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Sarginson C, Nicoletta J, Charlebois T, Enouy S, Tabri N. The correlates of appearance focused self-concept: personality traits, self-concept, sociocultural, and early life experience factors. J Eat Disord 2024; 12:108. [PMID: 39095922 PMCID: PMC11295510 DOI: 10.1186/s40337-024-01065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Theory and research indicate that an appearance focused self-concept (i.e., placing overriding importance on physical appearance for self-definition and self-worth) plays a role in the etiology and maintenance of disordered eating and eating disorders. Although the consequences of an appearance focused self-concept are palpable, less is known about its correlates. Accordingly, we examined a range of factors that may characterize appearance focused people, including personality traits (perfectionism, impulsivity, sensation-seeking, hopelessness, and anxiety sensitivity), self-concept (global self-esteem and self-concept clarity), sociocultural (thin-ideal, muscular-ideal, general attractiveness internalizations, and perceived pressure to be thin), and early life experiences (adverse childhood experiences, attachment styles) factors. METHODS Female undergraduate university students (N = 568; Mage = 19.58, SDage = 4.24) completed a questionnaire battery that included the Beliefs About Appearance Scale, Depressive Experiences Questionnaire-Self-Criticism-6 Scale, Frost-Multidimensional Perfectionism Scale, the Revised Almost Perfect Scale, Substance Use Risk Profile Scale, Self-Concept Clarity Scale, Rosenberg Self-Esteem Scale, Sociocultural Attitudes Towards Appearance Questionnaire-4 Scale, Adverse Childhood Experiences Questionnaire, Experiences in Close Relationships Scale Short Form, and the Dietary Restraint subscale of the Eating Disorders Examination Questionnaire. RESULTS Multiple regression analyses were conducted for each set of factors separately and together. For personality traits, perfectionism, impulsivity, and anxiety sensitivity were uniquely associated with appearance focused self-concept. For self-concept, global self-esteem and self-concept clarity were uniquely associated with appearance focused self-concept. For sociocultural, general attractiveness internalization, thin-ideal internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. For early life experiences, attachment anxiety and avoidance were uniquely associated with appearance focused self-concept. In the combined analysis, the various factors explained 54% of the variance in appearance focused self-concept. Impulsivity, global self-esteem, general attractiveness internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. CONCLUSIONS Results for global self-esteem were consistent with prior research. Findings for evaluative concerns perfectionism were inconsistent with prior research. We discuss future research directions to examine the link between evaluative concerns perfectionism and appearance focused self-concept. We also discuss how sociocultural factors (general attractiveness internalization and perceived pressure to be thin) and impulsivity may help cultivate an appearance focused self-concept, advancing knowledge on the characteristics of appearance-focused people.
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Affiliation(s)
- Catherine Sarginson
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Juliana Nicoletta
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Thalia Charlebois
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Sarah Enouy
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
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Alsheweir A, Goyder E, Alzahrani M, Caton SJ. Determinants of Disordered Eating Behaviours (DEBs) among Adolescent Female School Students in Riyadh, Saudi Arabia: A Qualitative Study. Nutrients 2024; 16:2119. [PMID: 38999867 PMCID: PMC11243036 DOI: 10.3390/nu16132119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m2 to 27.51 kg/m2. EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.
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Affiliation(s)
- Azzah Alsheweir
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); or (M.A.); (S.J.C.)
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 145111, Saudi Arabia
| | - Elizabeth Goyder
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); or (M.A.); (S.J.C.)
| | - Maha Alzahrani
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); or (M.A.); (S.J.C.)
- Health Sciences College at Al-Lith, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Samantha J. Caton
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); or (M.A.); (S.J.C.)
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Sølvberg N, Torstveit MK, Solstad BE, Mountjoy M, Rosenvinge JH, Pettersen G, Sundgot-Borgen J. Risk factors for sexual harassment and abuse victimization among adolescent athletes and non-athletes: A one-year follow-up study. CHILD ABUSE & NEGLECT 2024; 147:106592. [PMID: 38113571 DOI: 10.1016/j.chiabu.2023.106592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/25/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The association between SHA and negative mental health increases the need to understand risk factors for SHA victimization, which is important for future development of prevention programs. OBJECTIVE To examine which combinations of demographic- and mental health factors were associated with subsequent SHA victimization, and the prevalence of elite athletes, recreational athletes, and reference students who experienced sexual revictimization. PARTICIPANTS AND SETTING Norwegian elite athletes and recreational athletes attending sport high schools, and reference students attending non-sport high schools (mean age: 17.1 years) were eligible for participation. METHODS The participants answered an online questionnaire at two measurement points one year apart, T1 and T2 (n = 1139, 51.1 % girls). After testing for measurement invariance, data were analyzed with Classification and Regression Tree analysis (CRT) using demographic- and mental health variables from T1 as independent variables, and SHA at T2 as outcome. RESULTS The combination of being a girl with high level of symptoms of eating disorders and other psychological symptoms was associated with subsequent reporting of SHA. Among the students with lifetime experience of SHA at T1 (n = 533, 58.3 %), 49.5 % reported revictimization at T2 (60.9 % girls, 32.2 % boys, p ≤ .001). The prevalence of SHA revictimization was lower among elite athletes (44.3 %) compared with recreational athletes (49.1 %) and reference students (59.4 %, p = .019). CONCLUSION The combination of female gender and mental health symptoms are risk factors for subsequent SHA victimization. These findings, and the high prevalence of SHA revictimization is important knowledge for developing preventive programs targeting elite athletes, recreational athletes, and reference students.
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Affiliation(s)
- Nina Sølvberg
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Postboks 4014 Ullevål stadion, 0806 Oslo, Norway.
| | - Monica Klungland Torstveit
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Postboks 422, 4604 Kristiansand, Norway.
| | - Bård Erlend Solstad
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Postboks 422, 4604 Kristiansand, Norway.
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada; International Olympic Committee Working Group on the Prevention of Harassment and Abuse in Sport, Lausanne, Switzerland; International Research Network on Violence and Integrity in Sport, Antwerp, Belgium.
| | - Jan H Rosenvinge
- Department of Psychology, UiT -The Arctic University of Norway, Postboks 6050 Langnes, 9037 Tromsø, Norway.
| | - Gunn Pettersen
- Department of Health and Care Sciences, UiT - The Arctic University of Norway, Postboks 6050 Langnes, 9037 Tromsø, Norway.
| | - Jorunn Sundgot-Borgen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Postboks 4014 Ullevål stadion, 0806 Oslo, Norway.
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Aucoin P, Gardam O, St John E, Kokenberg-Gallant L, Corbeil S, Smith J, Guimond FA. COVID-19-related anxiety and trauma symptoms predict decreases in body image satisfaction in children. Child Psychiatry Hum Dev 2023; 54:1666-1677. [PMID: 35543799 PMCID: PMC9091148 DOI: 10.1007/s10578-022-01364-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
The present study investigated short-term longitudinal effects of COVID-19-related trauma and separation, social, and generalized anxiety symptoms on children's body image satisfaction. Participants were 247 Canadian children (121 boys, 123 girls) aged between 7 and 12 years (M = 9.04). Two cohorts of parents were recruited to complete a questionnaire at two time points on their children's body image satisfaction and COVID-19-related trauma and anxiety symptoms. The first cohort (n = 136 children) was recruited in Summer 2020 and the second cohort (n = 111 children) was recruited in Winter 2021. For each cohort, follow-up surveys were completed approximately five months later, therefore covering an entire year with both cohorts. Multilevel regression analyses showed that children's trauma and anxiety at Time 1 predicted significant decreases in body image satisfaction at Time 2. Older children were especially at risk of decreased body image satisfaction as a result of their COVID-19-related trauma, social anxiety and generalized anxiety symptoms. Younger girls were susceptible to decreased body image satisfaction as a result of their separation anxiety symptoms. Given that children's body image dissatisfaction is a precursor to the development of eating disorders, these findings shed light on potential targets for early intervention with children who are at-risk of developing such difficulties.
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Affiliation(s)
- Philip Aucoin
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada
| | - Olivia Gardam
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada
| | - Elizabeth St John
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada
| | - Laila Kokenberg-Gallant
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada
| | - Sophie Corbeil
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada
| | - Jonathan Smith
- Department of Education, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Fanny-Alexandra Guimond
- School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, K1N 6N5, Ottawa, Ontario, Canada.
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Franco L, Nakano EY, Raposo A, Alturki HA, Alarifi SN, Chaves C, Teixeira-Lemos E, Romão B. Eating Attitudes of Patients with Celiac Disease in Brazil: A Nationwide Assessment with the EAT-26 Instrument. Nutrients 2023; 15:4796. [PMID: 38004190 PMCID: PMC10674570 DOI: 10.3390/nu15224796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.
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Affiliation(s)
- Luiza Franco
- Instituto de Educação Superior de Brasilia, IESB University Center, Brasília 70200-730, Brazil;
| | | | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Hmidan A. Alturki
- General Directorate for Funds & Grants, King Abdulaziz City for Science & Technology, Riyadh 11442, Saudi Arabia;
| | - Sehad N. Alarifi
- Department of Food and Nutrition Science, Al-Quwayiyah College of Sciences and Humanities, Shaqra University, Shaqraa 11971, Saudi Arabia;
| | - Cláudia Chaves
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Edite Teixeira-Lemos
- CERNAS Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Bernardo Romão
- Instituto de Educação Superior de Brasilia, IESB University Center, Brasília 70200-730, Brazil;
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Lessard LM, Puhl RM, Foster GD, Cardel MI. Parental Communication About Body Weight and Adolescent Health: The Role of Positive and Negative Weight-Related Comments. J Pediatr Psychol 2023; 48:700-706. [PMID: 37377019 DOI: 10.1093/jpepsy/jsad040] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE Research has consistently documented adverse effects of parent weight-related comments on adolescent health. However, little empirical attention has focused on isolating the impact of weight-related comments from mothers versus fathers, and the valence of their comments. The present study examined the extent to which positive and negative weight-related comments from mothers and fathers are related to adolescent health and wellbeing, and whether these associations differ according to adolescent sociodemographic characteristics. METHODS Data were collected from a diverse sample of 2032 U.S.-based adolescents aged 10-17 years (59% female; 40% White, 25% Black or African American, 23% Latinx). Online questionnaires assessed perceived frequency of negative and positive weight-related comments from mothers and fathers, as well as four indicators of adolescent health and wellbeing: depression, unhealthy weight control behaviors, weight bias internalization (WBI), and body appreciation. RESULTS More frequent negative weight-related comments from parents were associated with poorer adolescent health and wellbeing, while positive comments contributed to lower levels of WBI and body appreciation; these associations were documented regardless of whether mothers or fathers were the source of such comments, and considerable consistency was demonstrated across adolescent sociodemographic characteristics. CONCLUSION Findings highlight differences in adolescent health based on how parents discuss their body weight (i.e., negatively or positively), and similarity in associations regardless of whether mothers or fathers are the source of weight communication. These findings reiterate the importance of efforts to educate parents on ways to engage in supportive communication about weight-related health with their children.
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Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy and Health, University of Connecticut, USA
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Health, University of Connecticut, USA
- Department of Human Development and Family Sciences, University of Connecticut, USA
| | - Gary D Foster
- WW International, Inc, USA
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, USA
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Napp AK, Kaman A, Erhart M, Westenhöfer J, Ravens-Sieberer U. Eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic. Front Psychiatry 2023; 14:1157402. [PMID: 37304440 PMCID: PMC10254422 DOI: 10.3389/fpsyt.2023.1157402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Background Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors. Materials and methods Eating disorder symptoms and associated factors were examined in a sample of n = 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11-17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from n = 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample. Results Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic. Conclusion The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.
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Affiliation(s)
- Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Public Health, Alice Salomon University of Applied Sciences, Berlin, Germany
- Department of Psychology, Apollon University of Applied Sciences, Bremen, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Coimbra M, Paixão C, Ferreira C. Exploring eating and exercise-related indicators during COVID-19 quarantine in Portugal: concerns and routine changes in women with different BMI. Eat Weight Disord 2022; 27:225-232. [PMID: 33751463 PMCID: PMC7982514 DOI: 10.1007/s40519-021-01163-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/01/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The present study aimed to understand how quarantine associated with COVID-19 was experienced by women from different BMI groups (underweight, normal weight, pre-obesity, and obesity), by exploring the changes introduced in eating and exercise routines and the differences between BMI groups regarding shape concern, weight concern, and binge eating behaviours reported during this time. METHODS This study comprised 580 women aged between 18 and 65 years old, who completed self-report measures, during the mandatory confinement in Portugal due to COVID-19. The total sample was divided into four groups, according to their BMI. RESULTS Results revealed that overall, there were no significant differences between the groups regarding the eating and exercise routine changes introduced during quarantine. However, significant differences between the four groups were found in the reported body and eating-related difficulties (shape concern, weight concern, and binge eating behaviours), with the pre-obesity and obesity groups presenting significant higher levels. CONCLUSIONS Our study suggests that, even though the changes introduced to the eating and exercise routine are independent of BMI, the pre-obesity and obesity group represent a major vulnerability group for the development of eating disorders. We hope this study allows professionals to understand the need to develop different guidelines and strategies for the pre-obesity and obesity female population during the deconfinement period. LEVEL OF EVIDENCE Level V-Descriptive study.
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Affiliation(s)
- Maria Coimbra
- CINEICC-Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal.
| | - Carolina Paixão
- CINEICC-Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
| | - Cláudia Ferreira
- CINEICC-Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
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Lessard LM, Wang EY, Watson RJ. School Safety Among Sexual and Gender Minority Adolescents: Implications for Eating and Weight Control Behaviors. THE JOURNAL OF SCHOOL HEALTH 2021; 91:788-795. [PMID: 34426965 PMCID: PMC8461655 DOI: 10.1111/josh.13069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Unhealthy weight control and disordered eating behaviors are prevalent among adolescents who identify as a gender and/or sexual minority (SGM). The current study examined how perceptions of school safety contribute to reduced negative weight control and eating behaviors across adolescents with diverse sexual and gender identities. METHODS Data on perceptions of school safety, as well as negative weight control and disordered eating behaviors (ie, binge eating, eating to cope), were drawn from a large national sample of SGM secondary school students (ie, grades 7-12; N = 17,112; LGBTQ National Teen Survey). RESULTS Differences in negative weight control and disordered eating behaviors emerged as a function of gender identity and sexual orientation. School safety was significantly associated with fewer negative weight control behaviors (B = -0.30, p < .001), reduced binge eating (B = -0.19, p < .001), and less eating to cope (B = -0.21, p < .001). Despite slight variation in the strength of these associations, the protective effects of school safety were significant across sexual and gender identities. CONCLUSIONS Findings suggest that efforts to support feelings of school safety among SGM students are likely to have positive implications for eating and weight-related behaviors, and emphasize the need for interventions to promote climates of safety and inclusion within the school setting.
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Affiliation(s)
- Leah M. Lessard
- Rudd Center for Food Policy & Obesity, University of Connecticut
| | | | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut
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Lessard LM, Puhl RM. Adolescents' Exposure to and Experiences of Weight Stigma During the COVID-19 Pandemic. J Pediatr Psychol 2021; 46:950-959. [PMID: 34313727 PMCID: PMC8344898 DOI: 10.1093/jpepsy/jsab071] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents' feelings about their bodies and perceived changes in weight stigma from peers, parents, and social media during the pandemic. METHODS Four hundred fifty-two adolescents (11-17 years old) completed an online survey during the Fall of 2020. Measures assessed perceived changes in exposure to weight stigmatizing social media content (stress eating jokes, weight gain memes) and experiences of weight stigma (weight-based bullying, teasing, hurtful comments) by parents and peers, as well as body dissatisfaction, during the COVID-19 pandemic. Weight status and gender were examined as individual difference variables. RESULTS The majority (53%) of adolescents reported increased exposure to at least one form of weight stigmatizing social media content during the pandemic. Additionally, pandemic-related increases in body dissatisfaction were prevalent (41%), especially among girls with higher body mass index (≥85th percentile; 67%). On average, the extent to which adolescents experienced weight-based mistreatment from parents and peers remained consistent with their pre-pandemic experiences. CONCLUSIONS Overall, these findings highlight changes in the social messages that adolescents receive about their bodies, as well as their subjective body satisfaction, during the pandemic. Results underscore the need for healthcare providers and mental health professionals to be aware of the potential rise in weight stigma during the pandemic, and encourage families and schools to engage in supportive, rather than stigmatizing, weight-related communication with youth.
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Affiliation(s)
- Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut
| | - Rebecca M Puhl
- Rudd Center for Food Policy and Obesity, University of Connecticut
- Department of Human Development & Family Sciences, University of Connecticut
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11
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Bristow C, Meurer C, Simmonds J, Snell T. Anti-obesity public health messages and risk factors for disordered eating: a systematic review. Health Promot Int 2021; 35:1551-1569. [PMID: 32150266 DOI: 10.1093/heapro/daaa018] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In response to the increasing prevalence of overweight and obesity, public health efforts to curb these conditions have been delivered in abundance. There is concern however that the messages used to target these conditions may be increasing risk factors for disordered eating. Therefore, we sought to systematically review the literature on the effects of anti-obesity public health messages on risk factors for disordered eating. Seven electronic databases were searched for articles meeting the inclusion criteria, resulting in the inclusion of 12 studies of various methodologies that measured one or more risk factors for disordered eating following exposure to public health messages. Few studies specifically and accurately measured disordered eating behaviours. Most studies found that messages were stigmatizing towards persons who are overweight/obese, and exacerbate thin ideals and drive for thinness. Interestingly, the same was not found for measures of body dissatisfaction. Messages promoting smaller meals were also thought to be potential triggers for disordered eating. Whilst the studies included in this review offered both quantitative and qualitative insights into how public health messages may have adverse effects on eating behaviours, there was a consistent lack of valid reporting measures and clear classification of outcomes overall. Hence, future research is recommended using valid reporting tools such as validated questionnaires, as well as prolonged exposure to the intervention condition to determine longer-term impact.
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Affiliation(s)
- Claire Bristow
- Faculty of Education, Monash University, Wellington Road Clayton, Melbourne, VIC 3800, Australia
| | - Capella Meurer
- Faculty of Education, Monash University, Wellington Road Clayton, Melbourne, VIC 3800, Australia
| | - Janette Simmonds
- Faculty of Education, Monash University, Wellington Road Clayton, Melbourne, VIC 3800, Australia
| | - Tristan Snell
- Faculty of Education, Monash University, Wellington Road Clayton, Melbourne, VIC 3800, Australia
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12
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Larsen A, Lilja M, Sturidsson K, Blatny M, Hrdlicka M, Stickley A, Ruchkin V. Bulimia symptoms in Czech youth: prevalence and association with internalizing problems. Eat Weight Disord 2020; 25:1543-1552. [PMID: 31621001 PMCID: PMC7581576 DOI: 10.1007/s40519-019-00790-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status. METHOD The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations. RESULTS The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems. DISCUSSION Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies. LEVEL OF EVIDENCE V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).
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Affiliation(s)
- Anna Larsen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Marie Lilja
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Knut Sturidsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden
| | - Marek Blatny
- Department of Psychology, Faculty of Arts MU, Brno, Czech Republic
| | - Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Andrew Stickley
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
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13
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Fardouly J, Magson NR, Rapee RM, Johnco CJ, Oar EL. The use of social media by Australian preadolescents and its links with mental health. J Clin Psychol 2020; 76:1304-1326. [PMID: 32003901 DOI: 10.1002/jclp.22936] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Preadolescent social media use is normative and could influence mental health. This study investigated: (a) Differences between preadolescent users and non-users of various social media platforms on mental health, (b) unique links between time spent on those platforms, appearance-based activities on social media, and mental health, and (c) the moderating role of biological sex on those relationships. METHOD Preadolescent youth (N = 528; 50.9% male) completed online surveys. RESULTS Users of YouTube, Instagram, and Snapchat reported more body image concerns and eating pathology than non-users, but did not differ on depressive symptoms or social anxiety. Appearance investment uniquely predicted depressive symptoms. Appearance comparisons uniquely predicted all aspects of mental health, with some associations stronger for females than males. CONCLUSIONS Preadolescents could be encouraged to reduce their opportunities to make appearance comparisons and to invest less in their appearance on social media. Preadolescents may benefit from social media intervention programs.
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Affiliation(s)
- Jasmine Fardouly
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Natasha R Magson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Carly J Johnco
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Ella L Oar
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
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14
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Wilksch SM, O'Shea A, Ho P, Byrne S, Wade TD. The relationship between social media use and disordered eating in young adolescents. Int J Eat Disord 2020; 53:96-106. [PMID: 31797420 DOI: 10.1002/eat.23198] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The relationship between social media (SM) use and disordered eating (DE) has not been adequately explored in young adolescents. METHODS Data from 996 Grade 7 and 8 adolescents (n = 534 girls; M age = 13.08) was investigated. DE cognitions (Eating Disorder Examination-Questionnaire [EDE-Q]), DE behaviors (Project Eating Among Teens), and SM use measures related to Facebook, Instagram, Snapchat, and Tumblr were completed. RESULTS DE behaviors were reported by 51.7% of girls and 45.0% of boys, with strict exercise and meal skipping the most common. A total of 75.4% of girls and 69.9% of boys had at least one SM account where Instagram was the most common, used by 68.1% of girls and 61.7% of boys. Global EDE-Q scores were significantly higher for girls and boys with each type of SM account, except for Facebook and Instagram for girls. A greater number of SM accounts was associated with higher DE scores for both cognitions and behaviors. Girls with Snapchat and Tumblr accounts and boys with Snapchat, Facebook and Instagram were significantly more likely to have both DE behaviors and over-evaluation of shape and weight in the clinical range. Greater daily time spent using Instagram was associated with significantly higher Global EDE-Q scores and DE behaviors for girls, while this pattern was also found for Snapchat usage and DE behaviors for girls. CONCLUSIONS A clear pattern of association was found between SM usage and DE cognitions and behaviors with this exploratory study confirming that these relationships occur at younger-age than previously investigated.
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Affiliation(s)
- Simon M Wilksch
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Anne O'Shea
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Pheobe Ho
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Sue Byrne
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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15
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Parental Control of the Time Preadolescents Spend on Social Media: Links with Preadolescents’ Social Media Appearance Comparisons and Mental Health. J Youth Adolesc 2018; 47:1456-1468. [DOI: 10.1007/s10964-018-0870-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 12/23/2022]
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16
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Lydecker JA, Grilo CM. Does your child's weight influence how you judge yourself as a parent? A cross-sectional study to define and examine parental overvaluation of weight/shape. Prev Med 2017; 105:265-270. [PMID: 28987340 PMCID: PMC5659758 DOI: 10.1016/j.ypmed.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 12/23/2022]
Abstract
Parents are integral stakeholders in children's health and development, and yet there is a dearth of research on parental attitudes and parents' personal weight and eating psychopathology, which have the potential to influence pediatric obesity and eating disorder treatments meaningfully. Overvaluation of weight/shape is a core concept in eating-disorder assessment and treatment defined as self-evaluation excessively based on weight/shape, which research has demonstrated to be clinically important psychopathology. A novel and related concept, parental overvaluation of weight/shape, could be defined as parents' self-evaluation unduly based on their child's weight/shape, yet this concept has not been studied and its clinical importance is unknown. The aim of this study was to examine the distinctiveness of parental overvaluation of weight/shape from personal overvaluation of weight/shape, and to examine associations of parental overvaluation with parents' psychopathology and children's weight and eating behaviors. The current study examined differences among parents with (n=134) and without (n=872) parental overvaluation using a cross-sectional design. Parental overvaluation was more common among parents with binge-eating disorder and bulimia than obesity and healthy-weight. Parental overvaluation was modestly associated with personal overvaluation. Parents with and without parental overvaluation differed on personal eating-disorder psychopathology and children's weight and eating behaviors. Importantly, differences remained after adjusting for personal overvaluation and child BMI. This study highlights a novel construct-parental overvaluation-associated with, but distinct from, parental eating disorders and personal overvaluation. Parental overvaluation may warrant clinical attention among parents seeking pediatric obesity or eating-disorder treatment, or treatment for personal eating disorders.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, United States.
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, United States
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17
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Handford CM, Rapee RM, Fardouly J. The influence of maternal modeling on body image concerns and eating disturbances in preadolescent girls. Behav Res Ther 2017; 100:17-23. [PMID: 29128584 DOI: 10.1016/j.brat.2017.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/03/2017] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
Research suggests that mothers may influence the development of body image concerns and eating disturbances in their daughters by modeling negative body image beliefs and unhealthy eating behaviors. However, the causal nature of that mode of influence is yet to be established. This study implemented an experimental design to examine the impact of mothers' modeling of negative comments about their own appearance and diet on their daughters' body image concerns and eating behaviors. Participants were 8-12 year old girls and their mothers (N = 50). While viewing thin-ideal magazine advertisements with their daughter, mothers were instructed to make either negative comments about their own weight, shape, and diet or to make no appearance or diet related comments. Daughters' levels of body esteem, body satisfaction, and eating attitudes were assessed pre- and post-manipulation, and their actual eating habits were measured post-manipulation. Girls whose mothers had made self-critical comments about their own appearance and diet reported lower body esteem, lower body satisfaction, more problematic eating attitudes, and ate significantly fewer sweets than girls whose mothers had not made self-critical comments. These results have implications for disordered eating prevention programs, suggesting that greater emphasis be placed on discouraging negative modeling behaviors among mothers.
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Affiliation(s)
- Charlotte M Handford
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia.
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia.
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia.
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18
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Mitchison D, Hay P, Griffiths S, Murray SB, Bentley C, Gratwick‐Sarll K, Harrison C, Mond J. Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents. Int J Eat Disord 2017; 50:118-126. [PMID: 27539911 PMCID: PMC6585604 DOI: 10.1002/eat.22592] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. METHOD Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. RESULTS Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. DISCUSSION Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126).
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Affiliation(s)
- Deborah Mitchison
- Department of PsychologyMacquarie UniversitySydneyNew South WalesAustralia,School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Phillipa Hay
- Centre for Health Research, Sydney, Western Sydney UniversityNew South WalesAustralia
| | - Scott Griffiths
- Department of PsychologyUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
| | - Stuart B. Murray
- Department of PsychiatryUniversity of CaliforniaSan FranciscoCalifornia
| | - Caroline Bentley
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Kassandra Gratwick‐Sarll
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Carmel Harrison
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Jonathan Mond
- School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
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19
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Wilksch SM, Paxton SJ, Byrne SM, Austin SB, O'Shea A, Wade TD. Outcomes of three universal eating disorder risk reduction programs by participants with higher and lower baseline shape and weight concern. Int J Eat Disord 2017; 50:66-75. [PMID: 27768806 DOI: 10.1002/eat.22642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/13/2016] [Accepted: 09/30/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate if baseline shape and weight concern (SWC) moderated outcomes in Prevention Across the Spectrum, a randomized-controlled trial (RCT) of 3 school-based programs aimed at reducing eating disorder and obesity risk factors. METHOD N = 1,316 Grade 7 and 8 girls and boys (M age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; Helping, Encouraging, Listening and Protecting Peers Initiative (HELPP) or control (usual school class). Moderation was explored by testing interaction effects for group (Media Smart; Life Smart; HELPP; Control) × moderator (SWC: higher-SWC; lower-SWC) × time (post-program; 6-month follow-up; 12-month follow-up), with baseline risk factor scores entered as covariates. RESULTS Moderation effects were found for shape concern, weight concern, eating concern, regular eating (i.e., meal skipping), physical activity, body dissatisfaction, dieting, and perfectionism. Post-hoc testing found eating concern at post-program was the only variable where higher-SWC Media Smart participants experienced a reduction in risk relative to controls. Both higher-SWC Life Smart and HELPP participants reported an increase in eating concern relative to controls and both groups were skipping more meals than controls at 12-month follow-up. Amongst lower-SWC participants, Media Smart was the only group to experience a benefit relative to controls (physical activity). CONCLUSIONS This study highlights the need for moderator analyses to become more routinely conducted in universal trials, to ensure that participants across baseline risk levels are benefiting and not harmed from program participation. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:66-75).
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Affiliation(s)
- Simon M Wilksch
- School of Psychology, Flinders University, South Australia, Australia
| | - Susan J Paxton
- School of Psychological Science, La Trobe University, Victoria, Australia
| | - Susan M Byrne
- School of Psychology, University of Western Australia, Western Australia, Australia
| | - S Bryn Austin
- Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Social and Behavioral Sciences Harvard Chan School of Public Health, Boston, Massachusetts
| | - Anne O'Shea
- School of Psychology, Flinders University, South Australia, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, South Australia, Australia
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20
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Singlehurst H, Corr S, Griffiths S, Beaulieu K. The Impact of Binge Eating Disorder on Occupation: A Pilot Study. Br J Occup Ther 2016. [DOI: 10.1177/030802260707001108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Johnson ER, Weiler RM, Barnett TE, Pealer LN. Extreme Weight-Control Behaviors and Suicide Risk Among High School Students. THE JOURNAL OF SCHOOL HEALTH 2016; 86:281-287. [PMID: 26930240 DOI: 10.1111/josh.12380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Suicide is the third leading cause of death for people ages 15-19. Research has established an association across numerous risk factors and suicide, including depression, substance abuse, bullying victimization, and feelings of alienation. However, the connection between disordered eating as manifested in extreme weight-control behaviors (EWCB), and suicidal thoughts, ideation, and attempts among adolescents is less understood. Given the prevalence of adolescent suicide, this investigation examined associations between EWCB and suicide risk among high school students. METHODS Data were collected from a convenience sample of 4178 students in grades 9-12 attending 5 public high schools using the Youth Risk Behavior Survey (YRBS) questionnaire. Logistic regressions were used to estimate associations between EWCB and suicide controlling for grade level and race, reported separately by sex. RESULTS Students who reported seriously considering suicide had higher odds of exhibiting all 3 EWCBs [adjusted odds ratio (AOR)(male) = 3.0 (confidence interval (CI): 1.4, 6.5); AOR(female) = 4.5 (CI: 2.5, 8.3)]. Moreover, students who reported they made plans about suicide were also more likely to exhibit all EWCBs [AOR(male) = 3.7 (CI: 1.7, 7.9); AOR(female) = 4.2 (CI: 2.3, 7.7)]. CONCLUSIONS EWCBs were significantly associated with suicide risk, furthering the evidence suggesting a link between disordered eating and suicide. Findings demonstrated the need for school health services that address disordered eating in the effort to reduce adolescent suicide.
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Affiliation(s)
- Emily R Johnson
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, PO Box 118210, 1864 Stadium Road, Suite 106K, Gainesville, FL 32611.
| | - Robert M Weiler
- Department of Global and Community Health, College of Health and Human Services, George Mason University, 4400 University Drive, MS 5B7, Fairfax, VA 22042.
| | - Tracey E Barnett
- Department of Behavioral Science and Community Health, College of Public Health and Health Professions, University of Florida, PO Box 100175, 1225 Center Drive, Gainesville, FL 32610.
| | - Lisa N Pealer
- Hassett Willis, 1100 New York Avenue, NW, Washington, DC 20005.
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22
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Pemde HK. Body Image in Adolescents - A Clinical Issue. Indian J Pediatr 2015; 82:1086-8. [PMID: 26381543 DOI: 10.1007/s12098-015-1901-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 08/31/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Harish K Pemde
- Center for Adolescent Health and Department of Pediatrics, Lady Hardinge Medical College and Associated Kalwati Saran Children's Hospital, New Delhi, 110001, India.
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23
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Tabri N, Murray HB, Thomas JJ, Franko DL, Herzog DB, Eddy KT. Overvaluation of body shape/weight and engagement in non-compensatory weight-control behaviors in eating disorders: is there a reciprocal relationship? Psychol Med 2015; 45:2951-2958. [PMID: 25994276 DOI: 10.1017/s0033291715000896] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Overvaluation of body shape/weight is thought to be the core psychopathology underlying eating disorders, which propels engagement in non-compensatory weight-control behaviors. In turn, these behaviors lead to binge eating and/or maintenance of low weight thereby reinforcing overvaluation. The present study investigated the reciprocal relationship between overvaluation and engagement in non-compensatory weight-control behaviors (defined in two ways: restrictive eating and compulsive exercise) among women diagnosed with anorexia nervosa or bulimia nervosa (N = 237). METHOD Participants completed clinical interviews in which weekly eating disorder symptoms and behaviors were assessed over 2 years. RESULTS Overvaluation on a given week was associated with greater engagement in non-compensatory weight-control behaviors during the following week. Further, engagement in non-compensatory weight-control behaviors on a given week was associated with greater overvaluation during the following week. These findings held true regardless of participants' shape/weight concerns (feelings of fatness and fat phobia), and eating disorder diagnosis. CONCLUSIONS Our data provide empirical support for key aspects of the transdiagnostic cognitive-behavioral model of eating disorders and suggest that targeting non-compensatory weight-control behaviors in treatment may help alleviate overvaluation and shape/weight concerns.
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Affiliation(s)
- N Tabri
- Department of Psychiatry,Massachusetts General Hospital Eating Disorders Clinical and Research Program,Boston,MA,USA
| | - H B Murray
- Department of Psychiatry,Massachusetts General Hospital Eating Disorders Clinical and Research Program,Boston,MA,USA
| | - J J Thomas
- Department of Psychiatry,Massachusetts General Hospital Eating Disorders Clinical and Research Program,Boston,MA,USA
| | - D L Franko
- Department of Psychiatry,Massachusetts General Hospital Eating Disorders Clinical and Research Program,Boston,MA,USA
| | - D B Herzog
- Department of Psychiatry,Harvard Medical School,Boston,MA,USA
| | - K T Eddy
- Department of Psychiatry,Massachusetts General Hospital Eating Disorders Clinical and Research Program,Boston,MA,USA
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24
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Wilksch SM, Paxton SJ, Byrne SM, Austin SB, McLean SA, Thompson KM, Dorairaj K, Wade TD. Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity. Psychol Med 2015; 45:1811-1823. [PMID: 25524249 DOI: 10.1017/s003329171400289x] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND A randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors. METHOD A total of 1316 grade 7 and 8 girls and boys (mean age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups. RESULTS Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys. A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls. CONCLUSIONS Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems.
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Affiliation(s)
- S M Wilksch
- School of Psychology, Flinders University,SA,Australia
| | - S J Paxton
- School of Psychological Science, La Trobe University,VIC,Australia
| | - S M Byrne
- School of Psychology, University of Western Australia,WA,Australia
| | - S B Austin
- Adolescent and Young Adult Medicine, Boston Children's Hospital,Boston,MA,USA
| | - S A McLean
- School of Psychological Science, La Trobe University,VIC,Australia
| | - K M Thompson
- School of Psychology, University of Western Australia,WA,Australia
| | - K Dorairaj
- School of Psychology, University of Western Australia,WA,Australia
| | - T D Wade
- School of Psychology, Flinders University,SA,Australia
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25
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Kranciukaite-butylkiniene D, Rastenyte D, Goriniene G. Associations between quality of life and lifestyle peculiarities in stroke survivors: the results of the EROS study. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:26-32. [DOI: 10.17116/jnevro201511512226-32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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26
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Perfecting Weight Restriction: The Moderating Influence of Body Dissatisfaction on the Relationship Between Perfectionism and Weight Control Practices. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/bec.2014.11] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study explored the moderating effect of body dissatisfaction (BD) on the relationship between perfectionism and weight restricting and control behaviours (WRCBs). A sample of 167 female undergraduates completed self-report measures of perfectionism, BD and WRCBs. BD was not found to moderate the relationship between either perfectionism and dieting, or perfectionism and exercise. Instead, BD uniquely predicted both dieting and exercise, as did the perfectionism dimensions of self-oriented perfectionism, concern over mistakes, parental standards, and organisation. BD moderated the relationship between perfectionism and purging for analyses involving self-oriented perfectionism, concern over mistakes, and doubts about actions, such that there was a significant positive association between perfectionism and purging when BD was high but not low. Perfectionism and BD are important in different ways to WRCBs. The importance of measuring multiple dimensions of perfectionism and differentiating between the various types of WRCBs is highlighted.
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Incollingo Belsky AC, Epel ES, Tomiyama AJ. Clues to maintaining calorie restriction? Psychosocial profiles of successful long-term restrictors. Appetite 2014; 79:106-12. [PMID: 24747211 PMCID: PMC4198019 DOI: 10.1016/j.appet.2014.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/22/2014] [Accepted: 04/09/2014] [Indexed: 11/24/2022]
Abstract
To combat the obesity epidemic, interventions and treatments often recommend low-calorie dieting. Calorie restriction (CR) as a weight intervention, however, is often unsuccessful, as most people cannot sustain the behavior. Yet one small group has maintained extreme CR over years - members of the CR Society and followers of The CR Way. This study examined stable psychosocial characteristics of these individuals to identify traits that may promote success at long-term CR. In 65 participants, we measured diet, eating behaviors, and personality traits comparing calorie restrictors with two age-, gender-, ethnicity-, and education-matched comparison groups (normal weight and overweight/obese). We first tested whether the CR group restricted calories without indications of eating disorder pathology, and second, what crystallized psychosocial characteristics set them apart from their nonrestricting comparisons. Results indicated the CR group averaged 10 years of CR but scored lower than comparison groups on measures of disordered eating (p < .001) and psychopathology (p < .001). Particularly against overweight/obese participants, CR participants scored lower on neuroticism (p < .04) and hostility (p < .01), and were stronger in future time orientation (p < .05). Overall, CR profiles reflected high self-control and well being, except for having few close relationships. This study suggests a potential predisposition for successful long-term CR without disordered eating. Since modifying trait factors may be unrealistic, there may be psychosocial boundaries to the capacity for sustaining CR. Paralleling a movement toward personalized medicine, this study points toward a personalized behavioral medicine model in behavioral nutrition and treatment of overweight/obesity.
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Affiliation(s)
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, CA, USA.
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Esch L, Zullig KJ. Middle School Students’ Weight Perceptions, Dieting Behaviors, and Life Satisfaction. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2008.10599061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Laura Esch
- a Department of Student Health Services , Miami University , 102 Student Health Services, Oxford , OH , 45056
| | - Keith J. Zullig
- b Department of Community Medicine , West Virginia University, School of Medicine , Morgantown , WV , 26506
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Wick K, Leipold-Haas S, Dye L, Strauß B. Bindungsmuster, Figurzufriedenheit und auffälliges Essverhalten bei 13- bis 18-jährigen weiblichen und männlichen Jugendlichen. KINDHEIT UND ENTWICKLUNG 2012. [DOI: 10.1026/0942-5403/a000088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Als potentielle Risikofaktoren für die Entwicklung von Essstörungen sind unsichere Bindung sowie Unzufriedenheit mit dem eigenen Körper bekannt. Diese Studie untersucht den Zusammenhang von Bindungsmustern, Figurzufriedenheit und Essverhalten bei einer nicht-klinischen Stichprobe von Jugendlichen beiderlei Geschlechts. Folgende Variablen wurden bei 13- bis 18-jährigen Mädchen und Jungen (n = 851) an neun Schulen in Jena (Thüringen) erhoben: Bindungsmuster (dt. Version der Adult Attachment Scale, AAS), Figurzufriedenheit (Stunkard Skalen) und Essverhalten (dt. Version des Eating Attitudes Test, EAT-26D). In einem Gesamtmodell stellt die Einschätzung zu dick zu sein das größte Risiko für die Entwicklung einer Essstörung dar (OR = 8,9), gefolgt vom weiblichen Geschlecht (OR = 3,9), Übergewicht (OR = 3,4) sowie unsicherer Bindung (OR = 2,6). Die Ergebnisse bestätigen den positiven Zusammenhang zwischen Bindungsmuster, Figurzufriedenheit und Essverhalten auch für eine jugendliche, nicht-klinische Stichprobe von Jungen und Mädchen und ergeben damit wichtige Implikationen für primär- und sekundärpräventive Interventionen.
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Affiliation(s)
- Katharina Wick
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
| | - Steffi Leipold-Haas
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
| | - Louise Dye
- Human Appetite Research Unit, Institute of Psychological Sciences, University of Leeds
| | - Bernhard Strauß
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena
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Lam CB, McHale SM. Developmental patterns and family predictors of adolescent weight concerns: a replication and extension. Int J Eat Disord 2012; 45:524-30. [PMID: 22253079 PMCID: PMC3323688 DOI: 10.1002/eat.20974] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2011] [Indexed: 11/10/2022]
Abstract
OBJECTIVE We examined how weight concerns changed across adolescence and whether within-person changes in parent-adolescent relationships were longitudinally linked to within-person changes in adolescent weight concerns. METHOD Participants were mothers, fathers, and the two eldest adolescent siblings from 201 families. Adolescents rated their weight concerns on five occasions across 7 years. Parents rated their acceptance of and conflict with their adolescents, and adolescents rated their depressive symptoms, a year prior to each weight concern measurement. RESULTS Although girls' weight concerns increased from early to late adolescence and then leveled off, boys' weight concerns remained relatively unchanged. Moreover, controlling for adolescents' depressive symptoms, when mothers reported less acceptance of and fathers reported more conflict with their adolescents than usual, adolescents reported more weight concerns than usual in the following year. DISCUSSION Findings highlight the vulnerability of adolescents and the role of both mothers and fathers in the etiology of weight-related problems.
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Affiliation(s)
- Chun Bun Lam
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Susan M. McHale
- Department of Human Development and Family Studies, 210 South Henderson Building, The Pennsylvania State University, University Park, PA 16802
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Brooks S, Prince A, Stahl D, Campbell IC, Treasure J. A systematic review and meta-analysis of cognitive bias to food stimuli in people with disordered eating behaviour. Clin Psychol Rev 2011; 31:37-51. [DOI: 10.1016/j.cpr.2010.09.006] [Citation(s) in RCA: 164] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 08/23/2010] [Accepted: 09/15/2010] [Indexed: 11/25/2022]
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Lehoux PM, Howe N. Perceived non‐shared environment, personality traits, family factors and developmental experiences in bulimia nervosa. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 46:47-66. [PMID: 17472201 DOI: 10.1348/014466506x111285] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The role of perceived non-shared environmental influences and personality traits in the risk of developing bulimia nervosa (BN) was compared in 40 women with BN and their non-eating disordered sisters. METHODS The two sisters were compared for (a) eating pathology, (b) perceived non-shared environmental factors (differential family relationships, developmental teasing, traumatic experiences), (c) personality traits (impulsivity, affective instability, narcissism), and (d) psychopathology (anxiety, depression). RESULTS Specific perceived non-shared risk factors (e.g. perceptions of teasing), nonspecific non-shared risk factors (e.g. insecure paternal attachment) and personality traits (e.g. narcissism) distinguished women with BN from sisters. In the final logistic regression, insecure paternal attachment predicted the risk for BN, while trends were apparent for narcissism and developmental teasing after controlling for psychopathology. CONCLUSIONS Our correlational cross-sectional design does not allow for investigation of direction of effects. However, it is an important first step in identifying possible perceived non-shared environmental influences and personality traits that may constitute vulnerability factors predisposing individuals to the development of BN. Findings are discussed in the light of existing models of risk factors for the etiology of BN.
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Affiliation(s)
- Pascale M Lehoux
- Centre Hospitalier de l'Université de Montreal, Montréal, Quebec, Canada.
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Self-figure drawings in women with anorexia; bulimia; overweight; and normal weight: A possible tool for assessment. ARTS IN PSYCHOTHERAPY 2010. [DOI: 10.1016/j.aip.2010.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Eating and weight concerns among Sikkimese adolescent girls and their biocultural correlates: an exploratory study. Public Health Nutr 2010; 14:853-9. [DOI: 10.1017/s1368980010002478] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesGrowing concern about ideal body image among adolescent girls in developing countries has led them to follow dietary modifications. In general, the ideal body image is perceived as a ‘thin body’ and now tagged with the concept of being physically fit. The present study evaluates the prevalence of weight concerns, and subsequent eating behaviour modifications among a group of adolescent girls in Sikkim.DesignPre-tested FFQ and dietary behaviour questionnaire were canvassed through direct interviews. Anthropometric measurements were taken following standard techniques. In the present study, dieting stands for skipping meals or avoiding certain food items.SettingSikkim, India.SubjectsA total of 577 girls were selected from several blocks of all four districts of Sikkim.ResultsThe results of the study show that concern with weight reduction is growing among adolescent girls, particularly among urban girls of affluent families. Girls from families with a higher economic status are about two times more likely to report dissatisfaction with their body weight (OR = 1·96; P ≤ 0·05) and these girls are five times more likely to report the need for dieting.ConclusionsIt is evident that weight concern and dissatisfaction over body weight are growing among adolescents. It can be safely argued that eating disorder, once a problem of the Western world, is now slowly creeping in among adolescents of the developing world as a consequence of rapid lifestyle changes over the past few decades.
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Wilksch SM. Universal school-based eating disorder prevention: Benefits to both high- and low-risk participants on the core cognitive feature of eating disorders. CLIN PSYCHOL-UK 2010. [DOI: 10.1080/13284207.2010.500310] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Simon M. Wilksch
- School of Psychology, Flinders University , South Australia, Australia
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High frequency of psychopathology in subjects wishing to lose weight: an observational study in Italian subjects. Public Health Nutr 2010; 14:373-6. [PMID: 20537213 DOI: 10.1017/s1368980010001576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the frequency of psychiatric disorders in subjects wishing to lose weight categorized according to BMI. DESIGN Cross-sectional study. SETTING An academic outpatient clinical nutrition service in Italy. SUBJECTS A total of 207 subjects (thirty-nine men and 168 women; mean age: 38·7 (sd 14·1) years) consecutively attending the study centre for the first time between January 2003 and December 2006. RESULTS In the entire study group, eighty-three (40 %) subjects had a psychiatric disorder according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. Eating disorders were the most prevalent psychiatric condition (thirty-six subjects, 17·4 %), followed by mood and anxiety disorders (9·7 % and 8·7 %, respectively). The frequency of psychiatric disorders among different BMI categories was as follows: 75·0 % in underweight, 50·0 % in normal weight, 33·3 % in overweight and 33·3 % in obese subjects. CONCLUSIONS Psychiatric disorders may be frequently found in subjects wishing to lose weight. Our results highlight the importance of psychiatric assessment especially in underweight and normal-weight subjects.
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Associations between body mass index, weight control concerns and behaviors, and eating disorder symptoms among non-clinical Chinese adolescents. BMC Public Health 2010; 10:314. [PMID: 20525394 PMCID: PMC2904271 DOI: 10.1186/1471-2458-10-314] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 06/06/2010] [Indexed: 11/25/2022] Open
Abstract
Background Previous research with adolescents has shown associations of body weight, weight control concerns and behaviors with eating disorder symptoms, but it is unclear whether these associations are direct or whether a mediating effect exists. This study was conducted to investigate the prevalence of overweight and obesity, weight control concerns and behaviors, and eating disorder symptoms and to examine the mediating function of weight control concerns and behaviors on the relationship between body mass index (BMI) and eating disorder symptoms among non-clinical adolescents in China. Methods A cross-sectional survey among 2019 adolescent girls and 1525 adolescent boys in the 7th, 8th, 10th and 11th grades from seven cities in China was conducted. Information on weight control concerns and behaviors, and eating disorder symptoms (Eating Disorder Inventory-3) were collected from the adolescents using a self-administrated questionnaire. Results Weight control concerns and behaviors, and eating disorder symptoms were prevalent among the study population. A high proportion of adolescents scored at or above the threshold on the eating disorder inventory (EDI) subscale such as bulimia, interoceptive deficits, perfectionism, and maturity fears, which indicated eating disorder symptoms. High BMI was significantly associated with high score of drive for thinness, body dissatisfaction, bulimia, low self-esteem, interceptive deficits and maturity fears, so do perceived body weight status. Almost all weight control concerns and behaviors we investigated were significantly associated with high EDI subscale scores. When weight control concerns were added to the model, as shown in the model, the association between BMI and tendency of drive to thinness and bulimia was attenuated but still kept significant. The association between BMI and body dissatisfaction were no further significant. The association of BMI and drive for thinness, body dissatisfaction and bulimia was considerably weaker than when weight control behaviors were not included. Conclusions Weight control concerns and behaviors may be mediators of the association between BMI and eating disorder symptoms. Interpretation of these weight control problems is crucial to develop culturally appropriate educational and intervention programs for adolescents.
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Psychosocial Characteristics of Young Norwegian Women Interested in Liposuction, Breast Augmentation, Rhinoplasty, and Abdominoplasty: A Population-Based Study. Plast Reconstr Surg 2010; 125:1536-1543. [PMID: 20440172 DOI: 10.1097/prs.0b013e3181d5135a] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mousa TY, Al-Domi HA, Mashal RH, Jibril MAK. Eating disturbances among adolescent schoolgirls in Jordan. Appetite 2010; 54:196-201. [DOI: 10.1016/j.appet.2009.10.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 10/07/2009] [Accepted: 10/30/2009] [Indexed: 11/25/2022]
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Mousa TY, Mashal RH, Al-Domi HA, Jibril MA. Body image dissatisfaction among adolescent schoolgirls in Jordan. Body Image 2010; 7:46-50. [PMID: 19910269 DOI: 10.1016/j.bodyim.2009.10.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 10/10/2009] [Accepted: 10/11/2009] [Indexed: 01/01/2023]
Abstract
The present study has investigated the occurrence of body image dissatisfaction among adolescent schoolgirls in Amman, Jordan, and the risk factors that are known to predispose it including individual, familial and social variables. A sample of 326 adolescent girls aged 10-16 years was recruited from public and private schools in Amman. Participants completed a socio-demographic data sheet, eating attitude test, and body shape questionnaire. Approximately, 21.2% of participants displayed body image dissatisfaction in which physical changes associated with puberty and exhibiting negative eating attitudes were associated with this dissatisfaction. Additionally, mass media messages, as well as peers and family pressures towards thinness were associated with participants' preoccupation with their body image. In conclusion, negative body image perception was observed in the present sample. Therefore, well-controlled prospective studies and development of intervention programs on body image among adolescent girls in Jordan are needed.
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Affiliation(s)
- Tamara Y Mousa
- Department of Nutrition and Food Science, University of Jordan, Alal Al-Fasi Street, P.O. Box 960364, Amman 11196, Jordan.
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Crespo C, Kielpikowski M, Jose PE, Pryor J. Relationships Between Family Connectedness and Body Satisfaction: A Longitudinal Study of Adolescent Girls and Boys. J Youth Adolesc 2009; 39:1392-401. [PMID: 20938726 DOI: 10.1007/s10964-009-9433-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Accepted: 06/19/2009] [Indexed: 01/30/2023]
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Abraham S, Boyd C, Lal M, Luscombe G, Taylor A. Time since menarche, weight gain and body image awareness among adolescent girls: onset of eating disorders? J Psychosom Obstet Gynaecol 2009; 30:89-94. [PMID: 19533487 DOI: 10.1080/01674820902950553] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Eating, body weight and shape feelings and behaviours of female adolescents in relation to the time since their first menstrual period were studied. METHOD Three hundred sixty three female school students, aged 12-17 years participated in a cross-sectional computer survey. RESULTS There was a significant increase in body weight following menarche including a rapid rise from 7-12 months after menarche (47.4 kg, 95% CI 45.2-49.7, 56.9 kg 95% CI 54.0-59.8). Students did not immediately adjust their perception of body weight to incorporate this rapid rise. The discrepancy between actual and desired weight was greatest 7-12 and 13-24 months after menarche. Weight losing behaviours and associated feelings around body image increased significantly following menarche in adolescents of all body weights. Increases were related to body weight and time since menarche, but not to age. Binge eating commenced more than 6 months after menarche and purging behaviour after 12 months. CONCLUSION Both time since menarche and increase in body weight following menarche are associated with increasing concerns about eating, body image and weight losing behaviour. Some young women develop eating disorders. Menarche and subsequent weight gain appear as a risk factor for the onset of eating disorders.
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Affiliation(s)
- Suzanne Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, NSW, Australia.
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Wilksch SM, Wade TD. An investigation of temperament endophenotype candidates for early emergence of the core cognitive component of eating disorders. Psychol Med 2009; 39:811-821. [PMID: 18752731 DOI: 10.1017/s0033291708004261] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND This study was designed to investigate potential temperament endophenotypes for clinically significant importance of shape and weight. METHOD Seven temperament risk factors for eating disorders and the Eating Disorder Examination were assessed in 699 female twins aged 12-15 years. Each variable was evaluated against the following endophenotype criteria: associated with illness in the general population; found in non-affected family members at a higher rate than in the general population; and, heritable. RESULTS All seven variables were significantly associated with clinically significant importance of shape and weight, while thin-ideal internalization, ineffectiveness, body dissatisfaction and sensitivity to punishment were found at significantly elevated levels in non-affected twins, when controlling for sister's temperament score. These four variables had genetic correlations with importance of shape and weight, ranging from 0.48 to 0.95. CONCLUSIONS Future research should evaluate the stability of the identified endophenotypes and their utility for predicting significant growth in importance of shape and weight, and also whether different endophenotypes emerge when the importance of weight and shape reaches its peak in adolescents, around 15 to 16 years of age.
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Affiliation(s)
- S M Wilksch
- School of Psychology, Flinders University, Adelaide, Australia.
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Westerberg J, Edlund B, Ghaderi A. A 2-year longitudinal study of eating attitudes, BMI, perfectionism, asceticism and family climate in adolescent girls and their parents. Eat Weight Disord 2008; 13:64-72. [PMID: 18612254 DOI: 10.1007/bf03327605] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The aim of this longitudinal study of 383 Swedish adolescent girls (11 and 13 years old at year 1) and their parents was to examine changes in eating attitudes over a two-year period, and to investigate the predictive value of eating attitudes, perfectionism, asceticism, family climate and body mass index (BMI) for the development of disturbed eating attitudes. The following self-report questionnaires were used: Children's Eating Attitudes test, Eating Attitudes Test, Eating Disorder Inventory for Children, Eating Disorder Inventory 2, I Think I Am and The Family Climate. The frequency of disturbed eating attitudes increased with increased age in the girls. Children's eating attitudes, higher BMI than peers, the girls rating of a less healthy relation to family and their fathers' eating attitudes at year 1 contributed most to the prediction of disturbed eating attitudes for the girls 2 years later. The results suggest that early signs of disturbed eating attitudes and higher BMI than peers may be important predictors for the development of more serious eating disturbances among adolescent girls.
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Affiliation(s)
- J Westerberg
- Department of Public Health and Caring Science, Uppsala University, S-751 83 Uppsala, Sweden.
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Barrack MT, Rauh MJ, Barkai HS, Nichols JF. Dietary restraint and low bone mass in female adolescent endurance runners. Am J Clin Nutr 2008; 87:36-43. [PMID: 18175735 DOI: 10.1093/ajcn/87.1.36] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Because disordered eating (DE) has been related to menstrual irregularity (MI) and low bone mineral density (BMD) in some studies of female athletes but not in others, it seems beneficial to assess the DE attitudes and behaviors most associated with these conditions. OBJECTIVE We aimed to determine the relation between Eating Disorder Examination Questionnaire (EDE-Q) subscale scores, pathologic behaviors, MI, and low BMD in adolescent female runners. DESIGN Participants were 93 female competitive cross-country runners 13-18 y old. The EDE-Q, composed of subscales for weight concern, shape concern, eating concern, and dietary restraint, was used to assess DE. Menstrual history was determined by using a questionnaire derived from a medical history form administered before participation in high school athletics. The International Society for Clinical Densitometry and the World Health Organization criterion of <or=-2 or <or=-1 SD, respectively, was used to categorize runners as having low BMD. RESULTS Runners with elevated restraint had a significantly (P<0.001) greater incidence of low BMD than did runners with elevated weight and shape concern. After adjustment for possible confounding variables (including menstrual history), lumbar spine BMD, bone mineral content, and BMD z score values were lowest in runners with elevated restraint. In addition, total-body BMD and total-body BMD z scores were significantly (P<0.05) lower in runners with elevated restraint than in those with elevated weight or shape concern. Elevated EDE-Q scores for weight or shape concern, pathologic behaviors, or any combination of the 3 without concurrent dietary restraint were not significantly associated with low bone mass. CONCLUSION These findings suggest that, in adolescent female runners, dietary restraint may be the DE behavior most associated with negative bone health effects.
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Affiliation(s)
- Michelle T Barrack
- Department of Exercise and Nutritional Science, San Diego State University, San Diego, CA 92182-7251, USA.
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Abbate-Daga G, Gramaglia C, Malfi G, Pierò A, Fassino S. Eating problems and personality traits. An Italian pilot study among 992 high school students. EUROPEAN EATING DISORDERS REVIEW 2007; 15:471-8. [PMID: 17960784 DOI: 10.1002/erv.770] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the prevalence of eating problems and to investigate personality traits associated with disturbed eating behaviours among Italian high school students. METHOD Cross-sectional study involving 992 students from six high schools in Turin, Italy. Students completed the Eating Attitudes Test-40 (EAT-40), the Temperament and Character Inventory (TCI) and a Food Frequency Questionnaire (FFQ); their weight and height were measured. RESULTS 5.5% of the whole sample and 7.4% of girls scored above the EAT-40 cutoff value. A higher Body Mass Index (BMI) correlates with higher EAT scores. Low scores on Self-Directedness and Reward Dependence together with high Persistence emerged in subjects with eating problems. DISCUSSION Dieting and higher BMI are confirmed as correlates of eating problems. Personality traits measured with the TCI emerge for the first time as correlates of eating problems. Longitudinal studies should clear whether these are risk factors or not.
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Affiliation(s)
- Giovanni Abbate-Daga
- Psichiatria Universitaria CPR DCA, Ospedale San Giovanni Battista-Department of Neuroscience, Psychiatry Section, University of Turin, Italy
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Boschi V, Bellini O, Matrone G, Lo Schiavo FR, Siervo M. Why do normal weight young women look for diet-therapy? Findings from a pilot study in a clinical and non-clinical population. Eat Weight Disord 2007; 12:e35-8. [PMID: 17615486 DOI: 10.1007/bf03327588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The behavioural factors that drive a normal weight woman to embark on a diet and to look for nutritional support in weight loss clinics are still not completely understood. A pilot cross-sectional study was carried out in 70 young (age range: 18-35 yr), normal weight women attending a weight loss clinic in South of Italy (Naples). They were compared to a population of 94 normal weight students (age range:17-23 yr) who had never attended a weight loss clinic. Subjects with eating disorders have been excluded. Weight and height were measured and body mass index (BMI) was calculated. Eating behaviour was assessed using a validated Italian version of the Eating Disorders Inventory (EDI) questionnaire. The two groups were matched for BMI (22.4 vs 22.1 kg/m2), smoking and physical activity. Students were more educated and less likely to be on a diet at the time of the study. Students had statistically significant lower scores for drive for thinness, body dissatisfaction, inadequacy and interpersonal disrupt. The bulimia scale was the only significant predictor (p<0.05) of BMI in the patients' group; body dissatisfaction (p<0.05) predicted BMI in the control group. This study has shown that weight concern and health awareness are not the only factors that lead a normal weight woman to look for nutritional counselling but there is an underlying substrate of psychological and social distress behind the request, which should be properly assessed before starting any nutritional therapy in the clinical practice.
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Affiliation(s)
- V Boschi
- Unit of Human Physiology and Dietetics, Department of Neuroscience and Behavioural Science, Faculty of Medicine, University Federico II, 80131 Naples, Italy.
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Benninghoven D, Tetsch N, Kunzendorf S, Jantschek G. Perceptual body image of patients with anorexia or bulimia nervosa and their fathers. Eat Weight Disord 2007; 12:12-9. [PMID: 17384525 DOI: 10.1007/bf03327767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Little is known about how fathers of patients with eating disorders perceive their own body. In this study we investigated body image perception of patients with anorexia and bulimia nervosa and body image perception of their fathers in a computer assisted approach. METHODS A computer program, the somatomorphic matrix, is presented that allows modeling of perceived and desired body-images of patients and their relatives. Patients and fathers rated their own body images and fathers additionally rated the body images of their daughters. The images implemented in the program correspond with defined percentages of body fat and muscularity. Selected images were compared with subjects' anthropometric data regarding body fat and muscularity. Data from 42 father-daughter-dyads (27 patients with anorexia, 15 with bulimia nervosa) were examined. Differences between both diagnostic groups were compared and associations between fathers' and daughters' body image perceptions within each group were investigated. RESULTS Patients with anorexia nervosa overestimated their bodies on the body fat dimension. Patients with bulimia nervosa wished to have a body with less fat. Fathers of both groups of patients perceived their own bodies correctly but wished to have less body fat and to be more muscular. The wish for a change in body fat of anorexia nervosa patients was highly correlated with fathers' BMI (r=0.49; p=0.009). The wish for a change in body fat of bulimia nervosa patients was correlated with fathers' distorted body image perception in terms of muscularity (r=-0.66, p=0.007) and with fathers' wish for a more muscular body (r=-0.51, p=0.05). CONCLUSION Body images of patients with eating disorders and their fathers are related in the group of patients with bulimia nervosa. Perhaps, body images of fathers should be addressed in family therapy with patients with bulimia nervosa.
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Affiliation(s)
- D Benninghoven
- Campus Luebeck, Clinic for Psychosomatic Medicine, University of Schleswig- Holstein, Luebeck, Germany.
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Siervo M, Grey P, Nyan OA, Prentice AM. A pilot study on body image, attractiveness and body size in Gambians living in an urban community. Eat Weight Disord 2006; 11:100-9. [PMID: 16809982 DOI: 10.1007/bf03327758] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE We investigated the attitudinal and perceptual components of body image and its link with body mass index (BMI) in a sample of urban Gambians. We also looked at cross-cultural differences in body image and views on attractiveness between Gambians and Americans. METHODS Four groups of 50 subjects were assessed: men 14- 25y (YM); women 14-25y (YW); men 35-50y (OM); women 35-50y (OW). Socio-economic status, education, healthy lifestyle and western influences were investigated. Height and weight were measured. Body dissatisfaction was assessed with the body dissatisfaction scale of the Eating Disorder Inventory. Perceptions of body image and attractiveness were assessed using the Body Image Assessment for Obesity (BIA-O) and Figure Rating Scale (FRS). RESULTS Different generations of Gambians had very different perceptions and attitudes towards obesity. Current body size was realistically perceived and largely well tolerated. Older women had a higher body discrepancy (current minus ideal body size) than other groups (p<0.001). Regression analysis showed they were not worried about their body size until they were overweight (BMI=27.8 kg/m2), whilst OM, YM and YW started to be concerned at a BMI respectively of 22.9, 19.8 and 21.5 kg/m2. A cross-cultural comparison using published data on FRS showed that Gambians were more obesity tolerant than black and white Americans. DISCUSSION The Gambia is a country in the early stage of demographic transitions but in urban areas there is an increase in obesity prevalence. Inherent tensions between the preservation of cultural values and traditional habits, and raising awareness of the risks of obesity, may limit health interventions to prevent weight gain.
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Affiliation(s)
- M Siervo
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
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Viner RM, Haines MM, Taylor SJC, Head J, Booy R, Stansfeld S. Body mass, weight control behaviours, weight perception and emotional well being in a multiethnic sample of early adolescents. Int J Obes (Lond) 2006; 30:1514-21. [PMID: 16718286 DOI: 10.1038/sj.ijo.0803352] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate weight perception, dieting and emotional well being across the range of body mass index (BMI) in a population-based multiethnic sample of early adolescents. DESIGN Cross-sectional population-based survey. SUBJECTS In total, 2789 adolescents 11-14 years of age from three highly deprived regional authorities in East London, in 2001. MEASUREMENTS Data were collected by student-completed questionnaire on weight perception, dieting history, mental and physical health, health behaviours, social capital and sociodemographic factors. Height and weight were measured by trained researchers. Overweight was defined as BMI > or =85th centile and obesity as BMI > or =98th centile. Underweight was defined as BMI< or =15th centile. RESULTS In all, 73% were from ethnic groups other than white British. Valid BMI were available for 2522 subjects (90.4%) of whom 14% were obese. Only 20% of overweight boys and 51% of overweight girls assessed their weight accurately. Accuracy of weight perception did not vary between ethnic groups. In all, 42% of girls and 26% of boys reported current dieting to lose weight. Compared with white British teenagers, a history of dieting was more common among Bangladeshi, Indian and mixed ethnicity boys and less likely among Pakistani girls. Self-esteem was not associated with BMI in girls but was significantly lower in obese boys than those of normal weight (P=0.02). Within ethnic subgroups, self-esteem was significantly lower in overweight white British boys (P=0.03) and obese Bangladeshi boys (P=0.01) and Bangladeshi girls (P=0.04), but significantly higher in obese black African girls (P=0.01) than those of normal weight. Obese young people had a higher prevalence of psychological distress (P=0.04), except among Bangladeshi teenagers, where overweight and obese young people had less psychological distress than those of normal weight (P=0.02). Birth outside the UK was associated with reduced risk of obesity in girls (P=0.02) but not with history of dieting, weight perception or psychological factors in either gender. CONCLUSION High levels of current dieting for weight control and inaccurate perception of body mass are common across all ethnic groups. However, dieting history and the associations of obesity with self-esteem and psychological distress vary between ethnic groups. Interventions to prevent or treat obesity in black or minority ethnicity groups must consider cultural differences in the relationship between body mass, self-esteem and psychological distress.
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Affiliation(s)
- R M Viner
- Department of Paediatrics, Royal Free & University College Medical School, University College London, London, UK.
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