Body image satisfaction and weight concerns among a Mediterranean adult population

Are Patients With Adult Traumatic Brachial Plexus Injuries Satisfied With Their Appearance?

PURPOSE

Adult traumatic brachial plexus injuries (tBPI) are devastating physically and emotionally. In addition to the physical loss of function and pervasive neuropathic pain, patients describe difficulty with negative self-image and social relationships. Our goal was to gain an initial understanding of body image and satisfaction with appearance among tBPI patients.

METHODS

Among 126 patients in a prospective cohort study, 60 completed a brachial plexus injury-specific modification of the Satisfaction with Appearance survey. The survey encompasses three major domains: social discomfort because of the affected limb, interference with relationships because of the affected limb, and appearance of the affected limb. We performed a cross-sectional descriptive analysis to provide an initial understanding of these domains among brachial plexus injury patients.

RESULTS

Among all 60 patients, nearly half (27/60, 45%) reported they are satisfied with their overall appearance. The appearance of their affected hand(s) was the body part with which patients expressed the most concern. Patients also reported feeling increasingly uncomfortable among those less familiar to them: 11/60 (18%) were uncomfortable around family, 18/60 (30%) were uncomfortable around friends, and 19/60 (32%) were uncomfortable around strangers. One-quarter (15/60, 25%) of brachial plexus injury patients agreed that their injury interfered with relationships and that their tBPI was unattractive (16/60, 27%) to others.

CONCLUSIONS

Almost half of patients who have experienced tBPI endorse dissatisfaction with their appearance, which can subsequently interfere with their personal relationships. Further, tBPI may influence patients' comfort levels in unfamiliar social surroundings and may influence how patients feel they are perceived by others.

CLINICAL RELEVANCE

The patient's perception of their affected limb and its influence on their daily social interactions should be recognized by their tBPI care team, noting opportunities for improved counseling.

An Analysis Through to Congruence Between Real and Self-Perceived Body Mass Index in Nursing Students

BACKGROUND/OBJECTIVES

Overweight and obesity are growing concerns that also affect nursing staff, healthcare professionals that play a critical role in public health awareness and intervention. This study aimed to define the health parameters associated with body weight, analyze if there is an erroneous self-perception of overweight/obesity through the distortion of body weight perception, and determine the predictive factors of body weight distortion.

METHODS

A cross-sectional study of 224 nursing students gathered anthropometric and demographic data. Self-perceived body weight was assessed using Stunkard and Stellar's scale. Descriptive statistics and multinomial logistic regression identified significant predictors of weight distortion.

RESULTS

The analysis found that men reported greater weight discrepancies than women. Specifically, 57% of the men (28 of 49 participants) underestimated their real BMI, while only 23% of the women (40 of 175 participants) did so. Age, sex, and weight classification emerged as significant explanatory variables for the distortion of body weight perception.

CONCLUSIONS

The findings indicate a significant vulnerability among nursing students to the misperception of their own body weight status, highlighting the need for targeted training strategies. These strategies should focus on correcting misperceptions of obesity among health professionals throughout their working life to improve future obesity prevention efforts for society.

Towards active health: A study on the relationship between physical activity and body image among college students

Aims

Active health is a new concept, model, and system for maintaining a state of whole-person health. In the context of the increasing severity of college students' mental health, it is of great significance to explore the relationship between physical activity and college students' body image based on an active health perspective.

Methods

A survey was conducted among 853 college students in Zhejiang province using the physical activity rating scale, body image scale, sense of acquisition of sports body shaping scale and social adjustment scale. Using SPSS25.0 and Amos 24.0 software for data processing and analysis.

Results

(1) There is a significant positive correlation between physical activity, body image, sense of acquisition of sports body shaping, and social adjustment. There is a significant positive correlation between physical activity and body image among college students; The sense of acquisition of sports body shaping a significant mediating role between physical activity and the promotion of college students' body image. The effects of physical activity on body image were mainly achieved through the following three mediating pathways: (1) physical activity → sense of acquisition of sports body shaping → body image, the mediating effect value of this pathway was 0.18, which accounted for 31.6 % of the total effect, with a confidence interval of [0.08, 0.28], (2) physical activity → social adaptation → body image, the mediating effect value of this pathway was 0.09, which accounted for 15.8 % of the total effect of 15.8 %, with a confidence interval of [0.03, 0.15], and (3) physical activity → sense of acquisition of sports body shaping → social adaptation → body image, a pathway with a mediated effect value of 0.09, accounting for 15.8 % of the total effect, with a confidence interval of [0.01, 0.17].

Conclusions

Physical activity is an important factor in promoting the body image of college students, and there is a chain intermediary effect between physical activity and body image. School sport has its own disciplinary value and unique strengths in advancing the development of body image in adolescents, and the significant mediating effects of sense of acquisition of sports body shaping and social adaptation in this process provide theoretical support for the body image turn to move from theory to practice in the field of school sport.

Examining gender difference in disordered eating behaviour and its associated factors among college and university students in Sarawak

Background: Disordered eating is common among late adolescents and young adults who pursue an idealised body image. Aims: This study aims to determine the prevalence of disordered eating between males and females and its associated factors among college and university students in Sarawak. Methods: A cross-sectional study involving 20 public and private colleges and universities in Sarawak, from September 2017 to March 2020. Respondents completed self-administered questionnaires both in the English and Malay language. Data about sociodemographic characteristics, body mass index, eating attitude, body dissatisfaction, perceived sociocultural pressure, self-esteem, drive for muscularity and perfectionism were collected. Results: A total of 776 respondents (male: 30.9%; female: 69.1%) aged 19 to 25 years old took part in the study. The overall prevalence of disordered eating was 25.2% (95% confidence interval (CI) 21.9; 28.7) with females (28.6%, 95% CI 24.6; 32.9) higher than males (15.6%, 95% CI 10.5; 21.9). Multivariate analysis showed for both male and female models, perceived sociocultural pressure (male: β = 1.125, p < 0.01; female: β = 1.052, p = 0.003), drive for muscularity (male: β = 1.033, p = 0.017; female: β = 1.032, p < 0.01) and perfectionism (male: β = 1.098, p = 0.02; female:β = 1.119, p < 0.01) were predictors for disordered eating. Conclusion: The prevalence of disordered eating among college and university students in Sarawak was high. The findings suggest that although there were gender differences in the prevalence of disordered eating, its associated factors were the same. The findings of this study will be useful for designing and implementing disordered eating prevention and intervention programme.

Recreational Physical Activity and the Mediterranean Diet: Their Effects on Obesity-Related Body Image Dissatisfaction and Eating Disorders

Obesity is a non-communicable disease that is associated with a number of serious physical and mental health conditions. The present study examines the effect of recreational physical activity and the Mediterranean diet on body image dissatisfaction and propensity for eating disorders. It is based on 1311 participants categorized by body mass index (BMI) into a normal ΒΜΙ group (NBG; N = 513), an overweight and obese ΒΜΙ group (OBG; N = 492), and a control group (CG; N = 309). All participants completed the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS), Rosenberg Self-esteem Scale (RSES), Eating Attitudes Test-26 (EAT-26), Mediterranean Diet Score (MedDietScore), and Fitness Evaluation and Fitness Orientation subscales from the original Multidimensional Body-Self Relations Questionnaire (MBSRQ). The results of the multiple regression analysis indicated that the overall prediction of the variables was statistically significant. A multivariate analysis of variance (MANOVA) demonstrated the existence of significant interactions between groups and gender across a range of scales. Despite higher body image dissatisfaction in the OBG group, they maintained positive self-esteem and did not exhibit eating disorder tendencies. Notably, women reported greater dissatisfaction than men across all three groups. Our findings have practical implications for public health promotion strategies, policymaking, future research, and clinical practice. Encouraging regular exercise and adherence to the Mediterranean diet could improve body satisfaction and reduce eating disorder risk. Policymakers can advocate for community-based policies promoting physical activity and healthy eating habits.

Development and validation of a photograph-based instrument to assess nutrition literacy: The NUTLY project

Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n = 329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n = 158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α = 0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9 ± 4.4), followed by health professionals (38.5 ± 4.1) and declined with decreasing education (p < 0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9 ± 4.3 vs. 33.9 ± 6.9, p < 0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC = 0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.

Lifestyle Satisfaction Among Jazan University Employees: A Cross-Sectional Study Exploring Lifestyle Choices and Influencing Factors

BACKGROUND

Lifestyle includes habits, behaviors, values, attitudes, and economic levels that define an individual or group's way of living for people living in the same region at a specific time. In the last few decades, with urbanization and modernization, most adults, especially in Arab countries, including Saudi Arabia, have adopted a sedentary, less active lifestyle. This study aims to assess lifestyle choices and satisfaction among employees of Jazan University, Jazan, Saudi Arabia.

METHODS

This was a cross-sectional study that was conducted in the Jazan University campus in the southwestern region of Saudi Arabia. Data were collected through personal interviews conducted by trained medical students. A structured questionnaire was filled out during the interviews. Data analysis was conducted using R software (version 4.2.3) (R Development Core Team, Vienna, Austria).

RESULTS

This study involved 1126 employees of Jazan University, with a response rate of 75%. The occupational distribution was as follows: 576 (51%) in administrative positions, 516 (46%) as faculty members, and 34 (3%) as healthcare workers. In terms of physical activity, 488 (43%) engaged in less than 150 minutes of weekly physical activity, while 363 (32%) reported no physical activity at all. Regarding body weight satisfaction, 590 (52%) were satisfied, while 536 (48%) were not. Males reported a higher satisfaction in body weight, physical activity, and eating behavior. Dietary choices, such as eating fruits and vegetables, low-fat meats, and avoiding high-sugar foods, positively correlated with satisfaction in eating behavior and body weight. The assessment of satisfaction with body weight, physical activity level, and eating behavior indicates that some university affiliates are satisfied with their lifestyle despite having unhealthy lifestyle choices.

CONCLUSION

The current findings indicate that Jazan University affiliates are experiencing a high prevalence of unhealthy lifestyles, especially in terms of low levels of physical activity, selection of unhealthy food items, and overweight and obesity. This study should be followed up by interventional designs to investigated best evidence-based approaches for lifestyle behavior change, especially among aging populations such as university affiliates.

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

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

Exploration of the nutrition knowledge among general population: multi-national study in Arab countries

BACKGROUND

Knowing what to eat and realizing the significance of healthful eating habits are among the important steps to promoting eating behavior. The current study aims to assess the nutrition knowledge (NK) among a convenient sample in four different countries, determine the association between different demographic factors and NK, and investigate the need for future interventions on nutrition in the four selected countries.

METHODS

A cross-sectional multi-national survey study among a convenient sample of 8,191 subjects from Egypt, Syria, Saudi Arabia, and Jordan who undertook surveys between January 2019 and January 2020. A pre-tested interview questionnaire was utilized for data collection from study participants. It included three sections: i) Sociodemographic characteristics:. ii). Section two included twenty-one questions related to NK.. iii). Section three included one question about NK sources.

RESULTS

About three-quarters showed inadequate nutrition knowledge (73.1%). Youth (15-24 yrs.) were more dependent on social media, with 87% using it as a primary source of NK, while adults (≥ 25 yrs.) demonstrated that 43% of them used social media. In contrast, TV was more prominent among them, with participants' characteristics such as living with parents, body mass index, and country of residence showing no association with NK. However, female sex, education, and reading nutrition articles are significantly correlated with adequate knowledge (p < 0.001). Significant predictors of satisfactory knowledge were age, sex, education, living with parents, and reading nutrition articles.

CONCLUSION

The study revealed low levels of NK indicating an urgent need to implement educational programs to promote nutrition knowledge. As NK is a modifiable determinant of diet intake and can positively impact the need for developing strategies in counselling and raising awareness among the general population to improve their health status.

High body weight variability is associated with increased risk of depression: a nationwide cohort study in South Korea

BACKGROUND

Body weight variability (BWV) negatively affects the incidence and outcomes of various diseases, but the nature of the association between BWV and depression remains unclear. In this study, we aimed to test the hypothesis that BWV is associated with the risk of new-onset depression.

METHODS

Data from a nationwide population-based cohort in the Korean National Health Insurance Service database were analyzed for 6 598 570 adults with no history of depression and reports of at least three health examinations. BWV was estimated using variability independent of the mean indices and divided into quartiles (Q1 lowest, Q4 highest BWV). Cox proportional hazard models were applied to assess the risk of depression according to the quartile of BWV.

RESULTS

The incident rate for depression from Q1 to Q4 of BWV was 20.7, 20.3, 20.8, and 22.2 per 1000 person-years, respectively. BWV, especially high BWV, was associated with an increased risk of depression after adjusting for age, sex, smoking, alcohol consumption, physical activity, income, diabetes mellitus, hypertension, and dyslipidemia. The hazard ratio (HR) of new-onset depression was highest in Q4 relative to Q1 in the total population (HR 1.12, p < 0.0001) and was higher in women than in men (HR 1.72 v. 1.16, p < 0.0001). In stratified analyses, regardless of obesity or weight change status at baseline, the risk of depression was increased when bodyweight fluctuated highly during follow-up.

CONCLUSIONS

High BWV was associated with an increased risk of depression. Further studies need to evaluate the role of high BWV with respect to the onset of depression.

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Background

Weight bias exhibited by health care students may continue into their future practice, compromising the provision of care that people living with overweight or obesity receive. This highlights the need to comprehensively examine the extent to which weight bias is present among health care students and the factors that may be associated with students' weight bias.

Methods

In this cross-sectional study, Australian university students enrolled in health care courses were invited via social media advertisements, snowball and convenience sampling, and by making direct contact with universities to complete an online survey. Students provided demographic information including discipline of study, perceived weight status, and state of residence. Students then completed several measures which assessed their explicit and implicit weight bias, and empathy. Descriptive statistics established the presence of explicit and implicit weight bias, and ANCOVAs, ANOVA, and multiple regression analyses were conducted to examine the potential factors associated with students' exhibited weight bias.

Findings

Between March 08, 2022, and March 15, 2022, 900 eligible health care students attending 39 Australian universities participated in the study. Students reported varying levels of explicit and implicit weight bias, with minimal differences between disciplines on most outcome measures. Students who identified as men (vs. women) exhibited higher of both explicit and implicit bias (Beliefs About Obese Persons (BAOP): p = 0.0002, Antifat Attitudes Questionnaire (AFA)-Dislike: p = 0.019, AFA Willpower p < 0.0001, Empathy for Obese Patients: p = 0.0011, Implicit Association Test: p = 0.022), and students who displayed greater (vs. less) empathic concern exhibited lower levels of explicit bias (BAOP, AFA Dislike and Willpower, and Empathy for Obese Patients: p < 0.0001). Having witnessed the enactment of weight stigma sporadically (vs. regularly) by role models was associated with greater attribution of the causes of obesity to willpower (a few times a month vs. daily: p = 0.020, a few times a year vs. daily: p = 0.022), and less time spent with people living with overweight or obesity outside of study was associated with more dislike (a few times a month vs. daily: p = 0.0048, once a month vs. daily: p = 0.0002) and less fear of fat (once a month vs. daily: p = 0.036, and once a month vs. a few times a week: p = 0.0028).

Interpretation

Results demonstrate the presence of both explicit and implicit weight bias among Australian health care students. Several characteristics and experiences of students were associated with their weight bias. Validity of the exhibited weight bias should be established in practical interactions with people living with overweight or obesity and novel interventions should be developed to ameliorate weight bias.

Funding

Research Training Program (RTP) Scholarship, Australian Government, Department of Education.

Sociodemographic Variables and Body Mass Index Associated with the Risk of Eating Disorders in Spanish University Students

Background: The passage through university is a complex experience that can heighten personal susceptibility to eating disorders. The objective of this research is to determine how gender, age, course, educational faculty, and body mass index (BMI) can influence the risk of eating disorders among university students. Method: A transversal and descriptive study is conducted with a sample of 516 Spanish students (57.2% female, 42.8% male; Mage = 21.7, SDage = 4.1) following 26 university degrees. The Inventory Eating Disorder-Reference criterion (EDI-3-RF) was administered to the students. Contingency tables were used between categorical variables with the chi-squared statistic, at a significance level of p < 0.05. The Student t-test was used for two independent samples and a one-way ANOVA test with the post hoc Bonferroni test for more than two groups. Pearson’s correlation and a simple linear regression analysis were used to analyze the relationship between the variables in its quantitative version. Results: It was found that the female students enrolled in the second year presented a greater obsession with thinness and body dissatisfaction (p = 0.029; d = 0.338); the male students practiced more physical exercise to control their weight (p = 0.003); and that students under the age of twenty (p < 0.010; d = 0.584) and students from both the Health (p = 0.0.13) and Law (p = 0.021) educational faculties showed greater bulimic behavior (d = 0.070). More females are underweight (z = 2.8), and more men are overweight (z = 2.4). Normal-weight students scored significantly higher in thinness obsession (p = 0.033). Overweight students scored significantly higher on thinness obsession (p < 0.001) and body dissatisfaction (p < 0.001). Obese students scored significantly higher on body dissatisfaction (p = 0.04). Conclusions: The data obtained in this study, reinforce the hypothesis that the female gender, at an age within the limits of early adolescence, in the first year of the degree courses, with specific university qualifications, and a high BMI constituted factors that could provoke an eating disorder. Consequently, it is necessary to implement preventive measures adapted to the circumstances of each university student.

The Somatomorphic Matrix-Female: More evidence for the validity of bidimensional figural rating scales for women

Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix-Female (SM-F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual-desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination-Questionnaire, the Body Shape Questionnaire-34, and the Depression Anxiety Stress Scales-21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM-F. Overall, the SM-F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores.

Body Self-Perception, Dietary Self-Efficacy, and Body Mass Index in Young Adults: A Cross-Sectional Survey

Background

Body self-perception and dietary self-efficacy may represent an important factor in the prevention of excess body weight.

Purpose

This study evaluated body self-perception, dietary self-efficacy, and body mass index (BMI) in the Peruvian population.

Methods

A cross-sectional online survey was administered to 190 men and 210 women. Each participant was shown 9 Stunkard anatomical silhouettes corresponding to BMI values. The results obtained were classified as underweight, normal weight, overweight, and obese. The Dieting Self-Efficacy Scale (DIET-SE) was also applied. Chi-square statistic, Kruskal-Wallis, Student t-test, and ANOVA were used to explore differences in means and proportions.

Results

Age was significantly higher in those who underestimated their weight and who were dissatisfied with their body (p = 0.000). BMI was higher in men, most were dissatisfied with their body (p<0.05), and were more likely to underestimate their weight compared to women (p = 0.000). Those participants who were dissatisfied with their body and who underestimated their weight were more likely to have an elevated BMI compared to those who were satisfied and who did not underestimate their weight. All participants had low dietary self-efficacy (LDSE), with a little higher proportion in men compared to women (62.6% vs 61.4%). The majority (45.9%) reported little confidence to resist high-calorie food temptations. More than half of the participants reported body dissatisfaction and LDSE, this was more frequent in men compared to women.

Conclusion

It is necessary to develop and implement preventive measures to improve self-perception of the body, taking into account factors such as gender, age, and eating habits.

Ideal body image for the opposite sex and its association with body mass index

This research studied the preferences reported by women and men about their Ideal Body Image for the Opposite Sex (IBIOS), and its association with body mass index (BMI). It also analysed the preferences of each sex for a woman's ideal body image (W-IBI) and a man's ideal body image (M-IBI). A total of 450 participants aged 18-70 years with different weights were studied. Their IBIOS was assessed using standard figural stimuli. The sample was divided in four groups by sex and age (<45 years; ≥45 years). Sex and age differences in IBIOS, as well as sex differences in the preferences for a woman's ideal body image (W-IBI) and a man's ideal body image (M-IBI), were tested using a non-parametric Mann-Whitney U test. The association between IBIOS and BMI was analysed using Spearman's correlation. In all groups, the most chosen silhouette as IBIOS was number 4. In the under-45 years group, women chose bigger silhouettes for the opposite sex than men did (p<0.05). In this age group women chose as ideal smaller silhouettes for the female body than men did (p<0.01). In addition, women and men in the younger age group and with normal weight chose smaller silhouettes, while those who were overweight or obese selected larger silhouettes (p<0.001). Age was found to be a relevant factor in IBIOS preferences, and in the association between IBIOS and nutritional status as measured by BMI, which was only observed to be significant in the younger age group.

Association between body image perception with demographic characteristics of physically active individuals during COVID-19 lockdown in Saudi Arabia

Objective

This study aimed to determine the relationship between body image perception and demographic factors among physically active (men and women) during the COVID-19 lockdown in Saudi Arabia.

Methods

A descriptive cross-sectional survey was employed among physically active individuals in Saudi Arabia between June and July 2020. Eligible participants completed a 19-item self-administered questionnaire that covered three areas: demographic questions, reasons for physical activity, and role or perceptions of body image during the COVID-19 pandemic quarantine.

Results

A total of 323 physically active individuals participated in this study. The majority of the participants were female (N=217, 72.7%), were married (66.6%), and living in the Middle region of Saudi Arabia (N= 268, 83%). The analysis shows that majority of the participants were dissatisfied with their current body shape. The analysis also showed a significant association between participants' educational attainment and BMI and body dissatisfaction (p= 0.001). The strongest predictor was BMI level, recording an odds ratio (OR) of 5.99 (CI: 2.15 – 10.54, p=0.001) in obese and an OR of 4.55 (CI: 1.31 – 9.35, p=0.001) in overweight, indicating that compared with normal weight, obese and overweight participants were more likely to be dissatisfied by five and four times, respectively.

Conclusion

This study indicates that physically active individuals are greatly influenced by the confinement period. Programs that promote physical activity in their house or during lockdown may help to encourage, lessen their anxiety, and maintain their health. This may also decrease the anxiety of individuals, particularly those active ones.

Attitudes Toward Obesity, Willingness to Lose Weight, and Treatment Preferences Among Overweight and Obese Saudi Adults

Background: Obesity has become a major health concern worldwide and is associated with several diseases and complications. Losing weight is an effective strategy to improve body mass index and prevent the complications of obesity. However, weight loss is dependent on the attitude of individuals toward obesity as well as their willingness to lose weight.

Aim: To explore attitudes toward obesity, willingness to lose weight, and treatment preferences among overweight and obese Saudi adults.

Methods: An analytical cross-sectional study was conducted among overweight and obese Saudis. We targeted adults aged 18 years and older, who visited family medicine clinics at King Abdulaziz Medical City for the National Guard in Riyadh, Saudi Arabia. The study was conducted from December 2020 to June 2021 using a self-administered questionnaire.

Results: Of the 403 participants, 82.5% were dissatisfied with their current body weight. Controlling chronic disease was a major motive for improving body weight (53.2%), and exercise and diet were the most preferred strategies to lose body weight. Age was a determinant in the attitude and willingness of participants to lose weight (p = 0.0001).

Conclusion: Participants in the current study reported high dissatisfaction rates about current weight and willingness to improve body weight. This should encourage healthcare providers to initiate weight status discussions and management with their overweight and obese clients.

Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up

Background

Metabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.

Objective

To assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.

Design

Prospective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.

Methods

The desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models.

Results

BMI decreased at T2 and T3 (T1: 0.3, T2: −0.7, T3: −1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: −0.02 at T1, −0.39 at T2 and −0.78 at T3. The perception of physical health increases in successive tertiles.

Conclusions

In older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals.

Clinical trial registration

http://www.isrctn.com/ISRCTN89898870, identifier 89898870.

The Interaction Effects of Age and Body Size on Body Appreciation and Health- Related Behaviors

Whilst the associations among age, body size, body (dis)satisfaction, and weight management behavior have been well documented, there is little research on how the combination of age and body size is related to body appreciation and health-related behavioral intentions. The purpose of this study is to identify the associations of age, body size, and their interactions with body appreciation and health-related behavioral intentions among Korean women. A cross-sectional research design was adopted with a convenience sampling method. Using an online survey questionnaire, complete data on body appreciation, health-related behavioral intentions, body size, height, weight, and age were collected from 531 Korean adult women aged 20-77 years. Using average scores for each variable, a series of hierarchical regression analyses were performed to identify the relative contributions of predictor variables on each criterion variable. The significant interaction terms were further examined using the PROCESS macro in SPSS. Overall, older Korean women were found to be more likely to have a positive body image and lower levels of behavioral intentions towards striving for a healthy body than younger women. This study confirmed the relative contribution of subjective body size in explaining women's body-related perceptions and behaviors, as compared to their actual BMI.

COVID-19 – Impact of the lockdown on the weight variation among the Lebanese population

The aim of this study is to assess lifestyle changes along with weight fluctuations during the COVID-19 lockdown in Lebanon. This cross-sectional study was conducted using a web-survey disseminated through social media platforms to a large sample of the Lebanese population between May 25th and June 8th, 2020, during the lockdown in Lebanon. Behavioral changes and weight variation during the confinement were assessed. Two thousand one hundred sixty-one participants (64.9% female) aged 18 to 78 years old were included in this study. On average, no net weight variation was reported by the participants. 59.3% of the smokers changed their smoking habits, 40.7% of the drinkers reported a decrease in alcohol consumption, 43.5% of the participants exercised less than one time weekly and 35.8% changed their diet. Increased frequency of physical activity, following a diet during lockdown, decreased weight dissatisfaction (P < 0.0001 for the three variables) were retained as significant factors associated with weight loss. Planning to engage in physical activity post lockdown was associated with weight gain (P = 0.021). In the Lebanese population, no net weight variation was reported during the lockdown. Increasing physical activity and initiating diet were associated with weight loss. Healthcare authorities should be alerted about the importance of these factors during the follow-up of the confined population.

Weight Maintenance after Dietary Weight Loss: Systematic Review and Meta-Analysis on the Effectiveness of Behavioural Intensive Intervention

After a low-calorie diet, only 25% of patients succeed in maintaining the result of weight loss for a long time. This systematic review and meta-analysis aims to explore whether patients undergoing intensive intervention during the maintenance phase have a greater preservation of the weight achieved during the previous slimming phase than controls. A bibliographic search was conducted using PubMed, Scopus, and Cochrane databases for clinical trials and randomised, controlled trials investigating the role of choice in weight-loss-maintenance strategies. Only studies with a follow-up of at least 12 months were considered. A total of eight studies, for a total of 1454 patients, was identified, each comparing a group that followed a more intensive protocol to a control group. Our metanalysis highlighted that an intensive approach even in the maintenance phase could be important to ensure greater success in the phase following the weight-loss period. However, it should be pointed out that the improvement was not so different from the trend of the respective controls, with a non-statistically significant mean difference of the effect size (0.087; 95% CI −0.016 to 0.190 p = 0.098). This finding, along with the observation of a weight regain in half of the selected studies, suggests this is a long work that has to be started within the weight-loss phase and reinforced during the maintenance phase. The problem of weight control in patients with obesity should be understood as a process of education to a healthy lifestyle and a balanced diet to be integrated in the context of a multidisciplinary approach.

Sex Differences in Body Image Perception and Ideals: Analysis of Possible Determinants

The study analyzed the differences between sexes in body image perception and body ideals to assess possible dissatisfaction and misinterpretation in the body image considered attractive for the other sex. Moreover, the influence of anthropometric traits and sports practice on body dissatisfaction and misjudgment was evaluated. Using a cross-sectional design, 960 Italian university students were investigated. Anthropometric characteristics were measured directly. Assessment of body image perception was performed using Thompson and Gray’s silhouettes. We developed two new indexes to assess the possible discrepancy between (1) the perceived silhouette of one’s body and that of the same sex deemed attractive to the other sex (FAD); (2) the silhouette is deemed attractive to the opposite sex and the average attractive silhouette selected by the opposite sex (AMOAD). As expected, females showed greater dissatisfaction with their bodies than males concerning both their own ideal and the silhouette they considered attractive to the opposite sex. Although both sexes misjudged the attractive silhouette for the opposite sex, women were found to be more wrong. According to the outcomes of multivariate regression models, stature, body composition parameters, amount of sport, sex, and FAD were significant predictors of dissatisfaction and misjudgment. In addition to action aimed at correcting misperceptions, the study revealed the importance of sports participation in improving the perception and acceptance of one’s body image.

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.

Depression, dietary intake, and body image during coronavirus disease 2019 quarantine in Peru: An online cross-sectional study

Objective:

The coronavirus disease 2019 affects the psychological well-being of populations. In the same way, it can be a potential threat to body image. The aim of the study was to explore associations between depressive symptoms, dietary intake, and body image during coronavirus disease 2019 quarantine.

Methods:

An online cross-sectional study was conducted in 589 Peruvian adults, 297 men (50.4%) and 292 women (49.6%). The mean age was 30.2 ± 9.4 years (range: 18–59 years). Participants completed three questionnaires, including a food frequency questionnaire, the Body Shape Questionnaire, and the Patient Health Questionnaire-9. Moreover, sociodemographic data were collected. The data were analyzed using the statistical software IBM SPSS version 24, and the chi-square test was used. A significance level of 5% was considered.

Results:

A total of 37.7% and 43.6% of the women reported depressive symptoms and dissatisfaction with body image, respectively. Depressive symptoms were associated with dietary intake and dissatisfaction with body image (p < 0.05). Dissatisfaction with body image was associated with dietary intake (p < 0.01).

Conclusions:

Depressive symptomatology plays an important role in the dietary intake and body image of the study population. It is suggested to address these factors through the implementation of health campaign programs and personalized therapeutic interventions.

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.

The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia

BACKGROUND

Growing evidence highlights the linkage between body image, eating, and exercise behaviors among adolescents.

OBJECTIVE

This study aims to determine the association between body image perception, nutritional status, and dietary and physical activity behaviors among adolescents in Indonesia.

METHODS

A cross-sectional household survey was conducted among a representative sample (n = 2160) of adolescent girls and boys aged 12 to 18 years in Klaten and Lombok Barat districts. The association between adolescents' body image, their diets, and physical activity patterns was determined using complex samples Cox's regression analysis. Separate multivariate models were developed for adolescent girls and boys.

RESULTS

Physical appearance was considered important to nearly all adolescents. Approximately 11% of girls and 14% of boys were overweight or obese, the majority of whom (∼70%) correctly perceived themselves as overweight or obese. More of overweight or obese adolescents felt unhappy about their perceived weight than their thin counterparts. With respect to the overweight/obese girls, the adolescents' perceptions of being overweight or obese was associated with a 63% reduction in the prevalence of overweight/obese girls consuming fatty snacks, such as deep-fried crackers (adjusted prevalence ratio (PR): 0.37, 95% confidence interval (CI): 0.19-0.71) and a 40% reduction in the prevalence of overweight/obese girls engaging in moderate-intensity physical activity (adjusted PR: 0.60, 95% CI: 0.38-0.94), after adjusting for potential confounders. No association between body image and eating and physical activity behaviors was observed among adolescent boys.

CONCLUSIONS

Body image may be one of the most important determinants of dietary and physical activity behaviors, and thus future efforts to foster healthy eating and physical activity behaviors among Indonesian adolescents need to address body image concerns.

Agreement between self-assessment of body image and measured body mass index in the Brazilian adult population

Silhouettes are used in the self-assessment of one's body size, shape and satisfaction. This technique can be helpful in intervention studies and in household studies in which body size measurements are not feasible. Despite its popularity, few studies have validated the Stunkard Figure Rating Scale (SFRS) to assess body image (BI) or nutritional status (NS). The present study assessed the agreement between self-assessment of BI by SFRS and measured BMI in adults from a national household survey in Brazil (n = 11247; 57.2% women, aged 20-99y). The subjects were asked to choose a silhouette from the SFRS that most resembled their current status prior to measures of body mass and stature. BMI-derived NS was then matched to the SFRS. The prevalence of overweight and obesity (OB) was 34.4 and 19.0%, respectively. Weighted kappa between SFRS and BMI was 0.45 and 0.43 and Spearman's correlation coefficient was 0.64 and 0.59 for women and men, respectively. Sex-specific receiver operating curves indicated that the silhouettes correctly (area under the curve > 0.80) identified OB and underweight (UW). In conclusion, SFRS provides only reasonable results when estimating the BMI distribution but it works well to identify OB and UW in the Brazilian adult population.

Psychosocial and Diet-Related Lifestyle Clusters in Overweight and Obesity

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of 100 adult individuals (60% females) with excessive weight (69% overweight; 31% obesity) was recruited. They completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis was performed. Three distinct intraindividual psychosocial and diet-related profiles were identified: a group of healthy individuals with excess weight (46%); a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile (18%); and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles, but were troubled by their weight (36%). Furthermore, individuals in the affected cluster had higher obesity (mean BMI ± SD = 32.1 ± 3.7) than those in the clusters of healthy (28.0 ± 3.0) and dysfunctional individuals (28.1 ± 3.3) (p < 0.05). The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to the individual's overall well-being.

Diet quality in middle-aged and older women with and without body weight dissatisfaction: results from a population-based national nutrition survey in Switzerland

Body weight dissatisfaction is associated with unhealthy dietary behaviours in young adults, but data are scarce regarding how this relationship evolves with age. The objectives of the present study were to assess the prevalence of body weight dissatisfaction and the association between body weight dissatisfaction, nutrient intake and diet quality in middle-aged and older women. We used data of a population-based sample of 468 middle-aged (50–64 y/o) and older (65–75 y/o) women, extracted from the cross-sectional 2014–15 Swiss National Nutrition Survey. Body weight dissatisfaction was assessed by questionnaire. Dietitians assessed dietary intakes using two non-consecutive computer-assisted multi-pass 24-h dietary recalls and performed anthropometric measurements. Nutrient intakes were calculated and compared with national dietary guidelines, and diet quality scored with the 2010 Alternate Healthy Eating Index (2010-AHEI). 41⋅1 % of women reported body weight dissatisfaction, and 49⋅8 % wanted to lose weight. Body weight dissatisfaction was associated with weight loss desire and a higher body mass index (BMI; P < 0⋅001). Women with body weight dissatisfaction consumed significantly less carbohydrates and dietary fibres, even when BMI was controlled for (P < 0⋅05). They also fell short of national dietary guidelines for magnesium and iron. Body weight dissatisfied women obtained lower 2010-AHEI scores than satisfied women (β −4⋅36, 95 % CI −6⋅78, −1⋅93). However, this association disappeared when the BMI was introduced in the equation. This highlights the importance of targeting both body dissatisfaction and unhealthy eating in obesity prevention and treatment at all ages.

Health-Risk Behaviors and Dietary Patterns Among Jordanian College Students: A Pilot Study

Background/Aims: Health promotion and the incorporation of health-protective behaviors in people's lifestyles have a great role in enhancing individuals' overall health and well-being. College students are at increased risk of developing unhealthy dietary and lifestyle behaviors. A cross-sectional pilot study was conducted to assess the health-risk behaviors among undergraduate college students at Jordan University of Science and Technology. Methods: The final sample included 136 students, with a mean age of 21.1 ± 2.37 years, mostly females (69%). A self-reported questionnaire was used for data collection about dietary and lifestyle behaviors among college students. The questionnaire consisted of four parts: sociodemographic characteristics, body weight classifications, lifestyle behaviors, and dietary patterns and intake, and eating behaviors. Results: Most of the students did not meet the daily recommendations for fruit (76%) and vegetable (82%) intake. Males were significantly consuming fast food more frequently (p = 0.019), and smoked cigarettes (p < 0.001) or hookah (p = 0.015) more frequently than did females. Further, the majority met the recommendations for physical activity (81%), but exceeded recommendations for sedentary behavior. Females were more likely to have normal weight or be underweight (OR = 4.865), to have a fear of weight gain (OR = 3.387), and to have the recommended sleeping hours (OR = 7.685) than were males. Conclusion: The results indicate the health-risk behaviors and the gender-related differences among college students.

Body satisfaction of female staff members working in primary schools in Mangaung, Bloemfontein

Background

The role of psychosocial determinants of overweight and obesity is receiving attention in South African literature. South Africans tend to exhibit an inaccurate perception of their body weight.

Aims

The purpose of this study was to determine levels of body satisfaction in female staff members working in primary schools in Mangaung, Bloemfontein.

Setting

Mangaung is a peri-urban area in Bloemfontein in the Free State province of South Africa.

Methods

Female staff members over the age of 18 years were invited to participate in the study. Anthropometric measurements of weight and height were measured using standardised techniques to calculate body mass index (BMI). Waist circumference (WC) was measured as an indicator of risk for non-communicable diseases (NCDs). Weight satisfaction was measured using a structured, self-administered body satisfaction questionnaire.

Results

The majority of the staff members (71.3%) were classified as obese (BMI > 30 kg/m²); similarly a majority of them were at a high risk of NCDs according to WC. A little over a third (34.8%) of the women perceived themselves to have a normal weight. The majority of the women who had no concern with their body image were obese (59.1%) and only 8.7% of the women in this study were markedly concerned with their body image. Of the 60.9% of women who reported having attempted to lose weight, 38.6% reported using exercise and 30.0% used water as a weight loss method.

Conclusion

Women's awareness of a healthy weight should be promoted if efforts to achieve weight loss are to be effective.

Nutrition Knowledge among College of Basic Education Students in Kuwait: A Cross-Sectional Study

Lack of nutrition knowledge may contribute to poor dietary practices. Schools are an ideal environment to address this issue and to start the process of nutrition education. Therefore, teachers should be equipped with adequate nutrition knowledge. This study was designed to evaluate the level of general nutrition knowledge and demographic variations in knowledge in a sample of students attending the College of Basic Education in Kuwait. A cross-sectional study was conducted using a modified and validated revised version of the General Nutrition Knowledge Questionnaire (GNKQ-R) for UK adults. Univariate and multivariate analyses were performed to determine the association between various factors and nutrition knowledge score. A total of five hundred and ninety-seven students completed the questionnaire. Most respondents (84.1%) had a poor level of nutrition knowledge using original Bloom's cutoff points. Sex, BMI, cooking habits, and who is responsible for preparing food in the household were the main determinants of nutrition knowledge score at p < 0.05. The mean score of the students was 40.06 ± 9.89 out of 84 points. Females scored significantly higher than males, at 41.10 ± 9.29 and 38.72 ± 10.48, respectively (p = 0.007). Students with a BMI of ≥30 achieved significantly greater scores (mean 42.30 ± 9.41) than those who were underweight, normal, or overweight (p < 0.001). Students who stated that they always cook their own food achieved significantly greater scores (mean 43.69 ± 9.58) than those who did not (p = 0.025). Students who stated that they depend on the housekeeper for food preparation achieved significantly lower scores (mean 38.86 ± 10.13) than those who prepare their own food or depend on their relatives to prepare food (p = 0.042). Poor nutrition knowledge was found among prospective teachers studying in the College of Basic Education. This must be rectified for the effective implementation of nutrition education programs in schools.

Associations of Body Dissatisfaction With Lifestyle Behaviors and Socio-Demographic Factors Among Saudi Females Attending Fitness Centers

OBJECTIVE

To examine body image perception and the associations of body dissatisfaction (BD) with socio-demographic and lifestyle factors among Saudi women attending fitness centers in Riyadh.

METHODS

Saudi females aged 16 years and older were recruited from 12 randomly selected fitness centers in Riyadh, using stratified clustered sampling technique (n = 460). Height and weight were measured to calculate actual body mass index (BMI). A previously validated instrument was used to collect socio-demographic and lifestyle variables including physical activity (PA), sedentary behaviors, sleep and dietary habits. Stunkard Figure Rating Scale silhouettes were used to assess perceived and desired body shape.

RESULTS

The participants had a mean (SD) age of 29.2 (8.2). The majority were not married (57%), with no children (66%) and had college degrees (78%). While 63% were overweight or obese, nearly 40% of women underestimated their perceived body shape. The majority of respondents (87%) were dissatisfied with their body shape including 68% of normal weight women. Females who had BD were significantly older, had higher BMI, reported more weight loss attempt and had expended less time in vigorous (p = 0.033) and total (p = 0.042) PA than those who were satisfied with their body shape. However, when adjusting for socio-demographic variables, logistic regression analysis revealed significant associations of BD with higher BMI, shorter membership duration of fitness club, and reduced dairy products and energy drinks consumption.

CONCLUSION

Except for BMI and decreased dairy products and energy drinks consumption, many lifestyle behaviors did not associate with BD among Saudi females attending fitness centers. The findings can inform healthcare providers when intervention strategy is implicated for females with BD. Future studies should compare the associations of BD with lifestyle behaviors between males and females attending fitness centers and seeking weight loss.

Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis

The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.

Are there associations between religious affiliation and drive for muscularity? A cross-sectional survey of young Muslim women, Christian women and atheist women from Germany

BACKGROUND

Over the last 20 years, society's perception of the ideal female body size in Western cultures has changed from thin to athletic, and many women practice sports to achieve well-toned bodies. However, to date, no study has investigated whether Muslim women who live in a Western country and veil their bodies strive for lean or muscular bodies too. The current cross-sectional survey therefore addressed this question.

METHODS

Veiled Muslim women (n = 70), unveiled Muslim women (n = 50), Christian women (n = 79), and atheist women (n = 68) living in Germany answered several questionnaires assessing engagement in sports, body appreciation, and drive for leanness and muscularity. Univariate and multivariate analyses were conducted to compare the four groups.

RESULTS

The results of univariate and multivariate analyses showed that Muslim women engaged less in sports and veiled Muslim women reported higher body appreciation than did Christian and atheist women. Although the groups did not differ significantly in drive for muscularity, Muslim women showed lower levels of drive for leanness than did Christian and atheist women.

CONCLUSION

Given that Muslim women engaged less in sports and strived less for a lean body compared to Christian and atheist women, a well-toned body might be less important for them. Nevertheless, as being active is beneficial for general health, barriers that prevent Muslim women from engaging in sports should be diminished.

Dietary Quality Changes According to the Preceding Maximum Weight: A Longitudinal Analysis in the PREDIMED-Plus Randomized Trial

One-year dietary quality change according to the preceding maximum weight in a lifestyle intervention program (PREDIMED-Plus trial, 55–75-year-old overweight or obese adults; n = 5695) was assessed. A validated food frequency questionnaire was used to assess dietary intake. A total of 3 groups were made according to the difference between baseline measured weight and lifetime maximum reported weight: (a) participants entering the study at their maximum weight, (b) moderate weight loss maintainers (WLM), and (c) large WLM. Data were analyzed by General Linear Model. All participants improved average lifestyle. Participants entering the study at their maximum weight were the most susceptible to improve significantly their dietary quality, assessed by adherence to Mediterranean diet, DII and both healthful and unhealthful provegetarian patterns. People at maximum weight are the most benefitted in the short term by a weight management program. Long term weight loss efforts may also reduce the effect of a weight management program.

Prevalence of body image concern among schoolgirls aged 12-17 years in Iran

BACKGROUND/AIM

Adolescent girls' concerns about their body images can negatively affect their social and academic performance. This study aimed to determine the prevalence of body image concern (BIC) in adolescent schoolgirls in Iran and its risk factors.

PATIENTS AND METHODS

This epidemiological study with cross-sectional design was conducted in 2018 on 396 middle schoolgirls aged 12-17 years (mean age = 14 years) living in Khorramabad, Iran. For screening BIC, the Persian version of BIC inventory (BICI) was used. Their birth order, school grade, school type, father's education, and household income were also recorded. Collected data were analyzed in SPSS v. 18 software using descriptive statistics and Chi-square test.

RESULTS

Of 396 girls, 106 (26.8%) had BIC, 89 (84%) reported moderate BIC, and 17 (16%) severe BIC. Their mean BICI score was 40.84 ± 12.93 (out of 42). Most of them reported to spend a significant amount of time checking their appearance in the mirror (n = 81, 20.5%) and examining flaws in their appearance (n = 74, 18.7%). A few of them were embarrassed to leave the house because of the appearance and avoided from looking at the appearance in the mirror (n = 6, 1.5%). There was no significant difference in BIC severity in terms of birth order, school grade, school type, father's education, and household income factors (P > 0.05).

CONCLUSION

The prevalence of BIC among schoolgirls in Iran is high. Appropriate therapeutic interventions should be carried out to improve their quality of life, mental health, and self-esteem to reduce the BIC prevalence.

Factors Underlying Food Choice Motives in a Brazilian Sample: The Association with Socioeconomic Factors and Risk Perceptions about Chronic Diseases

This study aimed to evaluate the food choice motives in a sample in Brazil and to identify how socioeconomic characteristics and risk perceptions about chronic diseases and weight gain affect these motives. The Food Choice Questionnaire (FCQ) is an instrument to analyze the motivations for food choice. The FCQ was completed by 525 adult individuals in Brazil. The participants were asked about their perceived risk of gaining weight, developing diabetes, and hypertension. Confirmatory factor analysis led to the rejection of the original FCQ structure, and, after exploratory factor analysis, 30 items of the FCQ were maintained in eight factors: Nutritional Composition, Preparation Convenience, Purchase Convenience, Mood, Sensory Appeal, Health, Price, and Familiarity. Sensory Appeal and Familiarity were, respectively, the most and the least important factors involved in food choices in this sample. A high education level, high income, age, and female sex positively affected FCQ factors (except for the Price factor). On the basis of FCQ scores, we defined five clusters: Health Driven, Practicality Concerned, Shape Concerned, Food Concerned, and Cooking Enthusiasts. In general, individuals were optimistic regarding the risk of developing diabetes, hypertension, and gaining weight, especially those from the Shape Concerned cluster. The differences in food choice motives presented here reinforce the existence of different niches of food consumption. Different types of products can attract specific target groups at the time of choice.

Body image before and after coronary artery bypass graft surgery: comparison and its contributing factors

BACKGROUND

Cardiovascular diseases are the leading cause of death in the world. Coronary artery bypass graft (CABG) surgery is among the treatment options for coronary artery disease. However, it is associated with significant physical and psychological problems. This study sought to compare body image before and after the surgery and to determine its contributing factors.

METHODS

This comparative study was conducted in 2017 on a sample of 140 patients consecutively recruited from Shahid Beheshti hospital, Kashan, Iran. Body image was assessed before and 4 weeks after the surgery (T1 and T2) using Multidimensional Body-Self Relations Questionnaire. The independent-sample and paired t tests, one-way analysis of variance, Pearson correlation test, and multiple regression were conducted for data analysis.

RESULTS

Participants' mean score of body image was 139.60 ± 13.21 at T1 and 160.25 ± 7.75 at T2 and the variation was statistically significant (p = < 0.001). At T1, only the three factors of age (p = 0.005), education at high school diploma and higher levels (p < 0.001), and being housekeeper (P = 0.048) could significantly explain BI (R² = 0.231). However, at T2, none of the factors were significant predictors for BI (P > 0.05).

CONCLUSIONS

Candidates for CABG have poor body image. After the surgery, their body image improves significantly. Healthcare providers need to employ programs to improve body image among these patients.

Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m² (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1: <10%, n = 1495; Q2: 10–15%, n = 1804; Q3: <15–20%, n = 1470; Q4: ≥20%, n = 1589). Diet was assessed using a validated food frequency questionnaire and a 17-item Mediterranean diet questionnaire. Physical activity was assessed by the validated Minnesota-REGICOR and the validated Spanish version of the Nurses’ Health Study questionnaire. Results. Participants reporting higher percentages of desired weight loss (Q3 and Q4) were younger, had higher real and perceived BMI and were more likely to have abdominal obesity. Desired weight loss correlated inversely to physical activity (Q1: 2106 MET min/week; Q4: 1585 MET min/week. p < 0.001) and adherence to Mediterranean diet (Q1: 8.7; Q4: 8.3. p < 0.001). Conclusions. In older Mediterranean individuals with weight excess, desired weight loss was inversely associated with Mediterranean lifestyle adherence. Deeply rooted aspects of the MedDiet remained similar across groups. Longitudinal research is advised to be able to establish causality.

Body Satisfaction, Weight Stigma, Positivity, and Happiness among Spanish Adults with Overweight and Obesity

Although previous evidence suggests that happiness is lower among individuals with obesity, research on the correlates of subjective well-being (SWB) is warranted to increase our knowledge. We aim to explore excess weight (i.e., measured and self-reported body mass index (BMI)), body image and satisfaction, self-stigma, positivity, and happiness among Spanish adults with overweight or obesity. We further aim to investigate the predictors of SWB in this sample. A convenience sample of 100 individuals with excess weight completed self-reports on the study variables and were weighed and their height measured. On average, the participants reported body perceptions revealing minor excessive weight, moderate body satisfaction, low-to-moderate weight-related stigma, and elevated positivity and happiness. BMI and gender/sex independently affected these variables, but there were no significant interaction effects. Furthermore, individuals with overweight or obesity with higher body satisfaction and elevated positivity were more likely to report being happy, independent of their age, gender/sex, weight, and weight-related stigma. Mediation effects were found for body satisfaction and positivity in the relationship between weight and happiness. Moreover, positive orientation suppressed the pervasive influence of stigma on SWB. Our findings confirm the key role of body image dimensions and weight-related stigma for happiness and add support to the relevance of positivity for overall well-being of individuals with excess weight. These results may inform obesity management actions focused on inclusive aesthetic models, combating social stigmatization and enhancing positivity for a flourishing and fulfilling life.

Male Figural Rating Scales: A Critical Review of the Literature

Figural rating scales are tools used to measure male body dissatisfaction. The present review aimed to examine the design and psychometric properties of male figural rating scales and make recommendations based on findings. Relevant databases were systematically searched for studies that had developed and validated male figural rating scales. Twenty studies were included in this review. Figural rating scales differed in terms of the number of images represented and type of stimuli used (hand-drawn silhouettes, hand-drawn figures, computer-rendered figures, and photograph figures). Reliability and validity evidence varied greatly in strength across all scales. Four of the 20 scales included a correlational analysis between figural rating scale scores and eating disorder symptoms. Results showed the moderate to high positive correlations between eating disorder symptoms and figural rating scale perceived and index scores, suggesting that figural rating scales are sensitive to detecting eating disorder symptoms. Ideally, male figural rating scales should show strong validity and reliability, include variations in both body fat and muscularity, utilise realistic body stimuli, and be interval scales. No existing male figural rating scale meets these criteria. However, this review identifies five figural rating scales that meet the majority of the recommended criteria.

Distorted body weight perception and its gender differences in middle-aged adults: population based study

Background

Increasing interest in appearance and the growing preference for a beautiful body can lead to physical and psychological problems due to an inappropriate body image perception. As such, there is a need to identify what factors may contribute to an inappropriate body image. The purpose of this study was to examine the presence of distorted body weight perception among middle-aged Koreans and identify gender differences and other factors that contribute to a distorted body image regarding body weight.

Methods

Data on 8363 middle-aged adults (aged 45–64 years) from the Korea National Health and Nutrition Examination Survey were analyzed using complex samples analysis considering weight, stratification variables, and cluster variables. The difference between perceived body image regarding body weight and actual body mass index was used to assess distorted body weight perception. Socioeconomic status, health behaviors, daily energy consumption, and psychological status (depression and stress) were assessed for their relationship to distorted body weight perception.

Results

Results showed that a distorted body image regarding body weight was more prevalent among middle-aged men (45.3%) than women (25.7%). Age, income, perceived health status, and health behaviors were significantly associated with distorted body weight perception in middle-aged men, whereas psychological factors were associated with distorted body weight perception in middle-aged women.

Conclusions

Further research on distorted body weight perception is needed to gain understanding of the gender differences between middle-aged men and women in Korea. Furthermore, to the results of the study can be used as a basis for developing various education, health mediation, and public health promotion interventions and programs to address body weight perception in middle-aged adults.

Association between depression, anxiety and weight change in young adults

BACKGROUND

To investigate whether there are bi-directional associations between anxiety and mood disorders and body mass index (BMI) in a cohort of young adults.

METHODS

We analysed data from the 2004-2006 (baseline) and 2009-2011 (follow-up) waves of the Childhood Determinants of Adult Health study. Lifetime DSM-IV anxiety and mood disorders were retrospectively diagnosed with the Composite International Diagnostic Interview. Potential mediators were individually added to the base models to assess their potential role as a mediator of the associations.

RESULTS

In males, presence of mood disorder history at baseline was positively associated with BMI gain (β = 0.77, 95% CI: 0.14-1.40), but baseline BMI was not associated with subsequent risk of mood disorder. Further adjustment for covariates, including dietary pattern, physical activity, and smoking reduced the coefficient (β) to 0.70 (95% CI: 0.01-1.39), suggesting that the increase in BMI was partly mediated by these factors. In females, presence of mood disorder history at baseline was not associated with subsequent weight gain, however, BMI at baseline was associated with higher risk of episode of mood disorder (RR per kg/m²: 1.04, 95% CI: 1.01-1.08), which was strengthened (RR per kg/m² = 1.07, 95% CI: 1.00-1.15) after additional adjustment in the full model. There was no significant association between anxiety and change in BMI and vice-versa.

CONCLUSION

The results do not suggest bidirectional associations between anxiety and mood disorders, and change in BMI. Interventions promoting healthy lifestyle could contribute to reducing increase in BMI associated with mood disorder in males, and excess risk of mood disorder associated with BMI in females.

Association of Health Status and Health Behaviors with Weight Satisfaction vs. Body Image Concern: Analysis of 5888 Undergraduates in Egypt, Palestine, and Finland

Little is known about the relationships between weight satisfaction, body image concern, healthy nutrition, health awareness, and physical activity among college students across culturally different countries. We assessed country and sex-specific associations between health status (self-rated health, depression, BMI), healthy behavior (healthy nutrition, physical activity, health awareness), weight satisfaction, and body image concern via a cross-sectional survey (5888 undergraduates) in Egypt, Palestine, and Finland. This health and wellbeing survey employed identical self-administered paper questionnaires administered at several Universities in two Eastern Mediterranean countries (Egypt, Palestine—Gaza Strip), and an online-survey comprising the same questions in Finland. Regression analyses were employed. Health status variables exhibited the strongest associations; high BMI and more depressive symptoms were more often among students satisfied with their weight (except in Palestine), but they were positively associated with body image concern irrespective of country or gender. Self-rated health was not associated with body image concern or weight satisfaction. Healthy behaviors were not associated with body image concern or weight satisfaction. Depressive symptoms and BMI were the most prominent predictors for body image concern. There were country-specific consistent results when using the body image concern score. Further research is necessary to compare body image across different cultures and countries.

Study of the Relationship between Body Mass Index, Body Image, and Lifestyle Behaviors: A Community Survey in Fiji

Introduction:

Public health promotion efforts aimed at overweight and obesity prevention often proceed from the premise that the first step should be losing weight. Appropriate perceptions of body image may be important for improving weight loss awareness. Therefore, we aimed to examine the relationship between body mass index and body image perception in Fiji, where increasing obesity is currently the most important health-related issue.

Methods:

Using the resident register based on the governmental census, one household member, aged between 18 and 69 years, was randomly selected from each household in two areas. There were 1,014 participants in the study. The questionnaire items were related to body image, dietary behaviors, physical activity, smoking habits, and alcohol consumption habits. Moreover, information regarding height, weight, blood pressure, and hemoglobin A1c were measured, and questions about social status (age, ethnicity, education, marital status, and employment), and subjective living status were asked. A multivariate logistic regression analysis was performed to analyze the relationship between body mass index (BMI) and body image perception.

Results:

Data from 391 men and 537 women were analyzed. Men within higher BMI quartiles smoked less (p = 0.0004) and drank less alcohol (p = 0.042). Women in higher BMI quartiles engaged in less physical activity (p = 0.022). Among the assessed data, both men and women in the higher BMI quartiles underestimated their body image compared with their actual physique (p < 0.0001). The higher BMI was associated with underestimated body image (men: odds ratio [OR] = 3.22, 95% confidence interval [CI], 1.94–5.35; p < 0.0001; women: OR = 18.11, 95% CI, 10.10–32.47; p < 0.0001).

Conclusions:

Higher BMI is strongly associated with underestimated body image among Fiji residents. Health-related counseling should be included within programs that aim to increase recognition of one’s actual physical size.

Body image in relation to nutritional status in adults from the Basque Country, Spain

The aim of this research was to analyse variation in body image perception and satisfaction by age, sex and nutritional status in an adult sample from the Basque Country, Spain. A case-control study was performed for 227 women and 178 men aged 18-70 years. Stunkard's silhouettes were used to evaluate Current Body Image (CBI) and Ideal Body Image (IBI), as well as dissatisfaction and inconsistency scores. Nutritional status was assessed following the WHO criteria for BMI in an adult population. The sample was divided into four groups based on sex and age (early adulthood <45 years, and middle/older adulthood ≥45 years). The Mann-Whitney U test was employed to evaluate sex and age differences, and the Gamma coefficient to assess the association between body image variables and nutritional status. Significant age differences in CBI (p<0.05) and sex differences in IBI (p<0.001) were detected. Both variables showed a positive association with BMI (p<0.01), which indicates that BMI is a biological characteristic related to body image satisfaction and influences participants' perception of themselves. Dissatisfaction scores showed that both sex and age differences (p<0.05) were negatively associated with BMI (p<0.001). Only participants ≥45 years presented sex differences in inconsistency scores (p<0.05); this variable was associated with BMI in women (p<0.01). Preferences in body image showed sexual dimorphism, with women preferring thinner bodies than men - a pattern observed in many Western populations - linked in part to sociocultural pressures. Women were more dissatisfied with their bodies than men; a higher dissatisfaction was observed in older relative to younger participants. The results confirm the association between nutritional status and body size perception and satisfaction, but also the relationship between nutritional status and the reliability with which women can classify themselves; in men, this relationship was not as clear.

Factors associated with body dissatisfaction among the Lebanese population

OBJECTIVE

To evaluate the factors associated with body dissatisfaction among the Lebanese population, including sociodemographic characteristics, self-esteem, stress, anxiety, depression, emotional regulation, emotional eating and the adult attachment style.

METHODS

This cross-sectional study, conducted between January and May 2018, enrolled 811 adult participants from all districts of Lebanon. The body dissatisfaction subscale of the eating disorder inventory version 2 (EDI-2) was used to measure body disturbance.

RESULTS

The mean age of the participants was 27.59 ± 11.76 years, with 66.5% females. The final model of the regression analysis showed that a higher binge eating score (Beta = 0.202), being married (Beta = 1.233), having a family history of eating disorders (Beta = 1.933), higher BMI (Beta = 0.076), dieting to lose weight (past 30 days) (Beta = 2.345), receiving comments from the family (Beta = 2.234) and pressure from TV/magazines to lose weight (Beta = 1.320), vomiting or taking laxatives to lose weight (past 30 days) (Beta = 1.861), higher depression (Beta = 0.103) and higher perceived stress (Beta = 0.107) were associated with a higher body dissatisfaction score. However, higher self-esteem (Beta = - 0.246), increased physical activity (Beta = - 0.022) and being divorced (Beta = - 4.226) were significantly associated with a lower body dissatisfaction score.

CONCLUSION

A significant association was found in this current study between the main variables: depression, self-esteem, social anxiety, eating disorders, family and television pressure and body image dissatisfaction.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Perceived Body Appearance and Eating Habits: The Voice of Young and Adult Students Attending Higher Education

This study examined the relationship between social-environmental influences and body image perception. Specifically, the study explored the perceived body appearance among young and older students attending higher education, and their eating experiences, as related to four main social-environmental circles: family, friends, work colleagues, and media. The present study interviewed 30 students (14 men and 16 women) ages 20–40. The findings show that most of the participants were concerned about their appearance, reported on various eating habits rooted on family tradition. Findings revealed differences among gender and age groups regarding, especially regarding sport and dissatisfaction with their own perceived appearance. Although more women reported on healthy eating habits and doing sport, they reported higher dissatisfaction with their body appearance. It was found that in both groups, family habits and their parents’ remarks about bodies had an ongoing effect and significant influence on their body self-perceptions. Further health promotion should be directed in particular to individuals with a perceived negative body image, in order to enhance positive body self-perception, implementing heathy eating habits and engaging higher commitment to sport.

A study on the interplay between emerging adulthood and eating disorder symptomatology in young adults

PURPOSE

The primary aim of this study was to investigate the interplay between Arnett's five features of emerging adulthood and ED symptomatology. The secondary aim of the study was to investigate possible gender differences concerning the relation between emerging adulthood and ED symptomatology.

METHODS

337 university students (252 females and 85 males) participated in this study. Each participant was asked to anonymously complete the following questionnaires: Inventory of the Dimensions of Emerging Adulthood (IDEA), Eating Attitudes Test (EAT-26), and Social Physique Anxiety Scale (SPAS).

RESULTS

The female group scored higher in the EAT-26 diet, SPAS, IDEA self-focus and IDEA total score measurements. Additionally, in the female group, identity exploration was correlated with EAT-26 total and bulimia, experimentation/possibilities with EAT-26 total and diet, and negativity/instability with EAT-26 total, diet and bulimia as well as SPAS score. In the male groups, the only significant correlation was between SPAS and instability/negativity. Finally, identity exploration could predict a higher probability of developing ED (EAT ≥ 20) for both the female and male groups.

CONCLUSIONS

Emerging adulthood and ED were found to have a close relationship, especially for females. Identity exploration was the emerging adulthood factor that showed the highest relation to ED symptomatology in both the male and female groups. More research is necessary to investigate the specifics of this relationship.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.