between problematic pornography use and eating disorder symptoms in men, with body comparison and body image as mediators, and perceived realism and anxiety and depression as moderators. We also analyzed the model for both heterosexual and sexual minority men to detect any differences. The current study included 705 Israeli men, 479 of whom identified as heterosexual and 226 as sexual minority. The majority of the sample (90.6%) identified as Jewish with a mean age of 32.5. Results showed that problematic pornography use was linked to more upward body comparison, which in turn was related to negative body image, and ultimately, increased severity of eating disorder symptoms. Anxiety and depression moderated the association between male body image and eating disorder symptoms. However, perceived realism did not moderate the link between problematic pornography use and upward body comparison. Whereas there were significant differences in the mean rank values between heterosexual and sexual minority men in all measures, the processes linking these measures were virtually the same. To reduce the risk of developing or worsening eating disorder symptoms, clinicians working with male clients should assess for problematic pornography use and body image concerns during therapy.

Comparison of body size perception of young women in Korea and the United States

Body size perception among young women in Asian and Western countries is believed to be quite different, however, there are no confirming studies. We analyzed the data from young women aged between 20 and 40 who participated in the National Health and Nutrition Examination Survey (2001-2018) of the United States (US) and Korea. US young women had higher rates of being overweight and obesity than Korean young women, and there was no significant change over 20 years. In both countries, the percentage of properly estimating one's own weight exceeded 70 percent and remained relatively steady. The percentage of overestimating one's own weight was only about 10 percent in Korea in 2001, but increased to 20 percent. In the case of the US, the percentage was about 15 percent in 2001-2002, but has since continued to decline. The percentage of underestimating one's own body weight was about 18 percent in Korea in 2001, but decreased to about 8 percent. In the case of the US, the percentage was very low at about 10 percent in 2001-2002, but gradually increased to about 18 percent in 2017-2018. In conclusion, young women in the US tend to underestimate their body size, and those in Korea tend to overestimate it.

Body Weight Dissatisfaction and Health Risk Behaviors in Adolescents

Body weight dissatisfaction has been described as a marker for various health diseases, given its direct association with social, physical, and emotional suffering. We investigated the association between body weight dissatisfaction and health risk behaviors in adolescents. This was a cross-sectional study conducted with 668 adolescents aged 14-19 years in the city of São José, southern Brazil. Body weight satisfaction/dissatisfaction was assessed using a questionnaire validated for the investigated population. Health risk behaviors included smoking, alcohol, illicit drugs, medication, non-prescription anabolic steroids, not using seatbelt, unsafe sexual behavior and not knowing how to deal with day-to-day stress. Among males, 66.1% were dissatisfied with their body weight (32.1% due to thinness and 34.0% due to overweight). Among females, 80.0% were dissatisfied with their body weight (24.5% due to thinness and 55.5% due to overweight). There were no significant differences regarding health risk behaviors according to body weight satisfaction/dissatisfaction and sex. Compared to males who were satisfied with their body weight, those who were dissatisfied due to being overweight were more likely to be using tobacco (OR: 2.9; 95% CI: 2.1-4.2), alcohol (OR: 1.7; 95% CI: 1.5-1.9) and anabolic steroids (OR: 2.7; 95% CI: 1.2-5.7). Compared to females who were satisfied with their body weight, those who were dissatisfied due to thinness were more likely to be consuming alcoholic beverages (OR: 1.6; 95% CI: 1.2-2.0) and less likely to be consuming illicit drugs (OR: 0.5; 95% CI: 0.3-0.8). Interventions aimed at health education regarding the non-adoption of risk behaviors such as alcohol and tobacco use, as well as the non-use of anabolic steroids, and favoring the maintenance of general health, may be important for adolescents with body dissatisfaction. These data suggest that health risk behaviors such as adolescent male use of tobacco, alcohol, and anabolic steroids and the use of alcohol and drugs by female adolescents can be related to body weight dissatisfaction.

Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs

Research shows negative correlations between media exposure of body images in the context of hegemonic beauty ideals and body satisfaction. The present study deals with the underlying mechanisms and the effects of different exposure contents. In the online experimental study, a sample consisting of 226 individuals (82.3% female, 17.7% male) received a three-minute exposure to Instagram images of women and men in the context of either hegemonic beauty ideals in the experimental group or body diversity in the control group. A conducted Mixed ANOVA with repeated measures showed significant group differences, including an increase in body dissatisfaction in the experimental group and a reduction in the control group after exposure. Statistically significant detrimental effects of exposure to images in the experimental group on women's state mood as well as descriptive similar tendencies on men's state mood were found. Moderating effects of the tendency to make upward social comparisons and the internalization of the gender-specific beauty ideal on the relationship between exposure content and the change scores of body dissatisfaction were found. Furthermore, a mediation model was calculated to investigate the effect of exposure content on post-measurement of body dissatisfaction, using the constructs "comparison processes regarding sexual attractiveness" and "assessment of one's own sexual attractiveness" as mediators. The model did not yield significant mediation, although significant relationships were found between the model components. Exploratory analyses were conducted on the influence of the assessment of one's own sexual attractiveness on related social comparisons and the intensity of engagement with Instagram content as a predictor of body dissatisfaction. The results highlight the relevance for psychoeducational purposes of addressing a critical engagement with depicted beauty ideals in social media. Moreover, the study proposes body diversity as an alternative content that can have a positive impact on body satisfaction, which can be actively sought during the individual Instagram user experience.

Associations between menopause and body image: A systematic review

BACKGROUND

The menopausal transition involves multiple biological and psychosocial challenges that may render middle-aged women vulnerable to body image concerns.

OBJECTIVE

The aim of this study was to summarize evidence on the associations between menopause and body image perception in healthy middle-aged women.

DESIGN

This study is a systematic review of observational studies.

DATA SOURCES AND METHODS

Menopause-related exposure measures included menopausal stages, menopausal symptoms, and reproductive hormone levels during the menopausal transition. Studies investigating body image as an outcome, including through a positive (e.g. body self-esteem) or negative (e.g. body dissatisfaction) lens, were considered eligible. Articles published before March 2023 were identified through MEDLINE, PsycINFO, and Embase and underwent double screening, extraction, and quality assessment by two independent investigators. Characteristics and results were summarized using narrative synthesis.

RESULTS

A total of 820 non-duplicate records were identified, with 18 observational studies deemed eligible for inclusion after full-text screening. All studies investigating menopausal symptoms and body image (n = 6) found some significant association between them, with a higher frequency, intensity, or number of symptoms being associated with greater body image concern. Differences in body image perception between menopausal stages were inconsistent across studies (n = 12), while evidence of potential associations between reproductive hormones and body image was minimal (n = 2). Findings should be interpreted with caution as 17 of the included studies used a cross-sectional design, and not all studies adjusted their analyses for relevant confounders.

CONCLUSION

Overall, menopausal symptoms showed relatively consistent associations with a more negative body image perception. Additional research is required to understand the potential role of menopausal stages and reproductive hormone levels in the body image perception of middle-aged women and to confirm the direction of reported associations.

REGISTRATION

PROSPERO-CRD42021241637.

Effects of social media on body dissatisfaction in junior high school girls in Japan

AIMS

Body dissatisfaction (BD) is a serious problem related to the incidence of eating disorders. Social media (SM) use is known to be associated with BD. With a view to preventing the incidence of eating disorders, this study aimed to investigate the association between SM and BD, particularly, the role of SM in the encouragement of thinness and its relationship with adolescent girls' BD.

METHODS

Junior high school girls aged 12-15 in Japan completed the Body Shape Questionnaire (BSQ), Eating Attitudes Test-26, Bulimic Investigatory Test Edinburgh, Depression Self-Rating Scale for Children, and SM usage. Participants were classified into two groups based on their BSQ cut-off score.

RESULTS

Overall, 161 students were recruited (44 participants with BD; 117 without BD). The BD group used SM more than the non-BD group (χ² (1) = 4.61, p = .032). The frequency of following SM accounts related to thinness was significantly higher in the BD group than in the non-BD group (χ² (1) = 7.76, p = .005). The association between BD and following SM accounts focused on thinness was the most important (adjusted OR = 3.82; 95 % CI: 1.05-13.89).

CONCLUSIONS

The risks of SM use increasing BD in adolescent girls should be considered to prevent mental disorders, including eating disorders.

A Review of Binge-Eating Disorder in Black Women: Treatment Recommendations and Implications for Healthcare Providers

PURPOSE OF REVIEW

We review relevant factors and barriers to care for binge-eating disorder (BED) in Black women. We examine evidence for the treatment of BED and provide recommendations to improve cultural relevance for assessing and treating BED in Black women.

RECENT FINDINGS

BED is the most common eating disorder among Black women. Moreover, evidence supports alternative factors that contribute to the onset of BED in Black women, including stress, trauma, and food insecurity. Furthermore, though there are evidence-based treatments for BED, disparities persist in access to care and treatment retention. Recommendations for increasing the cultural relevance of assessments and treatments are provided. Gaps in the literature remain on the use of evidence-based treatments for BED among Black women. As such, healthcare providers should include Black women as co-collaborators in their care and seek out training and consultation to aid in providing culturally affirming treatment.

Body mass index and quality of life in individuals with polycystic ovary syndrome: Dysmorphic concerns and eating disorders as mediators

Objective

Weight issues, dysmorphic concerns and eating disorders are common among individuals with polycystic ovary syndrome (PCOS) and are linked to poor quality of life (QoL). The goal of the current study was to examine whether the association between body mass index (BMI) and QoL was mediated by dysmorphic concerns, examining also the relations with eating disorder symptomatology.

Methods

Questionnaires were administered to 435 individuals with PCOS aged between 18 and 40 years (M = 27.62; SD = 4.83) to measure dysmorphic concerns, eating disorder symptoms and QoL. Participants were also asked to report their height and weight to compute their BMI.

Results

Structural equation modeling was used to observe the relationship between the variables. The results revealed a direct relationship between QoL, BMI, dysmorphic concerns and eating disorder symptomatology. In addition, dysmorphic concerns were related to BMI and eating disorder symptomatology. Furthermore, the results showed the mediating role of dysmorphic concerns and eating disorder symptoms in the relationship between BMI and QoL.

Conclusion

The current results highlight the potential importance of harmful relationships with one's own body and food, explaining why weight issues may be linked to different levels of QoL in PCOS individuals. The implications of these findings are discussed.

Mediation models of anxiety and depression between temperament and drive for thinness and body dissatisfaction in anorexia nervosa

PURPOSE

Anorexia nervosa (AN) is a life-threatening condition in which temperament, anxiety, depression, and core AN body-related psychopathology (drive for thinness, DT, and body dissatisfaction, BD) are intertwined. This relationship has not been to date disentangled; therefore, we performed a multiple mediation analysis aiming to quantify the effect of each component.

METHODS

An innovative multiple mediation statistical method has been applied to data from 184 inpatients with AN completing: Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire, Eating Disorders Inventory-2, State-Trait Anxiety Inventory, and Beck Depression Inventory.

RESULTS

All affective temperaments but the hyperthymic one were involved in the relationship with DT and BD. Only the anxious temperament had a significant unmediated direct effect on DT after the strictest correction for multiple comparisons, while the depressive temperament had a significant direct effect on DT at a less strict significance level. State anxiety was the strongest mediator of the link between affective temperament and core AN body-related psychopathology. Depression showed intermediate results while trait anxiety was not a significant mediator at all.

CONCLUSION

Affective temperaments had a relevant impact on body-related core components of AN; however, a clear direct effect could be identified only for the anxious and depressive temperaments. Also, state anxiety was the strongest mediator thus entailing interesting implications in clinical practice.

LEVEL OF EVIDENCE

V, cross-sectional study.

Body image and compulsive exercise: are there associations with depression among university students?

PURPOSE

Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students.

METHODS

Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms.

RESULTS

Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression.

CONCLUSION

In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males.  Body dissatisfaction was  positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students.

LEVEL OF EVIDENCE

III, cohort study.

TRIAL REGISTRATION

http://clinicaltrials.gov/ID : NCT04465435.

"Belly Only Pregnancy" content on social media and in internet blogs: a qualitative analysis on its definition and potential risks and benefits

PURPOSE

Social media enlarge the impact of health and fitness trends on body image and lifestyle choices, also in birthing parents. A new and yet to investigate social media trend addressing expectant mothers is "Belly Only Pregnancy". This qualitative study sought to define this new trend and clarify whether content related to this trend might disrupt body image or eating habits in expectant mothers.

METHODS

Picture and text data were gathered on a key day by screening Instagram and blog posts including or linking #bellyonlypregnancy. The identified data were categorized applying qualitative content analysis using MAXQDA software version 2018.

RESULTS

Three hundred and fifty-one Instagram and eight blog posts were included. Our qualitative analysis' results indicated that the term "Belly Only Pregnancy" was used for describing: (1) The phenotype of an athletic woman whose abdominal size enlarges during pregnancy while not gaining excessive fat tissue. (2) An active lifestyle during pregnancy consisting of healthy nutrition and regular exercise pursuing goals like fast weight loss post-partum. Also, bodily, and mental gestational changes and the feasibility of this lifestyle were discussed.

CONCLUSION

A "Belly Only Pregnancy" allegorizes an ideal body type for expecting mothers. Especially women with increased vulnerability for an eating disorder might be negatively affected by the consumption of content linked to this trend. However, the positive effects of a healthy diet and exercise should not be denied keeping into account the increasing prevalence of obesity and gestational diabetes.

LEVEL OF EVIDENCE

Level III: Evidence obtained from cohort or case-control analytic studies.

Body Image Dissatisfaction and Aggressive Behavior Among Chinese Children at Different Pubdertal Stages: A Path Analysis

Background

Body image dissatisfaction and aggressive behavior have become important public health problem in children and adolescents, and body image dissatisfaction may increase the occurrence of aggressive behavior. The aim of this study was to explore the correlation between body image dissatisfaction and aggressive behavior among Chinese children in different developmental stages.

Methods

The stratified cluster sampling method was used to effectively survey 518 children aged 8–15 years. The Body Shape Questionnaire and the Buss-Warren Aggressive Questionnaire scale were used to measure body image dissatisfaction and aggressive behavior. Pubertal development stages were divided into three stages according to Tanner criteria.

Results

There was a main correlation path of body image dissatisfaction - hostility - anger - indirect aggression - physical aggression in boys with stage I and stage II and in girls with stage I and stage III. In addition, there were direct paths of hostility - indirect aggression, hostility - verbal aggression, anger - physical aggression, and anger - verbal aggression in boys with stage I; hostility - indirect aggression, hostility - verbal aggression, and anger - physical aggression in boys with stage II and in girls with stage I; and anger - physical aggression, and anger - verbal aggression in girls with stage III.

Conclusion

Body image dissatisfaction might positively correlate with aggression through hostility among Chinese children and adolescents, and their association paths were different in different puberty stages.

Shifting the Focus: A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE.

The relationship between self-esteem, body dissatisfaction, and eating attitudes in bariatric surgery candidates

Objectives

Considering the effects of self-esteem, eating attitudes and body satisfaction on obesity and bariatric surgery outcomes, psychiatric evaluation is important for the identification and treatment of psychopathology, improvement of self-esteem, eating attitudes and body satisfaction. In this study, it was aimed to determine the relation between eating behaviors, body dissatisfaction, self-esteem and psychological symptoms in patients seeking bariatric surgery. Our second aim was to determine whether depressive symptoms and anxiety had a mediating role in the relationship between body satisfaction and self-esteem and eating attitudes.

Material and Methods

The study included 200 patients. Patients' data were retrospectively evaluated. Psychometric evaluation performed during the preoperative period included psychiatric examination and administration of the Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg SelfEsteem Scale, Body-Cathexis Scale, and Dutch Eating Behaviors Questionnaire.

Results

There was a positive correlation between self-esteem and body satisfaction and a negative correlation between self-esteem and emotional eating (r= 0.160, p= 0.024; r= -0.261, p <0.001 respectively). Body satisfaction had an effect on emotional eating mediated by depression and an effect on external and restrictive eating mediated by anxiety. Furthermore, anxiety mediated the relations between self-esteem and external and restrictive eating behaviors.

Conclusion

Our finding indicating that depression and anxiety have mediator effects on the relation between self-esteem, body dissatisfaction, and eating attitudes is significant since screening for these entities and their treatment is relatively more practical in clinical settings.

Childhood trauma and body dissatisfaction among young adult women: the mediating role of self-criticism

The present study examined the relationship between childhood trauma and body dissatisfaction among young women. The mechanisms through which childhood trauma are related to body dissatisfaction have not been sufficiently examined previously. The aims of the present study were to analyze the (i) relationships between childhood trauma, self-criticism, and body dissatisfaction and (ii) mediating role of self-criticism in the relationship between childhood trauma and body dissatisfaction. A total of 754 young adult women aged 18 to 30 years participated (M = 20.49 years; SD = 2.28). The findings showed positive correlations between childhood trauma, self-criticism, and body dissatisfaction. The mediation model indicated that (i) greater childhood trauma was associated with greater self-criticism, and (ii) greater self-criticism was significantly associated with greater body dissatisfaction. Therefore, childhood trauma was indirectly associated with increased body dissatisfaction and explained by the positive relationship with increased self-criticism. These results highlight the importance of childhood trauma in body dissatisfaction among young adult women and demonstrates self-criticism coping style as a key factor in this relationship. Early detection of self-criticism-based coping styles and childhood trauma could improve (i) quality of life and prevent the onset of body dissatisfaction, and (ii) treatment planning and prevent body dissatisfaction from escalating into major problems (e.g., eating disorders, body dysmorphic disorder, morbid exercise and/or depressive symptomatology).

Gender Differences in the Psychopathology of Obesity: How Relevant Is the Role of Binge Eating Behaviors?

Background: Obesity is a condition that affects humans both physically and mentally. Moreover, many psychopathological conditions can be observed in obese patients that may threaten the positive outcomes of bariatric surgery. Purpose: The aim of this study was to identify the main psychopathological correlates of obese candidates for bariatric surgery, with particular attention on the relationship between psychopathology and gender. Methods: In total, 273 candidates for bariatric surgery for obesity underwent a psychiatric evaluation using a compilation of psychometric scales: the Revised Symptom Checklist 90-R (SCL-90-R), the Eating Disorder Examination Questionnaire (EDE-Q), the Binge Eating Scale (BES), the Body Uneasiness Test (BUT) and the Obesity-Related Well-Being (ORWELL 97). The sample was divided on the basis of gender and binge eating disorder (BED) severity. Comparisons between the groups were performed using an analysis of variance model (ANOVA) or a Pearson’s chi-squared test. Further, we also divided our sample into a severe binge eating group (score > 27), a mild to moderate group (18 < score < 26) and a low/no symptoms group (score < 17). Results: Male and female subjects showed different results for the BES, with higher scores reported among women (17.50 ± 9.59) compared to men (14.08 ± 8.64). Women also showed higher scores across most of the SCL-90-R domains and worse outcomes in terms of quality of life. Both women and men in the severe binge eating group reported higher scores for the SCL-90-R. Conclusion: The symptoms of BED, along with body image dissatisfaction (BID), are among the most important to investigate for candidates for bariatric surgery in order to improve the surgery outcomes. Level of evidence: Level III as the evidence came from a cohort analytic study.

Sensor technology in eating disorders research: A systematic review

OBJECTIVE

Sensor technologies offer exciting potential to objectively measure psychopathological correlates of eating pathology and eating disorder (ED) research utilizing sensors has rapidly proliferated in the past several years. The aims of the present review are: (1) characterize the types of sensors that have been utilized in ED research, (2) identify the psychopathological factors relevant to EDs that have been assessed using sensors, (3) describe the data supporting the validity and reliability of these sensors, (4) discuss limitations associated with these sensors, and (5) identify gaps that persist within the ED literature with regard to use of sensor technologies.

METHOD

A systematic search was conducted of PubMed, PsycINFO, Web of Science, ProQuest, and "gray" literature sources. Eligible publications were empirical studies that utilized sensors to measure at least one psychological variable among clinical ED populations.

RESULTS

Sensors have been utilized with ED samples to measure eating behaviors, physical activity, sleep, autonomic nervous system activity, eyeblink startle response, visual attention, and visual-haptic object integration. The reliability and validity of these sensors varies widely and there are a number of significant gaps that remain in the literature with regard to the types of sensors utilized, context in which sensors have been used, and populations studied.

DISCUSSION

The existing literature utilizing sensors within ED research largely support the feasibility and acceptability of these tools. Sensors should continue to be utilized within the field, with a specific focus on examining the reliability and validity of these tools within ED samples and increasing the diversity of samples studied.

PUBLIC SIGNIFICANCE STATEMENT

Sensor technologies, such as those included in modern smartwatches, offer new opportunities to measure factors that may maintain or contribute to symptoms of eating disorders. This article describes the types of sensors that have been used in eating disorders research, challenges that may arise in using these sensors, and discusses new applications of these sensors that may be pursued in future research.

Motivation to consume palatable foods as a predictor of body image dissatisfaction: Using the Power of Food Scale in a Brazilian sample

The Power of Food Scale (PFS) is a questionnaire for self-assessing the motivation to consume palatable foods, especially in environments where food is abundant and constantly available. This study aimed to a) assess the factorial structure of the PFS in a Brazilian sample and b) examine the relationship between the power of food and body image dissatisfaction and BMI. The PFS and Body Shape Questionnaire (BSQ) were applied to a sample of 300 adults. Data were analysed using confirmatory factor analysis. Composite reliability (CR) was used to verify factor reliability. A partial least squares structural equation model was used to verify the effect of the PFS score on body image dissatisfaction. The PFS had an adequate factorial structure in this Brazilian sample, showing three well-defined factors: food available (CR = 0.91), food tasted (CR = 0.84), and food present (CR = 0.87). The BSQ showed one reliable factor (CR = 0.97). The power of the food aggregate factor significantly predicted body mass index (β = 0.16; p = .01) and body image dissatisfaction (β = 0.46; p < .001). The effect size was small for body mass index (f² = 0.02) and medium for body image dissatisfaction (f² = 0.26). The food present factor also had a slightly higher average among the three PFS factors. Women had higher PFS scores than men. Understanding the role that this motivation plays in physical and psychological outcomes such as body dissatisfaction can contribute to developing treatment strategies and support health professionals' performance in clinical settings.

Can more people be "Happy Being Me"? Testing the delivery of a universal body satisfaction program by clinicians and school staff

The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their first year of secondary school in the UK (Year 7 and after comparisons aged 11-12). HBM is a manualised universal prevention programme which aims to improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptomsStudy 1 tested the effectiveness of HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-intervention which was maintained at follow up. There were no significant changes in risk factors.Study 2 compared clinician (n = 172) and teacher (n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising for wider delivery are discussed.

Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation

Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.

Sex Differences in Body Image Perception and Ideals: Analysis of Possible Determinants

The study analyzed the differences between sexes in body image perception and body ideals to assess possible dissatisfaction and misinterpretation in the body image considered attractive for the other sex. Moreover, the influence of anthropometric traits and sports practice on body dissatisfaction and misjudgment was evaluated. Using a cross-sectional design, 960 Italian university students were investigated. Anthropometric characteristics were measured directly. Assessment of body image perception was performed using Thompson and Gray’s silhouettes. We developed two new indexes to assess the possible discrepancy between (1) the perceived silhouette of one’s body and that of the same sex deemed attractive to the other sex (FAD); (2) the silhouette is deemed attractive to the opposite sex and the average attractive silhouette selected by the opposite sex (AMOAD). As expected, females showed greater dissatisfaction with their bodies than males concerning both their own ideal and the silhouette they considered attractive to the opposite sex. Although both sexes misjudged the attractive silhouette for the opposite sex, women were found to be more wrong. According to the outcomes of multivariate regression models, stature, body composition parameters, amount of sport, sex, and FAD were significant predictors of dissatisfaction and misjudgment. In addition to action aimed at correcting misperceptions, the study revealed the importance of sports participation in improving the perception and acceptance of one’s body image.

Association of body perception and dietary weight management behaviours among children and adolescents aged 6-17 years in China: cross-sectional study using CHNS (2015)

Background

Obesity is rapidly globally increasing. Meanwhile, there is an increase in negative perception of the body image and, consequently, an increase in weight control management. Body perception plays an important mediating role between overweight or obesity and weight control behaviours. This study aims to examine whether body perception is associated with dietary weight management behaviours among Chinese children and adolescents.

Methods

Child body perception and health behaviours from Chinese Health and Nutrition Survey (2015) were assessed, and 729 boys and 640 girls who aged 6 to 17 years were included in this study. Variables assessed as covariates were sociodemographic, physical activity and body perception involving self-perceptive weight status and body image dissatisfaction (BID). Multivariate logistic regression was used to explore the association between dietary weight management behaviours and body perception.

Results

60.77% students rightly matched their body mass index (BMI) with self-perceived weight. The prevalence of BID was 59.39%. After adjustment for sociodemographic information, physical activities and BMI, those whose self-perceived weight status as overweight/obesity were associated with an increased risk of dietary weight management behaviours comparing to those who have normal weight in boys (OR = 5.07; 95% CI = 1.86, 13.87; P < 0.001) and girls (OR = 14.28; 95%CI = 5.73, 35.56; P < 0.001). And those who desire to be thinner were strongly associated with dietary weight management behaviours (OR = 9.51; 95%CI = 3.47, 26.09; P < 0.001) comparing to those who were satisfied with their body image in girls.

Conclusions

The results revealed that body perception had a significant association with dietary weight management behaviours and exited the discrepancy according to sex. It is necessary to promote healthy awareness of body perception and to establish self-motivation for improving basic health knowledge in school health education activities.

I Look at my whole body and i feel better: attentional bias, emotional and psychophysiological response by pure exposure treatment in women with obesity

Obesity is one of the most important health problems nowadays. In addition to the direct physical consequences, it is also a risk factor in the development of psychological (Eating disorders, body dissatisfaction, depression, anxiety, etc.) and social problems. Among there, body dissatisfaction is key for development and maintenance of such problems.

OBJECTIVE

to deepen the effectiveness of the body exposure treatment, both in its pure form and guided modality in subjective, psychological and attentional levels in people with body dissatisfaction and obesity.

METHODS

Evaluations were carried out in a total of 16 women with obesity and body dissatisfaction at the beginning and end of 6 treatment sessions of pure exposure in front of the mirror. The changes experienced at the subjective level (questionnaires and subjective discomfort during the sessions) and psychophysiological (eye-tracking and heart rate) were analyzed.

RESULTS

Pure exposure treatment reduces negative thoughts and emotions towards the body itself, as well as the experienced discomfort towards the most conflictive parts. Selective attention to those parts of the body classified as uglier by the participants (especially the rear view of the body) show a decrease in physiological reactivity.

CONCLUSIONS

Pure exposure treatment seems to be effective in reducing subjective and psychological symptoms associated with body dissatisfaction in people with obesity, this technique could be considered a good choice for the treatment of body dissatisfaction. This step is essential to guarantee the long-term therapeutic success of any other treatment (nutritional or/and physical activity) in the future.

Body Schema Self-Awareness and Related Dream Content Modifications in Amputees Due to Cancer

PURPOSE

the evaluation of body image perception, pain coping strategies, and dream content, together with phantom limb and telescoping phenomena in patients with sarcoma who underwent surgery for limb amputation.

MATERIAL AND METHODS

consecutive outpatients were evaluated at T0 (within 3 weeks after surgery) and T1 (4-6 months after surgery) as follows: demographic and clinical data collection; the Groningen Questionnaire Problems after Arm Amputation; the West Haven-Yale Multidimensional Pain Inventory; the Body Image Concern Inventory, a clinical trial to identify telescoping; and a weekly diary of dreams. Dream contents were coded according to the Hall and Van de Castle coding system.

RESULTS

Twenty patients completed the study (15 males and 5 females, mean age: 53.9 ± 24.6, education: 7.8 ± 3.4). All subjects experienced phantom limb and 35% of them experienced telescoping soon after surgery, and 25% still after 4-6 months. Both at T0 and T1, that half of the subjects reported dreams about still having their missing limbs. At T1 the patients' perceptions of being able to deal with problems were lower, and pain and its interference in everyday life were higher yet associated with significant engagement in everyday activities and an overall good mood. The dream content analysis highlighted that males were less worried about health problems soon after amputation, and women showed more initial difficulties that seemed to be resolved after 4-6 months after surgery.

CONCLUSIONS

The dream content analysis may improve clinicians' ability to support their patients during their therapeutic course.

ANÁLISE HISTÓRICO-CONCEITUAL DA IMAGEM CORPORAL EM FONTES CIENTÍFICAS DE PSICOLOGIA (1900-1935)

As pesquisas em imagem corporal creditam ao neurologista Paul Schilder (1886-1940) a definição do termo em 1935. A análise da composição do conceito pode contribuir para o entendimento de sua disseminação em uma comunidade de linguagem. Através de uma análise conceitual em fontes primárias buscou-se identificar a circulação do conceito na literatura de psicologia no início do século XX. Foram revisados artigos publicados em periódicos científicos de Psicologia e livros de Psicologia entre 1900 e 1935. Foram acessadas fontes nos idiomas espanhol, francês, inglês e português. Apenas dois artigos apresentaram referência explícita ao termo imagem corporal, enquanto os outros artigos tangenciaram ideias relativas à imagem do corpo. Já os textos dos livros de psicologia não apresentaram referências explícitas ao conceito, mas descreveram teorias alinhadas às pesquisas em percepção corporal pela literatura de processos psicológicos básicos. A compreensão geral de imagem corporal herdada pela literatura em psicologia foi antecedida por definições associadas ao esquema corporal, como a percepção de movimento e a propriocepção.

Relationships among Physical Self-Concept, Physical Activity and Mediterranean Diet in Adolescents from the Province of Granada

The aim of the present research was to analyse the relationships among physical self-concept, physical activity engagement and Mediterranean diet adherence in a sample of 1650 secondary school students from the province of Granada. The study design was descriptive-exploratory, cross-sectional and ex post facto. Measurements were taken from a single group. The PSQ, PAQ-A and KIDMED questionnaires were used to measure diet quality. Results showed the presence of a positive relationship among all dimensions of physical self-concept and physical activity engagement, with better outcomes being achieved in this self-perception with increasing engagement in sport. With regard to diet quality and its repercussions on physical self-concept, it was highlighted that the dimensions of the general self-concept, physical attractiveness and strength tended to be more positive as quality improved. In contrast, worse outcomes were produced in those with a low-quality diet. In this way, it was deemed necessary to continue investigating psychosocial factors with the aim of clarifying the relationships with psychological factors and health indicators. This would enable the development of prevention and intervention programs focused on promoting wellbeing in adolescents.

Use of latent class analysis as a method of assessing the physical activity level, sedentary behavior and nutritional habit in the adolescents' lifestyle: A scoping review

BACKGROUND

Currently, adolescents' lifestyle is commonly characterized by physical inactivity, sedentary behavior, and inappropriate eating habits in general. A person-oriented approach as Latent Class Analysis (LCA) can offer more insight than a variable-centered approach when investigating lifestyle practices, habits, and behaviors of adolescent population.

OBJECTIVE

The aim of the present study was to assess which variables are mostly used to represent the physical activity level, sedentary behavior SB) and nutritional habit in the adolescents' lifestyle in studies that used the LCA.

DESIGN

Scoping review.

METHODS

The study was a performed in accordance with the proposed criteria for systematic reviews and meta-analyses-Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered in PROSPERO (CRD42018108444). The original articles were searched in MEDLINE/PubMed, Scopus, ScienceDirect, Web of Science, PsycINFO, and SPORTdiscus. The Quality Assessment Tool analyzed the risk of bias of the included studies.

RESULTS

30 original articles were selected. The physical activity level (28 studies), SB and nutritional habits (18 studies) were the most common variable used to evaluate the adolescent's lifestyle by LCA model. Specifically, physical inactivity and high SB were the manifest variables with higher frequency in the negative latent classes (LCs) in adolescent girls. On the other hand, physical exercises and sports were activities more commonly labeled as positive LCs.

CONCLUSIONS

The LCA models of the most of selected studies showed that physical inactivity, high SB were the most common in the LCs with negative characteristics of the adolescents' lifestyle. Better understanding the results of analyzes of clusters of multivariate behaviors such as the LCA can help to create more effective strategies that can make the lifestyle of adolescents healthier.

Body dissatisfaction and disordered eating are prevalent problems among U.S. young people from diverse socioeconomic backgrounds: Findings from the EAT 2010-2018 study

PURPOSE

Body dissatisfaction and disordered eating are linked to adverse health consequences. Research describing socioeconomic patterns in the prevalence of these problems is important for informing the design of health services and efforts to improve health equity.

METHODS

Population-based cohort study (EAT 2010-2018: Eating and Activity over Time) of socioeconomically and ethnically/racially diverse U.S. young people who completed surveys as adolescents in 2009-2010 (mean age = 14.5 years) and as emerging adults in 2018 (mean age = 22.0 years). Participants were recruited from 20 schools in Minneapolis-St. Paul, Minnesota. Household socioeconomic status was determined using adolescent report of parental education, employment, and public assistance benefits. Analyses were conducted using data from 1531 participants and regression models that accounted for repeated measures within individuals.

RESULTS

Among females, high body dissatisfaction and unhealthy weight control behaviors (e.g., skipping meals) were more prevalent and regular use of lifestyle weight management behaviors (e.g., exercise) was less prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Among males, thinness-oriented dieting, unhealthy weight control behaviors, and extreme weight control behaviors (e.g., taking diet pills) were all more prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Few differences were observed across SES groups in models that adjusted for ethnic/racial identity and body mass index.

CONCLUSIONS

There is a need for greater attention to the reach and relevance of efforts to prevent disordered eating and improve body satisfaction to ensure efforts benefit young people across SES groups.

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

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

Differences in the Associations between Body Dissatisfaction and Eating Outcomes by Gender? A Lebanese Population Study

BACKGROUND

The objective of this study was to evaluate the impact of the interaction between body dissatisfaction and gender on eating disorders (restrained eating, binge eating, orthorexia nervosa, and emotional eating) among a sample of Lebanese adults.

METHODS

This cross-sectional study, conducted between January and May 2018, enrolled 811 participants selected randomly from all Lebanese Mohafazat. The mean age of the participants was 27.6±11.8 years. The majority were females (66.5%), had a high level of education (73.2%), and low income (77.9%). This study used the following scales: body dissatisfaction subscale of the Eating Disorder Inventory-second version, binge eating scale, Dutch restrained eating scale, orthorexia nervosa scale (ORTHO-15 scale), emotional eating scale, perceived stress scale, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale.

RESULTS

Body dissatisfaction was positively correlated to restrained eating (r=0.293, P<0.001), emotional eating (r=0.073, P=0.042) and binge eating (r=0.250, P<0.001). The interaction between body dissatisfaction and gender was significantly associated with more restrained eating (Beta=0.01, P<0.001) and orthorexia nervosa (Beta=-0.09, P<0.001), but not with emotional (Beta=-0.43, P=0.103) and binge eating (Beta=-0.08, P=0.358). When stratifying the analysis by gender, the results revealed that higher body dissatisfaction was significantly associated with more restrained eating in both genders, but particularly among women. Body dissatisfaction was significantly associated with higher emotional eating in men only and with higher orthorexia nervosa tendencies and behaviors in females only.

CONCLUSION

The interaction between body dissatisfaction and gender was significantly associated with orthorexia nervosa and restrained eating but not with binge or emotional eating. Higher body dissatisfaction was significantly associated with higher restrained eating, more pronounced in women, while it was significantly associated with higher orthorexia tendencies (lower ORTO-15 scores) in women only. Body dissatisfaction was associated with emotional eating in men only.