The role of puberty, media and popularity with peers on strategies to increase weight, decrease weight and increase muscle tone among adolescent boys and girls

Longitudinal Associations of (Un)popularity with Weight Perceptions and Dieting in Adolescence

Little is known about the unique effects of (un)popularity on body image and the characteristics influencing these effects. The goals of this study were to examine (1) the longitudinal associations of adolescents' (un)popularity with weight perception and dieting, (2) whether (dis)liking, self-esteem, and gender moderated these associations. Participants were 1697 Dutch adolescents (Mage = 14.18 years, SD = 1.29; 51% female), from a middle-class population. Participants completed peer nominations and self-reports in three consecutive school years. Mixed-effects models showed that (un)popularity did not predict weight perception and dieting over time. Concurrently, when liking was low, popularity predicted positive weight perception. Higher popularity predicted more dieting in females. This study highlighted that adolescents' body image varied in subgroups of social status.

A Systematic Review and Meta-Analysis: Child and Adolescent Healthcare Utilization for Eating Disorders During the COVID-19 Pandemic

OBJECTIVE

To conduct a meta-analysis documenting healthcare service utilization rates for pediatric (age <19 years) eating disorders during compared to before the COVID-19 pandemic.

METHOD

PsycINFO, MEDLINE, Embase, and Web of Science Core Collection were searched for studies published up to May 19, 2023. Studies with pediatric visits to primary care, inpatient, outpatient, and emergency department for eating disorders before and during the pandemic were included. This preregistered review (PROSPERO CRD42023413392) was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed with random-effects meta-analyses.

RESULTS

A total of 52 studies reporting >148,000 child and adolescent eating disorder-related visits to >300 health settings across 15 countries were included (mean age, 12.7 years; SD = 4.1 years; 87% girls). There was strong evidence of an increase in healthcare use for eating disorders during the pandemic (rate ratio [RR] = 1.54, 95% CI = 1.38-1.71). Moderator analysis revealed larger rate increases among girls (RR = 1.48, 95% CI = 1.28-1.71) compared to boys (RR = 1.24, 95% CI = 1.06-1.45) and for adolescents (age ≥12 to 19 years) (RR = 1.53, 95% CI = 1.29-1.81) compared to children (RR = 0.87, 95% CI = 0.53-1.43). Moderator analysis demonstrated strong evidence of increased use of emergency department (RR = 1.70, 95% CI = 1.48-1.97), inpatient (RR = 1.56, 95% CI = 1.33-1.84), and outpatient (RR = 1.62, 95% CI = 1.35-1.95) services, as well as strong evidence of increased rates of anorexia nervosa (RR = 1.48, 95% CI = 1.24-1.75).

CONCLUSION

Healthcare use for pediatric eating disorders increased substantially during the COVID-19 pandemic, particularly among girls and adolescents. It is important to continue to monitor whether changes in healthcare use associated with acute pediatric mental distress are sustained beyond the COVID-19 pandemic.

STUDY PREREGISTRATION INFORMATION

Risk factors for eating disorders for youth during the COVID-19 pandemic; https://www.crd.york.ac.uk/; CRD42023413392.

DIVERSITY & INCLUSION STATEMENT

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.

Attitude and behavioral differences regarding their children's social appearance according to the social appearance anxiety levels of the parents

Amaç: Bu araştırmada, sosyal görünüş kaygı düzeyi yüksek ve düşük ebeveynlerin, çocuklarının sosyal görünüşlerine ilişkin tutum ve davranış farklılıklarının incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu araştırmada, nitel araştırma yöntemlerinden bütüncül çoklu durum çalışması kullanılmıştır. Araştırmanın katılımcılarını Adana ili Yüreğir ilçesinde yaşayan okul öncesi dönemde çocuğu olan 16 ebeveyn oluşturmaktadır. Katılımcıların belirlenmesinde, aykırı durum örnekleme yöntemi kullanılmıştır. Araştırmada ebeveynlerin sosyal görünüş kaygı düzeylerini belirlemek için, Sosyal Görünüş Kaygısı Ölçeği (SGKÖ) kullanılmış ve 100 katılımcıya uygulanmıştır. Elde edilen veriler IBM SPSS 25 programıyla analiz edilerek, katılımcılardan en yüksek ve en düşük puan alan sekizer kişi olmak üzere toplam 16 ebeveyn belirlenmiştir. Araştırmacı tarafından oluşturulan yarı yapılandırılmış görüşme formu kullanılarak, ebeveynlerle görüşmeler yapılmıştır. Görüşmeler ses kaydı alınarak yapılmış ve ses kayıtları metne dönüştürülerek, metinler içerik analizine tabii tutulmuştur. Bulgular: Çalışmada, katılımcı grupta SGKÖ puanı en yüksek 66, en düşük 24, ortalama puan 35,71 ± 9,98 olarak elde edilmiştir. SGKÖ puan düzeyi düşük ebeveynlerin yaş ortalaması 34,75 ± 5,57’dir. SGKÖ puan düzeyi yüksek ebeveynlerin ise yaş ortalaması 31,62 ± 2,38’dir. Ebeveynlerin SGKÖ puan düzeylerine göre çocuklarının sosyal görünüşleri hakkındaki düşüncelerinde, çocuklarının bedenlerine yönelik beklentilerinde ve ideal çocuk bedeni tanımlamalarında farklılıklar belirlenmiştir. SGKÖ puanı yüksek ebeveynler, daha çok estetik görünüme ilişkin tanımlamalar yapmışlardır. Ayrıca SGKÖ puanı yüksek ebeveynlerin çocuklarının Beden Kitle İndeksi (BKİ) ile uyumsuz tanımlamalara sahip oldukları görülmüştür. Aksine SGKÖ puan düzeyi düşük olan ebeveynlerin ise çocuklarının bedenlerine ilişkin idealleştirmeye gitmedikleri anlaşılmıştır. Düşük ve yüksek SGKÖ puan düzeylerine sahip ebeveynlerin, çocuklarının sosyal görünüşlerine müdahalelerinde; fiziksel etkinliklerde, kıyafet tercihleri ve fiziksel görünüş uygulamalarında da farklılıklar bulunmuştur. Sonuç: SGKÖ puan düzeyleri düşük ebeveynler, çocuklarının bedenine ilişkin idealleştirmeye gitmezken, SGKÖ puanı yüksek ebeveynlerin estetik görünüme ilişkin tanımlamalar yaptıkları görülmektedir. Bunun yanı sıra, SGKÖ puanı yüksek ebeveynlerin çocuklarının BKİ ile uyumsuz tanımlamalara sahip olduğu görülmüştür. SGKÖ puan düzeylerindeki farklılığın, ebeveynlerin çocuk yetiştirme tutum ve davranışlarında da farklılıklara sebep olduğu belirlenmiştir. Çalışmamıza göre, SGKÖ puan düzeyi yüksek olan ebeveynler çocuklarının beden görünümlerine daha fazla müdahale etmektedirler. Yeme kısıtlamaları, harekete teşvik ve akranları ile kıyaslama şeklinde tutum ve davranışları daha fazla göstermektedirler.

Adolescent's self-reported weight and its association with media impact on decision to lose weight and body thinness perception

This study investigated the accuracy of self-reported weight among Kuwaiti adolescents and the associations of self-reported weight and calculated BMI with the impact of media use on adolescent’s decision to lose weight and body thinness perception. A total of 706 Kuwaiti adolescents (363 females) 15–18 year-olds were randomly selected from schools. Weight and height were self-reported by the adolescents and measured by the researchers. A specifically designed questionnaire reported the impact of media use on adolescent’s decision to lose weight and body thinness perception. There were significant (p < 0.001) relationships between measured and reported weight (r = 0.947), height (r = 0.777), and calculated BMI (r = 0.623). Intraclass correlation coefficients (95% CI) between self-reported and measured weight and height were 0.973 (0.968–0.977) and 0.867 (0.839–0.891), respectively. The mean differences between self-reported and measured weight (1.26 kg) and BMI (0.478 kg/m²) were relatively small. Females under-reported their weight and the calculated BMI from estimated weight and height was underestimated by adolescents with overweight/obesity. The impact of media use on the adolescent’s perception of being thin relative to the accuracy of the calculated BMI was significant (p = 0.043–0.001). The age-adjusted odds ratio of the calculated (underestimated) BMI in adolescents without overweight/obesity was 0.437 (95% CI = 0.257–0.741; p = 0.002). It was concluded that the validity of self-reported weight was high. Adolescents with overweight/obesity were more likely to underestimate their weight and calculated BMI. Educating adolescents about proper lifestyles and weight loss through media appears warranted.

Assessment of Actual Weight, Perceived Weight and Desired Weight of Romanian School Children-Opinions and Practices of Children and Their Parents

Objective: Children and parental awareness regarding weight is linked to the development and management of overweight and obesity. The aim of this study is to assess the actual weight, perceived weight, and desired weight of Romanian school children. Methods: A cross-sectional study was conducted in 2019 in seven schools from two counties of Romania and included 880 pupils aged between 10 and 15 years old and 665 parents. We administrated confidential questionnaires to the participants, and we measured children’s weight and height during school activities. Results: A total of 61.0% of pupils had normal weight, 7.4% were underweight, and 31.6% were overweight or obese. A total of 66.7% of normal weight children, 56.5% of overweight children, and 40% of underweight children perceived their weight accurately. Regarding parents, a majority correctly appreciated the weight of their normal weight children and only a third appreciated correctly the body weight of their underweight and overweight children. Factors such as body mass index, gender, weight related behaviors, parents’ estimation about their children’s weight, discussions of weight topics inside family, and bullying, cyberbullying and exclusion from groups were associated with misperceptions. Conclusion: The study provides useful information for health education activities targeting both children and their parents regarding appropriate body weight management of children.

Adolescents' Use of Sexually Explicit Internet Material Over the Course of 2019-2020 in the Context of the COVID-19 Pandemic: A Three-wave Panel Study

Recently, sexual health scholars have expressed concerns regarding adolescents' use of sexually explicit internet materials (SEIM) during the COVID-19 pandemic. Therefore, using latent growth curve modeling, the current study explored adolescents' changes in the frequency of SEIM use before, during, and after a strict lockdown period was established in Belgium. Attention was given to individual differences (i.e., gender, gender identity, sexual orientation, pubertal timing, and sensation seeking). A three-wave panel study over a 15-month period among 522 adolescents was used (M_age = 15.36, SD = 1.51, 67.1% girls). In general, SEIM use did not significantly increase over a 15-month period in the context of the COVID-19 pandemic. Only gender predicted a change in SEIM use frequencies with girls showing a greater, increasing change of SEIM use than boys. When addressing why adolescents used SEIM during a strict lockdown period, sexual arousal, stress, and boredom regulation motivations emerged as the most prevalent motivations. Loneliness regulation was the least prominent motivation. Individual differences were found regarding the gratifications sought according to adolescents' gender, pubertal timing, and sensation seeking. The findings offer a response to sexual scholars' worries in terms of adolescents' SEIM use during the COVID-19 pandemic.

Prevalence and correlates of weight gain attempts across five countries

OBJECTIVE

To determine the prevalence and correlates of weight gain attempts in a pooled sample of adults aged 18 and older from Canada, Australia, the United Kingdom, the United States, and Mexico.

METHOD

Data collected during 2 years (2018 and 2019) of the International Food Policy Study (N = 42,108) were analyzed. Unadjusted 12-month prevalence of weight gain attempts was estimated based on body mass index (BMI; kg/m² ), weight perception, country, survey year, and sex. Logistic regression analyses were estimated to determine the sociodemographic correlates (age, race/ethnicity, education, BMI, weight perception, weight perception accuracy, and self-rated mental health) of weight gain attempts among the pooled sample stratified by sex.

RESULTS

Men (10.4%) were significantly more likely than women (5.4%) to report weight gain attempts (p < .001). Nearly one in five (17.1%) men with a BMI in the "normal" range (≥18.5 to <25.0) reported weight gain attempts. Among both men and women, minority group identity was associated with higher odds, while older age and higher BMI category were associated with lower odds, of reporting weight gain attempts. Country differences over the two survey years showed the prevalence of weight gain attempts in 2019 (vs. 2018) was higher among women in Australia (p < .05) and men in the United States (p < .01).

DISCUSSION

Weight gain attempts are more common among men, compared to women, across five countries, potentially reflecting the global salience of the pursuit of a muscular body.

Self-Esteem and Binge Eating among Adolescent Boys and Girls: The Role of Body Disinvestment

Although low self-esteem and body disinvestment have been recognized as potential risk factors for disordered eating, no studies have explored how these factors may work together to predict binge eating in adolescents. Therefore, we hypothesized a path model for girls and boys separately to investigate whether the body’s investment dimensions (feelings towards the body, physical touch, body care, body protection) mediate the relationship between self-esteem and binge eating, and age moderate such relationships. Participants were 1046 Italian students aged between 11 and 19 years (472 girls, M_age = 14.17; 574 boys, M_age = 14.60) screened through self-report measures. Both models showed an acceptable fit (males: χ²₍₂₂₎ = 30.441; RMSEA = 0.026; CFI = 0.99; TLI = 0.97; SRMR = 0.023; females: χ²₍₂₂₎ = 34.723; RMSEA = 0.35; CFI = 0.98; TLI = 0.95; SRMR = 0.029). Negative body feelings and reduced body protection fully mediated the relationship between self-esteem and binge eating, regardless of gender. Our findings highlight the importance of interventions promoting body emotional investment to reduce adolescents’ vulnerability to binge eating.

Exploring transgender adolescents' body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth

Transgender adolescents (TGAs) face many of the same sociocultural and biological influences on body dissatisfaction and disordered eating as cisgender peers. Additionally, TGAs experience unique body- and gender-related concerns. The purpose of this study is to explore the nuances of gender identity, gender transitioning, body image, and disordered eating among TGAs. Case summaries and a synthesis of key themes are presented from interviews with nine TGAs aged 16-20 (M_age = 17). All participants reported engaging in at least one behavior to change their weight or shape. Consistent with a theoretical biopsychosociocultural model we proposed, TGAs described body dissatisfaction and disordered eating related to transgender-specific factors (e.g., behaviors aimed at minimizing secondary sex characteristics) and broader developmental and sociocultural factors. Some participants reported improvements in body image and disordered eating following gender transition. The interviews highlight complex associations among gender identity, gender transitioning, body image, and disordered eating during adolescence, suggesting that disentangling transgender-specific factors from other individual factors is difficult. These findings may guide future research on the prevalence and functions of disordered eating among TGAs and point to a unique set of needs for effective detection and treatment of concurrent gender incongruence, body dissatisfaction, and disordered eating.

Internalized Weight Bias, Teasing, and Self-Esteem in Children with Overweight or Obesity

Background: Although 2/3 of US adults and nearly 1/3 of US children have overweight or obesity, weight stigma is common. Many with overweight or obesity ascribe negative ideas to themselves, resulting in internalized weight bias (IWB). In adults, IWB has been associated with psychosocial problems; however, this relationship has been studied little in children. This study aims to describe IWB in children with overweight and obesity and to study the association of children's IWB with experienced weight bias, self-esteem, and their parents' IWB. Methods: Children ages 9-18 with overweight or obesity completed the Weight Bias Internalization Scale (WBIS), Rosenberg Self-Esteem Scale, and Perception of Teasing Scale; parents completed the Weight Bias Internalization Scale-Modified and the Perceived Weight Discrimination Scale. Descriptive statistics were used to assess IWB, self-esteem, and experienced weight stigma. Chi-square and t-tests were used to examine associations between categorical and continuous variables, respectively. Multivariate linear regression was used to identify correlates of IWB in children. Results: Of 111 child participants, the median WBIS score was 2.8 out of 7. Higher IWB was associated with more peer teasing (p < 0.001) and lower self-esteem (p < 0.001). IWB in children was not associated with child BMI z-score (p = 0.590) or higher parent IWB (p = 0.287). Conclusions: Children with overweight and obesity who have experienced more teasing by peers or who have lower self-esteem are more likely to have a higher IWB. However, increasing child BMI z-score and parent IWB are not associated with higher child IWB.

The Accuracy of Self-Reported Body Weight Is High but Dependent on Recent Weight Change and Negative Affect in Teenage Girls

BACKGROUND

Research studies often rely on self-reported weight to calculate body mass index. The present study investigated how the accuracy of self-reported body weight in adolescent girls is affected by overweight/obesity, race/ethnicity, and mental health factors.

METHODS

In a cohort of girls who participated in the Trial of Activity for Adolescent Girls at ages 11 and 17 (n = 588), self-reported and measured weight were compared, and linear regression models were fitted to model the over- or underreporting. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to calculate depressive symptom subscales for negative affect, anhedonia and somatic symptoms.

RESULTS

Allowing 3% difference between self-reported and measured weight for the correct reporting of body weight, 59.2% of girls reported their weight correctly, 30.3% underreported (-5.8 ± 4.8 kg), and 10.5% overreported (4.3 ± 3.5 kg). The average difference between self-reported and measured body weight was -1.5 ± 4.3 kg (p < 0.001). Factors for misreporting body weight were overweight (β ± SE - 2.60 ± 0.66%), obesity (β ± SE - 2.41 ± 0.71%), weight change between ages 11 and 17 (β ± SE - 0.35 ± 0.04% for each kg), height change between ages 11 and 17 (β ± SE 0.29 ± 0.10% for each cm), and negative affect (β ± SE - 0.18 ± 0.08% for each score unit).

CONCLUSIONS

The difference between self-reported and measured body weight in adolescent girls is relatively small. However, the accuracy of self-reported body weight may be lower in girls with overweight or obesity, recent weight and height change, and higher negative affect.

Determinants of health and well-being in adolescents : Review of sex differences with a focus on boys

A wide variety of variables determine health and well-being in adolescence. How these variables may differ in relation to gender or sex is often not clear. In addition, research on sex differences often focuses on females rather than males. This review gives an overview on the literature with respect to possible gender/sex-specific determinants and correlates of health and well-being in adolescent boys. The search strategy used the approach of a narrative review, which led to 17 papers being included. The data synthesis employed a qualitative and descriptive analysis approach. We found sex differences in three categories: clinical symptoms, health and well-being, and risk behavior. The results show a variety of determinants that lead to sex differences in health outcomes, such as peer relations, social economic status, physical activity and coping styles. Strengths and limitations of the literature and implications for future research are discussed.

Secular trends in adiposity within the context of changes in BMI across developmental periods among Polish schoolchildren-application of the Slaughter equation

OBJECTIVES

To estimate secular changes in the body fatness, assessed using the Slaughter equation, in the context of changes in BMI in different developmental periods among Polish schoolchildren studied over nearly 50 years.

METHODS

Data were collected during Polish Anthropological Surveys (1966, 1978, 1988, 2012). The total random sample consisted of 69,746 schoolchildren, aged 7-18. Three periods of development were identified: childhood, early adolescence, and late adolescence. Raw data of BMI were standardized for age classes. Based on the body fat percentage, calculated using Slaughter equation (involving triceps and subscapular skinfold thickness), fat mass (FM; kg), and then fat mass index (FMI = FM/height⁶; kg/m⁶) was assessed to enable comparison between body fatness and BMI. Statistical analyses included two-way ANOVA and post-hoc Tukey's tests.

RESULTS

In boys, in terms of changes per decade, between 1966 and 2012 acceleration in Z-BMI and deceleration in FMI were found, irrespective of developmental period. Regarding girls, deceleration of trend was found in terms of both features, with different intensity, depending on developmental period and year of study. The pattern of changes in FMI depending on developmental period was, to some extent, similar for both sexes.

CONCLUSIONS

Slaughter equation for abovementioned two skinfolds, as a method of body fatness assessment, might be a useful tool for research on boys across different developmental periods, but not on girls. Moreover, it should be used with caution when applied to secular changes in adiposity in both sexes, since the distribution of fat tissue varies across ontogenesis, but also over generations.

Toward A Greater Understanding of the Ways Family-Based Treatment Addresses the Full Range of Psychopathology of Adolescent Anorexia Nervosa

Family-based treatment (FBT) for anorexia nervosa (AN) is an empirically supported treatment for this disorder. Derived from several different schools of family therapy, it is a highly focused approach that initially targets weight restoration under parental management at home. However, the view that manualized FBT is solely a behavioral therapy directing parents to refeed their children AN with the single purpose of weight gain is a common but misleading over simplification of the therapy. Indeed, weight restoration is the main goal only in phase 1 of this 3-phase treatment. When practiced with fidelity and skill, FBT's broadest aim is to promote adolescent development without AN thoughts and behaviors interfering and disrupting these normal processes. Although weight restoration is a key starting point in FBT, the entire course of treatment takes into consideration the ongoing impact of starvation, cognitions, emotions, and behaviors on adolescent development. These factors associated with maintaining low weight are viewed in FBT as interfering with the adolescent being able to take up the tasks of adolescence and thus must be overcome before fully turning to those broader adolescent tasks. In addition, FBT recognizes that adolescence takes place in the context of family and community and respects the importance of learning in a home environment both for weight gain as well as related developmental tasks to have a lasting effect. Specifically, in this article we describe how the current FBT manualized approach addresses temperament/personality traits, emotional processing, cognitive content and process, social communication and connections, psychiatric comorbidity, and family factors. This report makes no claim to superiority of FBT compared to other therapies in addressing these broader concerns nor does it add interventions to augment the current manual to improve FBT.

[Tripartite Influence Scale (TIS) applied to university students: validation study and application]

The Tripartite Influence Scale (TIS) is used to assess the influence of social and family factors on individuals' body image. However, little evidence has been presented on the validity of the TIS construct. The study aimed to estimate the psychometric indicators in TIS and identify the degree of influence of the media, parents, and peers on body image in university students, considering different characteristics. University students of both sexes participated. The psychometric indicators in TIS were assessed for each sex using confirmatory factor analysis. Mean scores were calculated for each TIS factor. Prevalence rates for degree of influence were presented. A multivariate regression model was built to verify the relationship between target characteristics and TIS factor scores. The sample included 791 university students (63.2% women) 18 to 40 years of age. TIS did not initially display a good fit to the samples and was therefore refined. After refinement, the scale showed adequate validity and reliability for women and men. Significant differences were observed in the mean scores between women and men, and in the prevalence rates the majority of the students were in the low category. Work, consumption of food supplements for body changes, age, body mass index, self-rated diet, and level of physical activity were significantly related to TIS factors. Women were generally more influenced than men by the media and peers. Characteristics identified as related to TIS can be relevant for inclusion in clinical and research protocols.

Disordered Eating Among a Diverse Sample of First-Year College Students

OBJECTIVE

A cross-sectional study of first-year college students was conducted to identify the prevalence and predictors of disordered eating (DE).

METHODS

College freshmen students, aged 18 years, (n = 106) completed the Eating Disorder Examination Questionnaire (EDE-Q) and a supplemental survey. A subset of the sample (n = 77) underwent measurements of height, weight, and body composition. DE was defined as an elevated (3) weight, shape, eating concern, or dietary restraint EDE-Q subscale score.

RESULTS

The sample, consisting of 56.6%, 15.1%, 11.3%, and 11.3% Latino/a, Asian, African American, and Caucasian students, respectively (37% male), reported a 31.1% prevalence of DE. The current desire to lose weight was the strongest predictor of DE (odds ratio = 15.3; 95% confidence interval = 2.8, 82.5). Other variables linked to DE or elevated EDE-Q subscale scores included body mass index (BMI) 25.0 kg/m², vegetarianism, weight loss in the past year, female gender, and eating breakfast < 5 d/wk. Participants with BMI 25.0 kg/m² and the current desire to lose weight (n = 23) or following a vegetarian diet (n = 5) exhibited the highest prevalence of DE (78.3% and 80.0%, respectively). A higher proportion of Latinas reported binge episodes compared to female Caucasian, Asian, and African American students (36.4% vs. 0.0%, 6.7%, and 28.6%, respectively, p = 0.056, χ² = 7.6). Males, versus females, were more likely to report excessive exercise (56.4% vs. 37.3%, p = 0.056, χ² = 3.6).

CONCLUSIONS

This study adds to the current body of literature on DE by providing a diverse sample and potentially novel predictors and risk factors for DE.

Evaluating interest in narrative therapy for decision making about pectus excavatum treatment

OBJECTIVES

The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles.

METHODS

Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions, with 3 questions specifically evaluating interest in narrative therapy.

RESULTS

Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05).

CONCLUSIONS

The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisciplinary model.

Linking Magazine Exposure to Social Appearance Anxiety: The Role of Appearance Norms in Early Adolescence

Early adolescents (N = 1,591; M_age  = 11.698; SD = 0.892) participated in a two-wave panel study (6-month interval) to examine the longitudinal association between appearance-focused magazine exposure and social appearance anxiety. We revealed that magazine exposure positively correlated with the internalization of appearance ideals and the attribution of social rewards to attractiveness which, in turn, related to social appearance anxiety. Internalization and attribution of social rewards formed a reinforcing spiral; once internalized, early adolescents associate positive things with appearance ideals (e.g., peer acceptance) and the perception of rewards increases early adolescents' inclination to internalize ideals. Given the adverse consequences of social appearance anxiety, the findings warrant research on the role of media in the occurrence of social appearance anxiety.

Aspiring to have the looks of a celebrity: young girls' engagement in appearance management behaviors

Research suggests that sexualizing media messages are present in teen media and negatively affect young girls' body image. Yet, it is unknown whether exposure to teen television programs is associated with girls' engagement in appearance management behaviors. Two-wave longitudinal data among 785 girls (Mage = 11.65 years) were collected. Results show that teen television exposure was longitudinally related to appearance management, while the reverse relation was not supported. Approximately half of the girls indicated to manage their appearance to some extent, and 13- to 14-year-old girls were more likely to invest in their appearance than younger girls. Thirty percent of those who did not manage their appearance at the start of the study indicated to have initiated appearance management 6 months later. Frequent viewers were four times, three times, and twice as more likely to style their hair, wear heels, and apply make-up compared to non-viewers.

CONCLUSION

The current study showed that teen media exposure plays a role in young girls' appearance management. The findings point to a need to teach young girls about stereotypical messages in media content directed towards them. Prevention efforts should focus on girls who frequently watch teen media. What is Known: • Sexualizing media messages are present in teen media. • Gender identity development is one of the key tasks during adolescence. What is New: • Tween television exposure predicts 9- to 14-year-old girls' engagement in appearance management over time. • Engagement in appearance management behaviors did not predict 9- to 14-year-old girls' exposure to tween television programs.

Thin and sexy vs. muscular and dominant: Prevalence of gendered body ideals in popular dolls and action figures

We examined the extent to which popular dolls and action figures were portrayed with gendered body proportions, and the extent to which these gendered ideals were associated with heterosexual "success." We coded internet depictions of 72 popular female dolls and 71 popular male action figures from the websites of three national stores in the United States. Sixty-two percent of dolls had a noticeably thin body, while 42.3% of action figures had noticeably muscular bodies. Further, more thin dolls were portrayed with more sex object features than less thin dolls, including revealing, tight clothing and high-heeled shoes; bodies positioned with a curved spine, bent knee, and head cant; and with a sexually appealing facial expression. More muscular male action figures were more likely than less muscular ones to be shown with hands in fists and with an angry, emotional expression, suggesting male dominance.

Does psychological functioning mediate the relationship between bullying involvement and weight loss preoccupation in adolescents? A two-stage cross-sectional study

Background

Adolescent bullying is associated with a range of adversities for those who are bullied i.e., victims and bully-victims (e.g., those who bully others and get victimised), including reduced psychological functioning and eating disorder symptoms. Bullies are generally well-adjusted psychologically, but previous research suggests that bullies may also engage in problematic diet behaviours. This study investigates a) whether adolescents involved in bullying (bullies, victims, bully-victims) are at increased risk of weight loss preoccupation, b) whether psychological functioning mediates this relationship and c) whether sex is a key moderator.

Method

A two-stage design was used. In stage 1, adolescents (n = 2782) from five UK secondary schools were screened for bullying involvement using self and peer reports. In stage 2, a sample of bullies, victims, bully-victims and uninvolved adolescents (n = 767) completed a battery of assessments. The measures included the eating behaviours component of the Child and Adolescent Psychiatric Assessment, which was reduced to one factor (weight loss preoccupation) and used as the outcome variable. Measures of self-esteem, body-esteem and emotional problems were reduced to a latent (mediator) variable of psychological functioning. Multi-group analysis examined the effects of sex and all models were adjusted for covariates (BMI, pubertal stage, age, parental education and ethnicity).

Results

Bullies, victims and bully-victims were at increased risk of weight loss preoccupation compared to adolescents uninvolved in bullying. The mechanism by which bullying involvement related to increased weight loss preoccupation varied by bullying role: in bullies the effect was direct, in victims the effect was indirect (via reduced psychological functioning) and in bully-victims the effect was both direct and indirect. Sex significantly moderated the relationship in bullies: weight loss preoccupation was only statistically significant in bullies who were boys.

Conclusion

Bullying involvement during adolescence is associated with weight loss preoccupation. Bullies are likely driven by a desire to increase attractiveness and social status; whereas weight loss preoccupation in bullied adolescents may have maladaptive influences on diet and exercise behaviours due to its association with reduced psychological functioning. Future research should consider peer victimisation as a potential modifiable risk factor for reduced psychological functioning and weight loss preoccupation, which if targeted, may help to prevent maladaptive diet and exercise behaviours.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0491-1) contains supplementary material, which is available to authorized users.

Association between distorted body image and changes in weight status among normal weight preadolescents in Japan: a population-based cohort study

BACKGROUND

Distorted body image may be important risk factors for being underweight and overweight. The objective of this study was to investigate the association between having a distorted body image and being overweight or underweight among normal weight preadolescents in a population-based cohort study in Japan for each sex.

METHODS

The study participants were 1431 normal weight fourth-grade students (age range: 9-10 years) in Ina town, Japan from 2002 to 2007. The height and weight of each student were measured while they were in the fourth grade (at baseline) and seventh grade (3 years later). Childhood underweight and overweight were defined using the body mass index cut-off points proposed by the International Obesity Task Force. Information regarding the self-perceived weight status of each student at baseline was collected using a self-administered questionnaire. Children who were normal weight but perceived themselves as heavy or thin were regarded as having a distorted body images. A logistic regression model was used to calculate the odds ratios (ORs) and 95 % confidence interval (95 % CI) for being overweight or underweight 3 years later among those having a distorted body image at baseline.

RESULTS

Both boys and girls who perceived themselves to be heavy at baseline were at a statistically significantly greater risk of being overweight 3 years later as compared to boys and girls, respectively, who identified as being at a normal weight at baseline (boys: adjusted OR: 4.66, 95 % CI: 1.01-21.48; girls: 3.88, 1.56-9.65). Both boys and girls who perceived oneself to be thin at baseline were at a statistically significantly greater risk of bring underweight 3 years later as compared to boys and girls, respectively, who identified as being at a normal weight at baseline (boys: 5.51, 2.20-13.80; girls: 2.93, 1.40-6.11).

CONCLUSION

The results of the present study suggest that having a distorted body image in preadolescence is associated with being overweight or underweight in adolescence, among boys and girls, separately. Therefore, education regarding self-perceived weight could be important to help prevent underweight and overweight/obesity among preadolescent boys and girls in Japan.

Adolescent Boys' Reactions to Using Avatars to Represent Their Bodies

The purpose of this study was to provide a detailed description of completing the Attitudes and Avatars Instrument in the classroom and explore the feasibility and acceptability of the instrument.

METHODS

The descriptive study included three written open-ended questions for data collection to which young adolescent boys responded after completing the Attitudes and Avatars Instrument.

RESULTS

Fifty-nine boys between 11 and 14 years of age completed the instrument in the time allotted and had an overall positive reaction.

CONCLUSION

As the Attitudes and Avatars Instrument continues to develop as a screening instrument, it is imperative to obtain feedback from boys of diverse races and ethnicities.

Overweight trends among Polish schoolchildren before and after the transition from communism to capitalism

This study aims to reveal the secular trends in body mass index (BMI) and the prevalence of overweight and obesity among Polish schoolchildren between the years 1966-2012, during which intense socio-political changes took place. Four surveys were conducted in several districts of Poland looking at 69,746 schoolchildren aged 7-18. Significant increase in mean BMI as well as in the prevalence of overweight and obesity was observed. During this time the highest increase in both mean BMI and excess weight was observed between 1988 and 2012, i.e. after the political transformation, resulting in the improvement of living conditions. However, with respect to girls in late adolescence, between these years, the mean BMI as well as the prevalence of overweight were leveling off, while the percentage of boys with excess body fat in the same developmental category significantly increased in 2012. In the years 1966-1978 and 1978-1988 the pattern of changes in the prevalence of overweight and obesity reflected the social and economic circumstances, i.e. temporary economic improvements, or deepening political crises and food shortage. In conclusion, the weight status of schoolchildren strongly reflects socio-political changes that took place in Poland, as well as in most of the Central European countries in the last half century.

Autonomous motivation mediates the relation between goals for physical activity and physical activity behavior in adolescents

Overall, 544 children (mean age ± standard deviation = 14.2 ± .94 years) completed self-report measures of physical activity goal content, behavioral regulations, and physical activity behavior. Body mass index was determined from height and mass. The indirect effect of intrinsic goal content on physical activity was statistically significant via autonomous ( b = 162.27; 95% confidence interval [89.73, 244.70]), but not controlled motivation ( b = 5.30; 95% confidence interval [-39.05, 45.16]). The indirect effect of extrinsic goal content on physical activity was statistically significant via autonomous ( b = 106.25; 95% confidence interval [63.74, 159.13]) but not controlled motivation ( b = 17.28; 95% confidence interval [-31.76, 70.21]). Weight status did not alter these findings.

The relationship between distorted body image and lifestyle among Japanese adolescents: a population-based study

Background

Distorted body image plays a significant role in the development of obesity, eating problems, and eating disorders. The aim of this study was to investigate the relationship between distorted body image and lifestyle among Japanese adolescent boys and girls.

Methods

Subjects were 1731 seventh graders (age 12–13 years) from the Ina-town’s junior high schools, Japan, from 2005–2009. The height and weight of each subject were measured. Childhood underweight, overweight, and obesity were defined using the body mass index cutoff points proposed by the International Obesity Task Force. Information regarding the self-perceived weight status and lifestyles (exercise, snacking after dinner, breakfast, wakeup time, bedtime) of each subject was collected using a self-administered questionnaire. Self-perceived weight status was categorized into three groups (thin, normal, or heavy), and compared with the subjects’ actual weight status. Body image perception was categorized into the following three groups: an underestimated own weight status group (underestimated group), a correct own weight status group (correct group) and an overestimated own weight status group (overestimated group).

Results

The proportion of boys in the underestimated group was higher than that of girls, while the opposite was true for the overestimated group (P < 0.001). There were no statistically significant differences in lifestyle between the underestimated group and the correct group regardless of sex. In contrast, there were statistically significant differences between the overestimated group and the correct group in the lifestyle factors of exercise among boys and snacking after dinner among girls. The adjusted odds ratio (OR) in boys who exercised daily significantly decreased (OR: 0.35, 95 % CI: 0.16–0.77), while a significantly increased OR was observed in girls who snacked after dinner (OR: 1.53, 95 % CI: 1.07–2.19).

Conclusion

Adolescent boys tended to underestimate their body weight, whereas adolescent girls were likely to overestimate their body weight. Furthermore, lifestyle factors associated with distorted body image differed by sex, with exercise affecting body image perception among boys and snacking after dinner affecting body image perception among girls. Thus, lifestyle may lead to distorted body image among adolescents.

The role of high-quality friendships in female adolescents' eating pathology and body dissatisfaction

PURPOSE

Peers may serve as risk factors for body dissatisfaction and eating pathology through two possible routes: (1) promoting body dissatisfaction through appearance-related interactions (e.g. weight-teasing); (2) a non-specific social support route whereby poor quality peer relations result in depression and consequently eating pathology. The second route has received little attention and, therefore, was the focus of this study.

METHODS

A cross-sectional study in which 216 adolescent girls (aged 13-16 years) completed self-report measures of positive and negative friendship qualities, friendship functions, eating pathology, body dissatisfaction and depression.

RESULTS

Those reporting poorer quality friendships tended to show greater eating pathology and greater body dissatisfaction. These associations were reduced to non-significance when covarying depression. There was no evidence that the role of friendships was moderated by the extent to which participants valued close relations.

CONCLUSIONS

Low-quality friendships are associated with disordered eating and may be suitable targets for prevention.

Puberty as a critical risk period for eating disorders: a review of human and animal studies

This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty.

Pubertal development predicts eating behaviors in adolescence

OBJECTIVE

Early maturing girls are at increased risk for disordered eating. However, it is unclear if the association between puberty and disordered eating continues throughout pubertal development and if a similar association is exhibited in boys.

METHOD

Participants included 1340 same- and 624 opposite-sex twins from the Swedish Twin Study of Child and Adolescent Development. Pubertal development was assessed at age 13-14 with the pubertal development scale. General disordered eating, measured with the eating disorder inventory-2 (EDI) was assessed at age 16-17, and dieting and purging behaviors were assessed at both ages 16-17 and 19-20. We applied analysis of variance and logistic regression analyses to determine whether pubertal development in early-to-mid adolescence predicted eating disorder-related behaviors in late adolescence and young adulthood.

RESULTS

Pubertal development in early-to-mid adolescence was significantly associated with EDI scores and dieting in late adolescence. No significant association was observed between pubertal development and dieting and purging in young adulthood.

DISCUSSION

Complex combinations of cultural and biological influences likely converge during pubertal development increasing vulnerability to disordered eating. The impact of pubertal development on disordered eating appears to be limited to the adolescent period.

Body change techniques in Iranian adolescents. Relationship to sex and body weight status

OBJECTIVE

Several studies indicated that techniques to change body weight and appearance were prevalent and different among adolescents. The aim of the study, therefore, was to assess differences in frequency and type of body change techniques used among adolescents by sex and body weight status.

METHODS

A sample of 758 adolescents aged 12-18 years were recruited from private and public schools in Tehran. Information about socio-demographic background and body change techniques were collected via a self-administered questionnaire.

RESULTS

A high percentage of adolescents used body change techniques frequently to alter their body appearance. Girls changed normal eating pattern significantly (p=0.007) to lose weight more frequently than boys while boys used this method significantly (p=0.01) to gain weight more frequently than girls. Overweight/obese adolescents exercised significantly to change muscle size (p=0.03) and changed normal diet to lose weight (p<0.001) more frequently than normal weight adolescents. The relation between sex and body weight status with body change techniques (p<0.0) implied that male and female adolescents especially overweight/obese adolescents were frequently trying to change their body appearance.

CONCLUSION

Significant differences existed in using body change techniques according to sex and body weight status and these should be considered in obesity prevention programs for adolescents.

Body image, body satisfaction and dieting behavior in Japanese preadolescents: The Toyama birth cohort study

OBJECTIVES

To examine the relationships between body image, body satisfaction and dieting behavior in the context of pubertal changes in Japanese preadolescents.

METHODS

A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12-13) born in Toyama prefecture.

RESULTS

The percentages of those who perceived themselves fat, wanted to be thinner, and had tried dieting, which increased with body mass index (BMI), were significantly higher in girls than in boys (34.2% vs. 20.0%, 58.0% vs. 26.0%, and 17.3% vs. 5.7%, respectively). Independent of sex and BMI, those who wanted to be thinner and those who had tried dieting were more frequently observed in those who perceived themselves fat, and those who had tried dieting were more frequently observed in those who wanted to be thinner. Pubertal changes were significantly associated with dieting behavior, but their relationships to body image and body satisfaction differed between sexes; for boys, those who perceived themselves fat were more frequently observed in those without pubertal changes; whereas for girls, those who wanted to be thinner were more frequently observed in those with pubertal changes.

CONCLUSIONS

Dieting behavior of Japanese preadolescents was associated with whether they perceived themselves fat and wanted to be thinner, sometimes independent of whether they were actually overweight. Pubertal changes might induce a positive perspective of growing fat among boys and a desire to be thinner among girls, with the consequence that dieting behavior would be reinforced in those with pubertal changes.

Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents: The Toyama birth cohort study

OBJECTIVES

To analyze the path to dieting behavior in Japanese preadolescents.

METHODS

A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12-13) born in Toyama prefecture.

RESULTS

While increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0)for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior.

CONCLUSIONS

Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.

Equivalência Semântica da versão em português do "Body Change Inventory"

Com o crescimento das pesquisas acerca dos componentes da imagem corporal, fazem-se necessários instrumentos válidos que avaliem suas dimensões. O Body Change Inventory (BCI) avalia as estratégias adotadas para modificação do corpo entre adolescentes. O objetivo deste estudo foi descrever o processo de tradução e avaliação da equivalência semântica do BCI para a língua portuguesa. O processo envolveu as etapas de (1) tradução do questionário para o idioma português; (2) retrotradução para o inglês; (3) avaliação da equivalência semântica; e, (4) análise da compreensão verbal por especialistas e jovens brasileiros. As seis subescalas que compõem o instrumento foram traduzidas para o português. Foram realizadas adaptações na linguagem a fim de tornar o instrumento adequado à realidade brasileira. As questões foram interpretadas como de fácil compreensão tanto por especialistas quanto pelos jovens. O Questionário de Mudança Corporal encontra-se traduzido e adaptado para o idioma português, sendo ainda necessária a avaliação das equivalências operacional, de mensuração e funcional.

Differentiating the effects of maternal and peer encouragement to diet on child weight control attitudes and behaviors

Obese and overweight youth are more at risk for engaging in frequent dieting, unhealthy weight control behaviors and report more body dissatisfaction than their normal weight peers. Previous research has indicated that peer and maternal encouragement to diet is predictive of unhealthy weight related behaviors and attitudes. The current study aims to examine if maternal and peer encouragement to diet equally mediate the relationship between youth BMI z-score and (a) unhealthy weight control behaviors, (b) diet frequency and (c) body dissatisfaction in a sample of racially diverse boys and girls. Participants were 94 children/adolescents between the ages of 8-17. Results were stratified by gender. Three bootstrapped multiple mediation models were conducted to examine each outcome variable. Results indicated that maternal encouragement to diet mediated the relationships predicting unhealthy weight control and diet frequency for girls, but not for boys. Peer encouragement to diet significantly mediated the relationship predicting unhealthy weight control behaviors, with increased peer encouragement associated with fewer unhealthy weight control behaviors for girls. Peer encouragement to diet was not a significant mediator for any of the outcomes for boys. Results suggest that maternal encouragement to diet may play a larger role than peer encouragement to diet in predicting unhealthy weight attitudes and behaviors for girls.

Body image, eating disorders, and the relationship to adolescent media use

Historically and currently, media messages around body shape and size emphasize the importance of being below-average weight for women and hypermuscular for men. The media messages around physical appearance are not realistic for most and lead to body dissatisfaction for most adolescents. Interventions designed to mitigate the influence of negative media messages on adolescents' body image are presented; however, most have shown limited success.

Construct validity of a figure rating scale for Brazilian adolescents

Background

Figure rating scales were developed as a tool to determine body dissatisfaction in women, men, and children. However, it lacks in the literature the validation of the scale for body silhouettes previously adapted. We aimed to obtain evidence for construct validity of a figure rating scale for Brazilian adolescents.

Methods

The study was carried out with adolescent students attending three public schools in an urban region of the municipality of Florianopolis in the State of Santa Catarina (SC). The sample comprised 232 10-19-year-old students, 106 of whom are boys and 126 girls, from the 5th "series" (i.e. year) of Primary School to the 3rd year of Secondary School. Data-gathering involved the application of an instrument containing 8 body figure drawings representing a range of children's and adolescents' body shapes, ranging from very slim (contour 1) to obese (contour 8). Weights and heights were also collected, and body mass index (BMI) was calculated later. BMI was analyzed as a continuous variable, using z-scores, and as a dichotomous categorical variable, representing a diagnosis of nutritional status (normal and overweight including obesity).

Results

Results showed that both males and females with larger BMI z-scores chose larger body contours. Girls with higher BMI z-scores also show higher values of body image dissatisfaction.

Conclusion

We provided the first evidence of validity for a figure rating scale for Brazilian adolescents.

The role of early maturation, perceived popularity, and rumors in the emergence of internalizing symptoms among adolescent girls

Despite the widely reported link between early pubertal timing and internalizing symptoms among girls, less is known about the peer reputation of earlier maturing girls. The current study assesses whether early maturation is associated with perceived popularity and/or rumors, and whether these reputational factors help account for earlier maturing girls' vulnerability to emotional distress. Drawing on three waves of data collected from an ethnically diverse sample of middle school girls (n = 912), hierarchical multiple regression analyses revealed that more advanced development at the start of middle school predicted peer- and teacher-reported popularity as well as increased risk of being targeted for rumors. Mediation analyses suggested that popularity among boys can put earlier developing girls at risk for rumors. Finally, rumors acted as a partial mechanism through which early maturation was associated with subsequent internalizing symptoms. Knowledge of the peer mechanisms putting earlier developing girls at risk for psychosocial maladjustment can inform intervention and prevention efforts aimed at improving adolescent well-being.

Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS)

Background

Physical activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS).

Methods

The 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS) was used (n = 6 813; 51.3% male, response rate = 66.6%). Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA.

Results

Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls.

Conclusions

Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies.

Intense-personal celebrity worship and body image: Evidence of a link among female adolescents

OBJECTIVES

The aim of the present study was to examine the relationship between celebrity worship and body image within the theoretical perspective of intense para-social relationships with celebrities.

DESIGN

Correlation and multiple regression analyses were used to examine the relationships between celebrity worship and body image.

METHOD

Three samples, 229 (102 males and 127 females) adolescents, 183 (88 males and 95 females) full-time university undergraduate students, and 289 (126 males and 163 females) adults were administered an amended version of the Celebrity Attitude Scale, the Attention to Body Shape Scale, and the Body Shape Questionnaire-Revised.

RESULTS

Significant relationships were found between attitudes toward celebrities and body image only among female adolescents. Multiple regression analyses suggested that Intense-personal celebrity worship accounted for unique variance in scores in body image.

CONCLUSIONS

Findings suggest that in female adolescents, there is an interaction between Intense-personal celebrity worship and body image between the ages of 14 and 16 years, and some tentative evidence has been found to suggest that this relationship disappears at the onset of adulthood, 17 to 20 years. Results are consistent with those authors who stress the importance of the formation of para-social relationships with media figures, and suggest that para-social relationships with celebrities perceived as having a good body shape may lead to a poor body image in female adolescents.

Role of media and peers on body change strategies among adult men: is body size important?

There has been limited previous research that has examined the role of sociocultural influences on body change strategies among adult men. The current study investigated the role of specific types of messages (encouragement, teasing and modelling) from peers and the media on the strategies to change weight among adult men. Differences were evaluated between 526 men aged from 18 to 60 years from three groups (normal weight, overweight and obese) on body image, body change strategies and messages about their body received from peers and the media. Men were primarily drawn from United States, Australia and Europe. Results showed that messages received by men regarding losing weight or increasing muscle size differed according to weight. Body image and media messages were the strongest predictors of losing weight, whereas body image importance and messages from peers were the strongest predictors of increasing muscles. These findings highlight the importance of sociocultural influences on body change strategies among adult males.

A prospective investigation of interpersonal influences on the pursuit of muscularity in late adolescent boys and girls

This project examined whether interpersonal pressure to be muscular predicted late adolescents' pursuit of muscularity. Participants were 199 adolescents (16-19 years), mothers (n = 175), and friends (n = 159), assessed at two annual times. Pressure to be muscular was assessed with adolescents', mothers', and friends' reports of their relationships. Adolescents reported pressure from fathers and romantic partners, appearance satisfaction, disordered eating, and pursuit of muscularity. Adolescents', mothers', and friends' reports of pressure related to pursuit of muscularity at both times. Adolescents' perceptions and mothers' reports prospectively predicted pursuit of muscularity. Findings highlight the relevance of relationships to pursuit of muscularity in late adolescents.

Changes in central fatness and abdominal obesity in children and adolescents from Cracow, Poland 1983-2000

BACKGROUND

In the light of the world increase of overall and abdominal obesity, little is known about the trends in abdominal obesity and its prevalence in Poland, a country which at the end of 20th underwent a socio-economic transformation that conduced to obesogenic environments.

AIM

The study traced the trends and prevalence of abdominal obesity in two successive cohorts of children and adolescents from Cracow, Poland between 1983 and 2000.

SUBJECTS AND METHODS

The data examined in this study were from two series of cross-sectional studies; the first in 1983 included 3252 boys and 3288 girls, and the second in 2000 included 2409 boys and 2093 girls aged 4-20. Waist circumference (WC) and waist-to-height ratio (WHtR) were applied to assess the type of fat distribution.

RESULTS

Means of WC and WHtR were higher in juvenile but lower in childhood and late adolescence periods in boys and girls from the 2000 cohort as compared to the 1983 one. The prevalence of abdominal obesity in Cracow children examined in 1983 was 3.9% for boys and 2.4% for girls, and in 2000 was 6.4% and 3.1%, respectively (in boys: chi(2) = 16.03, p = 0.0001; in girls: chi(2) = 1.90, p = 0.1684).

CONCLUSIONS

The 1983-2000 trend towards increasing prevalence of abdominal obesity in children and adolescents from Cracow is not as intensive as in other European countries, e.g. Britain, but it requires further monitoring.

Examination of shared risk and protective factors for overweight and disordered eating among adolescents

OBJECTIVE

To identify shared risk and protective factors for purging, binge eating, and overweight.

DESIGN

Prospective cohort study.

SETTING

Population-based questionnaires of children and adolescents residing across the United States.

PARTICIPANTS

Girls (n = 6022) and boys (n = 4518), aged 11 to 17 years in 1998, in the ongoing Growing Up Today Study.

MAIN EXPOSURES

Putative risk and protective factors within the psychological, behavioral, and socioenvironmental domains.

MAIN OUTCOME MEASURES

Overweight, use of laxatives or purging (vomiting), and binge eating. Because of the low prevalence of purging, we did not examine shared factors for this behavior among boys.

RESULTS

In 1998, a total of 219 girls (3.7%) and 30 boys (0.7%) reported purging behaviors, 426 girls (7.1%) and 90 boys (2.0%) reported binge eating, and 1019 girls (17.4%) and 1040 boys (24.6%) were overweight. From 1999 through 2001, 331 girls (7.8%) initiated purging behaviors, 503 girls (11.8%) and 132 boys (4.5%) initiated binge eating behaviors, and 424 girls (10.0%) and 382 boys (13.6%) became overweight. Concern for weight was directly associated with all 3 weight-related problems among boys and girls. Among girls, dieting, parental weight-related teasing, and family meal frequency had a shared effect on the weight-related problems examined.

CONCLUSIONS

Factors within the psychological, behavioral, and socioenvironmental domains may have a shared effect on purging, binge eating, and overweight. Further research is needed to determine if an intervention designed to address these shared risk and protective factors is effective in simultaneously reducing these weight-related problems.

Impact of a healthy body image program among adolescent boys on body image, negative affect, and body change strategies

This study evaluated the effectiveness of a healthy body image program. In total, 421 adolescent boys completed a five-session intervention program or a wait list control group. There were no differences between the intervention and the control group at post-intervention or any of the follow-up times. Boys in the intervention group who were one standard deviation above the mean on body dissatisfaction at baseline, demonstrated a reduction in negative affect in the intervention group at post-test and 6 months follow-up. Prevention programs need to target boys who are at risk of adopting health risk behaviors, rather than being universally applied.