Eating behavior and body image among psychology students

Reliability of the Brazilian version of the questionnaire on eating and weight patterns-5 (QEWP-5)

PURPOSE

The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED) and bulimia nervosa (BN) as diagnosed by the DSM-5. This instrument was cross-culturally adapted for the Brazilian Portuguese and well understood by the target sample. The present study aimed to assess the test-retest reliability of the Brazilian version of QEWP-5 in a sample of undergraduate students from Dietitian and Psychology courses.

METHODS

The Brazilian version of QEWP-5 was administered to a sample of 345 male and female undergraduate students, from dietitian (n = 179) and psychology (n = 166) courses. The instrument was applied twice with a time interval of 2 weeks between the applications. The kappa coefficient was used to assess the temporal stability of the questionnaire in the screening of BED and BN.

RESULTS

Overall, the kappa coefficient for the screening of BED was .48, and for the screening of BN was .71. In the dietitian course, the temporal stability was .60 (for the assessment of BED) and .80 (for BN). In the psychology course, the kappa values for the assessment of BED and BN were .27 and .60, respectively. All values were statistically significant (p < .001).

CONCLUSION

In general, the stability of the Brazilian version of QEWP-5 was considered moderate to assess BED and substantial for the screening of BN in undergraduate students. Stratifying by course, the questionnaire had higher stability for the assessment of BED and BN in dietitian students.

LEVEL OF EVIDENCE

Level V, descriptive study.

Disordered eating attitudes among Iranian university students of medical sciences: The role of body image perception

BACKGROUND

Disordered eating attitudes and behaviors have become an issue of worldwide concern.

AIM

This research was designed to investigate the role of body image satisfaction in the relationship with eating attitudes among students of Qazvin University of Medical Sciences in Iran.

METHODS

In this cross-sectional study, 385 Qazvin university students of medical sciences were recruited by randomized stratified sampling in 2014. The students completed a three-part questionnaire (socio-demographic, Eating Attitudes Test and Body Shape Questionnaire) in their classrooms. We used hierarchical generalized linear models to identify variables significantly associated with Eating Attitudes Test scores.

RESULTS

The mean age of the students was 21.80 ± 2.98 years. Mean scores for the Eating Attitudes Test and Body Shape Questionnaire were 66.75 ± 29.8 and 11.86 ± 10.97 respectively; 18.5% of students had a score of 20 and above (≥ 20) that indicated disordered eating attitudes or as being at risk of eating disorders. In the multiple regression model, the Eating Attitudes Test was related to screening body image dissatisfaction (β = 0.122, P < 0.001). Body mass index was negatively related to the Eating Attitudes Test score (β= -0.488, P < 0.016), and diet was significantly correlated with an increased Eating Attitudes Test score (β = 5.803, P < 0.001).

CONCLUSIONS

The risk of eating disorders is relatively high among Iranian university students. It can be a warning to health policy makers and should be the focus of special attention. In the present study, the most important factor related to abnormal eating attitudes was body image dissatisfaction. Regarding the complexity of the causes of eating disorders, various preventive and therapeutic interventions are necessary to avoid the dissemination in society of an idealized view of excessive thinness and further unfavorable outcomes in college students.

Anthropometric status and body image perception among Moroccan university students

BACKGROUND

University students aged between 18 and 25 undergo several physical changes as a result of transition from adolescence to adulthood. Students do not always accept those changes and sometimes develop dissatisfaction towards their figures. In such cases, it is still not clear how actual body weight status can be affected by socio-cultural factors such as body image perception. The objective of this study was to determine the link between anthropometric status and body image perception among university students.

METHODS

Two hundred and forty six (246) university students from the Faculty of Sciences and Technologies within the Beni Mellal-Khenifra region in Morocco, aged 20-24 years were interviewed using face-to-face questionnaires. Anthropometric measurements and Body Mass Index were collected. Body image perception was assessed by Figure Rating Scale, and body size dissatisfaction was calculated as Feel minus Ideal Discrepancy (FID). Data were described using means and proportions. The Student t-test and the chi-square test have been used to assess the statistical significance of group differences.

RESULTS

Underweight students represented 16.7% of the investigated sample, while 11.4% suffered from overweight and obesity, higher in females students (14.4%) than in males (7.9%). Regarding body image perception, 43.9% of participants considered themselves underweight; whereas only 4.2% considered themselves overweight with no significant differences related to gender. Of note, the total prevalence of body image dissatisfaction was around 69.8%. Finally, among overweight/obese students, 88.9% of females and 71.4% of males expressed the wish to become thinner while 28.6% of the overweight/obese males wanted to get heavier.

CONCLUSION

The results of this study indicate a high rate of body image dissatisfaction and a tendency of participants to underestimate their body weight. This behavior may be a reflection of a real influence of social and psychological factors occurring during this critical period and may make university students vulnerable to many risk-taking behaviors. Thus, there is a need for suitable interventional programs and innovative strategies to ensure the understanding of the health consequences of overweight and obesity and to prevent associated comorbidities.

Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis

Objective:

To synthesize the risk of eating disorder (ED) symptoms in Brazilian university students through a systematic review and meta-analysis. Secondary goals were to analyze whether any specific majors were related to higher ED risk and whether any regions of Brazil had higher proportions of college students at risk of ED.

Methods:

The procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and a search was conducted in three electronic databases (MEDLINE, LILACS, and SciELO).

Results:

Thirty-three studies were included in the analysis, of which 14 were included in the meta-analysis. All included studies used self-report questionnaires, the most frequent of which was the Eating Attitudes Test (EAT-26). None of the studies used a structured interview to diagnose ED. A meta-analysis of studies with a cutoff ≥ 20 for the EAT-26 (n=5) found 14.9% (95%CI 12.8-17.2%) positive screenings, while those with a cutoff of t ≥ 21 (n=9) found 13.3% (95%CI 11.3-15.6%) positive screenings. There was a significantly higher proportion of positive screenings among nutrition majors than all other majors combined (26.5 and 20.5%, respectively).

Conclusion:

Nutrition students seem to be at higher risk of ED. Further research should investigate whether positive screenings translate to actual ED diagnoses.

Social anxiety symptoms and body image dissatisfaction in medical students: prevalence and correlates

ABSTRACT Objective Social anxiety disorder (SAD) and body image dissatisfaction (BID) are common problems among college students, but few studies focused on medical students. We aimed to estimate the prevalence, severity and correlates of SAD symptoms and BID among medical students of a Brazilian public university. Methods A cross-sectional study with 479 students, using structured instruments: Social Phobia Inventory (SPIN), Body Shape Questionnaire (BSQ), and Beck Depression Inventory (BDI). Bivariate analyses were followed by logistic regression models to obtain independent predictors of SAD symptoms, BID and both outcomes combined. Results Most students were single (99%) and female (58.7%). The prevalence rates of SAD symptoms (SPIN ≥ 19) and BID (BSQ ≥ 81) were 36.3% and 34.7%, respectively. Depressive symptoms (BDI ≥ 19) occurred in 8.8% of the sample. SAD symptoms were independently associated with: BID, thoughts of abandoning the course, difficulty making friends, depressive symptoms, and mental health treatment prior to university. Besides SAD symptoms, BID was associated with female sex, difficulty making friends, depressive symptoms, and body mass index (BMI). Seventy-eight students (16.3%) presented SAD symptoms and BID, which was associated with female sex, difficulty making friends, dissatisfaction with the course, depressive symptoms and BMI. Conclusion SAD symptoms and BID are common and related problems that should be screened for among medical students. The identification of specific correlates could contribute to the elaboration of preventive measures, minimizing the distress and negative impact of these mental health problems on relationships and academic performance.

Insatisfação com a imagem corporal em estudantes universitários – Uma revisão integrativa

RESUMO Objetivo Caracterizar a insatisfação corporal entre estudantes universitários. Métodos Revisão integrativa da literatura nas bases de dados PubMed, Lilacs, Bireme, portal SciELO e banco de teses com descritores indexados com os critérios de inclusão: população exclusivamente universitária, apresentação de dados referentes à frequência/prevalência da insatisfação corporal e/ou a caracterização de fatores relacionados. Resultados Foram selecionados 76 estudos (40 nacionais e 36 internacionais). A amplitude de insatisfação de imagem corporal em ambos os sexos foi de 8,3% a 87% nos estudos nacionais, e de 5,2% a 85,5% nos internacionais, avaliados, principalmente, por meio de escalas de silhuetas e/ou questionários (como o Body Shape Questionnaire, o Eating Disorder Inventory, e o Body-Self Relations Questionnaire Appearance Scales). Os fatores como exposição à mídia e redes sociais, o período menstrual e a baixa autoestima foram relacionados à insatisfação corporal. Conclusão A insatisfação corporal é um fenômeno comum entre os universitários, mas apresentando grande amplitude dependendo do sexo, instrumento, método e objetivo do estudo. Padronização na avaliação do construto é necessária para melhor compressão e discussão do problema.

Validation of the Norwegian short version of the Body Shape Questionnaire (BSQ-14)

BACKGROUND

The Body Shape Questionnaire (BSQ) is a widely used self-report measure of body shape dissatisfaction.

AIMS

We aimed to establish psychometric properties and report normative data for the Norwegian 14-item BSQ in a clinical and non-clinical sample.

METHODS

A total of 423 female students, 267 male students and 49 female inpatients [anorexia nervosa (AN) and subthreshold AN] were administered the BSQ, the Body Checking Questionnaire (BCQ), and the Eating Disorder Examination Questionnaire (EDE-Q).

RESULTS

On average, the male and female controls were aged (mean± standard deviation) 20.98 ± 5.68 years and 24.35 ± 9.89 years with mean body mass indexes (BMIs) of 23.34 ± 3.13 and 22.30 ± 3.62 kg/m(2), respectively. Patients were 19.04 ± 3.06 years with a mean BMI of 16.48 ± 1.81. Divergent validity was indicated by significantly (P < 0.001) different means between the patient group versus female controls, 56.80 ± 18.89 and 35.89 ± 15.19, respectively. Cronbach's alpha was satisfactory for all three groups (0.91-0.96), indicating excellent internal consistency. The BSQ correlated significantly (P < 0.001) with the BCQ and EDE-Q, indicating concurrent validity. BMI and BSQ scores did not correlate significantly within the population as a whole. However, when subdividing the sample, higher BMI was associated with higher BSQ scores among females and males within the non-clinical sample.

CONCLUSIONS

Our study provides psychometric support for the Norwegian version of the BSQ-14 among a clinical and non-clinical sample of both young men and women.

Risco para transtornos alimentares em escolares de Salvador, Bahia, e a dimensão raça/cor

OBJETIVO: Estimar a existência de fatores de risco associados aos transtornos alimentares em escolares da cidade de Salvador, Bahia, por meio da dimensão étnico-racial como fator de heterogeneidade. MÉTODOS: Os participantes da pesquisa são escolares do sexo feminino, na faixa etária entre 15 e 30 anos, residentes na cidade de Salvador, no Estado da Bahia. Foram investigadas 626 estudantes, selecionadas em instituições públicas e privadas de ensino médio e universitário. Utilizaram-se o Eating Atittude Test-26, o Body Shape Questionnaire e o Beck Depression Inventory como instrumentos de identificação de risco para os transtornos alimentares. A classificação étnico-racial se deu por autodeclaração, de acordo com as categorias do Instituto Brasileiro de Geografia e Estatística. Foram realizadas análises descritivas, bivariadas (χ2 de Pearson) e regressão logística multivariada para análise dos dados. RESULTADOS: As estudantes que se identificaram como amarelas ou indígenas têm 3,6 vezes mais chances de desenvolverem comportamentos alimentares desordenados e 4,8 vezes mais possibilidade de estarem insatisfeitas com sua imagem corporal. As pardas apresentam 2,5 vezes mais risco para essa insatisfação. A depressão é uma comorbidade que deve ser considerada, apesar de não estar associada significativamente à raça/cor. CONCLUSÃO: As mulheres não brancas em Salvador apresentam risco de desenvolver transtornos alimentares. Outros estudos que combinam métodos quantitativos e qualitativos podem permitir uma análise mais robusta quanto à relação entre transtornos alimentares e raça/cor e etnia.

Checagem corporal, atitude alimentar inadequada e insatisfação com a imagem corporal de jovens universitários

OBJETIVO: O objetivo do estudo foi avaliar a checagem corporal, a atitude alimentar inadequada e a insatisfação corporal em universitários de ambos os sexos. MÉTODOS: Participaram 587 indivíduos (311 homens). Foram avaliados os comportamentos de checagem (mulheres - Body Checking Questionnaire; homens - Male Body Checking Questionnaire), as atitudes alimentares inadequadas (Eating Attitudes Test-26) e a insatisfação corporal (Body Shape Questionnaire). Massa corporal e estatura foram autorreferidas para o cálculo do índice de massa corporal (IMC). Foi realizada estatística descritiva, inferencial e teste qui-quadrado (teste exato de Fisher) utilizando o software Statistic 8.0 e adotado nível de significância de 5%. RESULTADOS: A checagem corporal está associada às atitudes alimentares inadequadas e à insatisfação corporal, independentemente do sexo do indivíduo. Foram encontradas diferenças entre o sexo feminino e masculino para as variáveis avaliadas, sendo maior a frequência entre as mulheres. CONCLUSÃO: Concluiu-se que a checagem corporal é um comportamento presente e de alta frequência em universitários com risco para o transtorno alimentar e também naqueles insatisfeitos com sua imagem corporal.

Prevalence of body image dissatisfaction and associated factors among physical education students

OBJECTIVE

To determine the prevalence of and factors associated with body image dissatisfaction among physical education students enrolled in a public university.

METHODS

This study evaluated 236 students and assessed body image perception (silhouette scale), sociodemographic variables (sex, age, parental education, marital status, university course, work, living arrangement, study shift, and income), physical activity level (International Physical Activity Questionnaire - Short Version), dietary habits, tobacco use, excessive intake of alcohol (questions from the tobacco, alcohol and drugs, and nutrition domains of the FANTASTIC instrument), and nutritional status (body mass index [BMI]). Descriptive analysis, the chi-square test, Fisher's exact test, and crude and adjusted multinomial regression were used.

RESULTS

The prevalence of body image dissatisfaction was 69.5%; 44.1% were dissatisfied with excess weight. BMI ≥ 25.0 kg/m² was associated with dissatisfaction with excess weight; factors associated with dissatisfaction with slimness were being male, eating an unhealthy diet, and smoking tobacco.

CONCLUSION

Our findings suggest that female college students with a BMI ≥ 25.0 kg/m² are more likely to present dissatisfaction with excess weight. Being male, eating an unhealthy diet, engaging in physical activity for < 739.61 min/week and smoking tobacco were the variables associated with dissatisfaction with thinness.

Insatisfação corporal em universitários de diferentes áreas de conhecimento

OBJETIVOS: Verificar a prevalência de insatisfação corporal em universitários de diferentes áreas de conhecimento, bem como a relação com sexo e com estado nutricional. MÉTODOS: A amostra foi composta por universitários da Universidade Federal de Juiz de Fora (UFJF) de diferentes áreas de conhecimento. O Body Shape Questionnaire (BSQ) e a Escala de Silhuetas para adultos avaliaram a insatisfação corporal. Massa corporal e estatura autorreferidas foram utilizadas para o cálculo do índice de massa corporal (IMC). Para as análises estatísticas, foram realizados testes de associação, comparação e regressão logística. RESULTADOS: Dos 535 estudantes, com média de idade de 20,82 ± 3,03 anos, 245 eram do sexo masculino. A média do BSQ foi de 68,00 ± 28,74, sendo 88,9% livres de insatisfação. Porém, pela escala de silhuetas, 76,6% foram considerados insatisfeitos. Os estudantes da área de saúde e humanas foram, sem significância, mais insatisfeitos que alunos de exatas. As mulheres em relação aos homens (p < 0,05) e aqueles com sobrepeso/obesidade (OR: 3,174; p = 0,000) tiveram a maior frequência na classificação de insatisfação corporal. CONCLUSÃO: A maioria dos jovens mostrou-se livre de insatisfação corporal, não havendo relação com a área de estudo, porém as universitárias com IMC mais elevado apresentaram-se mais insatisfeitas com sua imagem corporal.

Insatisfação corporal, prática de dietas e comportamentos de risco para transtornos alimentares em mães residentes em Santos

OBJETIVO: Avaliar a insatisfação corporal, a prática de dietas e os comportamentos de risco para transtornos alimentares em uma amostra de mães residentes no município de Santos. MÉTODOS: Foi realizado um estudo transversal, de base populacional, com 453 mães de filhos com até 10 anos de idade. As mães responderam ao Teste de Atitudes Alimentares (EAT-26), à Escala de Figuras de Stunkard e a uma questão sobre a prática atual de dietas. RESULTADOS: Das mães, 29,9% apresentaram escore positivo para os comportamentos de risco para transtornos alimentares e 21,8% estavam fazendo dieta para emagrecer no momento da entrevista. No tocante à imagem corporal, 17,5% das mães estavam satisfeitas com o seu tamanho corporal, 71,5% gostariam de diminuir seu tamanho corporal e 11,0% gostariam de aumentá-lo. Os comportamentos de risco para transtornos alimentares foram mais frequentes nas mães insatisfeitas com seus tamanhos corporais (p < 0,0001). CONCLUSÃO: A maioria das mães investigadas estava insatisfeita com os seus tamanhos corporais. A frequência de mães que praticavam dietas ou tinham comportamentos de risco para transtornos alimentares foi similar ou superior aos demais estudos nacionais, conduzidos, em sua maioria, com populações consideradas de risco, como meninas adolescentes e jovens universitárias.

[Risk behaviors for eating disorders among female adolescents from different social strata in the Brazilian Northeastern]

This study sought to estimate the prevalence of eating disorders (ED) and identify risk factors among female adolescents in Fortaleza, Ceará, Brazil. It was conducted a sectional study with 652 high school students (14-20 years) using the Bulimic Investigatory Test of Edinburgh (BITE). A logistic regression model was applied. Approximately one quarter of participants showed risk eating pattern and control weight practices, among 1.2% signs of an installed ED were found. Fear of weight gain was reported by 62% of adolescents, independently if studying at public or private schools (p>0.05), but the use of risk practices was higher among private schools students (p<0.05). Not having a religion (OR: 2.2, 95%CI: 1.1-4.2) and studying in private school (OR: 1.7, 95%CI: 1.2-2.5) were associated with an increased risk of ED. The ED emerge as a public health problem even in the poor areas of Brazil and the desire for a thin body was not differentiated between different social strata, although the risk practices are significantly higher among respondents from private schools. Subjective and cultural aspects are presented not only as risk factors, but also as protectors.

Insatisfação com a imagem corporal em universitárias brasileiras

A insatisfação com a imagem corporal é avaliada por meio da diferença entre a figura real e a idealizada e pode influenciar comportamentos alimentares. OBJETIVO: Avaliar a insatisfação corporal de universitárias do sexo feminino nas cinco regiões do país e possíveis associações e correlações com a idade, o estado nutricional, a renda e o grau de escolaridade do chefe da família. MÉTODOS: 2.402 universitárias responderam à Escala de Silhuetas de Stunkard. As regiões foram comparadas por meio da análise de variância; correlações entre as variáveis foram analisadas pelos coeficientes de Pearson e Spearman. RESULTADOS: 64,4% gostariam de ser menores do que sua figura atual, e mesmo as estudantes eutróficas escolheram figuras saudável e ideal menores. Na região Norte foram apontados os mais magros padrões ideais e de saúde e na região Centro-Oeste, os maiores. CONCLUSÃO: A ocorrência de insatisfação corporal foi bastante expressiva, com algumas diferenças regionais e sociodemográficas que devem ser consideradas.