Gender, sexuality, body image and eating behaviours

Validation and measurement invariance of a Korean version of the Body Appreciation Scale-2 in cisgender sexual minorities and heterosexual adults

The Body Appreciation Scale-2 (BAS-2) has been validated in various languages across samples with different characteristics. However, its validation and invariance based on sexual orientation in Korean samples have yet to be examined. The current study validated the psychometric properties of the BAS-2 in Korean sexual minorities, and examined measurement invariance between sexual minority and heterosexual individuals and between sexual minority cisgender women and men. Responses from 449 sexual minority and 400 heterosexual individuals were analyzed. In the sexual minority sample, a confirmatory factor analysis supported the scale's unidimensional structure, exhibiting strong factorial validity; further, a correlation analysis revealed positive correlations with body satisfaction, positive sexual minority identity, life satisfaction, and self-esteem, supporting the convergent and criterion-related validity. A hierarchical regression analysis confirmed the incremental validity of the BAS-2 on life satisfaction and self-esteem. The BAS-2 was invariant across women and men at the scalar level in the sexual minority sample, and across sexual minorities and heterosexuals at the partial scalar level in the total sample. Latent mean comparisons indicated no significant differences in BAS-2 scores between sexual minority women and men, while sexual minorities scored significantly lower than heterosexuals. The multiple-indicators multiple-causes model provided evidence of differential item functioning.

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

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

Body satisfaction of lesbian and bisexual Brazilian women: Indicators of self-esteem, physical appearance perfectionism, and identity processes

This article examined the association between body satisfaction and sexual identification among lesbian and bisexual women, since these factors help to understand the cultural background of the objectification of female bodies in Latin cultures. Women who identify as lesbian (N = 239) and bisexual (N = 60) completed demographic data and measures of self-esteem, physical appearance perfectionism, lesbian and bisexual identity difficulties, and body satisfaction. We performed a three-stage hierarchical multiple regression to explore how variables relate to body satisfaction. The results suggest that self-esteem plays a key role, explaining 20.4% of the variance in body satisfaction. We discussed the psychosocial and cultural aspects involved in the relationship between the variables, and social and aesthetic pressures on women's bodies. This study contributes to discussions on psychosocial aspects associated with body satisfaction among Brazilian lesbian and bisexual women.

Body image disturbance and associated eating disorder and body dysmorphic disorder pathology in gay and heterosexual men: A systematic analyses of cognitive, affective, behavioral und perceptual aspects

OBJECTIVE

This study contributes to the quantitatively large, yet narrow in scope research on body image in gay men by assessing whether gay and heterosexual men systematically differ on various dimensions of body image disturbance and associated pathology, i.e., eating disorder and body dysmorphic disorder symptoms. Moreover, we examined the influence of general everyday discrimination experiences and involvement with the gay community on body image.

METHOD

N = 216 men (n = 112 gay men, n = 104 heterosexual men) participated in an online survey measuring the discrepancy between self-rated current and ideal body fat/ muscularity; drive for leanness, muscularity, and thinness; body satisfaction; body-related avoidance and checking; appearance fixing; overall body image disturbance; eating disorder and body dysmorphic disorder pathology; general everyday discrimination experiences; and involvement with the gay community.

RESULTS

Gay men showed a greater discrepancy between self-rated current and ideal body fat; higher drive for thinness, body-related avoidance, appearance fixing, overall body image disturbance, eating disorder and body dysmorphic disorder pathology; and lower body appreciation than heterosexual men (all p ≤ .05). Contrary to expectation, everyday discrimination experiences were more strongly associated with body image disturbance and eating disorder/ body dysmorphic disorder pathology in heterosexual men than in gay men (all p ≤ .05). Gay community involvement was not associated with any body image disturbance-, ED-, or BDD aspect in gay men (all p ≥ .20).

DISCUSSION

The results suggest greater body image disturbance in gay men than in heterosexual men regarding cognitions, emotions, behaviors, and perception as well as higher eating disorder and body dysmorphic disorder pathology. The results also suggest the dilemma of a thin, yet muscular body ideal in gay men. Surprisingly, discrimination experiences and involvement with the gay community did not explain differences in body image disturbance. Gay men may have become resilient to discrimination over time, and body ideals might differ across gay sub-communities.

Eating behavior in patients with smell loss

Background

The objective of this study was to determine how clinical characteristics and validated quality of life (QoL)-measures are associated with eating behavior in patients with olfactory dysfunction (OD).

Methods

For this cross-sectional study, 150 OD patients of different causes were retrospectively recruited. Olfactory function was measured using the Sniffin’ Sticks (TDI), while olfactory-related QoL was evaluated with the Questionnaire of OD negative and positive statements (QOD-NS and QOD-PS). The importance of olfaction was measured using the Importance of Olfaction Questionnaire (IOQ). The Dutch Eating Behavior Questionnaire (DEBQ) assessed eating behavior based on emotional, external, and restrained eating. Associations were sought between eating behavior metrics (as dependent variables) with clinical characteristics and olfactory-related outcome measures.

Results

Emotional, external, and restrained eating behavior deviating from normative standards were reported in 54%, 71.3%, and 68% of patients, respectively. Multivariate regression modeling revealed that emotional eating was associated with age (ß = –0.227, p = 0.032), the body mass index (BMI, ß = 0.253, p = 0.005), the TDI (ß = 0.190, p = 0.046), and the QOD-NS (ß = 0.203, p = 0.049). External eating was associated with OD duration (ß = 0.291, p = 0.005), the TDI (ß = 0.225, p = 0.018), the QOD-PS (ß = –0.282, p = 0.008), and the IOQ (ß = 0.277, p = 0.004). Restrained eating was associated with age (ß = 0.216, p = 0.033), the BMI (ß = 0.257, p = 0.003), male gender (ß = –0.263, p = 0.002), and the IOQ (ß = 0.332, p < 0.001).

Conclusion

Clinical characteristics and olfactory outcome measures differentially impact eating styles in OD patients. Our study’s results highlight the importance of considering unfavorable changes in eating behavior during clinical counseling.

Self-Reported Total Screen Time and Viewing Modes Are Associated with Body Dissatisfaction, Disordered Eating, and Cosmetic Surgery Intentions among Young Adults

While numerous studies have shown that media exposure is linked to body dissatisfaction and disordered eating behavior, limited research has examined these associations by screen-viewing mode. This study examined associations of total screen-time and screen-viewing modes with body dissatisfaction, disordered eating, and cosmetic surgery intention among young adults. Men (n = 3466) and women (n = 7300), aged 19 to 34 years, self-reported their screen-time on various TV viewing modes, and their body dissatisfaction, overeating, disordered weight control behaviors, and cosmetic surgery intentions. We fit linear, logistic, and multivariate models to examine cross-sectional associations between total screen-time and screen-viewing modes and body dissatisfaction, disordered eating, and cosmetic surgery intention. Handheld viewing was associated with body dissatisfaction for women only, and online viewing was associated with greater body dissatisfaction among both men (βˆ = 0.40; 95% CI, 0.15 to 0.65) and women (βˆ = 0.25; 95% CI, 0.10 to 0.40). Downloaded viewing was associated with higher odds of overeating behaviors among both men (OR = 1.24; 95% CI, 1.10 to 1.40) and women (OR = 1.21; 95% CI, 1.12 to 1.32), respectively. Although total screen time was associated with greater cosmetic surgery intention for both men (βˆ = 0.24; 95% CI, 0.09 to 0.39) and women (βˆ = 0.43; 95% CI, 0.28 to 0.58), sex differences were found for the viewing modes. Our results suggest that different viewing modes may be differently associated with men and women’s body image, disordered eating behavior, and cosmetic surgery intention. Future research should consider all modes of screen-viewing in our media environment.

Paradoxical Obesity and Overweight Disparities Among Sexual Minority Men: A Meta-Analysis

This study aims to analyze the prevalence and likelihood of overweight, obesity, and elevated body mass index (BMI) among sexual minority men (i.e., men who have sex with men [MSM], men who have sex with men and women [MSMW], and all sexual minority men), using men who have sex with women (MSW) as the reference group. Studies reporting mean BMIs or prevalence or likelihood of obesity, overweight, or elevated BMI categorized by sexual orientation were included. Data were pooled and analyzed to report mean differences (MDs) of BMIs, prevalence rates, odds ratios (ORs), and their respective 95% confidence intervals (CIs). Forty-three studies were included, with a median of 26,507 participants (median 3.37% sexual minority men). The respective mean overweight, obesity, and elevated BMI prevalence rates among MSM (36%, 23%, and 39%) and MSMW (33%, 27%, and 47%) were lower than those of MSW (44%, 26%, and 55%). This finding was consistent with a significantly lower BMI (MD −1.50 [−1.93, −1.08] kg/m²) and a decreased likelihood of overweight (OR 0.75 [0.64, 0.88]) and obesity (OR 0.84 [0.78, 0.90]). Sexual minority men present with a lower prevalence and likelihood of obesity and overweight than their heterosexual counterparts. The obesity paradox—a sustained catabolic state presenting with lower BMI—is a feasible explanation for this phenomenon, although further research exploring paradoxical cardiovascular findings is granted.

Hourglass Body Shape Ideal Scale and disordered eating

Disordered eating research has long considered the negative consequences of internalizing sociocultural appearance ideals (e.g., thin ideal, muscular ideal). However, the implications of internalizing a curvy or "hourglass" body shape remains unclear. The Hourglass Body Shape Ideal Scale (HBSIS) is a new self-report questionnaire that was developed and evaluated to appropriately measure the extent women subscribe to an hourglass body shape ideal. The measure was administered to a community and undergraduate sample of women via two separate online studies. Study 1 (N = 916) provided support for the factor structure as well as the convergent and discriminant validity of the HBSIS. The HBSIS was correlated with measures of appearance orientation, overweight preoccupation, and disordered eating. HBSIS was associated with disordered eating even after controlling for age, BMI, thin ideal and muscular ideal internalization. Further, higher HBSIS scores were associated with increased likelihood of having clinical levels of disordered eating symptoms. There were no racial and ethnic group differences on HBSIS. Study 2 (N = 195) replicated the factor structure of Study 1, in addition to its convergent and discriminant validity. The HBSIS allows for more precise examination of appearance-ideal internalization, capturing a unique construct understudied within eating pathology literature.

The role of sexual orientation in the relationships between body perception, body weight dissatisfaction, physical comparison, and eating psychopathology in the cisgender population

PURPOSE

Body weight dissatisfaction (BWD) and visual body perception are specific aspects that can influence the own body image, and that can concur with the development or the maintenance of specific psychopathological dimensions of different psychiatric disorders. The sexual orientation is a fundamental but understudied aspect in this field, and, for this reason, the purpose of this study is to improve knowledge about the relationships among BWD, visual body size-perception, and sexual orientation.

METHODS

A total of 1033 individuals participated in an online survey. Physical comparison, depression, and self-esteem was evaluated, as well as sexual orientation and the presence of an eating disorder. A Figure Rating Scale was used to assess different valences of body weight, and mediation analyses were performed to investigated specific relationships between psychological aspects.

RESULTS

Bisexual women and gay men reported significantly higher BWD than other groups (p < 0.001); instead, higher body misperception was present in gay men (p = 0.001). Physical appearance comparison mediated the effect of sexual orientation in both BWD and perceptual distortion. No difference emerged between women with a history of eating disorders and without, as regards the value of body weight attributed to attractiveness, health, and presence on social media.

CONCLUSION

This study contributes to understanding the relationship between sexual orientations and body image representation and evaluation. Physical appearance comparisons should be considered as critical psychological factors that can improve and affect well-being. The impact on subjects with high levels of eating concerns is also discussed.

LEVEL OF EVIDENCE

Level III: case-control analytic study.

Appearance discrimination and binge eating among sexual minority men

Sexual minority men (SMM) face substantial disparities in rates of binge eating compared to heterosexual individuals, underscoring the need to study risk factors for the development of binge eating amongst SMM. One potential explanation for this disparity in binge eating is minority stress theory, which posits that minority groups face stressors, such as discrimination, due to their stigmatized position in society. Additionally, specific domains of discrimination may confer different levels of risk for binge eating. Therefore, the current study examined the association of various forms of discrimination, including appearance-based discrimination, and binge eating in a sample of SMM. A sample of 200 SMM (analytic sample of N = 187) from the greater Boston area completed self-report questionnaires assessing frequency of different forms of perceived discrimination (appearance, sexual orientation, race, etc.) and binge eating. A hierarchical binary logistic regression model was used to examine the association of different forms of discrimination with binge eating. 9% of the sample reported binge eating. Appearance-based discrimination was the most common form of discrimination (47%), and was significantly associated with binge eating, over and above all other forms of discrimination and sociodemographic variables, OR = 1.71, 95% CI = [1.24, 2.35], Wald χ2 (1) = 10.65, p = .001. Findings suggest that appearance-based discrimination may be related to binge eating in SMM. Clinicians may consider assessing appearance-based discrimination among SMM patients.

Body image disturbance and sexual orientation: An updated systematic review and meta-analysis

Negative body image, or body image disturbance (BID) has been associated with depression, low self-esteem, and the development of eating disorders. Furthermore, BID may affect an individual regardless of gender or sexual orientation. To synthesise the current literature, we conducted a meta-analysis of 48 studies to determine if BID differed between lesbian versus heterosexual women, lesbian women versus gay men, and gay versus heterosexual men. Body image measures were grouped according to similarities in constructs measured, resulting in five different categories (global satisfaction, figural-rating scales, cognitive measures, affect measures, and male body image). The results indicated that lesbian women reported experiencing less BID compared to heterosexual women on measures of global satisfaction, but more compared to gay men, and gay men reported experiencing greater BID compared to heterosexual men on three out of five analyses. Moderation analyses indicated that the study quality was not a statistically significant moderator of the effect sizes. Results from this updated meta-analysis indicate that, to some degree, BIDs affect individuals regardless of gender and sexual orientation; however, there is some variability associated with sexual orientation.

General Self-Efficacy and Body Weight: The Role of Race and Gender

Overweight and obesity have become a prominent concern for policymakers, the Surgeon General, scholars, and for work organizations. The estimated annual cost of obesity in terms of lost productivity is in the tens of billions of dollars, and the estimated annual medical cost of obesity is in the hundreds of millions of dollars. Psychologists have become increasingly interested in issues related to body weight, such as ways to help people reduce body weight. The aims of our study are twofold. First, based on social cognitive theory, we offer the first study of the relationship between general self-efficacy (GSE) and body weight based on a large, representative sample. Second, we also offer an understanding of the role of race and gender as potential boundary conditions of this relationship. Findings indicate that race moderates the relationship between GSE and body weight (both BMI and perceived weight) such that this relationship is positive for Blacks but negative for Whites. Gender did not moderate the relationship between GSE and body weight. These results suggest that body weight is unrelated to general self-efficacy in the population writ large and that body weight is differentially related to self-efficacy based on race but not gender.

Examining day hospital treatment outcomes for sexual minority patients with eating disorders

OBJECTIVE

Epidemiological data support that sexual minorities (SM) report higher levels of eating pathology. Theories suggest these disparities exist due to stressors specific to belonging to a minority group; however, few studies have specifically explored differences between SM and heterosexual individuals in clinical eating disorder samples. Thus, the present study compared SM and heterosexual patients with eating disorders on demographic characteristics and eating disorder and psychological outcomes during day hospital treatment.

METHOD

Patients (N = 389) completed surveys of eating pathology, mood, anxiety, and skills use at treatment admission, 1-month post-admission, discharge, and 6-month follow-up. Overall, 19.8% of patients (n = 79) identified as SM, while 8.0% (n = 32) reported not identifying with any sexual orientation. SM were more likely to present across genders (17.7% of females, 24.2% of males, 33.3% of transgender patients, and 87.5% of nonbinary patients).

RESULTS

SM patients were significantly more likely to endorse major depressive disorder, panic disorder, and self-harm at admission than their heterosexual counterparts. Multilevel models demonstrated that across time, SM patients demonstrated greater eating pathology, emotion dysregulation, depressive symptoms, and anxiety symptoms. Significant interactions between sexual orientation and time were found for eating pathology and emotion dysregulation, such that although SM patients started treatment with higher scores, they improved at a faster rate compared to heterosexual patients.

DISCUSSION

Consistent with minority stress theory, SM patients report greater overall eating disorder and comorbid symptoms. Importantly, results do not support that there appear to be significant disparities in treatment outcome for SM patients in this sample of day hospital patients.

Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders

Despite the many benefits of regular, sustained exercise, there is evidence that exercise can become addictive, to the point where the exerciser experiences negative physiological and psychological symptoms, including withdrawal symptoms upon cessation, training through injury, and the detriment of social relationships. Furthermore, recent evidence suggests that the etiology of exercise addiction is different depending on the presence or absence of eating disorders. The aim of this study was to explore to what extent eating disorder status, body dysmorphic disorder, reasons for exercise, social media use, and fitness instructor status were associated with exercise addiction, and to determine differences according to eating disorder status. The key findings showed that the etiology of exercise addiction differed according to eating disorder status, with variables including social media use, exercise motivation, and ethnicity being uniquely correlated with exercise addiction only in populations with indicated eating disorders. Furthermore, body dysmorphic disorder was highly prevalent in subjects without indicated eating disorders, and could be a primary condition in which exercise addiction is a symptom. It is recommended that clinicians and practitioners working with patients who present with symptoms of exercise addiction should be screened for eating disorders and body dysmorphic disorder before treatments are considered.

Sexual fluidity and BMI, obesity, and physical activity

Analyzing reported changes in sexual identity over time is necessary for understanding young adult health risks. Utilizing waves 3 and 4 of the National Longitudinal Study of Adolescent to Adult Health, this paper studies the relationships between sexual identity changes and BMI, obesity, and physical activity among young adults in the U.S (N = 11,349). The results show that men who report a change toward a more homosexual identity have a significantly lower BMI and participate in more physical activity, while men who report a change toward a more heterosexual identity participate in less physical activity and have a higher BMI compared to those who did not report a change. For women, a change toward a more homosexual identity is significantly associated with more physical activity and lower odds of being obese compared to no change. The results suggest that specific sexual identity changes may also be linked to improvements in health.

•

Links between sexual fluidity and weight and physical activity are analyzed.

•

Certain sexual identity changes may improve weight and physical activity behavior.

•

The direction of sexual identity change matters more for men than for women.

Characterizing Lifetime and Daily Experiences of Weight Stigma among Sexual Minority Women with Overweight and Obesity: A Descriptive Study

Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma among sexual minority women with overweight/obesity. Participants were 55 sexual minority women ages 18-60 with a body mass index ≥25 kg/m2. Perceived lifetime weight stigma events were assessed at baseline. For the subsequent five days, participants used a smartphone to complete five daily, random EMA prompts assessing the frequency/characteristics of perceived weight stigma events in daily life. All participants reported at least one lifetime weight stigma event. During the EMA period, participants reported 44 momentary weight stigma events (M = 0.80), with 24% of participants reporting at least one event. During most instances of weight stigma, women perceived the stigma's cause to be their weight and another minority identity (e.g., sexual orientation). Findings showing high rates of perceived lifetime weight stigma in this sample and frequent co-occurrence of perceived weight stigma with stigma due to other marginalized identities in daily life underscore the need for future, larger studies investigating weight stigma through an intersectional lens in sexual minority women with overweight/obesity.

Nutrition-Related Messages Shared Among the Online Transgender Community: A Netnography of YouTube Vloggers

Purpose: Nutrition care guidelines for the transgender population do not exist, despite significant nutrition-related clinical and psychosocial considerations. Social networking sites (SNSs) provide multidirectional communication and have expanded in popularity among transgender users as a resource for health information and support. The nature of the content shared among the online transgender community is unknown, but may suggest the nutrition-related areas that are of most importance to the transgender population. The objective of this qualitative netnography was to describe the food and nutrition messages shared among the transgender community using video blogs (vlogs) on the SNS, YouTube. Methods: Public vlogs were assessed using the constant comparative method. Pseudoquantitative methods were used to capture the prevalence of each subtheme; quotes were documented verbatim. Data were collected from transgender users' public vlogs (n=30) self-published on YouTube from 2013 to 2018. Results: Six major themes were generated from the data analysis. These included the following: functions of diet and exercise; diet and exercise philosophies; "how to" vlogs; advice for success; using dietary supplements; and effects of hormone therapy. Conclusions: Nutrition-related messages are widely shared among the online transgender community through YouTube. The identified themes reflect topics of interest and expressed needs of transgender individuals. SNSs provide health care providers with a platform to improve patient education and health literacy. Health care providers may actively engage in online discussions to build trust, answer questions, and provide a source of accurate and evidence-based information.

The influence of Grindr, a geosocial networking application, on body image in gay, bisexual and other men who have sex with men: An exploratory study

Recent evidence indicates use of geosocial networking apps is associated with body image-related issues among gay, bisexual, and other men who have sex with men. The current study aims to elaborate upon these findings by investigating how Grindr, the most widely-used dating app among this population, impacts users' body image and body satisfaction. Using an exploratory, qualitative study design, semi-structured interviews were conducted with 13 current and previous Grindr users and analyzed thematically. Our findings suggest Grindr affects users' body image through three primary mechanisms: weight stigma, sexual objectification, and social comparison. In each case, normative user attitudes and behaviours interact with the app's constitutional elements to affect bodily perceptions in a way that differs in form or intensity from social influence via offline exchanges. These interactions are often enabled by features shared with traditional social networking sites, like asynchronous, text-based communication and technology-assisted appearance augmentation, but certain features unique to Grindr may also play an important role. Moreover, participants identified several protective factors and coping strategies which suggest the relationship between Grindr and body image is dependent on a number of complex interactions between technology, user, and environment. Limitations and suggestions for future research are also discussed.

Perceptions of body size and health among older queer women of size following participation in a health programme

Little research examines how older queer (lesbian and bisexual) women understand and construct meanings around their body size in the context of individual and community norms and identities. Grounded theory was used to analyse transcripts from 31 interview participants drawn from a health programme in the San Francisco Bay Area. Older queer women of size navigate tensions between body ideals and community ideals in and through their experiences of body size. Women's embodied experiences of fatness, chronic pain and weight changes shifted in tandem with their experience of interactions with other queer women, as well as what bodies and body ideals should be in 'the lesbian community'. This study found that bodily norms and health ideologies are embedded and embodied in communities and navigated through the ongoing formation and configuration of communities over time. Body acceptance movements may be out of touch for this population based on their internalisation of the medical model in which weight loss automatically means improved health. Health interventions for older, queer women of size must be community-based to effectively shift behaviours, norms and expectations around healthy living in fat, ageing bodies.

A Systematic Review of Sexual Orientation Disparities in Disordered Eating and Weight-Related Behaviors among Adolescents and Young Adults: Toward a Developmental Model

Adolescence is a sensitive period for the development of disordered eating and weight-related behaviors, and sexual minorities may be particularly at risk due to heightened minority stress and challenges related to sexual identity development. This review synthesized findings from 32 articles that examined sexual orientation disparities (each with a heterosexual referent group) in four disordered eating behaviors (binging, purging, restrictive dieting, diet pill use) and four weight-related behaviors (eating behaviors, physical activity, body image, and Body Mass Index [BMI]). Potential variations by outcome, sex, race/ethnicity, and developmental stage were systematically reviewed. Evidence supporting sexual orientation disparities in disordered eating and weight-related behaviors was more consistent among males than females. Among females, sexual orientation disparities in disordered eating behaviors appeared to be more pronounced during adolescence than in young adulthood. Sexual minority females generally reported more positive body image than heterosexual females but experienced disparities in BMI. Sexual orientation differences in eating behaviors and physical activity were especially understudied. Incorporating objectification and minority stress theory, a developmental model was devised where body image was conceptualized as a key mechanism leading to disordered eating behaviors. To advance understanding of sexual orientation disparities and tailor intervention efforts, research in this field should utilize longitudinal study designs to examine developmental variations and incorporate multi-dimensional measurements of sexual orientation and body image.

Body Image and Sexual Dissatisfaction: Differences Among Heterosexual, Bisexual, and Lesbian Women

Gender-based differences in body image dissatisfaction are not conclusive. Women's body experiences and their impact on sexual satisfaction may advance knowledge on how heterosexual, bisexual, and lesbian women internalize heterosexist values. In this study, we quantitatively examined the degree of body image and sexual dissatisfaction experienced by heterosexual, bisexual, and lesbian women, to determine whether body dissatisfaction can predict sexual dissatisfaction. Three hundred and fifty-four women completed an online survey measuring body and sexual dissatisfaction. No sexual orientation-based differences were observed in body or sexual dissatisfaction; however, body concerns were found to have less influence on sexual dissatisfaction in lesbian women compared to heterosexual and bisexual women. Standards of beauty remain constant among all women, yet removing themselves from the male gaze may be interpreted as a protective factor which shields women from expressing concern about their appearance during sexual activity.

Relationship Quality and Perceived Partner's Body Appreciation Is Related to Women's Own Body Appreciation and Sexual Functioning

Research on body appreciation is limited, especially when examining its relationship to sexual functioning. The aim of this study was to explore the relationship between body appreciation and sexual functioning, while measuring perceived partner's body appreciation and general relationship quality. A sample of 244 women aged 18 to 30 completed measures of sexual functioning, relationship quality, and body image online. General relationship quality and perceived partner's appreciation of one's body predicted levels of sexual functioning. Levels of body appreciation did not predict sexual functioning over and above general relationship quality and perceived partner's appreciation of one's body. This study is the first to demonstrate the significance of general relationship quality and perceived partner's body appreciation in relation to levels of body appreciation and sexual functioning. The findings highlight the importance of understanding body appreciation and its role in buffering the harmful impacts of viewing idealized images within the media.

The Relationship Between Body Image and Sexual Functioning Among Gay and Bisexual Men

Gay and bisexual men report high body dissatisfaction compared to heterosexual counterparts, but no studies to date have examined how this may impact their sexual functioning. The present study investigated body image domains as predictors of sexual functioning problems (inhibited desire, erectile dysfunction, and premature ejaculation) among an online community sample of 185 gay and bisexual men, ages 18-40. Participants reported moderate to high body image satisfaction and sexual functioning consistent with previous literature with nonclinical male samples. Overall, the total variance accounted for by regression models was low. Body image variables were not predictive of sexual desire. However, increased drive for muscularity and lower affective body esteem were predictive of erectile difficulties. Additionally, negative behavioral body image in sexual situations and evaluative body dissatisfaction were associated with premature ejaculation. Understanding this relationship may have implications for gay and bisexual men's health and wellbeing. Future research directions are discussed.

Body Image as Well as Eating Disorder and Body Dysmorphic Disorder Symptoms in Heterosexual, Homosexual, and Bisexual Women

Body image disturbance is a core symptom of eating disorders (EDs) and body dysmorphic disorder (BDD). There is first evidence that females' body image differs depending on sexual orientation, with heterosexual women (HEW) appearing to show more body image disturbance symptoms than homosexual women (HOW). Such disparities might be moderated by everyday discrimination experiences and involvement with the lesbian community. However, to date, there has been no comprehensive assessment of a broad range of body image facets such as drive for thinness, leanness, and muscularity; body avoidance; body checking and body dissatisfaction; and ED and BDD pathology as well as moderating factors. Moreover, studies have often neglected bisexual women (BIW). A total of N = 617 women (n = 180 HOW, n = 322 HEW, n = 115 BIW) completed an online survey assessing the various facets of body image, ED and BDD pathology, discrimination experiences, and involvement with the lesbian community. Significant group differences were found regarding drive for leanness and thinness, body checking, investment behavior, and body ideal (all p<.05). BIW showed significantly more body checking than HOW. Compared to HEW, HOW reported a significantly lower drive for leanness and thinness as well as compared to HEW and BIW less investment behavior. HOW preferred a body ideal with significantly more body fat than did HEW (all p<.05). In contrast, no differences emerged in body dissatisfaction, drive for muscularity, body-related avoidance, ED and BDD pathology, and body image disturbance (all p>.05). In all groups, discrimination experiences were positively related to ED and BDD pathology and to body image disturbance (all p < .05); however, discrimination was significantly correlated with more body image facets in HEW than in HOW or BIW. Involvement with the lesbian community was positively correlated with a larger ideal body size in HOW (p < .05) and negatively correlated with drive for muscularity in BIW (p < .05). Despite the group differences in several body image facets, we found no consistent evidence of increased vulnerability to body image disturbance or associated pathology depending on sexual orientation. However, in HEW, discrimination experience might pose a risk factor for the development of body image-related pathology and single facets of body image disturbance.

An Electronic Ecological Momentary Assessment Study to Examine the Consumption of High-Fat/High-Sugar Foods, Fruits/Vegetables, and Affective States Among Women

OBJECTIVE

To examine the associations between high-fat/high-sugar foods (HFHS) and fruit and vegetable (FV) consumption and affective states in women.

METHODS

The researchers used electronic ecological momentary assessment to capture HFHS and FV consumption in the past 2 hours (predictor) and current affective states (outcome) across 1 week among 202 women. Multilevel linear regression was conducted. Weight status was tested as a moderator.

RESULTS

Consumption of FV in the past 2 hours was positively associated with feeling happy (P < .05). Women who consumed more HFHS or fewer FV than others in the study reported higher average sadness (both P < .05). Overweight or obese women who reported more frequent HFHS consumption than others had higher average stress than normal weight women (P < .05).

CONCLUSIONS AND IMPLICATIONS

The association between HFHS consumption and stress might be stronger in overweight or obese than normal weight women. Future studies could further enhance the electronic ecological momentary assessment method to explore other time-varying moderators and mediators of food consumption and affect.

Weibliche Homosexualität, Maskulinität und Körperzufriedenheit

Zusammenfassung. Theoretischer Hintergrund: Homosexuelle Frauen sind zufriedener mit ihrem Körper als heterosexuelle Frauen. Homosexualität ist folglich möglicherweise ein Schutzfaktor vor Körperunzufriedenheit. Unklar bleibt der zugrundeliegende Mechanismus für diesen Schutzfaktor. Fragestellung: Es wird untersucht, ob die höhere Körperzufriedenheit auf unterschiedliche Geschlechtsrollen, insbesondere Maskulinität, rückführbar ist. Methode: Diese Frage wurde an einer Stichprobe von N = 478 Frauen mittels einer Mediatoranalyse beantwortet. Ergebnisse: Homosexuelle Frauen waren zufriedener mit ihrem Körper als Heterosexuelle und erreichten höhere Werte für Maskulinität. Maskulinität mediierte den Unterschied bezüglich Körperzufriedenheit. Schlussfolgerungen: Teilweise vermittelt über Maskulinität, kann weibliche Homosexualität als Schutzfaktor vor Körperunzufriedenheit angesehen werden.

Peer Victimization and Unhealthy Weight Control Behaviors-the Role of Intersecting Identities among New York City Youth

We investigated the intersection of sexual minority, gender, and Hispanic identities, and their interaction with peer victimization in predicting unhealthy weight control behaviors (UWCB) among New York City (NYC) youths. Using logistic regression with data from the 2011 NYC Youth Risk Behavior Survey, we examined the association of sexual identity, gender, ethnicity, and peer victimization (dating violence, bullying at school, electronic bullying) in predicting UWCB. Sexual minority youths, dating violence victims, and youths bullied at school had 1.97, 3.32, and 1.74 times higher odds of UWCB than their counterparts, respectively (P < 0.001). The three-way interaction terms between (i) dating violence, gender, and sexual identity and (ii) electronic bullying, gender, and sexual identity were statistically significant. The effect of dating violence on unhealthy weight control practices was strongest among sexual minority males (OR = 4.9), and the effect of electronic bullying on unhealthy weight control practices was strongest among non-sexual minority males (OR = 2.9). Sexual minority and gender identities interact with peer victimization in predicting unhealthy weight control practices among NYC youths. To limit the prevalence and effect of dating violence and electronic bullying among youths, interventions should consider that an individual's experiences are based on multiple identities that can be linked to more than one ground of discrimination.

Association of weight control behaviors with body mass index and weight-based self-evaluation

Objective:

To determine the frequency of weight control behaviors (WCBs) and their correlation with body mass index (BMI) and weight-based self-evaluation.

Methods:

Data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from 27,501 volunteers (30.4% men, mean age 28.9±8.7 years).

Results:

The most prevalent WCBs for men and women were exhaustive physical exercise and prolonged fasting, respectively. Frequent exhaustive physical exercise was the only behavior more often adopted by men. BMI was positively associated with WCBs, which were very frequent in obese subjects. About 15% of normal-weight women reported using diuretics and laxatives, and 12.2% reported vomiting as a WCB at least occasionally. Among subjects who regarded body weight highly in their self-evaluation, there was a strong positive association with all WCBs, at similar degrees, in both genders. Compared to those who never base their intrinsic personal value on body weight, those who frequently base intrinsic value on body weight were at 25-30 times higher risk of inducing vomiting.

Conclusion:

The prevalence of participants adopting WCBs was high, especially in women and obese subjects. Weight-based self-evaluation was more strongly associated with WCBs than BMI.

Body image and sexual orientation: The experiences of lesbian and bisexual women

Western cultures promote a thin and curvaceous ideal body size that most women find difficult to achieve by healthy measures, resulting in poor body image and increased risk for eating pathology. Research focusing on body image in lesbian and bisexual women has yielded inconsistent results. In total, 11 lesbian and bisexual women were interviewed regarding their experiences with body image. Interpretative phenomenological analysis revealed that these women experienced similar mainstream pressures to conform to a thin body ideal. Furthermore, participants perceived additional pressure to conform to heteronormative standards of beauty since the normalisation of homosexuality and the increase in Lesbian, Gay, Bisexual and Transgender representation in mainstream media.

Body Talk: Body Image Commentary on Queerty.com

In this study, we conducted a content analysis of 243 photographic images of men published on the gay male-oriented blog Queerty.com. We also analyzed 435 user-generated comments from a randomly selected 1-year sample. Focusing on images' body types, we found that the range of body types featured on the blog was quite narrow-the vast majority of images had very low levels of body fat and very high levels of muscularity. Users' body image-related comments typically endorsed and celebrated images; critiques of images were comparatively rare. Perspectives from objectification theory and social comparison theory suggest that the images and commentary found on the blog likely reinforce unhealthy body image in gay male communities.

The Relationship Between Body Image and Domains of Sexual Functioning Among Heterosexual, Emerging Adult Women

Introduction

Research suggests that body image affects sexual functioning, but the relationship between specific types of body image (evaluative, affective, and behavioral) and domains of sexual functioning (desire, arousal, and orgasm) has not been investigated.

Aim

To determine whether, and to what degree, body image concerns (evaluative, affective, and behavioral) influence aspects of women’s sexual functioning (desire, arousal, and orgasm).

Methods

Eighty-eight sexually active women in heterosexual romantic relationships completed surveys assessing evaluative, affective, and behavioral body image and sexual functioning. Body composition data also were collected using dual energy x-ray absorptiometry.

Main Outcome Measures

Sexual functioning was assessed using the desire, arousal, and orgasm subscales of the Female Sexual Functioning Index.

Results

Hierarchical multiple regression analysis indicated that poor evaluative, affective, and behavioral body image were detrimental to women's sexual functioning. Specifically, dissatisfaction with one's body predicted decrements in desire (β = −0.31, P < .05) and arousal (β = −0.35, P < .01). Similarly, feeling that others evaluate one's body negatively predicted decrements in desire (β = 0.22, P < .05) and arousal (β = 0.35, P < .01). Feeling negatively about one’s appearance predicted decrements in arousal (β = 0.26, P < .05). Negative thoughts and feelings about one’s body during a sexual encounter (body image self-consciousness) predicted decrements in arousal (β = −0.37, P < .01) and orgasm (β = −0.25, P < .05).

Conclusion

Findings from this study suggest important linkages between body image and sexual functioning constructs and indicates that interventions to improve body image could have concomitant benefits related to sexual experience.

Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review

The scientific community appears to be less interested in sexuality of eating disorders (EDs) as compared to other psychiatric or medical comorbidities. However, a clear association between sexual problems and ED psychopathology was reported from different perspectives. The overarching goal of this systematic review was to evaluate the general approach of the scientific literature toward the topic of sexuality and EDs. In particular, four different categories of research have been individuated, encompassing the role of puberty, and sexual abuse in the pathogenesis of the disorders, sexual dysfunctions, and the association between sexual orientation and EDs psychopathology. Timing of puberty with its hormonal consequences and the changes in the way persons perceive their own body represent a crucial period of life for the onset of the disorder. Sexual abuse, and especially childhood sexual abuse are well-recognized risk factors for the development of ED, determining a worse long-term outcome. Recent research overcome the approach that considers sexual activity of EDs patients, in terms of hypersexuality and dangerous sexual behaviors, considering the sexuality of EDs persons in terms of sexual desire, satisfaction, orgasm and pain. Results from this line of research are promising, and describe a clear relationship between sexual dysfunction and the core psychopathological features of EDs, such as body image disturbances. Finally, the analysis of the literature showed an association between sexual orientation and gender dysphoria with EDs psychopathology and pathological eating behaviors, confirming the validity of research developing new models of maintaining factors of EDs related to the topic of self-identity.

Eating disorders and the media

PURPOSE OF REVIEW

In June 2015, the newspapers in England once again pointed at the media industry as responsible for the spread of eating disorders.

RECENT FINDINGS

This article reviews this argument and previous research on the role of the media industry in the perpetration of images that may foster eating disorders.

SUMMARY

It has been recently argued, coherently with previous research, that the media may be responsible for the spread of eating disorders. This article reviews this literature, and evaluates what the real role of the media in the spread of eating disorders is. The article argues that considering the portrait of thin models in the media industry as responsible for eating disorders is a misanalysis of the problem and evaluates some of the more profound reasons that may lead to the adoption of the disordered eating symptomatology.

Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students

PURPOSE

This study examined associations of gender identity and sexual orientation with self-reported eating disorder (SR-ED) diagnosis and compensatory behaviors in transgender and cisgender college students.

METHODS

Data came from 289,024 students from 223 U.S. universities participating in the American College Health Association-National College Health Assessment II (median age, 20 years). Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were compared among transgender students (n = 479) and cisgender sexual minority (SM) male (n = 5,977) and female (n = 9,445), unsure male (n = 1,662) and female (n = 3,395), and heterosexual male (n = 91,599) and female (n = 176,467) students using chi-square tests. Logistic regression models were used to estimate the odds of eating-related pathology outcomes after adjusting for covariates.

RESULTS

Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were highest among transgender students and lowest among cisgender heterosexual men. Compared to cisgender heterosexual women, transgender students had greater odds of past-year SR-ED diagnosis (odds ratio [OR], 4.62; 95% confidence interval [CI], 3.41-6.26) and past-month use of diet pills (OR, 2.05; 95% CI, 1.48-2.83) and vomiting or laxatives (OR, 2.46; 95% CI, 1.83-3.30). Although cisgender SM men and unsure men and women also had elevated rates of SR-ED diagnosis than heterosexual women, the magnitudes of these associations were lower than those for transgender individuals (ORs; 1.40-1.54).

CONCLUSIONS

Transgender and cisgender SM young adults have elevated rates of compensatory behavior and SR-ED diagnosis. Appropriate interventions for these populations are urgently needed.

Relationships Between Body Image, Body Composition, Sexual Functioning, and Sexual Satisfaction Among Heterosexual Young Adults

This study investigated the association between body image and body-image self-consciousness on sexual satisfaction, accounting for relationships between body fat and body image, and between sexual functioning and sexual satisfaction, while controlling for relationship satisfaction. Participants were 143, 18-25 year-old Caucasian men and women in heterosexual monogamous relationships, recruited from the University of Guelph and surrounding community in Ontario, Canada. Various domains of body image, body-image self-consciousness, sexual satisfaction and functioning, and relationship satisfaction data were collected by questionnaires. Body fat was measured using dual energy X-ray absorptiometry. Among men, body image was positively associated with sexual satisfaction, after controlling for relationship satisfaction. Men with greater body fat were more likely to have poorer behavioral and affective body image. Only body image specific to the sexual encounter influenced sexual functioning. Among women, no domain of body image was associated with sexual satisfaction, after controlling for relationship satisfaction. Women with greater body fat were more likely to have poorer affective and sexual-encounter-specific body image. As percent total fat increased, sexual functioning decreased. Our results suggest a complex pattern of relationships exists among body image and body composition constructs and sexual and relationship variable; and that these relationships are not the same for men and women.

The Effect of Breakfast Prior to Morning Exercise on Cognitive Performance, Mood and Appetite Later in the Day in Habitually Active Women

Pre-exercise nutritional practices for active females exercising for mood, cognitive and appetite benefits are not well established. Results from an initial field pilot study showed that higher energy intake at breakfast was associated with lower fatigue and higher overall mood and alertness post-exercise (all p < 0.05). In a follow-up, randomised, controlled trial, 24 active women completed three trials in a balanced, cross-over design. At 0815 h participants completed baseline cognitive tasks, mood and appetite visual analogue scales (VAS) and were administered a cereal breakfast (providing 118 or 236 kcal) or no breakfast. After 45 min, they completed a 30 min run at 65% heart rate reserve (HRR). Parameters were re-assessed immediately after exercise, then hourly until lunch (~1240 h), immediately post-lunch and at 1500 and 1900 h via a mobile phone. Breakfast enhanced feelings of relaxation before lunch (p < 0.05, d > 0.40), though breakfast was detrimental for working memory mid-afternoon (p = 0.019, d = 0.37) and mental fatigue and tension later in the day (all p < 0.05, d > 0.038). Breakfast was also beneficial for appetite control before lunch irrespective of size (all p < 0.05, d > 0.43). These data provide information on pre-exercise nutritional practices for active females and suggest that a small breakfast eaten prior to exercise can benefit post-exercise mood and subjective appetite ratings.

An Examination of the Tripartite Influence Model of Body Image

According to the tripartite influence model of body image, appearance pressures from family, friends, partners, and the media lead to body dissatisfaction and restrained eating behaviours. There is strong support for this model among young, White heterosexual women. Evidence suggests that women who identified as lesbian as bisexual (LB) may be protected from sociocultural pressures around thinness, but no known research has tested the tripartite model among LB women. The current research tests this model with 264 heterosexual and 208 LB adult women. Heterosexual women reported more thin-ideal internalization than LB women. For both groups of women, pressures from the media, male romantic partners, and family were most strongly associated with weight satisfaction and thin-ideal internalization. However, the impact of these pressures differed for the two groups; the heterosexual women’s model included significant pathways from these pressures to weight satisfaction and restrained eating, which were not significant for the LB women. Differences also emerged between our findings and previous research with younger women; pressure from friends was not related to body image in the model for either group. These findings suggest that further research is needed to explore how diverse groups of women experience sociocultural pressures around thinness.

Lifestyle and treatment adherence among overweight adolescents

This study evaluated the influence of overweight adolescents' lifestyle on the adherence to weight control, and identifies their predictors. Participants were 94 adolescents, aged 12-18 years, attending a Paediatric Obesity Clinic. Lifestyle was assessed using the "Adolescent Lifestyle Profile" and treatment adherence through the "Therapeutic Adherence to Weight Control Questionnaire." Adherence to weight control was associated with various lifestyle domains. Several predictors were identified for lifestyle and adherence to weight control among overweight adolescents. A broad array of inter-correlations and predictors were identified and should be taken into account when designing adolescent weight control interventions.

Sense of Belonging to Layers of Lesbian Community Weakens the Link Between Body Image Dissatisfaction and Depressive Symptoms

There is evidence to suggest that body image dissatisfaction and depressive symptoms are related among lesbians and that the strength of this relationship may be influenced by individuals’ sense of belonging to the lesbian community at each of the three layers: broad, organizational, and friendship. The broad layer provides an overarching ideology and, within this layer, individuals may not have direct contact with each other. The organizational layer is represented by groups, organizations, or activities, which exist to bring together lesbians who have a shared interest or proximity, such as lesbian support, social, or interest groups. The friendship layer refers to one’s personal network of friends, and it provides general support and acceptance of oneself as a whole person. A sample of 162 self-identified Australian lesbians completed measures of body image satisfaction, depressive symptoms, and sense of belonging. Results demonstrated that sense of belonging to each layer moderated the body image dissatisfaction→depressive symptoms relationship such that the relationship weakens with increasingly higher levels of sense of belonging. Results further showed that high levels of sense of belonging to the organizational and friendship layers were particularly protective. Examining each layer of community simultaneously has shown the importance of more intimate relationships, in addition to the relationships at the broad layer. The results have significant implications for treatment interventions. Practitioners should consider ways to connect lesbians to these more intimate layers of community.

Marital status and body weight, weight perception, and weight management among U.S. adults

Married individuals often have higher body weights than unmarried individuals, but it is unclear how marital roles affect body weight-related perceptions, desires, and behaviors. This study analyzed cross-sectional data for 4,089 adult men and 3,989 adult women using multinomial logistic regression to examine associations between marital status, perceived body weight, desired body weight, and weight management approach. Controlling for demographics and current weight, married or cohabiting women and divorced or separated women more often perceived themselves as overweight and desired to weigh less than women who had never married. Marital status was unrelated to men's weight perception and desired weight change. Marital status was also generally unrelated to weight management approach, except that divorced or separated women were more likely to have intentionally lost weight within the past year compared to never married women. Additionally, never married men were more likely to be attempting to prevent weight gain than married or cohabiting men and widowed men. Overall, married and formerly married women more often perceived themselves as overweight and desired a lower weight. Men's marital status was generally unassociated with weight-related perceptions, desires, and behaviors. Women's but not men's marital roles appear to influence their perceived and desired weight, suggesting that weight management interventions should be sensitive to both marital status and gender differences.