Body Image in Adult Women: Moving Beyond the Younger Years

Body image and eating issues in midlife: A narrative review with clinical question recommendations

Midlife is a period of transition that is influenced by multiple biopsychosocial and cultural factors. Eating and body image issues are common at this life stage. The purposes of this narrative review are to explore: 1) the aspects of midlife that make individuals vulnerable to eating issues and body image concerns and 2) how these factors may be influenced by weight, cultural background, and socioeconomic status. Within this review, we aim to explore nuances of how eating and body image issues present in some historically marginalized groups at midlife. The aim is to provide clinicians who care for midlife individuals with practical tools to initiate conversations regarding body image and eating issues. Ideally this will facilitate early intervention and assessment for individuals who are struggling with new, chronic, or relapse of symptoms of disordered eating.

Do appearance related safety behaviors contribute to distress intolerance? A Multi-method examination

Individuals elevated in distress intolerance (DI) may engage in dysfunctional behavioral strategies to cope with their distress. One behavioral strategy that may be related to DI is appearance related safety behavior (ARSB; i.e., maladaptive behavior that seeks to mitigate the feared consequences of the negative evaluation of appearance). We examined the relationship between DI and ARSBs in two separate samples of women. In Study 1 (N = 91), we found in an unselected sample that ARSBs were robustly associated with DI cross-sectionally while accounting for symptoms of depression and body dysmorphia. Further, greater ARSBs predicted increases in DI longitudinally. In Study 2, among a clinical sample of women with elevated appearance concerns (N = 94), we examined the experimental effect of reducing ARSBs compared to a self-monitoring control. Relative to control, instructions to reduce ARSBs led to lower DI, but this effect was only found for individuals low in baseline DI. Overall, we found preliminary evidence that ARSBs may be a salient factor in contributing to and maintaining DI; and SB fading may be a helpful strategy for reducing DI. We discuss these findings in the context of existing literature and provide directions for future research.

Body image and physical activity in Latinas

Women with negative body image engage in less physical activity. The purpose of this study is to examine the relationship between body image and physical activity in Latinas participating in a lifestyle program. Participants (age 43.8 ± 10.1 years and BMI 30.4 ± 5.2 kg/m2) were enrolled in a 12-month culturally and linguistically adapted, individually tailored, intervention focused on increasing moderate-to-vigorous intensity physical activity (MVPA). Longitudinal assessments were conducted on body image dissatisfaction (BID) using the Figure Rating Scale, MVPA using the 7-day PAR interview, and objectively measured body weight. Pre-intervention BID did not significantly predict MVPA change. Participants experienced considerable reduction in BID. Greater MVPA engagement and weight loss were independently related to BID reduction. Acculturation did not moderate these relationships. Body image improved in Latinas participating in a cognitive and behavioral physical activity intervention regardless of weight loss and acculturation level.

How Gender-Targeted Body Image Concerns Influence People's Sugar-Sweetened Beverages Consumption

As excessive sugar intake can result in obesity, type 2 diabetes, cardiovascular disease, and even cancer, this study aims to help people reduce sugar-sweetened beverages (SSBs) intake by exploring how gender-differed body image concerns influence people's attitude and intention of SSBs consumption. A 2 (Participants' gender: Male vs. Female) × 2 (Image gender: Male vs. Female) × 2 (Body image concern: Gaining weight vs. Losing muscle mass) online experiment was conducted to examine how the gender-differed body image concerns influence people's perception of SSBs. The findings showed that gender-differed body image concerns exerted a significant influence across genders. Muscle mass loss-related information is more effective in generating negative attitude toward SSBs from males. Female image-related physical appearance change is more effective in generating negative attitude toward SSBs from females. This study also contributes to targeted communication by revealing that the quality-oriented targeted information outperformed the traditional quantity-oriented targeted information. Furthermore, this study complements EPPM by discovering the underlying mechanisms of female-targeted body image concern, such as perceived severity and response efficacy.

A sociocultural model of the relationships between social media use and body image in midlife women

The use of photo-based social media has been associated with body image concerns among young women. Women in midlife are increasingly experiencing appearance pressures, and these pressures might be particularly strong on social media. However, to date, most of the research on social media use has focused on younger women, and this constitutes an important gap. The purpose of this study was therefore to examine a model of the relationships among social media use and body image among women aged 40 and over. A convenience sample of 192 women aged 40-73 years completed an online survey assessing selfie investment, social media appearance pressures, thin-ideal internalization, appearance comparison, weight and shape concerns, facial satisfaction, drive for youthfulness and drive for muscularity. The final sociocultural model was a good fit to the data, and thin-ideal internalization and appearance comparisons mediated the pathways between the social media variables and the body image ones.

Objectification and body esteem: age group patterns in women's psychological functioning

OBJECTIVES

Sexual objectification is related to negative outcomes for young adult women, but whether sexual objectification operates similarly for women in mid-life or older adulthood is less clear. Our aim was to assess self-objectification and sexually objectifying experiences for women in two different age groups, 18-27 and 48-90 and, further, test the relationship between objectification and psychological functioning. Based on objectification theory, we hypothesized that young adults would report higher self-objectification and sexually objectifying experiences compared to women in the older group. We further expected that these age differences would be related to body esteem and psychological functioning.

METHODS

We surveyed 218 women regarding their sexually objectifying experiences and self-objectification, as well as body esteem, global self-esteem, and mood/anxiety, all outcomes theoretically expected to be related to sexual objectification and self-objectification.

RESULTS

Sexually objectifying experiences and self-objectification were correlated with lower body esteem, lower global self-esteem, and higher mood/anxiety symptoms. Further, older women reported lower objectification and better psychological functioning. Tests of serial mediation showed that the relationship between age and two outcomes (self-esteem and mood/anxiety symptoms) was mediated by self-objectification and body esteem, while the model using experiences of sexually objectifying experiences was not supported.

CONCLUSION

Older women differed from younger women in the impact of self-objectification. We discuss these outcomes referencing age patterns and objectification theory.

Dissemination of a dissonance-based body image promotion program for mothers and daughters in church settings: A controlled pilot study of Reclaiming Beauty

This proof of concept, controlled pilot study expands on existing dissonance-based body image promotion programs by testing a modified version of the Body Project for 136 mothers and daughters aged 11-18 years old in church settings called Reclaiming Beauty. Mothers (n = 30) and their daughters (n = 35) who participated in Reclaiming Beauty were compared to mothers (n = 32) and daughters (n = 39) in a waitlist, assessment-only, control group on body image, eating psychopathology, and risk factor measures (thin-ideal internalization, physical appearance comparison) at pre-, post-, and 6-month-follow-up assessments. Intent-to-treat, multilevel modeling indicated that mothers and daughters in the Reclaiming Beauty group experienced significant improvement in body appreciation, body shape concerns, eating psychopathology, thin-ideal internalization, and physical appearance comparison over a six-month period compared to control participants. Changes in thin-ideal internalization and appearance comparison did not predict body image and eating psychopathology at follow-up. Baseline levels of body satisfaction did not moderate the effect of the program, except for its effect on body shape concerns. Findings provide preliminary support for delivering a dissonance-based body image promotion intervention to mothers and their daughters and the feasibility of leveraging the mother-daughter relationship as well as delivering interventions in church settings.

Dissatisfaction with body image and weight gain in middle-aged women: A cross sectional study

OBJECTIVES

To investigate the relationship between weight gain and body image perception in in middle-aged women.

METHODS

Cross-sectional study with 453 women. Body image was assessed using the Stunkard scale, in which women were classified as: satisfied or dissatisfied (general, thinness or obesity). The identification of possible factors associated with body image dissatisfaction was performed using binary logistic regression analysis.

RESULTS

The mean age was 55.7 (±9.6) years; 80.8% were classified as dissatisfied with body image. As for body composition, women satisfied with their body image had lower values of body fat and higher values of lean mass. In the logistic regression, for general dissatisfaction and obesity, the associated variables were BMI, education and physical activity. As for "dissatisfaction with thinness", only BMI was associated.

CONCLUSION

Thus, the prevalence of body image dissatisfaction is high in women and part of associated factors are linked to lifestyle behaviors.

Women's body representations across the life course: A comparative study in Southern Brazil

The aim of this study is to observe how women of different ages represent their bodies and the changes they undergo across their life course. The research is based on the theory of social representations, idealized by Serge Moscovici. A total of 201 women between 25 and 88 years old from southern Brazil participated in the research. The methodological instrument consists of a questionnaire containing free associations, sentence completion and selection of images. The processing and classification of the data were done by the software Evoc (2000) and content analysis. The results showed differences between the age groups. Younger women represented the body according to aesthetic references and manifested the desire to monitor the body. Older women related the body more frequently with notions of health, social relationships, and leisure. The memories of a younger body and anticipations of an older one reflected the conventions about ageing. The study also shows that concerns about bodily limitations and age-related diseases were frequent in all age groups and may guide behaviour and attitudes towards the body. The study can inform policymakers on the needs and expectations of a growing ageing sector of the population in Brazil and worldwide.

Profiles of body image concerns and their associations with disordered eating behaviors

Although body image concerns (BIC) are recognized as a core driver in the development of disordered eating behaviors, the combined role of various types of BIC remains underexamined. This study relied on latent profile analysis to identify the main configurations of self-reported BIC (i.e., body checking and avoidance, perceived physical appearance, and fear of negative appearance evaluation) observed in a sample of 419 French-Canadian individuals (Mage = 26.59, SDage = 9.23). The role of body mass index, sex, and age on profile membership was also examined, as well as the relation between profile membership and disordered eating behaviors (i.e., dieting, bulimia and food preoccupation, and oral control). Six distinct BIC profiles differing in terms of shape and level were identified, with women being more likely to display a profile characterized by higher levels of BIC. In turn, profiles characterized by higher levels of BIC were associated with more disordered eating behaviors. The present study can broaden our understanding of the onset and maintenance of disordered eating behaviors and inspire the development of more tailored body-image interventions.

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study

Introduction

Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood.

Methods

Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation.

Results

Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation.

Discussion

These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.

Body image and willingness to change it-A study of university students in Poland

The present study aimed to identify declared patterns of ideal appearance among students at selected higher education institutions in Poland. In the present study, we set out to identify the body image and the propensity to change it. In order to achieve the goal of the study, a nationwide survey was carried out using a voluntary diagnostic survey. A total of 810 respondents took part in the survey. The study was conducted using a custom-made self-designed survey questionnaire with an indirect interview technique via a web-based platform (CAWI). The study results indicate that women were far more eager to maintain an attractive appearance through dieting than men. Importantly, the respondents, both women and men, did not identify influencers as role models of attractive appearance. Results of the present survey reveal that attitudes towards one's physical appearance are diverse and influenced by the considered factors. The attributes that determined the perception of oneself as an attractive person included height, weight, and body build. Normal body weight is a key feature of an attractive appearance, according to the respondents; nevertheless, students show a higher tolerance for being overweight than for being underweight. Furthermore, preferences in this respect are largely conditioned by individual personal characteristics. According to young people, a person with an attractive appearance is one who eats and exercises regularly, and who does not fall into extremes in terms of their appearance. On the other hand, the fear of growing fat and losing one's attractive appearance was frequently indicated among the concerns over personal appearance. Only one in five respondents expressed complete satisfaction with how they looked, with men and those with a normal BMI significantly more likely to do so. Respondents expressed readiness to undertake a range of activities related to increased exercise regime, changes in their eating habits, or seeking assistance (e.g., of a personal trainer) to achieve the desired body shape. Our findings can be used as a basis for discussion and consideration in developing educational activities on nutrition, as well as on overweight- and obesity-related health issues.

Effect of social media on body image of pregnant and postpartum women in India

In the present times, there is a high influence caused by social media platforms in case of body image issues faced by an individual. Pregnancy is a stage for women where they go through several mental and physical changes. Realizing the inseparable role played by social media in this aspect, it is an attempt here to determine the effect caused by social media on the body image of pregnant women as well for those in their post-partum stages. The PRISMA method is used by the authors to arrive at 55 research papers from the Scopus databases that are systematically reviewed. The authors' review reveals that social media can have both negative and positive effects on women's perception of body image during pregnancy and the postpartum period.

Developing a definition of body neutrality and strategies for an intervention

The aim of this study was to provide a definition for body neutrality and understand the key strategies recommended to improve body neutrality for testing in future interventions. There is minimal academic literature on body neutrality and thus this study focused on examining websites where the concept has been discussed for some time. This was achieved using a realist synthesis of websites and a common elements approach to extract the key definition elements of body neutrality, strategies to improve body neutrality, in addition to the common critiques of both the body positivity and body neutrality movements. The initial search found 175 websites, of which 107 were included in the final synthesis, and common elements analysis followed after removal of duplicates and ineligible websites. Three elements, with several sub-elements, best operationalised the definition of body neutrality. Six strategies were found for development of a body neutrality intervention. This innovative study paves the way for rigorous evaluation of body neutrality. Recommendations for future work are provided, including the use of current measures, creating a new measure, and evaluating prevention and intervention programs including Single Session Interventions (SSIs).

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.

Normative body image development: A longitudinal meta-analysis of mean-level change

This meta-analysis synthesized longitudinal data on mean-level change in body image, focusing on the constructs of body satisfaction and dissatisfaction, body esteem, perceived attractiveness, valuation, self-objectification, and body shame. We searched five databases and accessed unpublished data to identify studies that assessed body image at two or more time points over six months or longer. Analyses were based on data from 142 samples representing a total of 128,254 participants. The age associated with the midpoint of measurement intervals ranged from 6 to 54 years. Multilevel metaregression models examined standardized yearly mean change, and the potential moderators of body image construct, gender, birth cohort, attrition rate, age, and time lag. Boys and men showed fluctuations in overall body image with net-improvements between ages 10 and 24. Girls and women showed worsening body image between ages 10 and 16, but improvements between ages 16 and 24. Change was greatest between ages 10 and 14, and stabilized around age 24. We found no effect of construct, birth cohort, or attrition rate. Results suggest a need to revise understandings of normative body image development: sensitive periods may occur somewhat earlier than previously believed, and body image may show mean-level improvements during certain age ranges.

Does the postpartum body image of primiparous women giving vaginal delivery affect their sexual functions and depression and fatigue levels?

The body image-related problems can negatively affect women's lives in many ways. The study was aimed at investigating the effects of postpartum body image on sexual functions, and fatigue and depression levels of primiparous women who gave birth vaginally. This cross-sectional study was conducted with 133 women who presented to the obstetrics and gynecology clinics of a state hospital in Turkey between June 2021 and December 2021. At the end of the study, a moderate relationship was determined between the women's body image and their depression (r = 0.500; p < 0.001) and fatigue (r = 0.666; p < 0.001) levels, and a weak relationship between their body image and sexual functions (r = -0.372; p < 0.001). According to the backward regression model used in the study, the women's fatigue and education levels accounted for their body image by 45.7%.

TikTok, TikTok, the time is now: Future directions in social media and body image

This article synthesizes practical strategies and future directions proposed by contributors to the special issue in Body Image on social media and body image. It also moves beyond the contributions of the special issue in an effort to provide additional guidance to researchers, clinicians, educators, and policymakers. First, we recommend that research on social media and body image extend beyond convenience sampling of young, White women and include children and older adults, boys and men, and underrepresented groups. Second, we urge researchers to move away from simplistic measures of social media and to utilize mixed-methods approaches. Third, we advocate for the development of new theories that can be tested longitudinally and that capture the unique influences of social media, rather than relying solely on existing models that were developed for traditional media. Fourth, we provide recommendations regarding practical strategies, such as the inclusion of media literacy campaigns, increased research on the role of reality check disclaimers, and further examination regarding the role of body positivity in prevention and intervention efforts. Finally, we end with recommendations regarding advocacy, such as using social media to harness positive efforts and partnering with social media companies regarding their use of algorithms.

Further evaluation of the psychometric properties of the German version of the Body Appreciation Scale-2 (BAS-2): Cross-validation, measurement invariance, and population-based norms

Using a representative sample of the German general population (N = 2509, 16-74 years), this work aimed to cross-validate the modified one-factor model recently reported for the German Body Appreciation Scale 2 (BAS-2). We also examined measurement invariance across gender, tested differential item functioning across age and BMI, systematically evaluated subgroup differences, and provided norms according to subgroups. Overall, the BAS-2 demonstrates good internal consistency. Cross-validation supported the generalizability of the modified one-factor model. Multi-group confirmatory factor analyses supported full scalar invariance across gender; comparisons revealed higher scores among men compared to women with a small effect size. Age (only women) and BMI (both genders) significantly predicted latent BAS-2 scores. Of note, differential item functioning for age and BMI was observed. Concerning manifest group differences, we found a significant main effect of weight status: Individuals with obesity reported the lowest body appreciation levels, while individuals with underweight/ normal weight reported highest levels. Our findings suggest that the German BAS-2 has good psychometric properties and is suitable for examining body appreciation across gender among German women and men. Moreover, norm values enable future usage of the scale in health and clinical research by providing reference data for interpretation.

Impact of skin care on body image of aging people: A quasi-randomized pilot trial

Aim

Support for various activities of daily living is essential for maintaining the health of residents in nursing homes. Although aging people who move to nursing homes often change their skin care habits, how these changes impact aging adults' social and mental well-being remains unclear. This study aimed to evaluate the effects of facial skin care on aging residents' self-body image, self-esteem, well-being, depressive symptoms and social cognitive function by a quasi-randomized controlled pilot trial in Japanese nursing homes.

Method

Thirty-seven older adult women living in nursing homes took part in this quasi-randomized controlled pilot trial. Eighteen participants applied a skincare gel-cream to the face twice a day for three months, while 19 participants used no skincare products. Self-body image and psychological measures such as the Cutaneous Body Image Scale (CBIS), the Rosenberg Self-esteem Scale (RSES), Philadelphia Geriatric Center Morale Scale (PGCMS) and Geriatric Depression Scale (GDS) were used in each nursing home to evaluate the pre- and post-treatment scores. In addition, cognitive items of the Functional Independence Measure (FIM) were evaluated as social cognitive function at pre- and post-treatment.

Results

There was a significant different change of the Cutaneous Body Image Scale scores (p = 0.045, r = 0.34) after three months between skin care group and control group. Although there were no clear significant differences in other psychological assessments, there was a higher number of them with positive changes in the skin care group compared to the control group.

Conclusion

Skin care may help improve cutaneous self-body image and positive emotion in aging female residents of Japanese nursing homes.

Ideal body image for the opposite sex and its association with body mass index

This research studied the preferences reported by women and men about their Ideal Body Image for the Opposite Sex (IBIOS), and its association with body mass index (BMI). It also analysed the preferences of each sex for a woman's ideal body image (W-IBI) and a man's ideal body image (M-IBI). A total of 450 participants aged 18-70 years with different weights were studied. Their IBIOS was assessed using standard figural stimuli. The sample was divided in four groups by sex and age (<45 years; ≥45 years). Sex and age differences in IBIOS, as well as sex differences in the preferences for a woman's ideal body image (W-IBI) and a man's ideal body image (M-IBI), were tested using a non-parametric Mann-Whitney U test. The association between IBIOS and BMI was analysed using Spearman's correlation. In all groups, the most chosen silhouette as IBIOS was number 4. In the under-45 years group, women chose bigger silhouettes for the opposite sex than men did (p<0.05). In this age group women chose as ideal smaller silhouettes for the female body than men did (p<0.01). In addition, women and men in the younger age group and with normal weight chose smaller silhouettes, while those who were overweight or obese selected larger silhouettes (p<0.001). Age was found to be a relevant factor in IBIOS preferences, and in the association between IBIOS and nutritional status as measured by BMI, which was only observed to be significant in the younger age group.

Prevalence of body image dissatisfaction among youth in the United Arab Emirates: gender, age, and body mass index differences

The term body image dissatisfaction (BID) describes the negative perceptions that a person carries about his or her own body. This study aimed to determine the prevalence of BID among youth in the UAE and how it is affected by three variables: sex, age, and body mass index (BMI). Participants were 728 UAE federal university students who responded to the Body Shape Questionnaire. Results indicated that 36.7% of students are dissatisfied with their body image. Gender differences analysis showed a higher level of BID for men than with women. No significant differences were observed for BID among the four age groups. Significant differences were shown for BID among the four common BMI/weight categories (underweight, normal, overweight, obesity. On the light of the results, the study suggested offering awareness programs for youth about healthy practices in daily life and including health education in schools and colleges curriculum. The study discussed the findings in relation to the available literature in the area and suggested some directions and topics for future research.

Evidence-based policy solutions to prevent eating disorders: Do disclaimer labels on fashion advertisements mitigate negative impact on adult women?

Exposure to media images portraying the thin ideal is associated with increased body dissatisfaction and disordered eating in women. Organizations and policymakers globally have proposed polices requiring warning or disclaimer labels on altered images. Research examining efficacy of disclaimer labels is growing but has largely overlooked adult women. This study extends current research by exploring novel disclaimer labels in a sample of adult women. Women (N = 872) recruited via Amazon's MTurk were randomly assigned to view 20 fashion advertisements with one of five labels: 1) no label; 2) general-digital-alteration label; 3) health-warning label; 4) specific-weight label; or 5) facial features/cosmetic label. Results revealed a significant increase in body dissatisfaction after advertisement exposure, irrespective of label group. Women who viewed advertisements with labels and recalled the labels reported lower body satisfaction and intention to purchase products compared to those who viewed advertisements with no label. Age appears to play an important role in how disclaimer labels affect women. Younger women of color appear to be more negatively impacted by the facial features/cosmetic label than older women of color. Findings are consistent with previous studies indicating no protective effect of disclaimer labels suggesting the need for more effective preventive strategies.

Recognising eating disorders in older people

Changes in eating behaviours, weight and mental health in older people may be related to psychological distress and indicate the presence of a diagnosable eating disorder, rather than 'anorexia of ageing'. Eating disorders in older people may be overlooked because signs and symptoms are assumed to be part of normal ageing. The role of nurses in the care of older people with eating disorders is likely to be detection, referral and support in accessing specialist intervention. This article offers an overview of eating disorders in older people and discusses why they may arise, why they may not be detected and how to recognise them. The authors describe a framework that nurses can use when assessing older people to determine whether they may have an eating disorder.

The effects of body-positive Instagram posts on body image in adult women

While recent studies have examined the effects of viewing body-positive social media content on body appreciation and satisfaction in young adult women, research has yet to include older adult women. The current study assessed the effects of viewing body-positive Instagram content on body image in 205 adult women (18-76 years old) who were randomly assigned to view either body-positive, thin-ideal, or appearance-neutral Instagram content. Our findings demonstrated that exposure to body-positive Instagram content resulted in greater levels of body appreciation and body satisfaction compared to exposure to thin-ideal and neutral Instagram content, while no significant differences were found between any of the conditions on self-objectification. Finally, age was only a significant moderator for one variable (self objectification) and condition (thin ideal), indicating that exposure to body-positive social media content may improve levels of body appreciation and satisfaction in adult women, regardless of age.

Cognitive training via a mobile application to reduce some forms of body dissatisfaction in young females at high-risk for body image disorders: A randomized controlled trial

Body dissatisfaction has been related to Body Image Disorders (BIDs) such as Eating Disorders (EDs) and Body Dysmorphic Disorder (BDD). This study investigates the efficacy of a mHealth app in reducing body dissatisfaction, BDD/ED symptoms and related features. Ninety-five women who were identified as high-risk of developing BIDs (using the Structured Clinical Interview for DSM-5) were randomized into: immediate-use App (iApp group; n = 47) and delayed-use App (dApp group; n = 48). The iApp group started using the app at baseline for 16 days (T1). The dApp group started using the app at T1 for 16 days. Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Multivariate Analysis of Variance (MANOVA) showed Group (iApp vs. dApp) × Time (T0 vs. T1) interactions indicating decrease in BDD symptoms and body dissatisfaction related to EDs in the iApp group at T1. The Reliable Change Index indicated changes on extreme body dissatisfaction/BDD symptoms for 34.74% of participants. Although preliminary, these findings highlight that a mHeatlh app might reduce BDD symptoms and body dissatisfaction related to EDs in women at high-risk for BIDs. Effects on ED symptoms and associated features seem more limited.

The clinical significance of binge eating among older adult women: an investigation into health correlates, psychological wellbeing, and quality of life

BACKGROUND

One type of overnutrition, binge eating (BE; eating an unusually large amount of food with loss of control), is prevalent among older adult women. Yet, little is known about the clinical significance of this eating disorder pathology in older adults, especially in relation to health outcomes used in geriatrics, while controlling for associations with body mass index (BMI).

METHOD

Women (N = 227) aged 60-94 completed two measures of BE and health/wellness questionnaires online. We used multivariable analyses to compare women with Clinical-frequency BE (≥ weekly frequency), Subclinical-frequency BE (< weekly), and No BE on health/wellness outcomes controlling for BMI. We conducted partial correlations controlling for BMI to examine associations between BE severity and health indices.

RESULTS

Controlling for BMI, the Clinical-frequency BE group reported poorer health-related quality of life (physical function, role limitations due to both emotional and physical problems, vitality, emotional wellbeing, social function, and pain) and poorer psychological health (depression, body image) compared to both Subclinical-frequency BE and No BE. The Clinical-frequency BE group also reported poorer sleep, nutritious food consumption, general health, and positive affect compared to No BE. Associations between a separate measure of BE severity and health indices confirmed findings from group comparisons.

CONCLUSION

Weekly BE may offer a promising screening benchmark for identifying one type of overnutrition in older women that is associated with numerous indicators of poorer health, independent of the effects of BMI. More research is needed to understand risks for and consequences of BE unique to older adult women. Binge eating (BE; eating an unusually large amount of food with loss of control), is prevalent among older adult women and is associated with health problems in younger populations. Yet, little is known about how BE is related to other health problems in older adults. We compared health behaviors, physical health, health-related quality of life, and psychological health between older adult women who reported weekly or more frequent BE (i.e., Clinical BE), those with low frequency BE (i.e., Subclinical BE), and those with no BE, while accounting for BMI. Older women in the Clinical BE group reported poorer health-related quality of life, more depression symptoms, and worse body image compared to the Subclinical BE and No BE groups. Compared to the No BE group, the Clinical BE group also reported poorer sleep, less frequent consumption of nutritious foods, worse health, and less frequent positive emotions. Using a separate measure of BE severity, we found similar associations with these health outcomes. Engaging in weekly BE may represent one type of overnutrition behavior in older women that is associated with numerous indicators of poorer health. More research is needed to understand risks for and consequences of BE unique to older adult women.

Risk factors in body image dissatisfaction: gender, maladaptive perfectionism, and psychological wellbeing

Discontent with one's appearance (body image dissatisfaction) has become a global phenomenon, associated with the development of extreme behaviours in order to correct perceived body image problems. Much of the literature has focused on associated destructive behaviours that result from body image dissatisfaction; however, there has been a dearth of research examining risk factors for body image problems in adults. Thus, the current study aimed to investigate risk factors associated with adult body image problems, focusing on two variables highlighted in the literature (gender and maladaptive perfectionism). The current study (1) compared gender differences in body image dissatisfaction and (2) investigated psychological wellbeing as a mediator between maladaptive perfectionism and body image dissatisfaction. The sample included 139 Australian adults from universities (55.7%) and the community (44.3%). Participants completed demographic questions, the Frost Multidimensional Perfectionism Scale, the Psychological Wellbeing questionnaire, the Multidimensional Body-Self Relations Questionnaire, and Marlowe-Crowne Social Desirability Scale. In contrast to predictions, females had higher body area satisfaction and appearance evaluation scores. Furthermore, in line with the hypotheses, psychological wellbeing fully mediated the relationship between maladaptive perfectionism and poor body image. The findings suggest gender, maladaptive perfectionism, and psychological wellbeing may act as risk factors for body image dissatisfaction.

Body image self-consciousness, sexting, and sexual satisfaction among midlife Canadians

Life circumstances at midlife are often different than those for younger adults (e.g., relationship type and duration, physical health, experience of sexual problems), and these circumstances impact experiences of sexuality and sexual behaviour. Past research on sexual behaviours like sexting, which has been primarily conducted on young people, may not generalize to middle-aged adults. Sexting may be a beneficial activity for midlife adults in long-term relationships who are seeking private and convenient ways to communicate sexual interest. Furthermore, as in younger samples, sexting may be associated with body image and sexual satisfaction. A cross-sectional study with a sample of 640 midlife (40–59 years old) married Canadians was conducted to address these suppositions. Structural equation modelling was used to test the factorial validity of a body image self-consciousness (BISC) scale and to investigate the connections between BISC, sexting frequency (to communicate sexual interest, to initiate sexual activity, and that include a picture), and sexual satisfaction. Almost one-half of participants (43%) reported sexting to communicate sexual interest, 37% sexted to initiate sexual activity, and 18% sexted sexy pictures of themselves. Women with lower levels of BISC were more likely to sext (communicate, initiate, and pictures), and men with lower levels of BISC were more likely to send sexts with pictures. Both men and women with lower levels of BISC and those who engaged in sexting to communicate sexual interest had higher levels of sexual satisfaction. Sexting may be an opportunity for busy marital partners to engage in technology-mediated sexual activity when apart. The current results indicate that technology-mediated sexual communication has similar psychological mechanisms to face-to-face interactions and that sexting may be a beneficial behaviour for sexual satisfaction within midlife marriages.

A prospective examination of relationships between social media use and body dissatisfaction in a representative sample of adults

This study examined the temporal sequence of the relationship between social media use and body dissatisfaction in adults. A representative sample of adults (19-92 years old; M = 52.83, SD = 13.43; 62.02% women, 37.98% men) completed measures of social media use, body dissatisfaction, age, gender, BMI, and demographic variables in 2015, 2016, 2017, 2018 and 2019 (N = 6258) in the New Zealand Attitudes and Values Study. In the full sample, higher social media use was significantly associated with higher body dissatisfaction one year later, as was higher body dissatisfaction with higher social media use one year later after controlling for body dissatisfaction/social media use (T-1), gender, age, BMI, ethnicity, relationships status, and SES. Effects were small. The prospective pathway from social media use to body dissatisfaction was significant in all age groups but the reverse relationship was only significant in the middle aged and older groups. Both pathway directions were significant in women but only the pathway from body dissatisfaction to social media use was significant in men. The research has limitations and replication is required. However, findings suggest raising awareness about how to use social media positively across the broad community, not merely in adolescents, may be worthwhile.

Is the relationship between BMI and body appreciation explained by body dissatisfaction and body image inflexibility among older adults? A study among older Chinese men and women

A number of previous studies reported a link between body mass index (BMI) and body appreciation; however, many of these studies were conducted in Western countries and addressed younger samples. Older adults, especially in East Asia, remain insufficiently examined. Therefore, the objective of this study was to examine the relationship between BMI and body appreciation and to explore two potential mediators, body dissatisfaction and body image inflexibility, as proposed in a previous meta-analysis. A community-based cross-sectional study was performed among 313 older Chinese men and women (M = 67.90, SD = 7.94). Mediation tests were conducted to examine the roles of body dissatisfaction and body image inflexibility in the relationship between BMI and body appreciation. BMI correlated significantly with body appreciation, body dissatisfaction, and body image inflexibility among older women but did not correlate with body appreciation among older men. Body dissatisfaction and body image inflexibility emerged as significant mediators in the relationship between BMI and body appreciation among older Chinese women. Reducing body dissatisfaction and body image inflexibility may be potential targets for helping older women with high BMI to promote their body appreciation.

Self-disgust as a potential mechanism underlying the association between body image disturbance and suicidal thoughts and behaviours

This study examined whether self-disgust added incremental variance to and mediated the multivariate association between measures of body image disturbance and suicidal thoughts and behaviours. We hypothesized that self-disgust would be associated with suicidal ideation above the effects of body image disturbance, and that self-disgust would mediate the relationship between body image disturbance and suicidal ideation. A total of N=728 participants completed The Body Image Disturbance Questionnaire, The Self-Disgust Scale, and the Suicidal Behaviours Questionnaire-Revised. Suicidality was significantly related to increased levels of self-disgust and body image disturbance, whereas self-disgust was associated with greater body image disturbance. Linear regression analysis showed that self-disgust was associated with suicidal thoughts and behaviours, over and above the effects of body image disturbance. Multiple mediation modelling further showed that self-disgust mediated the relationship between body image disturbance and suicidal thoughts and behaviours. Our findings highlight the role of self-disgust in the context of body image disturbance and support the notion that body image disturbance is associated with aversive self-conscious emotions. Interventions aiming to reduce the risk of suicidality in people with body image disturbance may address self-disgust and negative self-conscious emotions.

Weight Loss in Advanced Cancer: Sex Differences in Health-Related Quality of Life and Body Image

Weight maintenance is a priority in cancer care, but weight loss is common and a serious concern. This study explores if there are sex differences in the perception of weight loss and its association to health-related quality of life (HRQoL) and body image. Cancer patients admitted to Advanced Medical Home Care were recruited to answer a questionnaire, including characteristics, the HRQoL-questionnaire RAND-36, and a short form of the Body Image Scale. Linear regression analyses stratified by sex and adjusted for age were performed to examine associations between percent weight loss and separate domains of HRQoL and body image score in men and women separately. In total, 99 participants were enrolled, of which 80 had lost weight since diagnosis. In men, an inverse association between weight loss and the HRQoL-domain physical functioning, β = −1.34 (95%CI: −2.44, −0.24), and a positive association with body image distress, β = 0.22 (95%CI: 0.07, 0.37), were found. In women, weight loss was associated with improvement in the HRQoL-domain role limitations due to physical health, β = 2.02 (95%CI: 0.63, 3.41). Following a cancer diagnosis, men appear to experience weight loss more negatively than women do. Recognizing different perceptions of weight loss may be of importance in clinical practice.

Self-body recognition and attitudes towards body image in younger and older women

Despite the fact that ageing causes dramatic changes in bodily appearance, little is known about how self-body recognition changes across life span. Here, we investigated whether older, compared to younger women, differed in the ability of recognising their own than other women's body parts and whether this effect was associated to negative body image dispositions. Twenty-eight young (M_age: 25.93 years, SD_age = 4.74) and 25 middle-aged (M_age: 54.36 years, SD_age = 4.54) women completed an implicit task consisting of visual matching of self and others' body parts and an explicit self-other body discrimination task. Stimuli comprised of images of body parts of the participant and of other age- and BMI-matched models, which were presented in the original size or modified to look rounder or thinner. Measures of adiposity (i.e. BMI), body image concerns and appearance-related worries for specific body parts and for the whole body were also collected. Whilst both groups showed a self-body advantage in the implicit, but not in the explicit task, the advantage was notably bigger for the younger group. However, the implicit self-advantage was higher in those middle-aged women that displayed more body image concerns and worries for specific body parts. Furthermore, the two groups were comparably less able in recognising their body parts when presented thinner as compared to rounder or in their actual size. Overall, these findings open the possibility that, as women age, their implicit self-recognition abilities may decline in association with more negative body image dispositions.

The association between sexual function and body image among postmenopausal women: a cross-sectional study

BACKGROUND

Postmenopause physiological changes may alter body image (BI) during the postmenopausal period of life. Body image dissatisfaction may have negative effects on the sexual function of women. The present study aims to assess the relationship between body image and sexual function during the postmenopausal period.

METHODS

This cross-sectional study was performed on 231 postmenopausal women who were menopausal during the recent 5 years, aged > 40 years old, and referring to health centers in Tehran-Iran. The participants were recruited using a multi-stage sampling method. Data were collected using 3 questionnaires including socio-demographic, Fisher's Body Image, and female sexual function index (FSFI). Data were analyzed using SPSS 24 and multiple regression, Mann-Whitey, Pearson, and Spearman correlation tests.

RESULTS

Two hundred thirty-one postmenopausal women aged 52.53 ± 5.32 (mean ± SD) years old participated in the study. The mean and standard deviation of FSFI and BI of the women were respectively 19.59 ± 11.11(ranges 1.2-36) and 155.43 ± 37.09 (ranges from 46 to 230). According to FSFI, 62.8% of female sexual dysfunction (FSD) was reported. There were significant correlations between scores of total and all domains of FSFI with scores of total and all dimensions of BI. There was also a positive correlation between education and family income of the women and a negative correlation between age of husband and duration of menopause with their sexual function. Significant relationships were also shown between the women's and the husbands' jobs with the total score of women's sexual function. According to the multiple linear regression model, BI was a significant predictor of sexual function in postmenopausal women.

CONCLUSION

Body image is effective on the sexual function of postmenopausal women. Therefore, body image is necessary to be considered in future postmenopausal health promotion programs.

Modeling the associations between internal body orientation, body appreciation, and intuitive eating among early-adult and middle-adult men and women: A multigroup structural invariance analysis

This cross-sectional study investigated the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI in men and women between 30 and 70 years old as delineated in the acceptance model of intuitive eating. Self-report measures were administered to a final sample of 522 individuals consisting of early-adult men (ages 30-44; n = 153), middle-adult men (ages 45-70; n = 108), early-adult women (ages 30-44; n = 135), and middle-adult women (ages 45-70; n = 126). Overall mean age was 45.03 (SD = 10.95). Structural equation modeling evidenced that, for both age groups of men and women, internal body orientation was positively associated with body appreciation and body appreciation was positively associated with intuitive eating. Internal body orientation was positively associated with intuitive eating in each group, except early-adult women. The associations among age and BMI with the aforementioned variables were inconsistent. Although evidencing measurement non-invariance among a number of parameters, multigroup structural invariance analyses showed that the associations among internal body orientation, body appreciation, intuitive eating, age, and BMI were invariant across each gender and age. These results further confirm components of the acceptance model of intuitive eating among men and women in early-adulthood and middle-adulthood.

Body dissatisfaction in midlife women: The applicability of the tripartite influence model

Body image issues and disordered eating are relatively under-researched areas within midlife populations. Accordingly, this study investigated the applicability of the Tripartite Influence Model (TIM) to midlife women. In an online survey, predominately Australian female participants (N = 206) aged 40-55 years (M = 46.75, SD = 4.54) completed measures related to sociocultural pressures, thin-ideal internalisation, appearance comparison, body dissatisfaction, bulimic symptoms, restrained eating, and psychological distress. Path analysis was used to evaluate the model. Greater peer and media pressure were associated with greater appearance comparison, which in turn was associated with greater thin-ideal internalisation, and through this greater body dissatisfaction. Similarly, greater body dissatisfaction was associated with greater restrained eating and bulimic symptoms, which in turn were associated with greater psychological distress. Unexpectedly, family pressure also emerged as an important direct predictor of outcomes, while sociocultural influences were not associated with thin-ideal internalisation, nor was family pressure associated with appearance comparison. Furthermore, appearance comparison was not associated with body dissatisfaction. Overall, the findings provide partial support for applicability of the TIM for midlife women and suggest practical implications such as targeted interventions that may assist body image disturbance and associated outcomes for midlife women.

Is there a difference in body size dissatisfaction between the patients with obesity seeking and not seeking treatment for obesity?

BACKGROUND

Various factors motivate people to undertake treatment for obesity. Among others they include health benefits, willingness to please others, and dissatisfaction with one's appearance. The present study aimed to assess body size dissatisfaction in patients with obesity seeking and not seeking treatment for obesity.

METHODS

Two-hundred-sixteen adult subjects (154 women, 62 men) including 80 people with BMI ≥ 30 kg/m2 starting treatment for obesity (BMI 35.7 ± 5.3 kg/m2) and 136 volunteers with obesity (BMI 34.7 ± 4.3 kg/m2) not seeking treatment for obesity, were enrolled. Body size satisfaction was assessed using the Figure Rating Scale adapted by Stunkard.

RESULTS

Patients with obesity starting obesity treatment had more often a high level of body size dissatisfaction than volunteers with obesity not seeking the treatment (p <  0.001). There was a significant difference in the distribution of body size dissatisfaction in women (p <  0.05), but not in men (p = 0.47).

CONCLUSION

Patients with obesity, especially women, seeking obesity treatment more often represent a high level of body size dissatisfaction than volunteers with obesity not seeking treatment for obesity. This implies the need for public health campaigns to address negative attitudes or misconceptions about obesity and its treatment. Placing more attention and emphasis on body size dissatisfaction in more vulnerable women with obesity may help to define personal motivations and goals, strengthen the doctor-patient relationship and better adapt therapeutic strategies.

The Body Confident Mums challenge: a feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook

Background

Motherhood is a time of intense physical, psychological, and identity transformation, and body dissatisfaction may emerge through the process of pregnancy, birth, and adaptation to parenting. We present a feasibility trial of the Body Confident Mums Challenge, a program developed by adapting existing, effective interventions that focus on self-compassion and appreciation of body functionality to be specific to mothers.

Methods

The program was delivered using the social learning function in a closed Facebook group. Qualitative evaluation of evidence of change was conducted by gathering individual written reflections posted during the challenge (n = 120). Feasibility and acceptability was determined using a feedback survey (n = 22).

Results

Participant’s reflective posts indicated that they were embracing self-compassion, and de-prioritising body image concerns during the challenge. Feedback indicated that the program was mostly feasible and acceptable for mothers, with recommendations from some participants relating to slowing the pace of content delivery and reducing the time commitment of the Challenge.

Conclusions

The social media environment may therefore be a useful setting in which to implement brief intervention programs to improve body image and wellbeing.

Diet quality in middle-aged and older women with and without body weight dissatisfaction: results from a population-based national nutrition survey in Switzerland

Body weight dissatisfaction is associated with unhealthy dietary behaviours in young adults, but data are scarce regarding how this relationship evolves with age. The objectives of the present study were to assess the prevalence of body weight dissatisfaction and the association between body weight dissatisfaction, nutrient intake and diet quality in middle-aged and older women. We used data of a population-based sample of 468 middle-aged (50–64 y/o) and older (65–75 y/o) women, extracted from the cross-sectional 2014–15 Swiss National Nutrition Survey. Body weight dissatisfaction was assessed by questionnaire. Dietitians assessed dietary intakes using two non-consecutive computer-assisted multi-pass 24-h dietary recalls and performed anthropometric measurements. Nutrient intakes were calculated and compared with national dietary guidelines, and diet quality scored with the 2010 Alternate Healthy Eating Index (2010-AHEI). 41⋅1 % of women reported body weight dissatisfaction, and 49⋅8 % wanted to lose weight. Body weight dissatisfaction was associated with weight loss desire and a higher body mass index (BMI; P < 0⋅001). Women with body weight dissatisfaction consumed significantly less carbohydrates and dietary fibres, even when BMI was controlled for (P < 0⋅05). They also fell short of national dietary guidelines for magnesium and iron. Body weight dissatisfied women obtained lower 2010-AHEI scores than satisfied women (β −4⋅36, 95 % CI −6⋅78, −1⋅93). However, this association disappeared when the BMI was introduced in the equation. This highlights the importance of targeting both body dissatisfaction and unhealthy eating in obesity prevention and treatment at all ages.

Body image concerns and intuitive eating in older women

Intuitive eating has been described as representing a positive relationship with food that can support health. However, to date, most of the extant research on intuitive eating has been conducted among young women, limiting our understanding of how intuitive eating can contribute to supporting health in aging women. This study aimed to bridge this gap by exploring body image and eating correlates of intuitive eating in older women. The hypotheses were that among older women, intuitive eating would be significantly associated with lower disordered eating, weight and shape concerns, and fewer depressive symptoms, and that an indirect relationship between BMI and intuitive eating via weight and shape concerns would exist. Community women aged 60-75 (N = 200) completed questionnaires assessing intuitive eating, disordered eating, body concern, depressive symptoms and body mass index (BMI). Higher intuitive eating global scores were associated with lower restraint, lower eating concern, lower body concern, fewer depressive symptoms, and lower BMI. An indirect relationship between BMI and intuitive eating via weight and shape concern emerged, suggesting that being preoccupied by one's appearance hinder the ability to practice intuitive eating. These results suggest that intuitive eating is associated with positive outcomes among older women and might be a useful target for interventions designed to increase healthy aging.

Tailoring a dissonance-based body image intervention for adult women in a proof of concept trial: The Women's Body Initiative

Although historically conceptualized as problems of youth, recent research indicates that women of all ages experience body dissatisfaction and eating disorder (ED) pathology. Despite this, existing body image interventions predominantly target youth. The Body Project (BP) has extensive support for reducing ED risk factors in younger women and girls. The current proof-of-concept study investigated the feasibility, acceptability, and estimates of intervention effect sizes of a modified BP for adult women, the Women's Body Initiative (WBI). Conducted in the Southwestern United States, adult women (N = 13) aged 29-70 (M = 49.1) participated in 4, 1-h weekly sessions, completing measures at baseline, post-intervention, and 3-month follow-up. Participants rated the program as highly feasible and acceptable. Within-subjects effects sizes were medium to large for primary outcomes (body dissatisfaction, ED pathology) and secondary outcomes (psychosocial impairment, negative affect, quality of life, nutritious food consumption, and sleep) through 3-months. Results suggest preliminary feasibility and acceptability of WBI for adult women, and support proceeding with a larger trial to investigate intervention efficacy.

Dissemination of a dissonance-based body image promotion program in church settings: A preliminary controlled pilot study with adult women

Adult women report significant body dissatisfaction yet are often overlooked in body image promotion programs. Although few venues afford opportune settings for intervening with adult women, the church serves as a regular meeting place for many in the South of the United States. This study tested a dissonance-based body image program, Reclaiming Beauty (RB), adapted for adult women in church settings. Six groups (n = 30) were led by two trained church leaders (peer-led) and three groups (n = 21) were led by a trained peer leader and a researcher (researcher-co-led). RB participants, aged 30-77 years (M = 53.1 ± 12.7), completed assessments pre-intervention, immediately post-intervention, and 6 months post-intervention. Waitlist-controls (n = 31) completed assessments at time intervals consistent with intervention participants. RB participants reported significantly decreased thin-ideal internalization, body surveillance, and eating psychopathology at post-intervention and at 6 months post-intervention relative to controls. RB participants also reported significantly increased body satisfaction immediately post-intervention relative to controls, but this was not significant at 6 months post-intervention. Peer-led groups outperformed researcher-co-led groups on body surveillance at 6 months, but RB conditions did not otherwise differ. Our findings provide preliminary support for the dissemination of a culturally-modified dissonance-based body image program to adult women in church settings.

A scoping review of measures used to assess body image in women with breast cancer

OBJECTIVE

The emergence of body image studies in the oncology setting has led to the use of numerous measures to assess different dimensions of body image. The present study is a scoping review of the literature on body image in women with breast cancer to describe: measures used to assess body image in women with breast cancer, dimensions the measures used tap into, and gaps and issues needing attention going forward.

METHODS

Three databases were searched for peer-reviewed original studies that had: (1) full-texts available in English; (2) focused on women with breast cancer; and (3) assessed body image.

RESULTS

The search yielded 3,729 peer-reviewed articles; after screening, 562 articles met inclusion criteria. Of the 88 measures used, 28 were used in more than two studies and analyzed herein. The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire constituted the most frequently used measure. Most measures used focused on the affective dimension of body image (n = 24/28, 85.7%), followed by the cognitive (n = 20/28, 71.4%), behavioral (n = 13/28, 46.4%), and perceptual dimensions (n = 13/28, 46.4%).

CONCLUSIONS

This review provides a current summary of measures used to assess body image in women with breast cancer. Although some further development and refinement of body image measures could benefit the field, depending on the questions researchers or clinicians seek to answer, there are many available for use. Future research should use these measures to assess the effectiveness of interventions aimed at improving body image in women with breast cancer across the lifespan.

Is body image a predictor of women's depression and anxiety in postmenopausal women?

BACKGROUND

Women in perimenopausal and postmenopausal period are at increased risk of depression and anxiety. Physiologic changes in menopause can change body's appearance and function that may disturb body and then lead to anxiety and depression. This study aims to assess the relationship between body image with anxiety and depression among postmenopausal women.

METHODS

This descriptive study was performed on 307 women attending to the health centers in Tehran- Iran. Sampling was performed by a multi-staged randomized method. Data were collected by using Beck Depression questionnaire, Spielberger Anxiety Questionnaire, Fisher Body Image Questionnaire and Socio-demographic questionnaires. Data were analyzed by SPSS 21 and using t-test, Pearson and Spearman correlation tests and multiple linear regression methods.

RESULTS

The average age of the participants was 55.19 ± 4.034 years. Mean scores for body image, anxiety and depression were 163.26 ± 20.38, 12.00 ± 7.71 and 42.70 ± 8.40 respectively. Fifty five percent of women had mild to severe depression and 83.7% of them had mild to severe anxiety. Total score and all domains of body image had a negative correlation with depression and anxiety scores (P < 0.001). Multiple linear correlation showed that body image is a predictor for depression and anxiety (P < 0.001).

CONCLUSIONS

Body image of women can be effective on occurrence of depression and anxiety in menopause. Therefore, women's health policies should consider body image to control cognitive problems including depression and anxiety in menopause.

[Evolution of body image perception and distorsion with mat and apparatus Pilates practice in adult women]

Introduction

Introduction: the systematic practice of physical exercise may influence the perception and distortion of body image in adult women. Objective: to analyze the evolution of body image perception and distortion in adult women who performed a systematic practice of mat Pilates (PM) or Pilates with apparatus (PA). Methods: a total of 35 adult women participated in a PM (n = 19) or PA (n = 26) program for 16 weeks, two days a week. Body image was assessed before and after the interventions using the Eating Behavior Inventory 3 (EBI-3), Gardner's body image assessment scale, and Thompson and Gray's silhouette scale questionnaires. Results: the PM group showed a significant reduction in dissatisfaction with buttocks, dissatisfaction with body image, perceived image, distortion index, dissatisfaction index, perceived mental image, perceived affective image, cognitive dissatisfaction index, and affective dissatisfaction index (p < 0.05; ES: 0.26-0.80). As compared to the PA group, a significant reduction was shown in dissatisfaction with thighs, dissatisfaction with hips, dissatisfaction with body image, dissatisfaction index, cognitive dissatisfaction index, and affective dissatisfaction index (p < 0.05; 0.22-0.79). Conclusion: the systematic practice of PM or PA improves body image in adult women, reducing their body dissatisfaction.

Improvement of Body Satisfaction in Older People: An Experimental Study

Aging typically manifests itself in a variety of physical and cognitive alterations and challenges that are not always easily accepted. Feeling dissatisfied with these changes can also affect the mood and self-esteem of older people causing body image problems. The present study focuses on body satisfaction in Spanish older people (176 participants; M and SD = 64.03 ± 1 8.06; age range 50 to over 75) by employing experimental research to test whether psychosocial interventions may have a positive impact. Our aims are threefold: (1) To describe the body satisfaction of older people considering intervening variables, such as age, gender, having a stable partner, time of the year, and place of residence; (2) to compare body satisfaction improvement in older people participating in a specific body satisfaction program designed for this purpose versus a non-specific program run by the Spanish Red Cross; and (3) to examine the relationship between age, gender, having a stable partner, time of the year, place of residence, body satisfaction and participating in the experimental condition. The IMAGINA specific body image program yielded a significant improvement in body satisfaction when compared with the non-specific program in both men and women regardless of marital status and in some age groups: 50 to 54 years old, 60 to 64 years old, and 65 to 69. Male participants, as well as singles, were more satisfied with their bodies, and the contrary was true for divorced and separated. The IMAGINA program was particularly useful in participants with more body image problems. As shown, the pressure to fit beauty standards and related problems do not go away with age, a fact that is embodied and experienced differently in men and women.

Body image in older women: a mediator of BMI and wellness behaviors

Negative body image is prevalent among mid- and late-life women. In younger women, negative body image is associated with reduced quality of life (QOL) when controlling for body mass index (BMI), and mediates the relationship between obesity and emotional wellbeing. Yet, much remains unknown about body image in older populations. In our sample of women aged 50-86 (N = 181), negative body image mediated the relationship between BMI and sleep, all four domains of QOL, negative affect, nutritious food consumption, and psychosocial impairment, but not enjoyment of physical activity. Findings suggest negative body image impacts the wellbeing of older women.

Associations between body dissatisfaction, importance of appearance, and aging anxiety with depression, and appearance-related behaviors in women in mid-life

The impacts of body dissatisfaction have been widely studied among adolescent girls, but much less in women in mid-life. In this study, we evaluated the associations between body dissatisfaction, psychological health and behaviors used to manage age-related changes, in an online survey of 331 women aged 45-65. Body dissatisfaction, importance of appearance and aging anxiety were associated with higher depression scores. Moreover, importance of appearance and aging anxiety were associated with the probability of using "anti-aging" behaviors. It seems that with age, for a subgroup of women, the pressure to stay young may be added to that of staying thin.