Father-daughter relationship dynamics & daughters' body image, eating patterns, and empowerment: An exploratory study

Research indicates the role of parents in women's body dissatisfaction and maladaptive eating patterns. Fathers, in particular, have unique roles in determining daughters' protection against these health risks. Additionally, self-esteem, feminist values, and psychological empowerment are linked with body dissatisfaction and maladaptive eating patterns among women. This study examined the contributions of these psychological factors, family relational factors, and the role of fathers in empowering their daughters. Seventy-seven young adult women from intact families were recruited from Amazon Mechanical Turk and a university campus and completed self-report surveys. Participants were between the ages of 18 and 38 and primarily White. Results indicate that women with higher self-esteem and psychological empowerment endorsed greater body satisfaction. Women with higher self-esteem and endorsement of feminist values also reported significantly fewer maladaptive eating patterns. Greater family conflict was related to more maladaptive eating patterns. Analyses indicated increased body dissatisfaction and increased eating disorder risk decreased the odds of women reporting agency and fatherly supportive resources in their father-daughter communication narratives. Narrative data analysis revealed that fathers play a crucial role in promoting daughter's empowerment, egalitarian gender-role socialization, and healthy psychological wellbeing. Implications for research and clinical community-based treatment and prevention strategies are discussed.

Compassion-focused therapy for body weight shame: A mixed methods pilot trial

Individuals with bigger bodies (body mass index greater than 30) often experience body weight shame and are at increased risk for mental health vulnerabilities such as depression and anxiety. To date, there have been no studies specifically designed and pilot tested to help with body weight shame for individuals with bigger bodies that do not have a diagnosed clinical condition. The aim of current study is to investigate the initial feasibility of compassion-focused therapy (CFT) as a 12-session group intervention for the reduction in body weight shame for individuals with bigger bodies. The study used a mixed method repeated measure design, with both quantitative and qualitative measures, to assess the initial feasibility of the CFT group-based intervention. Participants (N = 5) attended a 12-session/2-h group CFT programme aimed to directly target body weight shame by cultivating compassion. Measurements were conducted at three time points (pre-, post- and 3-month follow-up intervention). Results indicated that CFT had a positive impact on reducing body weight shame, increasing compassion and improving health-engaging behaviours. Qualitative feedback indicated the importance of the group dynamics to help with the de-shaming of body appearance for individuals. Results from this feasibility trial are promising, and future research using randomized controlled trial methodologies should be conducted to evaluate the effectiveness of CFT as a treatment option for body weight shame for individuals with bigger bodies.

Drunkorexia: A new term and diagnostic criteria

Individuals who restrict their caloric intake and/or exercise excessively to mitigate the calories from alcohol consumption may suffer from an eating disorder, substance abuse disorder, or both. While the term "drunkorexia" has been used in both academic articles and popular culture, issues persist with respect to diagnosing and treating this condition. Classifying the behavior as a subcategory of Other Specified Feeding and Eating Disorders (OSFED) would provide patients with an increased likelihood of receiving insurance coverage for this condition. A consistent definition of this behavior and a more medically accurate/appropriate term-such as "alcoholimia"-are both needed to advance treatment and prevention efforts.

Barriers to access and utilization of eating disorder treatment among women

Anorexia, bulimia, and other specified feeding or eating disorders (OSFED) are psychiatric disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). One difference of eating disorders compared to other psychiatric disorders is the physical effects of the disease. Although anorexia is easier to physically detect than bulimia and OSFED, many women remain undiagnosed and untreated. Even if an eating disorder is recognized by the individual, barriers to clinical diagnosis and treatment persist. This study examines the barriers to treatment among women with anorexia, bulimia, and OSFED using Andersen's Behavioral Model. The physical, psychological, and personality trait differences among the eating disorder subgroups may affect treatment utilization and access.

The Relationships of Body Image, Feminism and Sexual Orientation in College Women

In this study, 409 undergraduate women completed surveys about their own body image, feminism and sexual orientation as well as their attitudes about others, that is, attitudes about weight in others, attitudes about feminism and attitudes about lesbians and gay men. There was a significant relationship between the three external measures of fat attitudes, attitudes towards feminism and attitudes towards lesbians and gay men, and it is argued that each of these three variables reflects some degree of political liberalism. We also found that the relationship between own identity and attitudes towards others was significant for feminism and sexual orientation, but non-significant for own body image and attitudes about fatness in others. Thus, the results of this study imply that fat people as a group have still not formed the kind of political or social cohesiveness that has been so advantageous to other oppressed groups, such as women or gay men and lesbians.

Sociocultural, Feminist, and Psychological Influences on Women's Body Satisfaction: A Structural Modeling Analysis

We explored sociocultural, feminist, and psychological influences on women's body dissatisfaction by examining the manner in which awareness and internalization of appearance standards, feminist ideology, and self-esteem affect body dissatisfaction. A main goal of the study was to test a model of potential protective mechanisms against internalization of appearance standards. The LISREL 8.5 program was used to perform structural modeling analyses on the proposed theoretical models. The results supported previous findings regarding the influential role of sociocultural variables on women's body dissatisfaction. In particular, internalization was found to mediate the relationship between awareness and body dissatisfaction. Feminist ideology and self-esteem were not found to serve as protective mechanisms against internalization. However, self-esteem appeared to directly affect body dissatisfaction.

Disordered Eating and Perceptions of Childhood Abuse Among Women in a Primary Care Setting

Research has demonstrated links between sexual abuse and disordered eating among women in college student and mental health samples. Little is known about such relationships among women from other samples or the relationship between other forms of childhood abuse as well as disordered eating (vomiting, starvation, laxative abuse). Prevalence of disordered eating was significantly higher among women who indicated a perceived childhood history of sexual, physical, or emotional abuse or who had personally witnessed violence.

What Triggers Abnormal Eating in Bulimic and Nonbulimic Women?; The Role of Dissociative Experiences, Negative Affect, and Psychopathology

Dissociative experiences and abnormal eating were examined in 92 non-eating-disordered women and 61 age-matched bulimic women. In the nonclinical sample of women, dissociative experiences were associated with abnormal eating attitudes and behavior, even after controlling for other forms of psychopathology; furthermore, dissociation mediated the relationships between abnormal eating and sexual abuse, abnormal eating and emotional distress, and abnormal eating and impulsivity Analyses using both bulimic women and occasional binge eaters among the controls showed that a combination of reported negative affect and dissociative experiences preceding a binge was associated with the highest levels of abnormal eating. Finally, in both bulimic women and occasional binge eaters, feelings of panic appeared to decrease as a binge episode progressed, whereas, in bulimic women only, dissociative experiences appeared to increase during binge eating. The implications for the role of dissociation in combination with emotional distress in triggering and reinforcing abnormal eating in women are discussed.

The impact of indicated prevention and early intervention on co-morbid eating disorder and depressive symptoms: a systematic review

BACKGROUND

Depressive and eating disorder symptoms are highly comorbid. To date, however, little is known regarding the efficacy of existing programs in decreasing concurrent eating disorder and depressive symptoms.

METHODS

We conducted a systematic review of selective and indicated controlled prevention and early intervention programs that assessed both eating disorder and depressive symptoms.

RESULTS

We identified a total of 26 studies. The large majority of identified interventions (92%) were successful in decreasing eating disorder symptoms. However fewer than half (42%) were successful in decreasing both eating disorder and depressive symptoms. Intervention and participant characteristics did not predict success in decreasing depressive symptoms.

CONCLUSIONS

Indicated prevention and early intervention programs targeting eating disorder symptoms are limited in their success in decreasing concurrent depressive symptoms. Further efforts to develop more efficient interventions that are successful in decreasing both eating disorder and depressive symptoms are warranted.

My 'Fat Girl Complex': a preliminary investigation of sexual health and body image in women of size

Women of size who inhabit non-normative bodies may have different experiences with body image and sexual health than women of average body size. In this exploratory study, we interviewed four women of size recruited from a larger mixed-methodological study of body image and sexuality. Each woman was interviewed twice on topics of body image, sexuality and sexual health. Reconstructive Horizon Analysis was used to analyse the content of the interviews. Women who expressed that their bodies had inherent personal and social value regardless of size did not articulate connections between body size and their sexual health. However, those women who looked externally for validation of their attractiveness struggled with acceptance of their sexuality and bodies and spoke of ways in which their body size and appearance hindered them from having the sexually healthy lives that they wanted. Findings highlight two important components of women's sexual health as participants related them to body image: the right to pleasure and the right to engage only in wanted sexual activity. Participants described how negative body attitudes affected both of these aspects of their sexual health. Interventions targeting weight-based stigma may offer a means of indirectly promoting sexual health and autonomy in women.

Health Belief Model deterrents of social support seeking among people coping with eating disorders

BACKGROUND

Eating disorders have the highest mortality rates of any psychiatric diagnosis (Sullivan, 1995). Understanding what prevents people from seeking or accessing that which can help them manage these disorders is critical to improving eating disorder outcomes. This study identifies specific barriers and deterrents individuals living with eating disorders perceive when deciding if and when they will seek eating disorder-specific social support.

METHODS

34 men and women living with eating disorders were recruited and interviewed regarding their experiences with managing their disorders, including reasons why they may forego seeking social support to help cope with these conditions.

RESULTS

Participant-reported reasons as to why they would forego seeking social support for the management of their eating disorders were framed against the five main constructs of the Health Belief Model. These include (a) perceived susceptibility to a health threat, (b) perceived severity of the health threat, (c) perceived benefit of protective health behaviors, (d) perceived self-efficacy with these protective behaviors, and (e) perceived barriers to performing these behaviors.

LIMITATIONS

It could be argued that since this study does not focus solely on one type of eating disorder, such as anorexia or bulimia, the barriers to social support may differ depending upon the characteristics inherent to the specific disorders.

CONCLUSIONS

Findings can be used to inform and improve therapeutic interventions to produce better long-term outcomes among people struggling with eating disorders.

Explaining the relation between thin ideal internalization and body dissatisfaction among college women: the roles of social comparison and body surveillance

Sociocultural models of disordered eating lack comprehensive explanations as to how thin ideal internalization leads to body dissatisfaction. This study examined two social psychological theories as explanations of this relation, namely social comparison and objectification theories, in a sample of 265 women attending a Southeastern university. Social comparison (both general and appearance-related) and body surveillance (the indicator of objectification) were tested as mediators of the relation between thin ideal internalization and body dissatisfaction using bootstrapping analyses. Results indicated that body surveillance was a significant specific mediator of this relation; however, neither operationalization of social comparison emerged as such. Results serve to elaborate upon the sociocultural model of disordered eating by providing a more comprehensive understanding of the processes by which thin ideal internalization manifests itself in body dissatisfaction. The current findings also highlight the importance of targeting body surveillance in clinical settings.

Social psychological theories of disordered eating in college women: review and integration

Because peer interaction, weight/shape, and self-concept formation are particularly salient to college women, the implications of social psychological theories may be especially far-reaching during the college years. College women may be particularly vulnerable to the effects of social comparison, objectification, and uses and gratifications theories, which describe social-cognitive mechanisms that provide an individual with information regarding her own view of her body and how she perceives that others perceive her body. The current paper will review and integrate findings related to these three theories of disordered eating in college women in an effort to present a more comprehensive understanding of the social psychological mechanisms that play a role in the development and maintenance of such pathology for this group of young women. Limitations of and future directions for research on these theories will be discussed, as will their potential integration with other factors that contribute to disordered eating and implications for treatment and prevention.

Downward spirals of body surveillance and weight/shape concern among African American and Caucasian college women

Within dominant American culture, females often learn to view themselves from an observer's perspective and to treat themselves as objects to be looked at (i.e., self-objectification), which can result in negative outcomes. Body surveillance (the indicator of self-objectification) has been found to predict concern with weight/shape in predominantly Caucasian samples, but research has not yet examined the potential reciprocal relations between body surveillance and weight/shape concern. Participants were 226 women attending a Midwestern university (70 self-identified as African American and 156 as Caucasian) who provided data at two time points, spaced about 5 months apart. Results revealed that downward spirals of body surveillance and weight/shape concern were apparent for the Caucasian but not the African American women. However, there was evidence that body surveillance helped account for change in weight/shape concern for the African American women.

Outcome of dialectical behaviour therapy for concurrent eating and substance use disorders

AIM

The current study examined the preliminary efficacy of dialectical behaviour therapy (DBT) adapted for concurrent eating disorders (EDs) and substance use disorders (SUDs).

METHOD

A matched randomized controlled trial was carried out with 25 female outpatients diagnosed with concurrent ED and SUD. Participants randomized to the intervention condition received DBT, whereas those randomized to the control condition received treatment as usual (TAU), both for a period of 1 year. A series of measures related to disordered eating, substance use and depression were administered to the participants at the beginning of treatment and at 3, 6, 9 and 12 months into treatment, followed by 3-month and 6-month follow-up assessments.

FINDINGS

Participants randomized to the DBT condition evidenced a superior retention rate relative to their counterparts in the TAU condition at various study time points, including post-treatment (80% versus 20%) and follow-up (60% versus 20%). Due to the unexpected elevated dropout rates and the worsening of ED-SUD symptomatology in the TAU condition, recruitment efforts were terminated early. Results from the DBT condition revealed that the intervention had a significant positive effect on behavioural and attitudinal features of disordered eating, substance use severity and use, negative mood regulation and depressive symptoms. Finally, increases in participants' perceived ability to regulate and cope with negative emotional states were significantly associated with decreases in emotional eating and increases in levels of confidence in ability to resist urges for substance use.

CONCLUSION

Results suggest that the adapted DBT might hold promise for treating individuals with concurrent ED and SUD.

KEY PRACTITIONER MESSAGE

The current study is the first study to report positive effects of DBT on individuals with concurrent eating and substance use disorders. Although the results require replication and extension, they suggest that the DBT may be promising for this population. The results suggest that clinicians treating individuals with concurrent eating and substance use problems should be particularly cautious of poor treatment retention and treatment complications. The results bear upon the highly salient and important issue of whether individuals with concurrent substance use need to be excluded from research studies and treatment programmes.

Body image and eating disturbance in African-American men who have sex with men: preliminary observations

Research related to eating and body image disturbance in males has focused almost exclusively on Caucasian men. This preliminary study examined the prevalence of disturbed eating and body image symptomatology in a highly understudied and difficult to assess population-African-American men (n = 18) who have sex with men. Nineteen percent of the sample scored above clinical cut offs for possible eating disorders with 25% of the sample endorsing occasional or more frequent vomiting after meals. Use of appearance-changing supplements and substances were frequently reported. Although most body image measures were similar to norms, self-ideal discrepancy for muscularity was almost three times greater than male weightlifters. The implications of problematic body image and eating behaviors and the link between body image and high-risk sexual behaviors are discussed.

The effects of exposure to feminist ideology on women's body image

Body image disturbance has become a common problem among women and there is a need to focus on creating empirically supported treatments. Psychoeducational interventions have reduced body image dissatisfaction, but their impact is limited because they do not offer women adaptive methods of interpreting the many appearance-related messages they receive. This study examined if exposure to a feminist perspective may provide alternative interpretations of cultural messages, thereby increasing body image satisfaction. Participants were randomly assigned to a feminist or psychoeducational intervention, or a control group. Exposure to the feminist condition resulted in increased self-identification as a feminist and greater appearance satisfaction, and changes in feminist identity were related to positive changes in body image. The findings indicate that exposure to feminist theories may serve as an effective intervention strategy.

Personal control and disordered eating in female adolescents with type 1 diabetes

OBJECTIVE

The onset and subsequent management of diabetes can challenge one's sense of control. Sense of control can also be affected by the biological changes accompanying normal pubertal development. The negative impact on one's sense of control may be further exacerbated when both events (i.e., diabetes and puberty) occur in relatively close temporal proximity.

RESEARCH DESIGN AND METHODS

This study examined the relationship between sense of control and disordered eating and glycemic control in 45 female adolescents with type 1 diabetes.

RESULTS

A lower sense of overall control and a lower sense of bodily control were both directly related to more severe eating-disordered symptoms. However, a lower sense of overall control and lower bodily control were related to poorer metabolic control primarily when the diagnosis of diabetes occurred closer to the onset of puberty.

CONCLUSIONS

Clinicians should assess and monitor perceptions of control and also consider the temporal proximity of disease onset and onset of puberty when managing type 1 diabetes in female adolescents.

Culture and eating disorders: a historical and cross-cultural review

Cultural beliefs and attitudes have been identified as significant contributing factors in the development of eating disorders. Rates of these disorders appear to vary among different racial/ethnic and national groups, and they also change across time as cultures evolve. Eating disorders are, in fact, more prevalent within various cultural groups than previously recognized, both within American ethnic minorities and those in other countries. This review examines evidence for the role of culture as an etiological factor for the development of eating disorders. Historical and cross-cultural experiences suggest that cultural change itself may be associated with increased vulnerability to eating disorders, especially when values about physical aesthetics are involved. Such change may occur across time within a given society, or on an individual level, as when an immigrant moves into a new culture. Further research into the cultural factors that promote the development of eating disorders is much needed. Understanding how cultural forces contribute to the development of disorders is needed so that preventive interventions can be created.

The influence of race, ethnicity, class, and sexual politics on lesbians' body image

Based on interviews conducted with eight lesbians, this paper explores how the intersection of gender, sexual identity, race, ethnicity, and class affect lesbians' feelings about their bodies. Their responses suggest that, while being female has a strong effect on lesbians' feelings about their bodies, issues of race, acculturation, and class also affect body image. Lesbian feminism and S/M politics also appear to play a significant role in lesbians' body image. These findings highlight the limitations of existing theories about body image and call for a more complex theory incorporating a more diverse range of experiences.