Body dissatisfaction and disordered eating symptoms in Finnish preadolescents

Body Dissatisfaction among Young Girls in Recreational Rhythmic Gymnastics

Body dissatisfaction is commonly associated with rhythmic gymnastics (RG) practice, but limited research exists on the prevalence of this issue among recreational level practitioners. This study examines body image dissatisfaction among young girls practicing RG recreationally. A total of 88 girls between six and eleven years of age, who participate in RG as an extracurricular activity, were measured and completed the Stunkard pictogram. To create a control group, 88 girls who did not practice RG were also recruited and matched to the gymnasts by age. Results revealed that the mean body mass index values in both groups were within the normal weight range. The mean score for body dissatisfaction was similar between the two groups, with slightly positive values (RG = 0.94; CG = 1.06). The Mann-Whitney U test showed that there was no significant difference in the ratings of actual body size, ideal body size, and body dissatisfaction between the RG and control groups. These findings suggest that practicing RG at a young age is not associated with body dissatisfaction among girls.

Body dissatisfaction and disordered eating symptoms in children's daily life: Can parents protect against appearance comparison on social media?

Research suggests that body dissatisfaction is common among children. However, it remains largely unknown how body dissatisfaction occurs on a daily basis and which environmental factors are linked to this. The purpose of this study was to examine (1) state body dissatisfaction, dietary restraint, compensatory exercise and loss of control eating among children and its association with upward comparisons via social media and (2) whether trust in parents may attenuate this association. Children from 10 to 12 years old (N = 50) were assessed three times a day during a two-week period. Trust was examined via a baseline questionnaire. State body dissatisfaction, dietary restraint, compensatory exercise, loss of control eating and upward comparisons were examined via Ecological Momentary Assessment (EMA). Multilevel analyses indicated that an a higher level of upward comparison is associated with a higher level of state body dissatisfaction, compensatory exercise and loss of control eating. Trust in father significantly moderated the association between appearance comparison and body dissatisfaction. No evidence was found for the protective role of trust in mother. Future research is necessary to enhance our understanding of state body dissatisfaction among children and of environmental factors that may protect children from the adverse effects of social media.

Body dissatisfaction and low self-esteem in elementary school-aged children: the role of media pressure and trust in parent-child relationships

Studies have indicated that the media plays a role in the development of body dissatisfaction in children. Nevertheless, there is limited understanding of the protective factors that may reduce this association, such as the parent-child relationship. Therefore, this study investigates children's body dissatisfaction and self-esteem and the role of media pressure and a trust in parent-child relationships herein. A sample of n = 246 participants (59.8% girls, aged 8-10) was recruited. Children completed self-report questionnaires that assessed body dissatisfaction, self-esteem, media pressure, and trust in parent-child relationships. Results revealed that higher scores on media pressure were linked to increased body dissatisfaction and decreased self-esteem. On the other hand, higher scores on trust in mother and father were associated with lower levels of body dissatisfaction and higher levels of self-esteem. However, the presence of trust in parent-child relationships did not attenuate the impact of media pressure on body dissatisfaction or self-esteem. Further investigation is necessary to gain a deeper understanding of how sociocultural and interpersonal factors interact and contribute to the development of body image problems. While current prevention and intervention programs predominantly focus on the individual, it may be beneficial to place greater emphasis on the family environment.

Childhood Overeating and Disordered Eating From Early Adolescence to Young Adulthood: A Longitudinal Study on the Mediating Role of BMI, Victimization and Desire for Thinness

Eating disorders have early origins, and there could be a continuum between childhood eating behaviors, such as overeating, and long-term disordered eating, but this remains to be shown. BMI, desire for thinness and peer victimization could influence this continuum, but their interactions are unknown. To fill this gap, the study used data from the Quebec Longitudinal Study of Child Development (N = 1511; 52% girls), in which 30.9% of youth presented a trajectory associated with high disordered eating from 12 to 20 years. The results support an indirect association between overeating at age 5 and disordered eating trajectories, with different mediation processes observed between boys and girls. The findings underscore the importance of promoting healthy body images and eating behaviors among youths.

Types of Eating Disorder Prodrome in Adolescence: The Role of Decision Making in Childhood

Psychiatric disorders like eating disorders (EDs) might be underpinned by differences in decision making. However, little previous research has investigated this potential relationship using longitudinal data. This study aimed to understand how components of decision making (delay aversion, risk adjustment, risk taking, quality of decision making and deliberation time) measured by the Cambridge Gambling Task in the United Kingdom's Millennium Cohort Study (MCS; n = 11,303; female = 50.17%) at age 11 might explain clusters/types of ED prodrome involving body dissatisfaction, intention to lose weight, dietary restraint, excessive exercise and significant under/overweight measured in the MCS at age 14. Latent class analysis revealed two groups within the cohort: a non-prodromal eating pathology group, who were more likely to be of "average" weight, according to the UK90, with minimal disordered attitudes and behaviors in relation to eating and weight; and a second group with prodromal eating pathology, who had more body dissatisfaction, a desire to lose weight, were using dietary restriction and exercise to influence weight and were more likely to be "overweight" according to the UK90. Logistic regression showed that, after adjustment for confounding, higher risk-taking scores were associated with a 60% greater probability of being in the prodromal eating pathology group (b = 0.47, OR = 1.60, p < 0.01), and higher scores on quality of decision making were associated with a 30% lower probability of being in the prodromal eating pathology group (b = -0.34, OR = 0.70, p < 0.05). Helping young people to engage in moderate risk taking and improving decision making might reduce the later presence of ED prodromes.

Body Mass Index, Physical Activity, and Body Image in Adolescents

Body image dissatisfaction is a concern for adolescents’ mental and physical well-being, and the role of body mass index (BMI) and physical activity (PA) in it is still unclear. This study investigates the associations of BMI and PA with body image, separately for boys and girls, in a large sample of Finnish adolescents. We also examine the associations of BMI with body image in varying PA levels. A total of 10,496 adolescents (girls 52.6%) were included in the analyses. Body image was assessed using a pictorial tool, and categorized as wishing for a smaller body, being satisfied, and wishing for a bigger body. BMI (kg/m²) was categorized as thin, normal weight, and overweight/obese. Self-reported PA was divided into three similar-sized categories as low, moderate, and high PA levels. Adjusted ordinal regression analyses were conducted. Our results show that adolescents with thinness had higher odds of wishing for a bigger body compared to their normal-weight peers, while adolescents with overweight/obesity had smaller odds of wishing for a bigger body. Adolescents in low and middle PA levels had lower odds of wishing for a bigger body compared to adolescents in the high PA level. Yet, the PA level modified the associations between BMI and body image, especially in adolescents with thinness and more so in girls than in boys. These findings highlight the need to pay attention to healthy weight gain and PA in adolescents to support their body image satisfaction.

Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis

Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10-19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.

Body Size Misperception and Dissatisfaction in Elementary School Children

Background: To examine the association between body size perception (BSP) and body size dissatisfaction (BSD) in elementary school children and to document the potential contribution of individual factors [age, sex, and actual body size (BMI Z-scores: BMIZ)] that may influence their relationship. Methods: This study included 269 children (124 boys and 145 girls) between 6 and 13 years of age (9.2 ± 1.6 years). The BSP score was calculated as the difference between the perceived actual body size and BMIZ (actual body size). A negative BSP score indicated an underestimation of their body size. To assess the BSD score, the difference between perceived actual body size and desired body size was calculated. A positive BSD score indicated a desire to be thinner. Results: Perceived actual body size was smaller than BMIZ, independent of age group and weight status. Overall, 64% of children underestimated their body size. The young children living with obesity demonstrated the highest misperception. Results also showed that the proportion of children who desired to be thinner was higher in overweight and obese subgroups. No significant relationship was found between BSP and BSD scores in the entire sample, while a positive association was observed among younger children in the normal-weight and obese subgroups (r = 0.40; p < 0.001 and r = 0.78; p < 0.05, respectively). Conclusions: Underestimation and dissatisfaction of body size are more prevalent in children living with overweight/obesity. Moreover, there is an association between BSP and dissatisfaction, yet this association is dependent on age and weight status.

Food Insecurity and Eating Pathology in Adolescents

Adolescence is a critical period for the emergence of eating disorders, and food insecurity may be related to eating pathology and weight, as evidenced in adults. However, little is known about food insecurity and eating pathology during this developmental period, and associations between food insecurity and body mass index (BMI) are mixed. Therefore, we examined associations between food insecurity and BMI percentile, self-reported eating-related pathology and binge eating, and subgroup differences by race/ethnicity. In a subset, we examined the relationship between food insecurity and real-world hunger, food craving, and loss-of-control eating using ecological momentary assessment (EMA). Fifty-eight adolescents at two sites (clinical sample, n = 38, BMI percentile ≥ 70th; community sample, n = 20, all BMI strata) completed self-report questionnaires. Adolescents were 15.2 ± 2.1 years old, 62% female, 50% Black, 34.5% Hispanic, with BMI percentile = 80.5 ± 25.8 (range 4-99). In the full sample, food insecurity was associated with greater BMI (p < 0.01), higher shape/weight overvaluation (p = 0.04), and greater number of binge eating episodes among those reporting at least one binge episode (p < 0.01), with significant relationships for BMI percentile, shape/weight overvaluation, body dissatisfaction, and binge episode frequency among Hispanic adolescents only (each p < 0.01). As in adults, food insecurity may be a risk factor for eating pathology, particularly for Hispanic teens.

Disordered eating and internalizing symptoms in preadolescence

OBJECTIVES

Research has demonstrated links between disordered eating, anxiety, and depression in adults and adolescents but there is limited research investigating these associations in preadolescence. The current study examined the associations between disordered eating, anxiety, and depression during preadolescence, as well as the role of gender in moderating these associations.

METHOD

Two hundred and thirteen children (M = 10.3 years; 51.2% male) reported levels of disordered eating (ChEAT) and anxiety and depression symptoms (RCADS-25).

RESULTS

Regression analyses support an association between disordered eating and both anxiety and depression in preadolescence. Overall, there were no significant differences between boys and girls when the main effect was examined, which differs from research in adolescents.

DISCUSSION

These findings highlight the importance of early detection for disordered eating behaviors and attitudes, as well as anxiety and depression in both boys and girls during preadolescence. Longitudinal research examining these associations is vital to help understand the trajectories of these problems, but also the gender differences in disordered eating that emerge during adolescence. Transdiagnostic interventions targeting several co-occurring problems, such as disordered eating, anxiety, and depression might be effective for preventing the development of eating disorders in the long term.

The Homeostatic Theory of Obesity: An Empirical Verification of the Circle of Discontent with an Assessment of Its Relationship to Restrained and Uncontrolled Eating among Children and Adolescents

The purpose of the present study was to provide an empirical verification of the Circle of Discontent with an assessment of its relationship to restrained and uncontrolled eating among children and adolescents. This study examined whether our results confirm a new hypothesized model. The total sample comprised 282 children and adolescents (148 girls and 134 boys; 141 participants with normal body weight and 141 with obesity). The mean age was 12.23 years (SD = 2.80), and the average BMI (body mass index) was 23.29 kg/m² (SD = 6.27). The following were used: Positive and Negative Affect Scale for Children, Children’s Body Image Scale, Figure Rating Scale, Three-Factor Eating Questionnaire and Eating Disorders in Youth. The obtained values of the model fit indices proved the goodness of fit. Our findings show that obesity accompanies body dissatisfaction and uncontrolled and restrictive eating. Moreover, the higher the level of restrictive eating, the lower the level of uncontrolled eating. The relationships between body dissatisfaction, negative affect and restrictive eating, as well as that between uncontrolled eating and high-energy consumption, are significant and positive. Other relationships are non-significant. The above-mentioned relationships established in the Circle of Discontent, as well as relationships of restrained and uncontrolled eating with variables described in the circle, were confirmed. Based on our results, preventive strategies and psychological interventions can be created and may include changes in body image, eating behaviors and emotional functioning.

Children's Eating Attitudes Test (ChEAT): a validation study in Finnish children

PURPOSE

To validate the Children's Eating Attitudes Test (ChEAT) in the Finnish population.

MATERIALS AND METHODS

In total 339 children (age 10-15 years) from primary schools in Southern Finland were evaluated at two time points. They answered the ChEAT and SCOFF test questions, and had their weight, height and waist circumference measured. Retesting was performed 4-6 weeks later. Test-retest reliability was evaluated using intra-class correlation (ICC), and internal consistency was examined using Cronbach's alpha coefficient (C-alpha). ChEAT was cross-calibrated against SCOFF and background variables. Factor analysis was performed to examine the factor structure of ChEAT.

RESULTS

The 26-item ChEAT showed high internal consistency (C-alpha 0.79), however, a 24-item ChEAT showed even better internal consistency (C-alpha 0.84) and test-retest reliability (ICC 0.794). ChEAT scores demonstrated agreement with SCOFF scores (p < 0.01). The mean ChEAT score was higher in overweight children than normal weight (p < 0.001). Exploratory factor analysis yielded four factors (concerns about weight, limiting food intake, pressure to eat, and concerns about food), explaining 57.8% of the variance.

CONCLUSIONS

ChEAT is a valid and reliable tool for measuring eating attitudes in Finnish children. The 24-item ChEAT showed higher reliability than the 26-item ChEAT.

LEVEL OF EVIDENCE

Level 5, cross-sectional, descriptive study.

Prevention of eating disorders: 2019 in review

This article reviews 11 prevention-related publications in Eating Disorders: The Journal of Treatment & Prevention during 2019. Two models from the 2018 review continue to frame this analysis: (1) the Mental Health Intervention Spectrum from health promotion → types of prevention → case identification and referral → treatment; and (2) parsing phases of prevention into rationale, theory, and methodology → clarification of risk factors → implications for specific preventive interventions → design innovation and feasibility (pilot) research → efficacy and effectiveness research → program dissemination. These articles illustrate how the theoretical complexity and rigorous methodological demands of prevention science are manifest in the eating disorder field. A subset of articles also demonstrates the importance of working with researchers and community stakeholders to improve our understanding of how ethnicity, class, and gender intersect with planning for improvements in all phases of prevention. Other subsets show the need to expand the list of relevant risk factors, and how the traditional schema of masculinity creates both maladaptive biases in case identification and obstacles to an effective and compassionate understanding of EDs. Finally, implications of the absence of efficacy, effectiveness, and dissemination studies are discussed.