Relationship between body mass index, body image, and fear of negative evaluation: Moderating role of self-esteem

The Effect of Negative Physical Self on Social Anxiety in College Students: The Bidirectional Chain Mediation Roles of Fear of Negative Evaluation and Regulatory Emotional Self-Efficacy

Purpose

The detrimental effects of social anxiety on college students require urgent mitigation. To explore the influencing factors and underlying mechanisms of social anxiety among college students, this study aims to examine the relationship between negative physical self and social anxiety, and the mediating effects of fear of negative evaluation and regulatory emotional self-efficacy.

Methods

The Negative Physical Self Scale, Brief Fear of Negative Evaluation Scale, Regulatory Emotional Self-Efficacy Scale, and Interaction Anxiousness Scale were administered to 924 Chinese college students. SPSS 26.0 was used for analysis, and the Bootstrap method was used to test the significance level of the mediating effect.

Results

Negative physical self was significantly and positively related to social anxiety in college students. Fear of negative evaluation and regulatory negative emotional self-efficacy played independent mediating roles between negative physical self and social anxiety. Fear of negative evaluation and regulatory negative emotional self-efficacy showed a bidirectional chain mediating effect between negative physical self and social anxiety.

Conclusion

This study elucidates the mechanistic pathways between negative physical self and social anxiety. The relationship between negative physical self and social anxiety is influenced by the mediating effects of fear of negative evaluation, regulatory negative emotional self-efficacy, and the bidirectional chain mediating effect of fear of negative evaluation and regulatory negative emotional self-efficacy. This finding provides a reference for policy makers and educators to develop interventions for social anxiety in college students.

Differences in the body image based on physical parameters among young women from the Czech Republic and Slovakia

BACKGROUND

The increased prevalence of overweight and obesity in the Czech Republic and Slovakia has led to heightened emphasis on weight control, particularly among women. Our aim is to explore body image perceptions among women in both countries and compare their attitudes, focusing on the relationship between body image and body mass index (BMI), height, weight, body fat and the weight control.

METHODS

The cross-sectional study involved 358 female students from the University of Pardubice and Constantine the Philosopher University in Nitra, with equal representation from the Czech Republic and Slovakia. Body parameters were assessed using anthropometric methods and the InBody 230 diagnostic device, while participants' perceptions of their bodies were evaluated using the Body Shape Questionnaire.

RESULTS

The results confirmed that BMI did not significantly influence self-perception among Slovak students, while Czech participants with increasing obesity tended to perceive themselves more negatively. Significantly higher median values for BMI (p = 0.0509), weight (p = 0.0507), height (p = 0.05) and body image (p = 0.002) were observed in the Czech Republic compared with Slovakia. No significant difference was found in weight control and fat between participants from both countries.

CONCLUSIONS

Although obesity was demonstrated in both nations, body satisfaction was different for participants from the Czech Republic and Slovakia.

Profiles of intuitive eating in adults: the role of self-esteem, interoceptive awareness, and motivation for healthy eating

OBJECTIVE

Intuitive eating is an eating behavior that has recently come to use mainly in the young population. Knowing that the Lebanese cultural diet differs from other countries, the purpose of this study was to investigate if there is a relationship between self-esteem, interoceptive awareness, and motivation for healthy eating in a sample of Lebanese adults using a Latent Profile Analysis approach.

DESIGN

Cross-sectional study.

SETTING

Lebanese governorates.

PARTICIPANTS

359 Lebanese participants enrolled in this study (mean age: 22.75 ± 7.04 years, 40.1% males), through convenience sampling in several Lebanese governorates. Participants were asked to fill anonymously the following scales: The Intuitive Eating Scale (IES-2), the Rosenberg Self-Esteem Scale, the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA), and the Motivation for Healthy Eating Scale (MHES).

RESULTS

Our findings revealed four profiles: profile 1 (n = 67; 18.66%) characterized by high SE and intermediate interoceptive awareness and motivation for healthy eating; profile 2 (n = 86; 23.97%) presented high SE, interoceptive awareness, and motivation for healthy eating; profile 3 (n = 86; 23.96%) characterized by high SE, interoceptive awareness, and motivation for healthy eating; class 4 (n = 108; 30.08) described by low SE, intermediate interoceptive awareness, and motivation for healthy eating One-way analysis of variance did not observe a significant difference between the four profiles based on intuitive eating (F = 1.810; p = 0.145; ɳp2 = 0.015).

CONCLUSIONS

Among a sample of Lebanese people, four profiles of interoceptive awareness, motivation for healthy eating, and self-esteem were observed, with no difference concerning intuitive eating.

Evaluating the influence of dental aesthetics on psychosocial well-being and self-esteem among students of the University of Novi Sad, Serbia: a cross-sectional study

BACKGROUND

A person's smile has been identified as one of the first observed facial characteristics. Even minor deviations from societal beauty standards, especially among younger individuals, can have a negative effect on their self-esteem. The aim of this research is to evaluate the self-perceived psychosocial impact of dental aesthetics and self-esteem among respondents and their association, as well as to determine the main factors contributing to dissatisfaction with dental appearance.

METHODS

This research was conducted as a cross-sectional study that surveyed students of the University of Novi Sad. Other Universities and private faculties were excluded from participation. Data collection used standardized questionnaires measuring the Psychosocial Impact of Dental Aesthetics (PIDAQ) and the Rosenberg Self-Esteem Scale (RSES). Questionnaire (an online GoogleForms) was sent to the students via official Facebook groups of the faculties, student's e-mails and Instagram profiles. Data analysis included descriptive statistics, Students T-test, ANOVA, multiple linear regression analysis and Spearman coefficient. To test internal consistency, Cronbach's alpha(α) was calculated for the questionnaire as a whole (0,761) and each used questionnaire (PIDAQ - 0.766; RSES - 0.765). Cronbach's alpha(α) was also calculated for each domain from PIDAQ (DSC-0.946; SI-0.882; PI-0.953; AC-0.916).

RESULTS

The study involved 410 participants, predominantly female (80%), aged between 21 and 23 (45.4%), primarily in ther first academic year (21.5%), and with a grade point average between 8.01 and 9.00 (42.4%). Data analysis has shown a statistically significant difference in the total PIDAQ score and SI subdomain in relation to the academic year (total PIDAQ p = 0.025; SI p = 0.000). In terms of self-esteem, results of multiple linear regression analysis showed that the academic year (95%CI: 0.410-1.837; p = 0.002) and the average point grade (95%CI: -0.025-1.600; p = 0.047) were significant predictors of greater self-esteem. The Spearman coefficient value (r=-0.316, p < 0.001) confirmed a statistically significant negative correlation between PIDAQ and self-esteem. Only 34% of respondents expressed satisfaction with their teeth. Dissatisfaction about the smile was primarily attributed to the arrangement and positioning of their teeth (32.2%). Financial constraints were identified as the main barrier for seeking interventions to improve smile satisfaction (39.5%).

CONCLUSION

Students experiencing a greater psychosocial impact of dental aesthetics tended to exhibit lower self-esteem.

Body image and dietary habits in adolescents: a systematic review

CONTEXT

Adolescence is a critical developmental stage in which increasing concerns about body image (BI) coincide with the consolidation of dietary habits (DHs). Multiple studies have sought robust associations between BI and DHs to prevent unhealthy behaviors.

OBJECTIVE

The aim of this systematic review was to examine the available literature on the association between BI perception (BIP) and/or satisfaction (BIS) and DHs in adolescents.

DATA SOURCES

A search was carried out of 5 electronic databases (PubMed, SciELO, Cochrane, Embase, and PsycInfo) using a combination of keywords (and synonyms) related to adolescence, BI, and diet.

DATA EXTRACTION

Data screening, extraction, and quality assessment were performed independently by 2 investigators using the PRISMA and AXIS guidelines.

DATA ANALYSIS

Of 2496 articles screened, 30 articles, published in English or Spanish, that evaluated the relationship between BI and DHs in adolescents aged between 10 years and 18 years, were included. A relationship between accurate BI perception in adolescents and healthy DHs was reported in 5 articles (16.2%). A relationship between overestimation of body weight in adolescents and healthy DHs was reported in 4 articles (13.3%). A relationship between underestimation of body weight and unhealthy DHs was reported in 8 articles (26.7%). In addition, 4 articles (13.3%) reported a relationship between BIS and healthy DHs. The desire to gain weight was associated with unhealthy DHs in 3 (10%) of the articles, while the desire to lose weight was related to healthy DHs in 3 (10%) of the articles and to unhealthy DHs in 3 (10%) other articles. There were also gender differences in the relationship between BIP or BIS and DHs.

CONCLUSION

Adolescents who underestimate their body weight tend to report less healthy DHs than body weight overestimators. Adolescents unsatisfied with their BI and with a drive for thinness frequently engage in DHs linked to losing weight.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020184625.

Short-Term Quality of Life after Autologous Compared with Alloplastic Breast Reconstruction: A Prospective Study

BACKGROUND

The aim of this prospective multicenter study was to evaluate whether autologous breast reconstruction (BR) leads to lower short-term quality of life (QoL) compared with alloplastic BR, due to the more physically demanding surgery and increased risk of severe complications of autologous BR.

METHODS

Changes in QoL after BR were measured in this prospective multicenter study using the BREAST-Q questionnaire, which was administered preoperatively and at 6 weeks and 6 months postoperatively. Characteristics and complications, classified according to Clavien-Dindo, were compared between alloplastic and autologous groups. Profile plots and generalized linear regression models were constructed to analyze the BREAST-Q subscales over time for both BR groups.

RESULTS

Preoperatively, women undergoing autologous BR scored lower on all BREAST-Q scales compared with women undergoing alloplastic BR, regardless of whether they underwent immediate or delayed BR. Women undergoing autologous BR scored higher at 6 weeks and 6 months postoperatively on the Satisfaction with Breasts ( P = 0.001), Psychosocial Well-Being ( P = 0.024), and Sexual Well-Being ( P = 0.007) subscales. Postoperative Physical Well-Being: Chest score was similar between the groups ( P = 0.533). Clavien-Dindo grade III or higher complications occurred more often among women in the autologous group (27% versus 12%, P = 0.042). Complications were not associated with worse BREAST-Q scores on any of the subscales.

CONCLUSIONS

In contrast to the authors' expectations, and despite the higher incidence of severe complications and lower preoperative breast satisfaction and QoL scores, women undergoing autologous BR had higher levels of breast satisfaction and psychosocial and sexual well-being, both at 6 weeks and 6 months after BR, compared with women undergoing alloplastic BR.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, II.

Global Self-Esteem, Body Composition, and Physical Activity in Polish University Students

Global self-esteem is a psychological concept that refers to the overall assessment of oneself as a person of value. Body composition is measured by indices such as BMI, BF, and LBM, which have implications for health and self-esteem. Physical activity is associated with numerous health and self-esteem benefits. The purpose of this study focuses on assessing the relationship between global self-esteem, body composition, and physical activity among Polish students. The study was conducted on a group of 305 students between the ages of 19 and 26. The participants were divided into groups according to their level of physical activity. The SES scale by M. Rosenberg assessed the subjects' global self-esteem. The results showed a negative correlation between body weight and BMI and global self-esteem, that is, the higher the body weight, the lower the self-esteem. On the other hand, higher levels of physical activity were associated with higher global self-esteem. The study suggests that maintaining healthy physical activity and body composition can help improve global self-esteem. The study highlights the importance of physical activity for mental health and self-esteem. It is worth encouraging and promoting physical activity among students to support an individual's physical and emotional health. Ultimately, this study may have implications for health policy, education, and intervention for students to emphasize the importance of physical activity for self-esteem and overall health.

Proposal for increasing diagnostic clarity in research and clinical practice by renaming and reframing atypical anorexia nervosa as "Restrictive Eating Disorder" (RED)

Atypical anorexia nervosa (AAN) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), is characterized by meeting all criteria for anorexia nervosa (AN) except for weight being within or above the "normal" range despite significant weight loss. The current definition is plagued by several problems, resulting in widely heterogeneous operationalizations in research and clinical practice. As such, the poorly defined diagnosis of AAN negatively impacts affected individuals and frustrates research attempts to better understand the syndrome. We consider conceptual flaws in the AAN description and contend that the undefined weight range and nature of weight loss renders these two factors functionally inapplicable in research and practice. They also represent a departure from the originally intended use of the AAN category, i.e., arresting a negative weight trajectory likely to result in AN, making the target population, and the application of the label, unclear. We propose revised criteria and a new name, restrictive eating disorder (RED), intended to reduce stigma and encompass a wide but better-defined range of presentations. The RED criteria focus on clinically significant restrictive behavior that disrupts normal living (i.e., impairment), and cognitive symptoms of overevaluation, disturbed experience, and lack of recognition of illness seriousness. We believe that RED may enable more appropriate clinical application, but also inspire coordinated research toward a more valid psychiatric nosology in the eating disorders field.

Self-Exposure on Instagram and BMI: Relations With Body Image Among Both Genders

Social media users can actively choose how they portray themselves and review the information they share to form and manage positive impressions on their audience. A high Body Mass Index (BMI) can lead to a bias of attention towards self-reported unattractive personal body areas. This dysfunctional body-related attention can lead to increased body dissatisfaction. Concerning social networks, people who usually post more photos on Instagram more frequently show higher body satisfaction. The main objective of this work was to analyze the relationship between BMI in young people, their own exposition on Instagram, positive body image and certain psychological variables: self-esteem, coping and well-being. The population-based sample consisted of 687 young Instagram users aged between 18 to 35 years old. The results found in this work revealed that BMI had a significant influence on the body exposure on Instagram in both genders, as well as in body image and certain psychological variables, such as coping and well-being. Moreover, we found that there is not a direct relation between BMI and the exposure of the entire body on Instagram. This relationship exists through positive body image, appearance care and management appearance behaviors. These results imply that positive body image affects body's exposure, so people with obesity or overweight tend to upload less photos with half or full body visible than people with normal weight or underweight. This is not because of their weight, but their valuation and appreciation of their bodies.

Association between body mass index, body image and self-esteem with sexual function: A survey of young women in Singapore

Introduction

Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women.

Method

A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55).

Results

BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78).

Conclusion

Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.

Many Facets of Eating Disorders: Profiling Key Psychological Features of Anorexia Nervosa and Binge Eating Disorder

Objective. The present study employs a profile analysis to identify and compare psychological features and core eating disorder (ED) symptoms in clinical samples of patients with anorexia nervosa (AN) and binge eating disorder (BED) and the general population (GP). Methods. A sample comprising 421 participants (142 patients with AN; 139 patients with BED; and 140 participants from the GP) was surveyed with the Eating Disorder Inventory-3 (EDI-3). Individuals with AN and BED were recruited and tested during their first week of a multidisciplinary inpatient program for weight loss and rehabilitation at the 'Rete DCA USL Umbria 1' (Eating Disorders Services), Italy. Results. The findings suggest distinct patterns of symptom presentation between the three samples across all the EDI-3 dimensions-with both the AN and BED groups scoring significantly higher than the GP. Patients with AN registered greater scores in all the psychological trait scales and the drive for thinness ED-specific dimension of the EDI-3 compared with their BED counterpart-which, instead, scored higher in the bulimia and body dissatisfaction subscales. These data support the transdiagnostic nature of the main risk factors for the onset and maintenance of EDs-which would vary in severity levels-and the existence of disease-specific pathways giving rise to AN and BED. Conclusion. This study for the first time compares patients with AN and BED with a non-clinical sample on main ED psychological features. This might inform classification approaches and could have important implications for the development of prevention and early intervention programs.

Relationships among inferiority feelings, fear of negative evaluation, and social anxiety in Chinese junior high school students

Introduction

This study aimed to explore the relationship between feelings of inferiority and social anxiety in Chinese junior high school students. In addition, it examined the potential mediating effect of fear of negative evaluation in this relationship.

Methods

A survey was administered to a sample of 734 Chinese junior high school students. The Feelings of Inadequacy Scale, Brief Fear of Negative Evaluation Scale, and Social Avoidance Distress Scale were used.

Results

First, there were significant positive correlations between all subscales for the inferiority feelings, social anxiety, and fear of negative evaluation. Furthermore, fear of negative evaluation mediated the predictive effects of four inferiority subscales (i.e., self-esteem, academic ability, appearance, and physical ability) for social anxiety. However, the total score for the sense of inferiority and social confidence subscale lacked this mediating effect.

Conclusion

The inferiority feelings of self-esteem, academic ability, appearance, and physical ability may directly and indirectly predict social anxiety through fear of negative evaluation.

The relationship between body mass index and food preoccupation in women: A moderated mediation of body-related self-conscious emotions and self-esteem

OBJECTIVE

Individuals who are preoccupied with food are more likely to develop maladaptive eating behaviours and eating disorders. Thus, it is advisable to investigate the factors that increase vulnerability to food preoccupation (FP) to prevent its harmful impact on physical and mental health. Our objective in this study was to investigate the relationship between body mass index (BMI) and FP in Polish women (N = 407) and examine a possible pathway through body-related shame and body-related guilt and self-esteem.

METHOD

Participants completed an abbreviated version of the Eating Attitudes Test-26, the Body and Appearance Self-Conscious Emotions Scale, and the Rosenberg Self-Esteem Scale.

RESULTS

The findings demonstrated a positive indirect effect of BMI on FP through body-related shame and body-related guilt. However, this effect was moderated by self-esteem only for body-related shame; namely, in women with a low or average level of self-esteem, higher BMI was related to higher body-related shame, which, in turn, was associated with higher levels of FP. These associations were not observed in women with a high level of self-esteem.

DISCUSSION

Body-related shame may help explain the relationship between BMI and FP. Moreover, self-esteem serves as a protective factor against body-related shame related to higher BMI and, as a result, against FP.

Measurement accuracy and reliability of self-reported versus measured weight and height among adults in Malaysia: Findings from a nationwide blood pressure screening programme

Most studies reporting prevalence of obesity use actual weight and height measurements. Self-reported weight and height have been used in epidemiological studies as they have been shown to be reliable, convenient, and inexpensive alternatives to actual measurements. However, the accuracy of self-reported weight and height might vary in different regions because of the difference in health awareness and social influences. This study aims to determine the accuracy and reliability of self-reported weight and height compared to actual measured weight and height among adults in Malaysia. This was a cross-sectional study conducted at the community level during blood pressure screening campaigns. Participants self-reported their weight and height in a questionnaire survey. Their weight and height were validated using measurements by researchers on the same setting. Body mass index (BMI) was defined as underweight (<18.5kg/m2), normal (18.5-22.9 kg/m2), overweight (23-27.4 kg/m2) and obesity (≥27.5 kg/m2). Bland-Altman analysis, intraclass correlation coefficients and weighted Kappa statistics were used to assess the degree of agreement between self-reported and measured weight and height. A total of 2781 participants were recruited in this study. The difference between the mean self-reported and measured weight and height were 0.4 kg and 0.4 cm respectively. Weighted Kappa statistics analysis showed that there was a substantial agreement between the BMI classifications derived from self-reported and actual measurement (ҡ = 0.920, p<0.001). There was no marked difference in the sensitivity and specificity of self-reported BMI among Malaysian adults by gender. We observed substantial agreement between self-reported and measured body weight and height within a sample of Malaysian adults. While self-reported body weight showed weaker agreement with actual measurements particularly for obese and overweight individuals, BMI values derived from self-reported weight and height were accurate for 88.53% of the participants. We thus conclude that self-reported height and weight measures may be useful for tracking and estimating population trends amongst Malaysian adults.

TikTok: a far-reaching opportunity for health professionals to address weight loss

OBJECTIVES

Recent behavioral research indicates that social media may be successfully integrated into weight loss interventions to mitigate the obesity epidemic that has been linked with type two diabetes, cardiovascular diseases, cancers, as well as poor psychological health. This study aimed to examine the content and characteristics of 100 most trending TikTok videos related to weight loss.

STUDY DESIGN

This was a cross-sectional, descriptive study.

METHODS

Videos were analyzed for source, predominant theme, and inclusion of specific content. Independent two-tailed t-tests assessed the effect of content on number of comments, likes, and forwards garnered by the videos.

RESULTS

More than 90% of the videos were consumer generated, indicating a missed opportunity by health professionals to use social media to provide accurate information regarding weight loss. Less than one-fifth of the videos were informational but significantly influenced the number of comments (P < .001) and likes (P = .002). Videos mentioning benefits ((P < .001) and speed of weight loss (P = .003) significantly influenced the number of forwards, whereas those that mentioned recipes (P = .005) and how to lose weight (P = .003) significantly affected the number of comments.

CONCLUSION

The results underscore the need for further research to elucidate the effectiveness of social media in impacting weight loss, as well as how they may supplement traditional health promotion and behavior interventions for weight loss.

A Negative Body Image among Adolescent and Young Adult (AYA) Cancer Survivors: Results from the Population-Based SURVAYA Study

Simple Summary

Adolescent and young adult (AYA) cancer survivors diagnosed with cancer between ages 18–39 years often experience negative body changes, such as scars, amputation, hair loss, disfigurement, body weight changes, skin buns, and physical movement limitations. A negative body image could have negative implications for the self-esteem, self-identity, and social relationships of AYAs. Despite the possible long-term effects of cancer on body image, within the AYA literature, limited studies focus on AYA cancer survivors in a quantitative way. Therefore, the aim of our population-based cross-sectional study was to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA survivors 5–20 years after diagnosis. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future longitudinal research could help to identify when and how this support for AYA survivors can be best utilized.

Abstract

Adolescent and young adult (AYA) cancer survivors (18–39 years at diagnosis) often experience negative body changes such as scars, amputation, and disfigurement. Understanding which factors influence body image among AYA survivors can improve age-specific care in the future. Therefore, we aim to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA cancer survivors (5–20 years after diagnosis). A population-based cross-sectional cohort study was conducted among AYA survivors (5–20 years after diagnosis) registered within the Netherlands Cancer Registry (NCR) (SURVAYA-study). Body image was examined via the EORTC QLQ-C30 and QLQ-SURV100. Multivariable logistic regression models were used. Among 3735 AYA survivors who responded, 14.5% (range: 2.6–44.2%), experienced a negative body image. Specifically, AYAs who are female, have a higher Body Mass Index (BMI) or tumor stage, diagnosed with breast cancer, cancer of the female genitalia, or germ cell tumors, treated with chemotherapy, using more maladaptive coping strategies, feeling sexually unattractive, and having lower scores of health-related Quality of Life (HRQoL), were more likely to experience a negative body image. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future research could help to identify when and how this support for AYA survivors can be best utilized.

Body mass index and quality of life in individuals with polycystic ovary syndrome: Dysmorphic concerns and eating disorders as mediators

Objective

Weight issues, dysmorphic concerns and eating disorders are common among individuals with polycystic ovary syndrome (PCOS) and are linked to poor quality of life (QoL). The goal of the current study was to examine whether the association between body mass index (BMI) and QoL was mediated by dysmorphic concerns, examining also the relations with eating disorder symptomatology.

Methods

Questionnaires were administered to 435 individuals with PCOS aged between 18 and 40 years (M = 27.62; SD = 4.83) to measure dysmorphic concerns, eating disorder symptoms and QoL. Participants were also asked to report their height and weight to compute their BMI.

Results

Structural equation modeling was used to observe the relationship between the variables. The results revealed a direct relationship between QoL, BMI, dysmorphic concerns and eating disorder symptomatology. In addition, dysmorphic concerns were related to BMI and eating disorder symptomatology. Furthermore, the results showed the mediating role of dysmorphic concerns and eating disorder symptoms in the relationship between BMI and QoL.

Conclusion

The current results highlight the potential importance of harmful relationships with one's own body and food, explaining why weight issues may be linked to different levels of QoL in PCOS individuals. The implications of these findings are discussed.

Body dissatisfaction and disordered eating in the perinatal period: an underrecognized high-risk timeframe and the opportunity to intervene

The normal physical changes associated with pregnancy may increase the risk of body dissatisfaction, which is associated with negative mental health outcomes including depression and disordered eating. The purpose of this study was to explore body image and eating concerns among a sample of participants in pregnancy and postpartum and to assess interest and suggestions for a relevant intervention. This was a cross-sectional survey study requiring 10-15 min to complete. Individuals were eligible to participate in the study if they were pregnant or within 1 year postpartum, between the ages of 18 and 45, able to read and write in English, and provided online informed consent. The survey included measures and open-text questions to explore body image, eating behaviors, and related concerns in the perinatal period and to inform the development of an intervention. There were 161 participants, and over 50% were dissatisfied with their body image; 52% were among pregnant participants and 56.2% of postpartum participants. Approximately 80% reported that they would have appreciated the opportunity to participate in a program focused on body acceptance or expectations of body changes in pregnancy and postpartum. We identified intervention preferences as well as commonly reported themes regarding experiences of body image and eating concerns in pregnancy and postpartum. Body dissatisfaction and eating concerns are prevalent issues in pregnancy and postpartum, and our findings underscore an opportunity to tailor an intervention relevant to body image and disordered eating for the perinatal population.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

A Moderated Mediation Model of Perceived Effect of Fitspiration Images on Self: The Influence of Media Literacy and BMI

The present study investigated the relationship between internal locus of control and the perceived impact of Instagram fitspiration images on the self with media literacy as the mediating role in this relationship. This study also examined the importance of body mass index (BMI) as a moderating factor in the mediated model, where higher BMIs could weaken the relationship between internal locus of control and the perceived effect of fitspiration images mediated through media literacy. A sample of 321 Malaysian university students who were fitspiration viewers filled out a self-report questionnaire assessing internal locus of control, media literacy, perceived effect of fitspiration images on self, body satisfaction and BMI. The data analysis was performed using SPSS PROCESS macro. Results show that internal locus of control is negatively associated with the perceived impact of fitspiration images on self, mediated by media literacy. However, BMI moderates the mediated relationship such that the negative relationship between internal locus of control and the perceived effect of fitspiration images through media literacy does not exert an effect on those with high BMI. These results accentuate the value of incorporating a potential mediator and moderator into the direct relationship between internal locus of control and perceived effect of media ideals on self to provide an enhanced understanding of this process and offer practical insights about the protective role of media literacy and negative effects of high BMI.

Body Dissatisfaction and Disordered Eating Behaviors: The Mediation Role of Smartphone Addiction and Depression

This study aimed to determine whether smartphone addiction and depression sequentially mediate the relationship between body dissatisfaction and disordered eating behaviors (e.g., restrained eating, emotional eating and external eating). A total of 5986 participants (54.1% females, average age = 19.8 years, age range = 17–32) completed the Satisfaction and Dissatisfaction with Body Parts Scale, the Three-Factor Eating Questionnaire, the Smartphone Addiction Scale and the Patient Health Questionnaire-9. Mediational analysis showed that, after controlling for age, sex and body mass index, body dissatisfaction was related to disordered eating behaviors through (a) the mediating effect of smartphone addiction, (b) the mediating effect of depression, and (c) the serial mediating effect of smartphone addiction and depression. In conclusion, our study showed for the first time that smartphone addiction and depression can be sequential mediator variables in the association between body dissatisfaction and disordered eating. However, this study is a cross-sectional study; future longitudinal studies could further test the causal associations between these study variables.

Totally Implantable Venous Access Devices: A Randomized Controlled Trial on the Effect of Psychological Support on Quality of Life and Body Image (BI-PORT)

Background: The presence of totally implantable venous access devices (TIVADs), as any permanent or semipermanent medical devices, has an impact on the quality of life (QoL) of patients. Therefore, the purpose of this trial was to evaluate the efficacy of psychological support for patients undergoing this procedure.

Methods: This randomized controlled trial (RCT) aimed to compare the efficacy of a psychological intervention vs. standard care on QoL in patients receiving TIVAD for chemotherapy treatment (ClinicalTrials.gov NCT02075580). The trial was conducted at the Veneto Institute of Oncology IOV-IRCCS (Padua, Italy) between October 2013 and September 2018. Participants were neoplastic adults receiving TIVAD for chemotherapy treatment for any cancer, not undergoing visible demolitive interventions, without psychopathological diagnosis and language understanding. The exclusion criteria were patients without a diagnosis of cancer, with psychopathological diagnosis, or with language misunderstanding.

Results: The variation of C30-QL2 and BR32-BI was not statistically different between intervention and control arms in men and women. However, the variation of C30-SF was statistically better in the intervention than control arm in men [mean difference (MD) 22.3, 95% CI 3.5 to 41.0] but not in women (MD −2.7, 95% CI −24.0 to 18.7). The variations of the other secondary outcome measures were not statistically different between intervention and control arms.

Conclusion: Psychological support did not show any clear advantages on global QoL and body image perception in patients at 15 days after TIVAD insertion for chemotherapy. In contrast, male patients might benefit from even a very short psychological counseling before or during chemotherapy even if they do not seem to ask for it.

Variation of psychological and anthropometrics measures before and after dieting and factors associated with body dissatisfaction and quality of life in a Lebanese clinical sample

Objective

The primary objective of this study was to assess a change in the psychological states (stress, self-esteem, anxiety and depression), anthropometric measurements and physical/mental quality of life before and after diet in a sample of Lebanese subjects visiting a diet clinic. The secondary objectives included the evaluation of factors associated with body dissatisfaction, mental and physical quality of life (QOL) before the intervention of the diet program and the change in quality of life after this intervention among those participants.

Methods

This cross-sectional study, conducted between May and August 2018, enrolled 62 participants recruited from three diet clinics. The QOL was measured using the 12-item Short Form Health Survey (SF-12) and the psychological states was measured using the following scales: The Rosenberg Self-esteem Scale, Perceived Stress Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale.

Results

A significant reduction in body dissatisfaction, anxiety, waist, weight and body fat and a significant increase in the physical and mental quality of life was seen after diet compared to before it (p < 0.001 for all). No significant variation in perceived stress (p = 0.072), self-esteem (p = 0.885), and depression (p = 0.353) after diet were found. Higher BMI (β = 0.440) and higher anxiety (β = 0.132) were associated with higher body dissatisfaction scores, whereas higher self-esteem (β = − 0.818) was significantly associated with lower body dissatisfaction. Higher perceived stress (β = − 0.711), higher body dissatisfaction (β = − 0.480) and being a female (β = − 4.094) were associated with lower mental QOL. Higher Physical Activity Index was significantly associated with higher mental and physical QOL (β = 0.086 and β = 0.123 respectively).

Conclusion

The results indicate the effectiveness of diet programs in enhancing the quality of life, psychological and anthropometric measures.

The Relationship between Alexithymia, Dysmorphic Concern, and Exercise Addiction: The Moderating Effect of Self-Esteem

As with other addictions, exercise addiction can severely impact individuals' lives and have significant psychophysical consequences. Consequently, the study of the mechanisms involved in this psychopathological condition has great clinical and practical relevance. Therefore, the goal of the present study was to explore the risk factors and protective factors for exercise addiction, with a particular focus on the roles of alexithymia, body image concerns, and self-esteem. A sample of 288 regular exercisers (mean age = 28.35 years, SD = 8.26; 72% females, 18% males) completed the Exercise Addiction Inventory, 20-Item Toronto Alexithymia Scale, Body Image Concern Inventory, and Rosenberg Self-Esteem Scale. Data were analyzed by implementing a moderated mediation model. Results showed a significant and positive association between alexithymia and exercise addiction, totally mediated by body image concerns. Furthermore, self-esteem showed a relevant moderating effect, such that at high levels of self-esteem the effect of alexithymia on body image concerns became insignificant. Such data have important implications, highlighting some core variables on which it might be useful to keep a focus in order to elaborate tailored interventions, from both preventive and treatment perspectives.

The Perceived Match Between Observed and Own Bodies, but Not Its Accuracy, Is Influenced by Movement Dynamics and Clothing Cues

Own-perceived body matching - the ability to match one's own body with an observed body - is a difficult task for both general and clinical populations. Thus far, however, own-perceived body matching has been investigated in situations that are incongruent with how we are used to experience and perceive our body in daily life. In the current study, we aimed to examine own-perceived body matching in a context that more closely resembles real life. More specifically, we investigated the effects of body movement dynamics and clothing cues on own-perceived body matching. We asked participants to match their own body with an externally perceived body that was a 3D-generated avatar based on participants' real bodies, fitted with a computer-generated dress. This perceived body was (1) either static (non-walking avatar) or dynamic (walking avatar), (2) either bigger, smaller, or the same size as participants' own body size, and (3) fitted with a dress with a size either bigger, smaller, or the same as participants' own dress size. Our results suggest that movement dynamics cues did not improve the accuracy of own-perceived body matching, but that confidence about dress fit was higher for dynamic avatars, and that the difference between dynamic and static avatars was dependent on participants' self-esteem. Furthermore, when participants were asked to rate the observed body in reference to how they wanted to represent themselves to others, dynamic avatars were rated lower than static avatars for the biggest-sized bodies only, possibly reflecting the influence of movement cues on amplifying socio-cultural stereotypes. Finally, while smaller body/dress sizes were systematically rated higher than bigger body/dress sizes for several self-report items, the interplay between body and dress size played an important role in participants' self-report as well. Thus, while our research suggests that movement and garment dynamics, allowing for realistic, concrete situations that are reminiscent of daily life, influence own-body perception, these cues did not lead to an improvement in accuracy. These findings provide important insights for research exploring (own-) body perception and bodily self-awareness, with practical (e.g., development of online avatars) and clinical (e.g., anorexia nervosa and body dysmorphic disorder) implications.

Appearance Concerns, Psychosocial Outcomes, and the Feasibility of Implementing an Online Intervention for Adolescents Receiving Outpatient Burn Care

The current study assessed the prevalence of appearance concerns, psychosocial difficulty, and use of an appearance-focused social and psychological support resource (Young Person's Face IT; YPF) within a population of teens (12-17 year-olds) receiving outpatient burn care with the goal to assess the feasibility of routine use of the resource in outpatient burn care. The study sample included 78 patients ages 12 to 17 receiving outpatient care for burns at one hospital. Appearance concerns were measured via the Burn Outcomes Questionnaire Appearance Subscale, the Appearance Subscale of the Body Esteem Scale for Adolescents, and a 2-part question which asked participants directly about appearance concerns related to the burn injury. A large majority (70.0%) of study participants reported appearance concerns on at least one appearance measure and girls reported more burn-related appearance concerns compared with boys. Psychosocial difficulty was measured via the Pediatric Symptom Checklist-17 (PSC-17) and measures of social functioning were collected and compared within the sample by burn size, burn location, sex, and appearance concerns. Internalizing symptoms were prevalent on the PSC-17 (18.6% risk) and decreased self-worth and increased social anxiety symptoms were significantly associated with having appearance concerns. Although interest in YPF was high (78.3%), actual use of the resource among those who signed up to pilot it (n = 46 participants) was low (19.4% use). Results indicate that there is a need for and interest in appearance-focused social anxiety resources for adolescents with burn injuries such as YPF, but more research is needed to understand its feasibility in clinical practice.

The Accuracy of Self-Reported Body Weight Is High but Dependent on Recent Weight Change and Negative Affect in Teenage Girls

BACKGROUND

Research studies often rely on self-reported weight to calculate body mass index. The present study investigated how the accuracy of self-reported body weight in adolescent girls is affected by overweight/obesity, race/ethnicity, and mental health factors.

METHODS

In a cohort of girls who participated in the Trial of Activity for Adolescent Girls at ages 11 and 17 (n = 588), self-reported and measured weight were compared, and linear regression models were fitted to model the over- or underreporting. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to calculate depressive symptom subscales for negative affect, anhedonia and somatic symptoms.

RESULTS

Allowing 3% difference between self-reported and measured weight for the correct reporting of body weight, 59.2% of girls reported their weight correctly, 30.3% underreported (-5.8 ± 4.8 kg), and 10.5% overreported (4.3 ± 3.5 kg). The average difference between self-reported and measured body weight was -1.5 ± 4.3 kg (p < 0.001). Factors for misreporting body weight were overweight (β ± SE - 2.60 ± 0.66%), obesity (β ± SE - 2.41 ± 0.71%), weight change between ages 11 and 17 (β ± SE - 0.35 ± 0.04% for each kg), height change between ages 11 and 17 (β ± SE 0.29 ± 0.10% for each cm), and negative affect (β ± SE - 0.18 ± 0.08% for each score unit).

CONCLUSIONS

The difference between self-reported and measured body weight in adolescent girls is relatively small. However, the accuracy of self-reported body weight may be lower in girls with overweight or obesity, recent weight and height change, and higher negative affect.

How are body mass and body attitude impacted by a behaviour change intervention in primary care? A pragmatic randomised controlled trial

Aims:This study evaluated the effect of behaviour change interventions at Norwegian Healthy Life Centres on change in body mass index (BMI) and body attitude, and explored the predictors for change after 6 months. Methods: We randomised 118 participants to either an intervention or a control group. Eligible participants: ⩾18 years and able to take part in group-based interventions. Body attitude, weight, and height were assessed at inclusion and after 6 months. We analysed the data using simple and multiple regression. Results: Eighty-six participants completed 6-month follow-up. The study found no intervention effect on BMI or body attitude across the two groups. However, an interaction effect indicated that the leaner participants in the intervention group reduced their weight significantly (b 0.94, p < 0.001). BMI reduction was predicted by self-efficacy for physical activity and autonomous motivation for change. Weight loss was associated with impaired body attitude, body shape concern, impaired weight-related self-esteem, weight cycling, and controlled motivation for change. Improvement in body attitude was positively impacted by self-rated health, the experience of childhood respect, life satisfaction, and self-efficacy for physical activity. Impaired body attitude was predicted by body shape concern, impaired weight-related self-esteem, and controlled motivation. Conclusions: The interventions did not affect body mass on average, but promoted weight loss among the leaner participants. Because weight reduction was associated body shape concern and impaired body attitude, the study supports the claim that interventions should be weight neutral and aim to improve body image and psychological well-being rather than weight reduction.

Body Image Quality of Life Inventory: cross-national study in college students from four different countries

PURPOSE

This study was aimed to examine the psychometric proprieties of the Body Image Quality of Life Inventory (BIQLI) among Brazilian, Portuguese, Mozambican, and Italian college students.

METHODS

A total of 1630 subjects (Brazilians = 446; Portuguese = 480, Mozambicans = 360, and Italians = 344) completed the Portuguese (Brazilian, Portuguese, and Mozambican students) and the Italian versions (Italian students) of the BIQLI for measuring the effects of body image on one's quality of life. Psychometric testing included confirmatory factor analysis (CFA), discriminant and convergent validity, internal consistency, and composite reliability. The cross-national invariance of the BIQLI was assessed by multi-group analysis using ΔCFI. Moreover, the global score of the BIQLI for all countries was calculated by an algorithm and compared using the Welch's ANOVA and the Games-Howell post-test (α = 5%).

RESULTS

CFA showed an inadequate fit of unifactorial model of the BIQLI. Therefore, an alternative model comprising nine first-order factors and one second-order factor was proposed and evaluated. This new model showed adequate fit in all samples, despite some limitations that were found with respect to its convergent and discriminant validity. The alternative BIQLI model was invariant among countries. Global scores for the influence of body image on quality of life were significantly different across countries, with the Italians presenting the lowest scores.

CONCLUSIONS

The BIQLI factorial model found in this study represents a reliable and valid alternative to its original structure for the assessment of the effect of body image on college students' perceived quality of life. This model must be further tested in other populations.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Parent-Related Normative Perceptions of Adolescents and Later Weight Control Behavior: Longitudinal Analysis of Cohort Data From Brazil

PURPOSE

Body image-related norms can be imposed by parents and can shape adolescents' body satisfaction in consequential ways, yet evidence on long-term effects is scarce. Longitudinal data from a country with strong body image focus provided a unique opportunity to investigate long-term influences of normative parent-related perceptions.

METHODS

Multinomial logistic regression was used on data from a 1993 birth cohort in Brazil to investigate the association of normal-body mass index (BMI) adolescents' perception of their parent's opinion of their weight at age 11 years with their weight control attempts at 18 years, testing a mediating role for body dissatisfaction at age 15 years. All models controlled for body dissatisfaction at age 11 years and BMI change between ages 11 and 15 years.

RESULTS

A total of 1150 boys and 1336 girls were included. Girls were more likely than boys to diet without nutritionist advice to lose weight (51.5% vs. 34.3% among boys) and use medication to gain weight (12.7% vs. 4.2%). Normal-BMI adolescents who reported at age 11 years that their parents thought they were thin had higher odds of feeling thinner than ideal at age 15 years (odds ratio 2.8, 95% confidence interval 1.8-3.2; and odds ratio 2.0, 95% confidence interval 1.5-2.7) among boys and girls, respectively). Feeling thinner than ideal at age 15 years was associated among girls with higher odds of weight gain attempts at age 18 years. Similar patterns appeared among girls reporting that their parents thought they were fat at age 11 years, feeling fatter than ideal at age 15 years and having higher odds of weight loss attempts at age 18 years. Body dissatisfaction was a statistically significant mediator among girls but not boys.

CONCLUSIONS

A long-term influence of parent-related perceptions via a likely trajectory of body dissatisfaction is evident among girls.

Body frame size, body image, self-esteem, and health-related quality of life in schoolchildren

OBJECTIVE

The aim of this study was to explore the relationship between body frame size (BFS) and body image, self-esteem, and health-related quality of life (HRQL) in Mexican schoolchildren.

METHODS

This cross-sectional study included children aged 6 to 11 years. Body image, self-esteem, and HRQL were evaluated through interviews. Two frame-size measures, biacromial and bitrochanteric diameters, were collected and summed for categorizing BFS as small, medium, or large. Height and weight were also measured. Spearman's correlations were determined and adjusted by sex, age, and body mass index (BMI). Multiple logistic regression analyses were performed with the psychological measure as the binary dependent variable, the categories of BFS as the independent variable, and sex, age, and BMI as control variables.

RESULTS

The correlation between BFS and body image was 0.15 (P < .01) and after BMI adjustment was 0.07 (P > .05). BFS did not correlate with self-esteem nor HRQL (P > .05). Of the children, 79% were dissatisfied with their body image, 20% had a low self-esteem, and 31.8% had a poorly perceived HRQL; there were no differences by BFS. The multivariate analysis showed that a large BFS was not associated with body image dissatisfaction (OR 1.2, 95% CI 0.6-2.3), low self-esteem (OR 1.3, 95% CI 0.7-2.6), or poor HRQL (OR 1.3, 95% CI 0.8-2.2).

CONCLUSIONS

BFS was not correlated with body image, self-esteem, or HRQL. A high self-esteem and a good level of HRQL prevailed, but a high proportion of children were dissatisfied with their body image. School interventions should promote an appropriate body image and a healthy lifestyle.