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Dahill LM, Morrison NMV, Touyz S, Mitchison D, Bussey K, Mannan H, Hay P. An exploration of how adolescents experience and reason their parents' comments on their weight, shape, and eating. J Adolesc 2023; 95:1488-1504. [PMID: 37464918 DOI: 10.1002/jad.12221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Disordered eating among adolescents is of increasing concern given associated physical and mental health sequelae. Cognitions underlying disordered eating are formed in childhood and adolescence. Parents are a significant presence during this period, so it is critical to understand how they influence their adolescent's eating cognitions and behaviors. METHODS Qualitative analysis using interpretative phenomenological analysis (IPA) methodology was employed to consider the lived experiences of 10 Australian adolescents (14-19 years), 60% female, as they engaged with their parents in a range of weight, shape, and eating communications. RESULTS Our inductive IPA revealed three key themes representing adolescents' experiences and meaning-making: Parents as Influencers-adolescents acknowledged parents are influencers (objects) within a wider context of community and cultural norms (symbols) and can be protective for peer influence on body image ideals; Expression and Perception-the "what" (weight-talk as an object) and the "how" (objects as independent influences) of gendered parental communication related to health and fitness ideals and illustrated diverse interpretations of both verbal and non-verbal expression; and Fertile Soil and Maturity-the adolescent's characteristics and context influence perceptions of communication, a fear of deviating from norms, and an overarching focus on being "healthy" yet not always knowing what that was. Perception of bidirectional communication also offered valuable insights into potential dangers through family loyalty and in-group permissions. CONCLUSIONS Findings highlight implications for the nuanced influence of parental communication and illustrate the pivotal role of parents within the bioecosystem of adolescent development.
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Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Stephen Touyz
- University of Sydney Inside Out, Camperdown, New South Wales, Australia
- Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- University of Technology Sydney, Broadway, New South Wales, Australia
| | - Kay Bussey
- Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Haider Mannan
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- South West Sydney Local Health District, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia
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Dahill LM, Hay P, Morrison NMV, Touyz S, Mitchison D, Bussey K, Mannan H. Associations between Parents' Body Weight/Shape Comments and Disordered Eating Amongst Adolescents over Time-A Longitudinal Study. Nutrients 2023; 15:1419. [PMID: 36986150 PMCID: PMC10059676 DOI: 10.3390/nu15061419] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Parents are key influencers of adolescents' attitudes on weight, shape, and eating, and make more positive than negative comments, with negative comments most impactful. This study examined prospective unique associations of parental positive and negative comments in a community sample of adolescents with paediatric psychosocial quality of life (PED-QoL), Eating Disorder Weight/Shape Cognitions (EDEQ-WS), BMI percentile, and Psychological Distress (K10) scales. Data were from 2056 adolescents from the EveryBODY study cohort. Multiple regressions were conducted for the impacts of parental positive and negative comments on four dependent variables at one year after controlling for their stage of adolescence (early, middle, late). Multiple imputation and bootstrapping were used for handling missing data and violations of normality. Results indicated that positive maternal comments on eating were associated with increased EDCs and better quality of life at one year. Paternal positive weight shape comments were associated with a decrease in psychological distress, but positive eating comments saw a decrease in quality of life. Findings highlight the nuances of parental comments and how these are perceived and interpreted, and could alert health care workers and family practitioners who have weight, shape, and eating conversations to be aware of the potential influence of their communication.
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Affiliation(s)
- Lucy M. Dahill
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- South West Sydney Local Health District, Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia
| | - Natalie M. V. Morrison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Kay Bussey
- Centre for Emotional Health, Macquarie University, North Ryde, NSW 2109, Australia;
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2051, Australia; (P.H.); (N.M.V.M.); (D.M.); (H.M.)
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Puhl RM, Lessard LM, Pudney EV, Foster GD, Cardel MI. Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives. Pediatr Obes 2022; 17:e12962. [PMID: 36350198 DOI: 10.1111/ijpo.12962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known about parent and adolescent motivations for engaging in weight communication. OBJECTIVES To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management. METHODS Independent samples of parents (N = 1936) and unrelated adolescents (N = 2032) completed questionnaires assessing their agreement with different reasons they engage in, or avoid, parent-adolescent weight communication, using 7-point Likert scales (strongly-disagree to strongly-agree). RESULTS Parents, irrespective of sex, race/ethnicity, and child's weight status, expressed stronger motivations for engaging in weight communication in order for their child to feel good about his/her weight and body size compared to being motivated because a health professional raised their child's weight as a concern. Adolescent motivations for weight communication with parents stemmed from health concerns and worry about their weight; avoidance stemmed from feeling embarrassed, upset, or not wanting to obsess about weight. Differences emerged across sex and race/ethnicity but were most pronounced by weight status and weight management. CONCLUSION Parents and adolescents have different motivations for engaging in or avoiding weight communication. Protecting adolescents' emotional wellbeing and body esteem are viewed as reasons for both engaging in or avoiding weight communication.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA.,Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Leah M Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA
| | - Ellen V Pudney
- Department of Pediatrics, Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA.,Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
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Puhl RM, Lessard LM, Foster GD, Cardel MI. A Comprehensive Examination of the Nature, Frequency, and Context of Parental Weight Communication: Perspectives of Parents and Adolescents. Nutrients 2022; 14:nu14081562. [PMID: 35458124 PMCID: PMC9032323 DOI: 10.3390/nu14081562] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
Research suggests that many parents make comments about their child’s weight, which is associated with negative adolescent health outcomes. Gaps in this literature include an underrepresentation of fathers, limited knowledge regarding positive versus negative parental weight comments and differences across race/ethnicity, and adolescent preferences for parental weight communication. The present study addressed these research gaps through a comprehensive investigation of two diverse samples of U.S. parents (n = 1936) and adolescents (n = 2032), who completed questionnaires about their experiences and perspectives of parental weight communication. Positive weight comments from parents were more frequent than negative comments, though both were commonly reported across sex, race/ethnicity, and weight status. In general, boys, fathers, Latino/a parents and adolescents, and adolescents with a high BMI and/or engaged in weight management reported more frequent parental weight-talk. Parent–adolescent weight communication occurred both in-person and digitally, and across daily life contexts. Although the majority of parents communicated positive messages of body diversity and respect, 44% and 63% of adolescents said they never want their mothers and fathers, respectively, to talk about their weight. Adolescents were offered circumstances that would increase their comfort level in having these conversations. Findings have implications for health professionals working with families to promote supportive health communication at home.
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Affiliation(s)
- Rebecca M. Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT 06269, USA
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT 06103, USA;
- Correspondence:
| | - Leah M. Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT 06103, USA;
| | - Gary D. Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- WW International, Inc., New York, NY 10010, USA;
| | - Michelle I. Cardel
- WW International, Inc., New York, NY 10010, USA;
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32611, USA
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Exploring associations between positive and negative valanced parental comments about adolescents' bodies and eating and eating problems: a community study. J Eat Disord 2022; 10:43. [PMID: 35331338 PMCID: PMC8953043 DOI: 10.1186/s40337-022-00561-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one's weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons' and daughters' psychological distress and eating disorder cognitions (EDCs). METHODS A representative mixed-sex sample of 2204 Australian adolescents (12-19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours. RESULTS Correlation analyses revealed that adolescents' reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs. CONCLUSIONS Overall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years. Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.
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Wanniarachchi VU, Scogings C, Susnjak T, Mathrani A. Fat stigma and body objectification: A text analysis approach using social media content. Digit Health 2022; 8:20552076221117404. [PMID: 35990109 PMCID: PMC9386857 DOI: 10.1177/20552076221117404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
This study investigates how female and male genders are positioned in fat stigmatising discourses that are being conducted over social media. Weight-based linguistic data corpus, extracted from three popular social media (SM) outlets, Twitter, YouTube and Reddit, was examined for fat stigmatising content. A mixed-method analysis comprising sentiment analysis, word co-occurrences and qualitative analysis, assisted our investigation of the corpus for body objectification themes and gender-based differences. Objectification theory provided the underlying framework to examine the experiential consequences of being fat across both genders. Five objectifying themes, namely, attractiveness, physical appearance, lifestyle choices, health and psychological well-being, emerged from the analysis. A deeper investigation into more facets of the social interaction data revealed overall positive and negative attitudes towards obesity, which informed on existing notions of gendered body objectification and weight/fat stigmatisation. Our findings have provided a holistic outlook on weight/fat stigmatising content that is posted online which can further inform policymakers in planning suitable props to facilitate more inclusive SM spaces. This study showcases how lexical analytics can be conducted by combining a variety of data mining methods to draw out insightful subject-related themes that add to the existing knowledge base; therefore, has both practical and theoretical implications.
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Affiliation(s)
| | - Chris Scogings
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Teo Susnjak
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Anuradha Mathrani
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
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Dahill LM, Touyz S, Morrison NMV, Hay P. Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health 2021; 21:450. [PMID: 33676473 PMCID: PMC7936414 DOI: 10.1186/s12889-021-10416-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 02/09/2021] [Indexed: 01/29/2023] Open
Abstract
Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623. Prospectively registered 15th October 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10416-5.
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Affiliation(s)
- Lucy M Dahill
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Stephen Touyz
- Department of Psychology, University of Sydney, Sydney, Australia
| | - Natalie M V Morrison
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, Australia
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Prevalence of Parental Comments on Weight/Shape/Eating amongst Sons and Daughters in an Adolescent Sample. Nutrients 2021; 13:nu13010158. [PMID: 33418994 PMCID: PMC7825281 DOI: 10.3390/nu13010158] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Reports suggest that 12–76% of adolescents have experienced parental comments regarding their weight/shape and/or eating behaviours. Parents may engage in conversations about weight/shape and eating out of concern, even without any ill intent; however, the associations of these comments with subsequent problematic psychosocial and eating behaviours are evidenced. Therefore, an in-depth understanding of the content and prevalence of such comments is needed. To date, adolescent-reported prevalence estimates have not included differentiation between mother or father and sons or daughters, nor have they considered eating-focussed comments. This study considered the prevalence of positive and negative parental commentary regarding weight/shape and eating with a focus on parental origin. A total of 2287 Australian male and female adolescents participated via a self-report survey. Adolescents reported frequent positive comments on weight/shape and on eating, most commonly maternal positive comments on weight/shape (78%; 95% CI 77–80). Daughters reported significantly more maternal comments on weight/shape (positive and negative) as well as more negative eating comments from mothers than did sons. Sons reported significantly more negative weight/shape comments from fathers than did daughters. Some negative comments increased significantly with age. These findings support a notable prevalence of reported parental weight/shape and eating comments directed at their offspring, particularly from mothers.
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Ciloglu H, Yilmaz M. Attitudes and Self-Perception of 10- to 14-Year-Old Students Toward Obese Children. J Sch Nurs 2020; 38:279-286. [PMID: 32573323 DOI: 10.1177/1059840520933341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This cross-sectional study was carried out to investigate the self-perception of primary school students aged 10-14 and their attitudes toward obese children (n = 693). There was a weak, positive, and highly significant correlation between the mean scores for the overall Attitude Toward Obese Children Scale, the Self-Perception Profile for Children Scale, and the Acceptance of Obese Peers subscale (p = .000). There was a weak, positive, and highly significant correlation between all the subscales except for the Rejection of Obese Peer and Social Acceptance and Athletic Competence subscales (p < .01). Self-perception in adolescence is effective throughout life in terms of community mental health. Therefore, it is of great importance to carry out education and awareness-raising studies in schools to gain students positive attitudes and behavior toward individuals with different characteristics.
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Affiliation(s)
| | - Medine Yilmaz
- Department of Public Health Nursing, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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Albano G, Rowlands K, Baciadonna L, Coco GL, Cardi V. Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model. Neurosci Biobehav Rev 2019; 107:846-861. [PMID: 31585134 DOI: 10.1016/j.neubiorev.2019.09.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/05/2019] [Accepted: 09/29/2019] [Indexed: 01/27/2023]
Abstract
Obesity is associated with difficulties due to stigma and loneliness. These impact negatively on individuals' quality of life and behaviour change efforts. Increased sensitivity to others' negative feedback might play a role in the maintenance of these difficulties and could be addressed in psychological interventions. We conducted a systematic review of interpersonal difficulties in individuals with obesity, across the lifespan. We investigated early interpersonal adversity (i.e. frequency of teasing/bullying), perceived interpersonal stress and quality of social life, based on a rejection sensitivity model. The databases PubMed, Web of Knowledge and AGRIS, Embase, Medline and PsychINFO were searched for published peer-reviewed journal articles (1980-June 2018). Thirty-two studies met inclusion criteria. Results from the meta-analyses (n = 16 studies) indicated that overweight/obese individuals reported more frequent experiences of teasing/bullying, greater interpersonal stress and poorer quality of social life than healthy weight individuals. Findings in the systematic review aligned to this evidence. Psychological interventions targeting increased sensitivity to negative interpersonal feedback could improve interpersonal functioning and, in turn, eating behaviours in individuals with obesity.
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Affiliation(s)
- Gaia Albano
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Luigi Baciadonna
- Queen Mary University of London, Biological and Experimental Psychology, School of Biological and Chemical Sciences, London, UK.
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Makowski AC, Kim TJ, Luck-Sikorski C, von dem Knesebeck O. Social deprivation, gender and obesity: multiple stigma? Results of a population survey from Germany. BMJ Open 2019; 9:e023389. [PMID: 30948564 PMCID: PMC6500240 DOI: 10.1136/bmjopen-2018-023389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Individuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories. DESIGN Representative cross-sectional telephone survey. PARTICIPANTS 692 randomly selected adults (≥ 18 years) in Germany. METHODS Different vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses. RESULTS A low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES. CONCLUSIONS Results support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.
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Affiliation(s)
- Anna Christin Makowski
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tae Jun Kim
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Luck-Sikorski
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
- SRH University of Applied Health Sciences, Gera, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Schmidt J, Martin A. Appearance Teasing and Mental Health: Gender Differences and Mediation Effects of Appearance-Based Rejection Sensitivity and Dysmorphic Concerns. Front Psychol 2019; 10:579. [PMID: 30949099 PMCID: PMC6435521 DOI: 10.3389/fpsyg.2019.00579] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/01/2019] [Indexed: 01/03/2023] Open
Abstract
Appearance teasing is a common phenomenon in social interactions, especially in adolescence. Several studies have shown its negative impact on mental health as well as on body image. While these findings prove stable in various contexts, less evidence is available for possible gender differences in these relationships. In particular, the role of two important body image variables - appearance-based rejection sensitivity (ARS) and dysmorphic concerns - and their contribution to mental health impairments has not been assessed in gender-specific process models. In a cross-sectional survey-study (N = 501; 407 f, 94 m), we retrospectively assessed early appearance teasing experiences, as well as current ARS, dysmorphic concerns, depression, anxiety, and self-esteem. We analyzed gender differences in these variables and their interrelations. We then examined the mediating role of ARS and dysmorphic concerns in explaining mental health variables in adulthood due to early appearance teasing in gender-specific serial-mediation models. The results show high ratios of early teasing experiences, but no significant gender difference regarding the frequency of early appearance teasing. While teasing experiences were significantly related to body image variables in adulthood in both genders (rs > 0.32; ps < 0.010), we observed significant relations with mental health outcomes in women (rs > 0.30; ps < 0.001) but not in men (rs < 0.20; ps > 0.250). Serial mediation models show that ARS and dysmorphic concerns mediate the effects of appearance teasing on mental health in all outcomes in women (ΔR2 > 0.17), but not in men (ΔR2 < 0.03). Findings remained stable when controlling for Body-Mass-Index, age, and relationship-status. The findings show similar frequencies of appearance teasing and associated negative effects on body image in men and women. Specifically, in women, the effects of teasing on mental health were stronger and mediated by ARS and dysmorphic concerns. Overall, the results point to the relevance of ARS for etiological models of body image disorders and female mental health. However, men did not show the same relationships of teasing and mental health. Differential resilience factors regarding the negative effects of early appearance teasing could be an important target for future research.
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Affiliation(s)
- Jennifer Schmidt
- Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany
- Department of Psychology, HSD Hochschule Döpfer University of Applied Sciences, Cologne, Germany
| | - Alexandra Martin
- Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany
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Alexius SL, Mocellin MC, Corrêa EN, Neves JD, Vasconcelos FDAGD, Corso ACT. Evidences of the association between individual attributes and bullying: a cross-sectional study with adolescents from Florianópolis, Santa Catarina State, Brazil. CAD SAUDE PUBLICA 2018; 34:e00118617. [PMID: 30570038 DOI: 10.1590/0102-311x00118617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 06/08/2018] [Indexed: 01/31/2023] Open
Abstract
This study aimed to estimate the prevalence of bullying and to verify the association between nutritional status, demographic and socioeconomic factors, and individual attributes among schoolchildren aged from 11 to 14 years. This is cross-sectional study with a probabilistic sample of 975 adolescents attending public and private schools in Florianópolis, Santa Catarina State, Brazil. Bullying was investigated with a self-administered questionnaire by applying Item Response Theory and dichotomized according to victimization or not. Body mass index (BMI) was classified according to the World Health Organization criteria. Data such as age, school type and location, household income, as well as the education background of the parents were collected by a questionnaire given to the parents. Crude and adjusted analyses were performed using logistic regression. The prevalence of victims of bullying and of overweight/obese adolescents was 13.2% and 29%, respectively. No association was found between bullying and age, sex, school type, mother's education, household income, and overweight/obesity. The crude analysis model indicated that overweight/obese adolescents and those with individual attributes (fat, thin, tall, short, good-looking, ugly, from a different ethnic background, rich, poor, with a disability and/or other) had a greater chance of being bullied. In the analysis model adjusted by household income and stratified by sex, boys were discriminated for being fat, good-looking, ugly, or for having a disability, while girls were discriminated for being fat, tall, short, ugly, rich, poor, among other individual attributes.
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Affiliation(s)
| | | | | | - Janaina das Neves
- Departamento de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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Mutlu B, Yilmaz M. Child-Adolescent Teasing Scale: psychometric properties of the Turkish version. Child Adolesc Ment Health 2018; 23:283-290. [PMID: 32677296 DOI: 10.1111/camh.12250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The tools to measure teasing are not available in Turkish literature. This study aimed to examine the psychometric properties and performance of a Turkish version of the Child-Adolescent Teasing Scale (CATS) among a sample of Turkish children. METHODS Four hundred middle school (grades 5-6-7-8) students comprised the sample. CATS is composed of four subfactors and 32 items. Language equivalence and content validity were assessed by five experts. Psychometric testing included internal consistency reliability (Cronbach's alpha coefficient and item-total correlations), test-retest reliability, construct validity (principal component analysis via oblique rotation and confirmatory factor analysis), and variability (floor and ceiling effects). RESULTS Of the participants, 52.5% were female. Their mean age was 12.54 ± 1.11. Language equivalence and content validity were assessed by five experts. The Content Validity Index of the scale was .87. The correlation coefficient ranged between .34 and .70. Cronbach's alpha was .92 for the total scale. The test-retest correlation value was r = .87. The scale confirmatory factor analysis showed that the scale had a four-factor structure. These four factors explained 55.51% of the total variance. The reliability coefficient of the relationship between each subscale in relation to the total scores of the scale ranged from .56 to .93. CONCLUSIONS In conclusion, the Turkish version of the CATS which has good psychometric properties similar to those of the original English version is a valid and reliable tool. While the original scale has 32 items, the Turkish version of the CATS has four factors and 23 items. It can be used to assess teasing in children and adolescents.
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15
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Philippi ST, Leme ACB. Weight-teasing: does body dissatisfaction mediate weight-control behaviors of Brazilian adolescent girls from low-income communities? CAD SAUDE PUBLICA 2018; 34:e00029817. [PMID: 29947652 DOI: 10.1590/0102-311x00029817] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/31/2017] [Indexed: 11/22/2022] Open
Abstract
The objective was to examine the mediation hypothesis of body dissatisfaction and analyze their association with weight-teasing and body satisfaction. A total of 253 girls who attended 10 schools from São Paulo, Brazil, participated in this study. Data collection was carried out through a validated and self-reported questionnaire. Study variables were weight-teasing (independent), body satisfaction (mediation), and weight control behavior (outcome). Effect mediation analyses showed a significance level of 5% (p < 0.05). Prevalence of family and peers weight-teasing were 38.5% and 40.6%, respectively. Body dissatisfaction was associated with unhealthy weight control behaviors when controlled by family and peer weight-teasing. Data indicate that family and peers teasing are important aspects that interfere in body satisfaction and weight control behaviors.
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16
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Parasympathetic cardio-regulation during social interactions in individuals with obesity-The influence of negative body image. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2017; 17:330-347. [PMID: 27905081 DOI: 10.3758/s13415-016-0482-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individuals with obesity in Western societies often face weight-related stigmatization and social exclusion. Recurrent exposure to prejudice and negative social feedback alters one's behavior in future social interactions. In this study, we aimed to investigate autonomic nervous system and affective responses to social interactions in individuals with obesity. Women and men with (n = 56) and without (n = 56) obesity participated in episodes of social inclusion and social exclusion using a virtual ball-tossing game. During the experiment, heart rate was measured and parasympathetic activity (overall high-frequency power and event-related cardiac slowing) was analyzed. Our results show that in novel social interactions, women with obesity, relative to the other groups, exhibited the strongest increase in parasympathetic activity. Furthermore, parasympathetic activity was related to a more negative body image in individuals with obesity, but not in lean individuals. Additionally, women with obesity reported a stronger decrease in mood after social exclusion than did the other participants. Our results demonstrate influences of objective and subjective bodily characteristics on parasympathetic cardio-regulation during social interactions. In particular, they show behavioral and physiological alterations during social interactions in women with obesity.
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