Body weight dissatisfaction in the Icelandic adult population: a normative discontent?

Beyond Gender: Interoceptive Sensibility as a Key Predictor of Body Image Disturbances

Body image disturbance (BID) involves negative attitudes towards shape and weight and is associated with lower levels of interoceptive sensibility (IS) (the subjective perceptions of internal bodily states). This association is considered a risk factor for developing eating disorders (EDs) and is linked to altered sensorimotor representations of the body (i.e., body schema). BIDs manifest across genders and are currently understudied in men. This study investigated gender-related differences in BID and its relationship to the body schema and IS. Data were collected from 86 men and 86 women. BID was assessed using questionnaires measuring self-objectification, state, and trait body dissatisfaction. IS was measured via the MAIA-2. The body schema was indexed via an embodied mental rotation task. Results showed that women reported higher BID than men across all scales. Gender differences in sub-components of interoceptive sensibility were found. Overall, both gender and interoceptive sensibility predicted BID. However, interoceptive sensibility exhibited its own unique association with BID beyond the influence of gender. BID, IS and gender were not significant predictors of performance in the body schema task. Therefore, while gender predicts differences in BID and interoceptive sensibility, there was no evidence of gender-related differences in body schema.

Development of Body Dissatisfaction in Women and Men at Different Educational Levels During the Life Course

BACKGROUND

Our study examines the rarely investigated associations between body dissatisfaction and educational level over the life course in women and men.

METHODS

A Finnish cohort (N = 1955) was followed by questionnaires at ages 22, 32, 42, and 52. Body dissatisfaction was measured by asking the respondents to evaluate their appearance using five response options. Analyses were done using logistic regression, while latent class analyses were used to identify classes of body dissatisfaction trajectories over the life course.

RESULTS

Body dissatisfaction increased with age in women and men. Among men, body dissatisfaction was related to lower education at the ages of 32 and 42. Also, men with lower education were more likely to maintain a less positive body image over the life course. In women, increasing body dissatisfaction during the life course was associated with lower education.

CONCLUSIONS

Differences in body dissatisfaction based on educational level are important to take into account in public health actions aiming to reduce socioeconomic inequalities in health and well-being.

Is body dissatisfaction related to an attentional bias towards low weight bodies in non-clinical samples of women? A systematic review and meta-analysis

Body dissatisfaction is defined as the negative subjective evaluation of one's body and is considered a risk factor for, and symptom of, eating disorders. Some studies show women with high body dissatisfaction display an attentional bias towards low weight bodies; however, this finding is not consistent, and results are yet to be systematically synthesised. We conducted a qualitative and quantitative synthesis of cross-sectional studies investigating the relationship between body dissatisfaction and attentional bias to low weight bodies in non-clinical samples of women. We searched PubMed, Scopus, Web of Science, PsycINFO, ProQuest, and OpenGrey for studies up until September 2022. We identified 34 eligible studies involving a total of 2857 women. A meta-analysis of 26 studies (75 effects) found some evidence from gaze tracking studies for a positive association between body dissatisfaction and attentional bias to low weight bodies. We found no evidence for an association from studies measuring attention using the dot probe task, electroencephalogram (EEG) recording, or the modified spatial cueing task. The results together provide partial support for the positive association between body dissatisfaction and attentional bias to low weight bodies in women. These findings can be used to inform future attentional bias research.

RISK OF EATING DISORDERS AND BODY DISSATISFACTION AMONG GYM-GOERS IN ANKARA, TURKEY

ABSTRACT Introduction: Although regular exercise is widely recommended to promote optimal health, it is thought that gym-goers are at risk for body dissatisfaction and eating disorders. Objective: This study assessed the risk of eating disorders and the prevalence of body dissatisfaction in gym-goers enrolled in a gym located in the city of Ankara, the capital of Turkey. Methods: This cross-sectional study was conducted with 206 gym-goers, 102 males (mean age of 25.8±7.86 years) and 104 females (mean age of 26.5±9.07 years), who regularly exercised at least twice a week at this gym during the years 2018 to 2019. Demographic characteristics and exercise status of the participants were collected through face-to-face interviews via a questionnaire form. The REZZY (SCOFF) questionnaire was administered to determine the risk of eating disorders and the Stunkard Figure Rating Scale was administered to determine body dissatisfaction. Results: The mean REZZY score in females (1.4±1.21) was higher than in males (0.8 ± 1.05) (p<0.01). In males, 26 out of 102 (25.5%) had a score indicating a risk of eating disorders. In females, 44 out of 104 (42.3%) had a score indicating a risk of eating disorders. The risk of eating disorders is higher in females than in males (p<0.05). While 49.0% of males stated that their current body size is greater than the ideal body size, 76.0% of females said that their current body size is greater than the ideal body size. Conclusion: Consequently, it was determined that gym-goers were a risk group in terms of eating disorders and body dissatisfaction. Level of Evidence: III; Cross-sectional study.

Gender differences in state body satisfaction, affect, and body-related attention patterns towards one’s own and a peer’s body: an Eye-Tracking Study with Women and Men

Background

Body-related attentional biases are assumed to contribute to the development and maintenance of body-related concerns or specific mental disorders such as eating disorders. However, while studies have indicated gender-specific differences in body-related concerns, less is known about gender-specific differences in body-related attention allocation.

Methods

An eye-tracking paradigm was used to assess women’s (n = 41) and men’s (n = 42) attention patterns towards their own and a peer’s body. Additionally, state body satisfaction and affect were examined.

Results

While both women and men showed higher state positive and negative affect after viewing one’s own body than after viewing a peer’s body, only women displayed worse state body satisfaction after viewing one’s own body than after viewing a peer’s body. Conversely, both genders showed a similar deficit-oriented attention pattern, irrespective of the presented body type.

Conclusions

The findings provide evidence of gender-specific differences in state body satisfaction after viewing one’s own and a peer’s body. However, these differences do not seem to be reflected by gender differences in body-related attention allocation. As both women and men showed a deficit-oriented attentional bias, they might benefit from interventions which aim to establish a functional or self-serving way of looking at one’s own body.

The associations of socioeconomic status and financial strain with restrained and emotional eating among 42-year-old women and men

The current study investigated how different aspects of socioeconomic status (SES) and experiencing financial strain are associated with restrained and emotional eating among 42-year-old Finnish women and men. Lower SES is shown to be associated with diets of poorer nutritional quality and obesity. Nevertheless, little research has been done on the association between SES, financial strain and psychological dimensions of eating behaviour. The study was based on questionnaire data from 734 women and 600 men aged 42 years who were participants in a Finnish cohort study. SES was measured through three different dimensions: education, occupation and household income. Data were analyzed using binary logistic regression models. Results showed that restrained eating was associated with higher household income level in women and with higher occupational position in men. Emotional eating was associated with higher financial strain among women. Also, women with lower college education had higher odds for emotional eating compared to women with vocational education or less. Among men, emotional eating was not statistically significantly associated with any of the SES variables nor with financial strain, which may also be due to the very low level of emotional eating reported by men. In conclusion, our findings indicate that restrained eating would be associated with higher status brought by belonging to a higher income or occupational group. Emotional eating, in turn, would be related to experiencing financial strain, rather than to traditional SES dimensions, in women. These results are relevant when health-related interventions are targeted to different SES groups.

Appearance-Related Partner Preferences and Body Image in a German Sample of Homosexual and Heterosexual Women and Men

There is evidence that gender as well as sexual orientation can affect body image. In particular, heterosexual women and homosexual men seem to be more vulnerable to a negative body image compared to homosexual women and heterosexual men. One reason for this may be derived from the fact that heterosexual women and homosexual men try to attract male romantic partners: As men place more importance on physical attractiveness than do women, the pressure to fulfill the sociocultural beauty ideal is thus increased. The present online study investigated differences in appearance-related partner preferences and their associations with measures of body image and eating pathology in homosexual and heterosexual women and men. The non-representative sample consisted of 893 participants (n = 201 lesbian women, n = 192 gay men, n = 349 heterosexual women, and n = 151 heterosexual men), who completed silhouette measures assessing their perception and expectations regarding body fat and muscularity of their own body and the body of a potential romantic partner, as well as questionnaires on drive for thinness, drive for muscularity, and eating pathology. Overall, few differences in appearance-related partner preferences emerged between the four groups. However, compared to heterosexual women, homosexual men appeared to prefer higher muscularity in potential romantic partners, which was also associated with increased drive for thinness and muscularity and increased eating pathology. The present findings indicate that, irrespective of sexual orientation, women and men tend to share similar standards regarding their own and a potential partner's physical appearance, potentially suggesting an increased hegemony of heteronormative beauty ideals in women and men in general.

Being Successful and Being Thin: The Effects of Thin-Ideal Social Media Images With High Socioeconomic Status on Women's Body Image and Eating Behaviour

Social media has outpaced traditional media to be the most popular sociocultural channel to transmit thin-ideal images, an established trigger for body image concerns and disordered eating in women. With an experimental design, the present research first demonstrated that exposure to thin images on social media threatened women's body image and increased their unhealthy food consumption (Study 1). However, given that thin images posted on social media are usually from wealthier people, the present research hypothesised that it may not be the body shape but the perceived socioeconomic status (SES) of images that indeed have negative effects on women. By manipulating the perceived SES of thin images and incorporating a baseline control group (Study 2), the present research provided causal evidence for the hypothesis by indicating that viewing thin images with parallel-perceived SES could significantly buffer undesirable thin-ideal effects on self-objectification and food intake. Therefore, future research needs to pay more attention to the role of SES in the thin media images literature.

Body Dissatisfaction Enhances Awareness and Facilitates the Consolidation of Body-Related Words During Rapid Serial Visual Presentation

Attentional biases have received considerable focus in research on cognitive biases and body dissatisfaction (BD). However, most work has focused on spatial allocation of attention. The current two experiments employed a rapid serial visual presentation (RSVP) task to investigate attention bias to body-related words in the temporal domain among young females with high and low BD. During this task, there were two targets presented in the same stimulus stream. The first target was defined as target one (T1) and the second was defined as target 2 (T2). Participants were asked to identify T2 while ignoring T1 in single task mode or identify both targets in the dual task mode. In the current study, Experiment 1 assessed the stimulus-driven attention of body-related stimuli. Participants were required to identify a target of neutral word (T2) as quickly and accurately as possible while ignoring the preceding target (T1) of neutral, fat-, or thin-related words. As expected, we observed spontaneous attentional blink (AB) effects elicited by both fat- and thin-related T1s among participants with high BD, suggesting enhanced awareness of body-related stimuli even when this information does not have to be identified. Such effects did not emerge among participants without BD. Experimental 2 investigated the goal-directed attention of body-related stimuli, during which participants needed to identify both the T1 and neutral T2. Participants with BD showed reduced AB effects after both fat- and thin-related T1, suggesting facilitated consolidation of body-related information in goal-directed attention among participants with BD. These findings have important clinical implications that it provided insight for creating more accurate attention bias modification (ABM) task aiming at reducing and preventing BD among young females.

Gender Differences in Body Evaluation: Do Men Show More Self-Serving Double Standards Than Women?

Generally speaking, compared to women, men are less dissatisfied with their own body and consider themselves to be better-looking and less overweight. So far, however, it is unclear whether these divergent body ratings arise from the application of double standards. With the present study, we examined whether men apply different standards to their own body than to other men’s bodies and whether they differ from women in this regard. To this aim, we presented n = 104 women and n = 93 men with pictures of thin, average-weight, overweight, athletic and hypermuscular male and female bodies on a computer screen. To manipulate identification, we showed the bodies of the respective participant’s gender once with the participant’s own face and once with the face of another person. Identity cues, such as faces, might activate different body schemata, which influence body ratings and thus lead to the application of double standards. Participants were instructed to rate their emotional reaction to the bodies according to valence and arousal, and to rate the bodies with respect to attractiveness, body fat, and muscle mass. The application of double standards was determined by calculating the difference between the rating of a body presented with the participant’s face and the rating of the same body presented with another person’s face. Both women and men showed self-deprecating double standards in valence, body attractiveness, body fat and muscle mass for the overweight body. Men also revealed self-deprecating double standards for the thin, average-weight and hypermuscular bodies, but evaluated the athletic body as more attractive and with a higher positive feeling when it was presented with their own face. Women did not show any self-serving double standards and showed fewer self-deprecating double standards than men. The results indicate that men devalue non-ideal bodies and upvalue ideal bodies when they are self-related, whereas women more rate in a fair-minded manner. Thus, in contrast to women, an advantage for men may be that they are able to self-enhance in the case of desirable bodies. This ability to self-enhance regarding desirable features might be beneficial for men’s self-worth and body satisfaction.

Prevalence of body dissatisfaction and its effects on health-related quality of life among primary school students in Guangzhou, China

Background

The relationship between body dissatisfaction (BD) and health-related quality of life (HRQoL) has been well documented in adolescents and adults but is less clear in children, particularly in China. The aims of this study were to describe body image perception and dissatisfaction and to examine their effects on HRQoL among primary school students in Guangzhou, China.

Methods

A total of 5734 children aged 8–12 years from 29 schools completed self-report questionnaires, which included the Paediatric Quality of Life Inventory 4.0 for measuring HRQoL and Ma figural stimuli for measuring BD. Based on their level of BD, the children were divided into three groups: no dissatisfaction, mild dissatisfaction and moderate or high dissatisfaction. Based on the children’s perceptions of their own body image, the groups were also categorized into just right, too fat and too thin groups. Height and weight were objectively measured using standardized methods, and a BMI z-score was derived using the age- and sex-specific WHO references from 2007 for children aged 5–19 years. Weight status was classified as underweight, healthy weight, overweight or obese.

Results

A total of 78.10% of children aged 8–12 years in Guangzhou had different levels of BD; boys had slightly higher levels BD than girls (p < 0.01), and obese children demonstrated the highest degree of BD (p < 0.01). However, BD levels did not differ significantly according to age (p = 0.194). Gender differences in body image perceptions were only found in children with a healthy weight (p < 0.01), but age differences in body image perception were present in both children with a healthy weight (p < 0.05) and underweight children (p < 0.05). Of the children with a healthy weight who were dissatisfied with their body image, 65.54% of the boys wanted to be heavier, whereas 52.95% of the girls wanted to be thinner (p < 0.01), and older children were more inclined to perceive themselves as too fat (p < 0.01). After controlling for the influence of confounding factors, significant trends for lower HRQoL scores with increasing BD levels persisted in all domains (p < 0.01).

Conclusions

BD is as common in children as in adolescents and adults and might be independently associated with HRQoL impairment. The present findings suggest that the current epidemic of BD is a threat to the health of primary school children in China, and prevention programmes for this population should be implemented in the future.

Life course, sociocultural factors and disordered eating in adult Mexican women

Disordered eating (DE) can appear in women of all ages and in diverse sociocultural contexts, however most research focuses on younger women in higher income countries. The purpose of this article was to explore the association of life course markers with DE, considering the effects of sociocultural factors, in a sample of adult women in Tijuana, Mexico. We employed data from a household survey (n = 2322) conducted in 2014, to evaluate the associations of DE with age, occupation, marital status and having children (life course markers), and indicators of social position and exposure to modernization (sociocultural factors). The prevalence of weight preoccupation was 69.2% (CI95% 67.3,71.1), the prevalence of dieting 24.8% (CI95% 22.4,27.3), and 2.0% (CI95% 1.4,3.0) had a probable eating disorder according to the questionnaire cutoff score. In the adjusted model, younger age, being employed, higher social position and indicators of exposure to modernization had positive associations with DE. There were interactions between marital status and body mass index, and between age and region of birth. The interaction terms showed that overweight was positively associated with DE among single and cohabiting participants, but not among the married ones; and that the negative association between DE and age was apparent from younger age groups in women born in less developed regions of Mexico. Our results replicate others in showing DE to be present in women through the life course, and point to at-risk groups in the confluences of life course, social position and modernization.

Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

OBJECTIVES

To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students.

METHODS

A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires.

RESULTS

Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight.

CONCLUSIONS

Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population.

Longitudinal changes in desired body weight compared to changes in body weight: evidence of adaptation to weight gain?

Background

Overweight individuals desire a lower weight than they actually have. Little is known on the extent to which this discrepancy is reduced over time due to adaptation or resignation. The aim of this study is to describe cross-sectional relationships and longitudinal changes in desired body weight and differences between actual and desired body weight according to gender, age and category of body mass index in a large, adult cohort in Tromsø, Norway.

Methods

Cross-sectional analyses of 8960 men and 9992 women aged 25–69 participating in Tromsø 4 (during 1994–1995), and longitudinal analyses of 3210 men and 3689 women participating in both Tromsø 4 (during 1994–1995) and Tromsø 6 (during 2007–2008). Simple descriptive statistics and linear regression was used to describe actual and desired weight, the difference between them, and how gender and age are related to the changes in actual and desired weight over this 13-year period.

Results

The difference between actual and desired body weight was largest for the obese and higher among the overweight than the normal weight for both genders. While normal weight men were quite satisfied with their body weight, normal weight women were not. Actual weight increased more than desired weight for all age groups and both genders except the oldest women. The difference between change in actual body weight and change in desired body weight during the 13-year follow-up was significantly larger among men (2.0 kg) than women (1.5 kg) (p < 0.001), and larger among young than older adults (p < 0.001). Adjusting for level of education had no impact on this relationship. Furthermore, the association between age and the difference between change in actual body weight during the 13 years and change in desired body weight in the same period did not differ between men and women and, in gender specific analyses, between subjects with normal weight and those who were overweight or obese at start of follow-up.

Conclusion

Older people adapt more to weight gain than younger age groups, with clear gender differences. Further studies of longitudinal changes in desired weight are warranted.

Electronic supplementary material

The online version of this article (doi:10.1186/s40608-016-0120-6) contains supplementary material, which is available to authorized users.

Women's weight and disordered eating in a large Norwegian community sample: the Nord-Trøndelag Health Study (HUNT)

OBJECTIVES

An increasing part of the population is affected by disordered eating (DE) even though they do not meet the full eating disorder (ED) criteria. To improve treatment in the range of weight-related disorders, there is a need to improve our knowledge about DE and relevant correlates of weight problems such as underweight, overweight and obesity. However, studies investigating DE and weight problems in a wide range of ages in the general population have been lacking. This paper explores DE, weight problems, dieting and weight dissatisfaction among women in a general population sample.

DESIGN

Cross-sectional study.

SETTING

The third survey of the Nord-Trøndelag Health Study (HUNT3).

PARTICIPANTS

The population included 27,252 women, aged 19-99 years, with information on DE outcomes and covariates.

OUTCOMES

DE was assessed with an 8-item version of the Eating Attitude Test and the Eating Disorder Scale-5. Body mass index (BMI) was objectively measured. Data on dieting and weight dissatisfaction were collected from self-reported questionnaires and analysed across weight categories. Crude and adjusted logistic and multinomial logistic regression models were used.

RESULTS

High rates of overweight (38%) and obesity (23%) were found. DE was associated with weight problems. In women aged <30 years, 11.8% (95% CI 10.3 to 13.1) reported DE, and 12% (95% CI 11.5 to 12.6) reported DE in women aged >30 years. In those of younger ages (19-29 years), lower weight predicted DE, while increasing weight predicted DE in older aged women (30-99 years). The majority of women were dissatisfied with their weight (58.8%), and 54.1% of the women reported dieting. Neither BMI status nor age was associated with dieting or weight dissatisfaction.

CONCLUSIONS

A high prevalence of DE was observed, and findings suggest that weight problems and DE are not distinct from one another. Dieting was associated with women's weight dissatisfaction, rather than with actual weight. This requires further investigations about directionality of effects.

Body shape dissatisfaction is a 'normative discontent' in a young-adult Nigerian population: A study of prevalence and effects on health-related quality of life

This study investigates the prevalence of weight misperception, weight preference, and body shape dissatisfaction (BSD) among young-adult Nigerians and assesses the impact of these factors on population quality-of-life (QOL). Relevant anthropometric data were collected according to internationally accepted protocols. Weight perception, weight preference, and BSD were measured using Stunkard silhouettes, while QOL was determined by subjective self-reporting. The results show that 26.7% of the population (18.8% for males and 34.5% for females) misperceived their weight. Among overweight participants, 56.6% (males) and 38.3% (females) thought they were thinner, while 11.5% (males) and 43.3% (females) thought they were heavier. Thin and obese males misperceived their weights more than their female counterparts. BSD was found in 62% of the population (52% for males and 71% for females) and was highest among obese participants (91.9%) and lowest among normal-weight participants (58.2%), irrespective of sex. In participants with BSD, QOL was worse in thin and normal-weight respondents who preferred to be heavier and in overweight respondents who preferred to be thinner. The high prevalence of weight misperception may lead to inappropriate weight loss habits, while BSD, a normative discontent in this population, negatively impacts subject QOL.

Body weight dissatisfaction: a comparison of women with and without eating disorders

OBJECTIVE

Body dissatisfaction is present in a majority of women without eating disorders (EDs), and almost all women with EDs. We compared body dissatisfaction in women with and without EDs to determine at which BMI women are content with their weight, and to determine if body dissatisfaction is affected by the presence of purging behaviours.

METHODS

We assessed women, age 18 to 55 with an ED (N=431) and without an ED (N=719) using the discrepancy between their current and desired BMI. This measure of body weight dissatisfaction (BWD) has been validated as being representative of overall body dissatisfaction. We also measured perceptions of (i) Body Appearance and (ii) Body Image to confirm our results.

RESULTS

Women with and without EDs wished to lose weight until very low weights were achieved (BMI 15-16 kg/m(2) and BMI 18-19 kg/m(2) respectively). BWD is higher in women with EDs (median 1.77, IQR 0-4.61) than women without EDs (median 0.85, IQR 0-1.80, p<0.001). Purging behaviours in women with EDs were associated with lower BMIs to achieve body satisfaction (BMI 15-16 kg/m(2)) than women who did not purge (16-17 kg/m(2)).

CONCLUSIONS

Body weight dissatisfaction is highly prevalent amongst women with and without EDs. Understanding body weight dissatisfaction in women with EDs and its association with purging may assist in the prevention, detection and treatment of these disorders. Women with EDs should be informed that body weight dissatisfaction will not resolve with the cessation of their disorder, as it is prevalent within the general population.

Prevalence of body dissatisfaction among United States adults: review and recommendations for future research

As the evidence supporting the role of body dissatisfaction (BD) in chronic disease risk factors and health behaviors increases, documenting the prevalence of BD is an essential first step in determining to what degree BD is a public health problem. Therefore, the primary purpose of this study is to critically evaluate research examining the population prevalence of BD among U.S. adults. Seven studies were located and provided estimates of prevalence of BD among U.S. adults that were extremely varied (11%-72% for women, and 8%-61% for men). While some of the variation may be due to increases in BD over time, the literature is also clouded by a lack of randomly selected samples, lack of consistency in measurement tools, lack of consistency in operational definitions of BD, and lack of standardized cut-off points for BD. Recommendations for improving BD prevalence research to enable public health research are provided.

Chronic weight dissatisfaction predicts type 2 diabetes risk: aerobic center longitudinal study

OBJECTIVE

Weight dissatisfaction, defined as discordance between actual and goal weight, may be associated with increased risk for several obesity-related comorbidities. The purpose of the study was to examine the association between weight dissatisfaction and risk of developing Type 2 diabetes.

METHOD

This longitudinal study used data from 9,584 adults enrolled in the Aerobics Center Longitudinal Study. Key variables included multiple measures of measured weight, self-reported goal weight, and incident diabetes. Weight dissatisfaction was defined as being above the median of measured weight minus goal weight. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetes incidence by weight dissatisfaction.

RESULTS

HRs for time until diabetes diagnosis revealed that family history of diabetes (HR = 1.46, 95% CI [1.13, 1.90]), age (HR = 1.03, 95% CI [1.02, 1.04]), and weight dissatisfaction (HR = 1.83, 95% CI [1.50, 2.25]) at baseline were statistically significant predictors. Longitudinally, higher risk was observed in individuals who either stayed dissatisfied (HR = 2.98, 95% CI [1.98, 4.48]) or became dissatisfied (HR = 1.51, 95% CI [0.79, 2.89]), compared with those who stayed satisfied. After additional adjustment for BMI, the elevated HR for those who remained dissatisfied compared with those who remained satisfied persisted (HR = 2.85, 95% CI [1.89, 4.31]).

CONCLUSIONS

Weight dissatisfaction, regardless of BMI, represents a potentially important psychophysiological modifier of the relationships between BMI and risk of Type 2 diabetes, and warrants greater attention in future studies of chronic disease risk.

The relationship between BMI and the prescription of anti-obesity medication according to social factors: a population cross sectional study

Background

Obesity is a global public health problem. There are a range of treatments available with varying short and long term success rates. One option is the use of anti-obesity medication the prescription of which has increased dramatically in recent years. Despite this, little is known about the individual and GP practice factors that influence the prescription of anti-obesity medication.

Methods

Multi-level logistic regression analysis was used to investigate factors associated with the prescription of anti-obesity medication in Northern Ireland using a population primary care prescribing database (~1.5 million people aged 16+ years) during 2009/10.

Results

While 25.0% of people are obese, only 1.3% (2.1% of females, 0.6% of males) received anti-obesity medication. The relationship between medication rates and age differed by gender (P < 0.001) with prescriptions higher in younger females and older males. Prescribing of anti-obesity medication reflected obesity prevalence across urban/rural areas and deprivation. There was an unexplained two-fold difference, between the 25^th and 75^th percentile, in the GP practice prescription of anti-obesity medication.

Conclusions

There is evidence of relative under-prescribing in males compared to females despite a similar prevalence of obesity. While the prevalence (and presumably the health consequences) of obesity worsens with age, younger females are more likely to be prescribed anti-obesity medication. This suggests an element of patient demand. Educational material to improve the understanding of the role of anti-obesity medication, for patients and practitioners, is recommended. But further study is needed to understand the factors responsible for the variation in prescribing between GP practices.

When overweight is the normal weight: an examination of obesity using a social media internet database

Using a large social media database, Yahoo Answers, we explored postings to an online forum in which posters asked whether their height and weight qualify themselves as "skinny," "thin," "fat," or "obese" over time and across forum topics. We used these data to better understand whether a higher-than-average body mass index (BMI) in one's county might, in some ways, be protective for one's mental and physical health. For instance, we explored whether higher proportions of obese people in one's county predicts lower levels of bullying or "am I fat?" questions from those with a normal BMI relative to his/her actual BMI. Most women asking whether they were themselves fat/obese were not actually fat/obese. Both men and women who were actually overweight/obese were significantly more likely in the future to ask for advice about bullying than thinner individuals. Moreover, as mean county-level BMI increased, bullying decreased and then increased again (in a U-shape curve). Regardless of where they lived, posters who asked "am I fat?" who had a BMI in the healthy range were more likely than other posters to subsequently post on health problems, but the proportions of such posters also declined greatly as county-level BMI increased. Our findings suggest that obese people residing in counties with higher levels of BMI may have better physical and mental health than obese people living in counties with lower levels of BMI by some measures, but these improvements are modest.

Gender differences in disordered eating and weight dissatisfaction in Swiss adults: which factors matter?

Background

Research results from large, national population-based studies investigating gender differences in weight dissatisfaction and disordered eating across the adult life span are still limited. Gender is a significant factor in relation to weight dissatisfaction and disordered eating. However, the reasons for gender differences in these conditions are still poorly understood. The aim of this study was to examine gender differences in weight dissatisfaction and disordered eating in the general Swiss adult population and to identify gender-specific risk factors.

Methods

The study population consisted of 18156 Swiss adults who completed the population-based Swiss Health Survey 2007. Self-reported weight dissatisfaction, disordered eating and associated risk factors were assessed. In order to examine whether determinants of weight dissatisfaction and disordered eating (dieting to lose weight, binge eating, and irregular eating) differ in men and women, multivariate logistic regressions were applied separately for women and men.

Results

Although more men than women were overweight, more women than men reported weight dissatisfaction. Weight category, smoking status, education, and physical activity were significantly associated with weight dissatisfaction in men and women. In women, nationality and age were also significant factors. Gender-specific risk factors such as physical activity or weight category were identified for specific disordered eating behaviours.

Conclusions

The results suggest that gender specific associations between predictors and disordered eating behaviour should be considered in the development of effective prevention programs against disordered eating.

Body weight dissatisfaction by socioeconomic status among obese, preobese and normal weight women and men: results of the cross-sectional KORA Augsburg S4 population survey

Background

Body weight dissatisfaction is an important factor in preventing weight gain and promoting weight loss or maintenance. This study focuses on differences in the rates of body weight dissatisfaction among obese, preobese and normal weight women and men by socioeconomic status within a general adult population in Germany.

Methods

Data were analyzed from 4186 adults aged 25 to 74 who participated in a cross-sectional, representative population-based health survey (KORA S4, 1999–2001, Augsburg region/Germany). Body mass was measured anthropometrically and indexed following international standards. Among the 2123 women participating in the survey, 40.3% had a normal weight, 34.9% were preobese, and 24.8% were obese (compared to 25.9%, 51.4% and 22.6% among men, respectively). Body weight dissatisfaction, educational level, household income and occupational status were assessed by computer-aided personal interviewing. An index for socioeconomic status was calculated and categorized into quintiles. Multiple logistic regressions were performed to test for differences in the odds of body weight dissatisfaction across socioeconomic strata in normal weight, preobese and obese groups. Body mass index, age, family status, place of residence and health behaviors were adjusted for.

Results

Overall, being dissatisfied with one’s body weight was more prevalent in women (48.3%) than in men (33.2%). In the normal weight group, no significant differences in the odds of being dissatisfied were found across socioeconomic groups among women or men. Among preobese men, compared to the lowest socioeconomic stratum, increased odds of being dissatisfied with one’s body weight were associated with the highest socioeconomic index group (OR = 2.3, 95% CI: 1.4–3.8), middle and high educational level (OR = 1.6, 95% CI: 1.1–2.3, and OR = 1.9, 95% CI: 1.3–3.7), high income (OR = 1.8, 95% CI: 1.2–2.7), and middle and high occupational status (both OR = 1.8, 95% CI: 1.2–2.6). Among preobese women, the odds of being dissatisfied were only significantly elevated in those with a middle educational level (OR = 1.6, 95% CI: 1.1–2.3). Among obese men, elevated odds were found in the highest socioeconomic index group (OR = 3.7, 95% CI: 1.8–7.5) and in those with a high educational level (OR = 2.3, 95% CI: 1.3–4.1), high income (OR = 2.6, 95% CI: 1.4–4.7), and middle and high occupational status (both OR = 2.2, 95% CI: 1.3–3.6). The odds of dissatisfaction among obese women were not associated with socioeconomic status as a whole, but were associated with a high educational level, albeit with a comparatively large confidence interval (OR = 3.6, 95% CI: 1.0–12.8).

Conclusions

In Germany, body weight dissatisfaction is more prevalent among obese and preobese men in high socioeconomic status groups, a pattern not found in women. The exception to this is a greater prevalence of dissatisfaction among obese and preobese women with a high educational level (albeit inconsistently). Moreover, there is a social gradient in body weight dissatisfaction, especially in obese men, which may partly explain why obesity is more prevalent in men with low socioeconomic status. It also suggests that they are a target group for obesity care in which body weight satisfaction is an important topic.