Body Image Concerns and Body Weight Overestimation Do Not Promote Healthy Behaviour: Evidence from Adolescents in Lithuania

Associations Between Body Image, Eating Behaviors, and Diet Quality Among Young Women in New Zealand: The Role of Social Media

Background/Objectives: This study investigates the relationship between diet quality and body image disturbance among young women aged 18-24, a crucial period for establishing lifelong health behaviors. Given the increasing exposure to social media, which often promotes unrealistic beauty standards, this research aims to explore associations between eating behaviors, diet quality, and body image disturbance. Methods: A mixed-methods approach was employed, combining qualitative focus group discussions with quantitative analysis. Focus groups (n = 19) explored themes of body image dissatisfaction. The Body Image Disturbance Questionnaire (BIDQ) was administered to 50 participants (young women aged 18-24) to quantitatively assess body image disturbance, while diet quality was evaluated using the Australian Recommended Food Scores (ARFS). The Three-Factor Eating Questionnaire (TFEQ-R18) was also used to assess eating behaviors, including cognitive restraint, uncontrolled eating, and emotional eating. A social influence questionnaire (SIQ) was administered to measure the effect of social influence. Pearson's correlation coefficient was used to determine the relationship between ARFS, BIDQ, and TFEQ-R18 scores. Results: Qualitative findings revealed persistent dissatisfaction with body shape, largely influenced by social media. Quantitatively, 65% of participants scored above the clinical threshold for body image disturbance (mean BIDQ score = 4.2, SD = 0.8). The correlation between ARFS and BIDQ scores was weak and not statistically significant (r = 0.057, p = 0.711). However, a significant positive correlation was observed between time spent on social media and body image disturbance (r = 0.58, p < 0.01). Additionally, TFEQ-R18 results indicated that 45% of participants displayed moderate levels of uncontrolled eating, and 36.5% demonstrated moderate levels of emotional eating. Conclusions: While social media is associated with body image concerns, its effect on eating behaviors and diet quality shows weak correlations, suggesting that other factors may mediate these outcomes. These results suggest the complexity of the associations between body image, eating behaviors, and diet quality, indicating that interventions should consider psychological drivers behind these concerns alongside social media usage.

Shifting goalposts: widening discrepancies between girls' actual and ideal bodies predict disordered eating from preadolescence to adulthood

BACKGROUND

Little is known regarding how disordered eating (DE) relates to perceived actual body size, ideal body size, and their discrepancy. This study examined changes in perceived actual body size, ideal body size, and actual-ideal discrepancies over time, and their relationship with subsequent DE.

METHODS

Participants were 759 female twins from the Minnesota Twin Family Study who reported on body image and DE every three to five years between approximately ages 11 to 29. We used multilevel modeling to examine developmental trajectories of body mass index (BMI) and Body Rating Scale Actual, Ideal, and Actual-Ideal discrepancy scores and compared the degree to which BMI, BRS body size perceptions, and body dissatisfaction predicted DE behaviors and attitudes over time. Participants were treated as singletons in analyses.

RESULTS

Perceived Actual body sizes and BMIs increased from age 10 to 33, whereas Ideal body sizes remained largely stable across time, resulting in growing Actual-Ideal discrepancies. Body size perceptions and Actual-Ideal discrepancies predicted subsequent DE behaviors and attitudes more strongly than did body dissatisfaction as measured by self-report questionnaires.

CONCLUSIONS

This research advances understanding of how female body size perceptions and ideals change across development and highlights their relationship with subsequent DE.

Analysis of the influence of educational level on the nutritional status and lifestyle habits of the young Spanish population

Aim

This study aims to analyze some nutrition and health habits of young people and the impact of educational attainment on health.

Methods

An observational, descriptive, and cross-sectional study was carried out using surveys. Using non-probabilistic snowball sampling, a previously validated questionnaire was disseminated through networks, collecting a sample of 9,681 people between 18 and 30  years old. Comparative analyses between groups were obtained by clustering and the corresponding statistical tests.

Results

The results showed how young people with higher education generally have a lower BMI, a higher healthy nutrition index, less frequent consumption of sugary drinks, and less smoking than their peers with basic education. These healthier habits are reflected in the higher self-perceived health status of the higher-educated group. While for all the educational levels analyzed, the minutes of physical activity practice are above the 150 min recommended by the WHO.

Conclusion

Our findings suggest that young people's education level is of fundamental importance for health, particularly for nutritional habits. In general, the lifestyle habits of the young Spanish population are healthy, but there is a need for improvement in those aspects related to nutrition and food.

Body image and dietary habits in adolescents: a systematic review

CONTEXT

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

OBJECTIVE

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

DATA SOURCES

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

DATA EXTRACTION

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

DATA ANALYSIS

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

CONCLUSION

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

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020184625.

Impact of a Web-Based Nutrition Intervention on Eating Behaviors and Body Size Preoccupations among Adolescents

We aimed to evaluate the impact of a web-based school nutrition intervention on eating behavior traits, body weight concern, body size perception and body size dissatisfaction in adolescents. Ten classes of secondary students in Canada (13.6 ± 0.8 years) were randomized into an intervention (n = 162 students) or control group (n = 75 students). Adolescents in the intervention, conducted between 2011 and 2013, participated in an online nutrition challenge to increase their consumption of vegetables, fruits and dairy products using a web-based platform over six weeks. Measurements were taken at baseline (PRE) and post-intervention (POST). No significant negative changes were observed between the intervention and control groups for eating behavior traits, body weight concern, body size perception and dissatisfaction. However, results suggest a trend for a positive effect of the intervention on susceptibility to hunger in boys (group × time interaction, p = 0.10). Specifically, boys experienced a reduction in their susceptibility to hunger in response to the intervention (PRE: 6.1 ± 3.8, POST: 4.8 ± 3.7, p = 0.009). An intervention aimed at improving the eating habits of adolescents did not negatively influence body size preoccupations. In response to the intervention, boys tended to show a lower susceptibility to hunger, which might help them to prevent overeating and adopt healthy eating habits.

Predictive factors of disordered eating among adolescents in Bosnia and Herzegovina

BACKGROUND

Due to excessive concerns and focus on weight control and body shape, adolescents often resort to inappropriate behaviours and attitudes towards eating, resulting in physical and psychological issues. This study aimed to assess possible relationships and predictor variables between disordered eating and age, BMI, body appreciation, self-esteem, quality of family interactions, psychosocial health and childhood trauma experience in adolescents of both sexes in the city of Mostar (Bosnia and Herzegovina).

MATERIALS AND METHODS

A cross-sectional study was carried out on a suitable sample of 724 high-school students aged 14-19 years. The following tools have been used: socio-demographic questionnaire, The Eating Attitudes Test (EAT-26), Body Mass Index (BMI), Body Appreciation Scale (BAS), Rosenberg's Self-Esteem Scale, Quality of Family Interaction Scale (KOBI), and Paediatric Quality of Life Inventory, version 4.0 (PedsQLTM) and Childhood trauma Questionnaire (CTQ). Collected data were analyzed in SPSS v. 20.0 software using Pearson's correlation coefficient and multiple regression analysis.

RESULTS

Body appreciation is the most significant predictor for developing disordered eating across the entire sample of adolescents (β = -0.325, P < 0.05) and individually for male adolescents (β = -0.199, P = 0.010) and female adolescents (β = -0.379, P < 0.001). In addition to this variable, BMI has proved to be a statistically significant predictor in explaining the eating behaviours of female adolescents (β = 0.185, P < 0.001), while this happens to be self-esteem for male adolescents (β = -0.211, P < 0.022).

CONCLUSION

The most significant risk factors for developing disordered eating in adolescents are body appreciation, BMI and self-esteem. Results of this research can contribute to enhancement of intervention programmes which promote a positive body image and aim to prevent disordered eating in adolescents of both sexes.

Body Image and Lifestyle Behaviors in High School Adolescents

This secondary data analysis study aimed to examine the associations between 1) body size perception (BSP) and body size dissatisfaction (BSD) and 2) lifestyle behaviors and BSP and BSD in adolescents. The study pooled cross-sectional data from two studies (n = 301) performed in adolescents. Weight and height were measured, while lifestyle behaviors and perceived actual and desired body size variables were self-reported. Linear regression analysis assessed the contribution of sex and zBMI to BSP and BSD scores. Pearson's correlation explored associations between BSP and BSD. Cohen's effect sizes compared satisfied and dissatisfied adolescents within the underestimators subgroup. A positive association between BSP and BSD scores was observed among girls living with normal-weight and overweight/obesity only (r = 0.26; p ≤ 0.001 and r = 0.38; p < 0.05, respectively). Underestimators who were satisfied with their body size showed a moderate effect size for a lower zBMI, a small effect size for lower screen time, and higher sleep duration compared to dissatisfied underestimators. Underestimation was associated with more body size satisfaction in adolescent girls with normal weight and overweight/obesity, suggesting a protective effect of underestimation. These findings support the hypothesis that body size satisfaction and underestimation in adolescents is associated with healthier lifestyle behaviors.

Body Image Perception and Satisfaction of Junior High School Students: Analysis of Possible Determinants

Body image (BI) is a multidimensional construct that refers to one's perceptions of and attitudes toward one's own physical characteristics. Adolescence is a critical developmental stage in which concerns about BI increase. Therefore, the present cross-sectional study aimed to evaluate body image and aesthetic body shape standards in a sample of middle school students living in China. The researchers gathered demographic information, as well as height and weight data, for their study. They used a body silhouette to assess body image perception and body shape aesthetics and calculated two indexes: BIP, which measures the accuracy of self-perception and the estimation of bodily dimensions, and BIS, which indicates the difference between an individual's perceived and ideal body images. A total of 1585 students in three grades at two middle schools were included in the study (759 = female, mean age = 13.67 ± 0.90; 839 = male, mean age = 13.70 ± 0.90). The results showed that the BIP bias rate of middle school students was 55.7%, and the BI dissatisfaction rate was 81.0%. Females tended to overestimate their body shape and desire to be thinner compared to males. Students with a higher BMI grading were more prone to underestimating their body shape and aspiring to be thinner. Furthermore, 8.6% of students chose underweight as the ideal body type for boys, while 22.6% chose underweight as the ideal body type for girls. In conclusion, there are significant gender differences in the aesthetic standards of body shape, and adolescents believe that for women, a thin body shape is beautiful.

Internalisation of stereotyped body appearance standards and body dissatisfaction in adolescent boys: Moderating role of sports participation

The aim of this study was to test the moderating role of sport participation in the mediation model of media pressures, internalisation of appearance ideals and body dissatisfaction in adolescent boys. Five hundred and seventy adolescent boys (mean age 17.2 ± 0.45; range 15-19 years) participated in the cross-sectional study. Adolescents completed a questionnaire consisting of measures of attitudes towards sociocultural pressures on appearance, body dissatisfaction and sport participation (participation in achievement sport, leisure exercising and non-participation in any sports). Sports participation moderated the associations between the internalisation of stereotyped appearance ideals and body dissatisfaction. In athletes, the effect of internalisation of thin body ideals on body dissatisfaction was not significant, while the effect of internalisation of muscular/athletic body ideals was negative. In leisure exercisers, the effect of internalisation of muscular body ideals on body dissatisfaction was not significant, yet internalisation of thin body ideals had a significant effect on body dissatisfaction. The strongest associations between appearance ideals internalisation and body dissatisfaction were found in adolescent boys who reported no participation in sports. Sports participation might be an effective tool in decreasing the negative effect of internalisation of stereotyped appearance ideals on adolescent boys' body image.

Parental Stress on Children's Appearance, Body Dissatisfaction, and Eating Behaviours in Chinese Children: A Pathway Analysis

Purpose

This study aimed to analyze the association pathways of parental stress on children's appearance, body dissatisfaction, and eating behaviours in Chinese children and adolescents.

Patients and Methods

The children aged 8-15 years were selected from 2 nine-year schools using stratified cluster random sampling. The appearance-related social stress questionnaire and the body dissatisfaction subscale of EDI-1 were used to investigate parental stress on children's appearance and body dissatisfaction, respectively. The self-administered eating frequency questionnaire was used to investigate children's eating behaviours.

Results

Body dissatisfaction in girls mediated associations between BMI, parental teasing, parental injustice and ignorance, parental encouragement and healthy eating behaviour: BMI → body dissatisfaction → healthy eating behaviour, parental teasing → body dissatisfaction → healthy eating behaviour, parental injustice and ignorance → body dissatisfaction → healthy eating behaviour, parental encouragement → body dissatisfaction → healthy eating behaviour. Parental injustice and ignorance directly and negatively predicted healthy eating behaviour in girls. In boys and girls, parental teasing was a direct predictor factor of unhealthy eating behaviour.

Conclusion

Parental teasing, parental injustice and ignorance, parental encouragement, and BMI through body dissatisfaction positively predicted healthy eating behaviour in girls, parental injustice and ignorance directly negatively predicted healthy eating behaviour in girls, and parental teasing directly positively predicted unhealthy eating behaviour in girls and boys. Therefore, parental pressure on children's appearance may pay important role in children's eating behaviours.

Relationships of weight perceptions with weight control related behaviors among Chinese children and adolescents: A school-based study in Zhejiang Province

OBJECTIVES

Weight perceptions have been implicated in weight control related behaviors among children and adolescents, yet studies in mainland China are scarce. We examined the associations of self-perceived weight status and weight misperception with weight control related behaviors in Chinese middle and high school students.

METHODS

We used cross-sectional data from the 2017 Zhejiang Youth Risk Behavior Survey which that included 17,359 Chinese students, with 8,616 boys and 8,743 girls. Perceived weight status, as well as height, weight and weight control related behaviors information was collected via a self-reported questionnaire. Odds ratios (ORs) with 95% confidence intervals (CIs) calculated by multinomial logistic regression were used to assess the relationships between weight perceptions and weight control related behaviors.

RESULTS

Among the 17,359 students aged 9 to 18 years, the mean (SD) age was 15.72 (1.64) years. Overall, 34.19% of children and adolescents perceived themselves as overweight and the prevalence of weight misperception was 45.44%, with 35.54% overestimation and 9.90% underestimation. Children and adolescents perceiving themselves as overweight were more likely to have weight control behaviors, with OR was 2.60 (95% CI: 2.39-2.83) for weight control attempt, 2.48 (2.28-2.70) for exercising, 2.85 (2.60-3.11) for dieting, 2.01 (1.51-2.68) for taking laxatives, 2.09 (1.67-2.02) for taking diet pills, and 2.39 (1.94-2.94) for fasting, respectively, compared to those with right weight status. Among children and adolescents with overestimating weight status, the OR was 2.40 (2.22-2.59), 2.50 (2.31-2.70), 2.85 (2.61-3.11), 1.81 (1.39-2.37), 2.20 (1.77-2.74), and 2.16 (1.77-2.63) for weight control attempt, exercising, dieting, taking laxatives, taking diet pills, and fasting, relative to those with accurate weight perception.

CONCLUSIONS

Self-perceived overweight and weight misperception are prevalent in Chinese children and adolescents, and positively associated with weight control related behaviors.

[Body image is associated with anthropometric status in adolescents, but not with lifestyle]

Body image is a construct of the multifaceted representation of body identity that involves self-perception, beliefs, attitudes about the body itself, which can be influenced by several factors. This study evaluated the association of body image with anthropometric and lifestyle indicators among adolescents. The sample comprised 465 adolescents aged 10 to 17 years from public schools in the city of Salvador-Bahia. The Silhouettes Scale assessed the body image. The anthropometric data (body mass index and waist circumference), the lifestyle (Physical Activity Questionnaire for Adolescents and television time), economic and demographic data were evaluated. Polytomous logistic regression assessed associations of interest by STATA, version 16.0. Overweight (OR:9,7; CI95%:5,4-17,5) and abdominal obesity (OR:14,0; CI95%: 5,0-39,3) were positively associated with body dissatisfaction. However, there was no association with lifestyle variables (physical activity: OR: 1,7, CI: 0,9-2,9, and TV time: OR:1,2; CI:0,8-1,9). The conclusion reached is that anthropometric status is an essential indicator of adverse body image outcomes in adolescents.

Secular trends in body image dissatisfaction and associated factors among adolescents (2007-2017/2018)

OBJECTIVE

To assess secular trends in body image dissatisfaction and associated factors among adolescents over a 10-year period (2007-2017/2018).

METHODS

The sample included 1,479 (2007, n = 531; 2017/2018, n = 948) high school adolescents of both sexes, aged 14 to 18 years, of schools in a city in southern Brazil, in 2007 and 2017/2018. Data were collected on sex, age, physical activity (IPAQ, short form), anthropometric measurements (body weight, height, and triceps and subscapular skinfolds), and body image dissatisfaction (figure rating scale). The variables were compared with Independent samples t-test and Mann-Whitney U-test. The associations between sex and other variables were examined with chi-square test, and the factors associated with body image were identified with multinomial logistic regression.

RESULTS

Most adolescents were dissatisfied with their body image in 2007 (65,2%) and 2017/2018 (71,1%). The prevalence of body dissatisfaction increased by 9.2% over the 10-year period, particularly dissatisfaction with thinness (21.3%). After stratification by sex, in 2017/2018 sample, dissatisfaction with overweight was 46.1% greater in boys, and dissatisfaction with thinness was 66.9% greater in girls. Factors found to be significantly associated with body image dissatisfaction were physical activity level, and body adiposity.

CONCLUSIONS

There was a secular trend toward increased body image dissatisfaction in both sexes. Future efforts should go beyond scientific production, in public and private environments aimed at increasing awareness of health issues related to body care in the physical, psychological, and environmental domains.

Weight misperception and substance use: Brazilian Study of Cardiovascular Risks in Adolescents (ERICA)

BACKGROUND

Adolescence is a crucial period for body image formation. Weight misperception is the discrepancy between individuals' body weight perception and their actual nutritional status. Both weight concerns and substance use are common among adolescents, and there is evidence of an associations between these two variables. Thus, the aim of this study was to assess the association between weight misperception and substance use (smoking and alcohol) in a national sample of normal weight Brazilian adolescents.

METHODS

Data were obtained from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, multicenter, national, school-based survey, carried out in 124 municipalities with more than 100,000 inhabitants from Brazil. The sample included adolescents aged 12-17 years, classified as normal weight by nutritional status evaluation. The following measures were collected: weight underestimation and overestimation (exposure); having tried cigarette smoking, current smoking, current alcohol consumption, binge drinking and current smoking and alcohol consumption(outcomes); macro-region, sex, type of school, and excessive screen time (confounders). The frequency of variables was calculated with 95% confidence intervals (CI). Poisson regression models were used to estimate prevalence ratios (PR).

RESULTS

In total, data from 53,447 adolescents were analyzed. Weight misperception was present in a third of the adolescents, with similar prevalence of weight underestimation and overestimation. In adolescents aged 12-14 years, weight underestimation and overestimation were associated with having tried cigarette smoking (PR: 1.18 and 1.43, respectively), current alcohol consumption (PR: 1.33 for both weight misperception categories), and binge drinking (PR: 1.96 and 2.01, respectively). Weight underestimation was associated with both having tried cigarette smoking and current alcohol consumption in boys (PR: 1.14 and 1.16, respectively) and girls (PR: 1.32 and 1.15, respectively). In girls, weight overestimation was associated with all substance use variables (PR between 1.19 and 1.41).

CONCLUSIONS

Our results showed an association between weight misperception and having tried cigarette smoking, alcohol consumption, and binge drinking in younger adolescents. In addition, weight overestimation was associated with all substance use indicators in girls. Based on our findings, interventions aimed to improve weight perception in normal weight adolescents may contribute to the reduction of substance use in this population.

Body image and health-related behaviors among fitspirit participants

Background

Body image variables such as body size perception (BSP) and body size dissatisfaction (BSD) can influence health-related behaviors. However, few studies have investigated these body image variables in adolescent girls participating in a physical activity intervention. Therefore, the study objectives were to examine the 1) associations between health-related behaviors (physical activity, screen-time, eating habits and sleep duration) and BSP and BSD among girls participating in FitSpirit, a physical activity intervention for girls; and 2) influence of weight control practices on the association between health-related behaviors and BSP and BSD.

Methods

This cross-sectional study assessed a sample of 545 adolescent girls (mean age: 15.0±1.5 years) from 240 schools. Body mass index, health-related behaviors, perceived actual body size and desired body size variables were self-reported and collected via an online questionnaire at the end of the FitSpirit intervention. A negative BSP score [perceived actual body size – calculated BMI z-score] indicates an underestimation of body size. A positive BSD score [perceived actual body size – desired body size] indicates a desire to reduce body size. A multiple linear regression analysis examined the effects of age, zBMI and health behaviors on BSP and BSD. A second multiple linear regression analysis examined the independent associations between BSP and BSD by weight control practice. The linear relationships between BSP and BSD were evaluated with Pearson’s correlations.

Results

Underestimation and dissatisfaction of body size are more prevalent in participants living with overweight/obesity. Screen-time and sleep duration were independently associated with BSP score (Beta=0.02; P<0.05 and Beta=-0.07; P<0.05, respectively), whereas only screen-time was associated with the BSD score (Beta=0.07; P<0.001). Physical activity was independently associated with the BSP score only in participants trying to control (maintain) their weight (Beta=-0.18; P<0.05).

Conclusions

Body size overestimation and dissatisfaction are associated with health-related behaviors, specifically with more screen-time and less optimal sleeping habits. Physical activity level does not appear to be associated with body image in girls engaged in a physical activity intervention and who want to lose or gain weight. Health promotion interventions could include screen-time and sleep components as they may influence body image.

Social network addiction symptoms and body dissatisfaction in young women: exploring the mediating role of awareness of appearance pressure and internalization of the thin ideal

BACKGROUND

Previous studies testing for a direct relationship between social networking sites (SNS) addiction and body dissatisfaction (BD) have yielded inconsistent results. Here, we aimed to identify underlying processes that could mediate this relationship. Specifically, we studied the relationship between SNS addiction symptoms and BD through the awareness of appearance pressures and the internalization of beauty ideals, both individually and serially: SNS addiction → Awareness → BD; SNS addiction → Internalization → BD; SNS addiction → Awareness → Internalization → BD.

METHOD

A total of 368 female undergraduates with SNS accounts completed scales to assess SNS addiction symptoms (Social Network Addiction Questionnaire), BD (Body Shape Questionnaire), awareness, and internalization (Sociocultural Attitudes Towards Appearance Questionnaire-4; awareness and internalization scales). A theoretical serial mediation model was constructed to examine the proposed relationships. Body mass index was included as a covariate to control the influence of this important variable.

RESULTS

The results indicated that both awareness and internalization independently mediated the relationship between SNS addiction symptoms and BD. Also, there was a significant serial mediation effect; women with more SNS addiction symptoms tended to be more aware of appearance pressure, which was associated with the internalization of beauty ideals. In turn, this internalization was positively related to BD symptoms.

CONCLUSIONS

These findings shed light on the indirect relationship between SNS addiction and BD, demonstrating independent and accumulative mediating effects of awareness and internalization.

The Relationship Between Body Mass Index and Depression, Anxiety, Body Image, and Eating Attitudes in Adolescents in Iran

Background

The aim of this study was to investigate the relationship between body mass index (BMI) and depression, anxiety, body image, and eating attitudes in 12- to 16-year-old adolescents.

Materials and Methods

In this descriptive-analytical study on 437 students in Shahrekord, Iran, selected by two-step random sampling (selection of schools and students), participants were divided into normal weight (BMI: 5-85^th), overweight (BMI: 85-95^th), and obese (BMI >95^th) groups and completed the questionnaires and data were analyzed by SPSS version 23.

Results

BMI had a positive correlation with anxiety, depression, and dysfunctional eating attitudes, and negative correlation with body image in adolescents. Mean scores of depression and anxiety in both overweight and obese groups were significantly higher than those in normal weight adolescents but scores of body image and eating attitudes were not different between overweight and normal weight groups.

Conclusion

Obesity and overweight may have adverse effects on mental health of adolescents and more attention to psychological aspect of obesity can help us to provide better health services to overweight and obese adolescents.

Cross-sectional study of BMI, weight concern, body size perception, dieting and mental distress in adolescents: The HUNT Study

OBJECTIVE

We examined the associations between body mass index (BMI), weight concern, body size perception, dieting and mental distress in a population-based study of 7350 adolescents.

DESIGN

Cross-sectional.

SETTINGS

Data from a Norwegian population-based cohort, The Young-HUNT3 (2006-2008) from the county of Nord-Trøndelag, Norway.

PARTICIPANTS

A total of 7350 adolescents (13-19 years) who had both self-reported questionnaire data and anthropometric measures.

PRIMARY OUTCOME MEASURES

Odds for mental distress given sex, BMI, weight concern, body size perception and dieting. Analyses were performed in binomial logistic regression models.

RESULTS

Compared with being overweight/obese, having weight concern, irrespective of BMI, was associated with higher OR for mental distress (MD) among boys and girls. Body size overestimation was associated with an increase in the OR for MD, in participants who were overweight/obese, had weight concern or dieted. This effect was more pronounced in boys.

CONCLUSIONS

Weight concern and body-size estimation are strongly associated with mental health in adolescent boys and girls. Routine assessment of adolescents' attitudes towards their weight and body size is advised.

Relationship of eating behavior and self-esteem with body image perception and other factors among female college students of University of Delhi

BACKGROUND

Eating disorders (EDs) can lead to life-threatening nutritional deficiencies whereas self-esteem influences interpersonal relationships and academic performance. Excessive concerns about body image resulting in body dissatisfaction not only affect psychological well-being but also predisposes to disordered eating behaviors. The objective of this study is to assess the eating behavior and level of self-esteem, their relationship with body image perception and also identify factors associated with them among undergraduate female college students.

MATERIALS AND METHODS

This cross-sectional study was conducted among 180 female undergraduate students of University of Delhi. Sociodemographic characteristics and anthropometric measurements were recorded. Eating Attitude Test-26, Rosenberg Self-esteem Scale, Contour Drawing Rating Scale and Body Shape Questionnaire 34 were used to assess eating behavior, self-esteem, body image dissatisfaction and body shape concerns, respectively. Both descriptive and inferential statistics were used and binary logistic regression was applied to identify the factors determining high risk eating behavior and low self-esteem.

RESULTS

In this study, 27.8% of the study participants were overweight or obese, 30.6% had body shape concerns and 76.7% had body image dissatisfaction. Significant proportion (13.9%) of the participants was identified as high risk for the development of EDs and having low self-esteem (12.8%). Body shape concern and family influences were significant predictors of high risk eating behavior whereas type of college and family influences significantly predicted low self-esteem.

CONCLUSIONS

The study concluded that factors such as nutritional status, family influences, type of college and body shape concerns lead to high risk eating behavior and low self-esteem. These findings will help in creating awareness on importance of concept of positive body image, healthy weight control behaviors and in developing future interventions.

Analysis of Adolescent Physical Activity Levels and Their Relationship with Body Image and Nutritional Habits

The main objective of this research article was to make a cluster analysis in Compulsory Secondary Education students with regard to their physical activity levels, their relationship with nutritional habits and body perception. In this study, a total of 1089 students participated, to whom a battery of tests was given in order to assess three aspects: levels of physical activity, food consumption habits and perception of body image. The main results indicated that the adolescent sample presented high levels of physical activity in comparison with other studies. In addition, a profile analysis was carried out, showing that there were no differences in physical activity, in nutritional habits or in body-image index. Taking into account gender, women who practice light physical activity had better nutritional habits. On the other hand, boys dominated in the group of moderate-to-high physical activity, while the girls were mainly included in the profile of low physical activity. Finally, body-image index was greater in men than women. It was concluded that is necessary to promote the importance of adequate nutritional habits in addition to physical activity, and it is necessary to promote body image, particularly among adolescent girls, given their low values of physical activity and worse body-image perception in relation to boys.

Psychosocial Predictors of Body Weight Congruence in Adolescents Aged 15 and 17 Years in Poland: Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Background: Body weight congruence (BWC) has implications for adolescent health. The main goal of this study was to examine the distribution of BWC and its relationship with six psychosocial factors. Methods: A representative sample of N = 3508 adolescents aged 15 and 17 years (52.4% girls) derived from the Health Behaviour in School-aged Children study, conducted in 2017/2018 in Poland, was used. BWC groups were defined based on self-reported BMI and subjective assessment of weight: (1) correct perception; (2) overestimation, and (3). underestimation. Principal component analysis (PCA) extracted the following two factors: a socio-relational factor (SR) related to perceived social support and social self-efficacy, and a body attitudes and social media exposure factor (BAME). Using the total sample, multinomial logistic regression was applied to estimate their impact on the BWC, and gender-specific models were compared. Results: Half (48.6%) of the adolescents correctly estimated their body weight, 31.0% overestimated it (girls 43.9%, boys 17.1%), and 20.0% underestimated it (boys 37.2%, girls 9.0%). Overestimation of body weight concerns 48.0% of normal weight girls, 50.0% of underweight girls, and 21.3% and 32.1% of normal weight and underweight boys, respectively. The percentage of normal weight (34.4%), and overweight and obese (30.8%) boys who underestimated their body weight was three times higher than the respective percentages of girls that underestimated their weight (9.0% and 11.9%). The SR factor protected adolescents from both underestimation (only in girls) and overestimation in the total sample (OR 0.74, 95%CI 0.68–0.81) and both genders. BAME increased this risk of overestimation in both genders (OR = 1.83, 95%CI 1.67–2.0), and the risk of underestimation among boys. Conclusions: Prevention programmes should include a wide range of psychosocial factors to improve BWC among adolescents.

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

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

Relationships among Physical Self-Concept, Physical Activity and Mediterranean Diet in Adolescents from the Province of Granada

The aim of the present research was to analyse the relationships among physical self-concept, physical activity engagement and Mediterranean diet adherence in a sample of 1650 secondary school students from the province of Granada. The study design was descriptive-exploratory, cross-sectional and ex post facto. Measurements were taken from a single group. The PSQ, PAQ-A and KIDMED questionnaires were used to measure diet quality. Results showed the presence of a positive relationship among all dimensions of physical self-concept and physical activity engagement, with better outcomes being achieved in this self-perception with increasing engagement in sport. With regard to diet quality and its repercussions on physical self-concept, it was highlighted that the dimensions of the general self-concept, physical attractiveness and strength tended to be more positive as quality improved. In contrast, worse outcomes were produced in those with a low-quality diet. In this way, it was deemed necessary to continue investigating psychosocial factors with the aim of clarifying the relationships with psychological factors and health indicators. This would enable the development of prevention and intervention programs focused on promoting wellbeing in adolescents.

Protective and Risk Factors in Exercise Addiction: A Series of Moderated Mediation Analyses

For a minority of individuals, exercise may become excessive and lead to an addictive behaviour. To better understand the processes by which exercise could become an addiction, the present study examined the risk and protective factors of exercise addiction among regular exercisers, by investigating the role of drive for thinness, bulimia, body dissatisfaction, body image concerns, and self-esteem. A sample of 319 Italian regular exercisers (M_age = 30.78 years, SD = 11.98) completed the Italian versions of the Exercise Addiction Inventory, Eating Disorder Inventory-3 Referral Form, Body Image Concern Inventory, and Rosenberg Self-Esteem Scale. Data were analyzed by implementing a series of moderated mediations. Drive for thinness, bulimia, and body dissatisfaction were positively associated with exercise addiction. An indirect path was found in each of these relationships, which included the mediation of body image concerns, as well as a significant moderation of self-esteem in the associations between drive for thinness, bulimia, body dissatisfaction, and the mediator. High self-esteem appeared to be a protective factor. The higher the level of self-esteem, the less indirect the effects of thinness drive, bulimia, body dissatisfaction, and body image concerns were on exercise addiction. Such findings contribute to a better understanding concerning the risk and protective factors of excessive exercise, and may have important practical implications in structuring interventions to reduce risk of developing exercise addiction, as well as orienting future research.

Overestimation of body weight and its association with parental, teacher and peer support: evidence from the Israeli Health Behaviours in Schools survey

OBJECTIVE

To investigate the association between family, teachers and peer support patterns on gaps in adolescent's weight perceptions.

DESIGN

A cross-sectional, school-based survey collected information on weight and height, weight perception, socio-economic and family characteristics and social support. Principal component analysis (PCA) was performed to capture social support patterns (SSP). Multivariable logistic regression was used to model adolescent weight perception, including SSP adjusted for demographic variables.

SETTING

The 2014 Israeli Health Behaviours in School-Aged Children (HBSC) survey.

PARTICIPANTS

Adolescents aged 11-18 years (n 7563).

RESULTS

In total, 16·1 % of the boys and 10·7 % of the girls were overweight or obese. Most participants perceived their size accurately. Body size was underestimated by 25·6 % of the boys and 15·1 % of the girls, while 15·2 % of the boys and 27·7 % of the girls overestimated their body size. PCA generated three SSP accounting for 81·9 % of the variance in social support. Female sex and higher SES increased odds of overestimating body size. Students in the top quartile (Q4 v. Q1-Q3) of family support and teacher support were less likely to overestimate their body size. Good parental communication reduced the odds of body size overestimation in middle school students. Male sex and higher family support increased odds of underestimation.

CONCLUSIONS

Significant support from parents and teachers was associated with accurate weight perceptions; thus, support skills may be amenable to intervention. Efforts should be made to educate adolescents on healthy weight.

Association Between Food Choices Motivators and Physical Activity in Body Image (dis)Satisfaction in Portuguese Adolescents

Concerns about weight and body image are common among adolescents since they are particularly vulnerable to body-image dissatisfaction due to the normal physiological, social, and psychological changes they are going through. This study aims to analyse the relationship between food choice motivations and physical activity in body-image perception among adolescents. Twelve to sixteen years old adolescents were recruited from three school districts. The Portuguese version of the Food Choices Questionnaire (FCQ) was used to assess food choice motivators, and the Quantification de l'Activité Physique en Altitude Chez les Enfants was used to assess physical activity and to calculate daily energy expenditure (DEE). Body image perception was measured using Collins' sequence of seven silhouettes. Body image (dis)satisfaction was estimated by the present body shape minus the desired body shape. ANOVA and Kruskal-Wallis tests were performed to compare groups, and the post-hoc Bonferroni test was used to compare target groups. A multinominal logistic regression was performed to analyse the association between gender, age, hours of sport's competition, FCQ, and body dissatisfaction. All analyses were performed in IBM SPSS Statistics 26.0. The sample comprised 286 adolescents (51.4% females). Means of FCQ categories varied between 0.33 and 0.97 (range: −2 to 2). Regarding the categories of FCQ, statistically significant differences were found in the category of body satisfaction and weight control among the three groups (p = 0.004). A preventive effect was found of choosing food regarding body satisfaction and weight control, on body-image dissatisfaction.

Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children

Background and Objectives: The perception of the body weight by children and parents influences the consequent actions undertaken for children’s body weight management. This study investigated the correspondence between objective evaluations of Romanian school children (actual weight) and perceptions about weight (perceived weight), preoccupation with body weight management (desired weight) and parents’ perceptions on children’s weight. Materials and Methods: A cross sectional study was performed among 344 children aged 11 to 14 and 147 parents from Cluj-Napoca, Romania. We made anthropometric measurements of children, and short questionnaires were completed by the children and the parents. Results: The results show that 3.8% of children were underweight, 68.3% had a normal weight and 27.9% were overweight. Of this sample, 61.5% of underweight children, 20% of normal weight children and 43.7% of overweight children had misperceptions about their weight. The percentage of parents who did not estimate their children’s weight correctly was 50%, 11.9% and 41.5%, respectively, for each of the three weight groups. The results of the logistic regression analyses showed that several factors were associated with the misclassification of their own body weight by the children, such as body mass index, gender, weight management practices, misclassification by the parents as well as parent–child discussions on these issues. Conclusions: Education for both Romanian parents and children is needed with regard to correctly identifying and managing children’ body weight.

Comparison between self-image and body mass index among children living in a slum in Rio de Janeiro, Brazil, 2012

OBJECTIVE

To analyze agreement/discrepancy between body self-image and Body Mass Index (BMI), according to variables related to type of food and environment influence.

METHODS

This was a cross-sectional analysis of 195 prepubescent children (≥5 years), attending a Primary Health Care service in Manguinhos, Rio de Janeiro. Z-scores were applied to classify BMI. Self-image was collected using the figure rating scale (silhouettes) validated for children. A multinomial model was used to estimate covariate association with the underestimated/overestimated BMI outcome in relation to self-image.

RESULTS

Overweight children underestimated their BMI, as compared with self-image, more often (58.6%) than obese children (22.0%) and children with adequate BMI (49.0%). This dissociation was correlated to participation in a cash transfer program (OR=2.01 - 95%CI 1.04;3.90) and daily consumption of sugar-sweetened foodstuffs (OR=3.88 - 95%CI 1.05;14.39).

CONCLUSION

Underestimation of BMI among overweight children should be taken into account by Primary Health Care services, in order to enhance intervention practices.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Associations Between Weight Perception, Unhealthy Weight Control Behavior, and Suicidal Ideation and Planning Among Korean Adolescents: A National Cross-Sectional Secondary Analysis

PURPOSE

This study aimed to investigate the associations between weight perception, unhealthy weight control behavior, and suicidal ideation and planning and identify the role of unhealthy weight control behavior as a mediator in these associations among Korean adolescents.

DESIGN AND METHODS

This national cross-sectional secondary study used data from the 2015-2017 Korea Youth Risk Behavior Web-Based Surveys, with a final sample of 96,285 adolescents who tried to manage their weight in the 30 days prior to the surveys. A multivariate logistic regression was conducted.

RESULTS

Both adolescent groups who perceived themselves to be underweight or overweight were significantly linked to a greater likelihood of suicidal ideation and planning (COR, 95% CI = 1.249, 1.141-1.367; COR, 95% CI = 1.339, 1.282-1.399) respectively. While adolescents with perceptions of being underweight are associated with suicidal ideation and planning through the suppression effect of unhealthy weight control behavior (Pathway A: OR, 95% CI = 0.628, 0.587-0.671), adolescents with perceptions of being overweight are linked with the same through the mediation effect (Pathway A: OR, 95% CI = 1.195, 1.141-1.251).

CONCLUSIONS

Adolescents with perceptions of being overweight are highly likely to have unhealthy weight control behavior that can be linked to the possibility of suicidal ideation and planning, while adolescents with perceptions of being underweight are comparatively less likely to engage in such behavior.

PRACTICE IMPLICATIONS

It is necessary to identify the status of weight perception among adolescents and closely monitor the unhealthy weight control behavior to prevent suicidal ideation and planning.

Gender specificities of cardiovascular risk factors in students

Aim. To study gender differences in the prevalence of cardiovascular risk factors (RF) among higher education medical students.

Material and methods. We examined 74 men and 143 women studying at higher education medical institution. Behavioral and biological RF were evaluated. Psychoemotional status of participants was evaluated by Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale-10 (PSS-10). Statistical analysis was carried out using the software package Statistica 10.0 (StatSoft Inc).

Results. Among men, a significantly higher percentage of patients with overweight (body mass index ≥25 kg/m2), higher blood pressure (BP), higher level of cholesterol, and smoking were recorded. Among women, a higher percentage of patients with tachycardia, a sedentary lifestyle, impaired sleep quality and falling asleep were recorded. Sleep duration in young women was significantly lower, and the level of anxiety, depression and stress were higher compared to men. Significant relationships between gender and psychological factors have been identified. Among women, correlations of psychological factors with such parameters as heart rate, total cholesterol, falling asleep and sleep quality were revealed. Among men, significant correlations of anxiety with increased BP, stress and exercise, as well as the presence of cardiovascular diseases in the father were revealed.

Conclusion. Gender specificities of RF were revealed: among men — higher frequency of metabolic disorders and higher blood pressure, and among women — psychological factors and low physical activity. It is reasonable to take they into account when developing and implementing individual diagnostic, treatment and prophylactic measures in students.

Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents

Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.

Dissatisfaction with Body Weight among Polish Adolescents Is Related to Unhealthy Dietary Behaviors

The aims of the study were to determine the socio-demographic factors that may affect body weight dissatisfaction and to analyze the relationship between eating habits and dissatisfaction with body weight among a national random sample of Polish adolescents aged 13–19 years. Data on gender, age, level of education, body weight status, screen time, body weight satisfaction and selected nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students from 207 schools participated in the study. A significant effect of gender, age, level of education, body weight status and screen time status on the participants’ dissatisfaction with the body weight was observed. The greater prevalence of body weight satisfaction was observed among boys, younger subjects, secondary school students, adolescents with normal body weight status and those with screen time up to 2 h. Whereas girls, older study participants (17–19 years old), overweight/obese adolescents and subjects with screen time over 4 h were more often dissatisfied with body weight. Furthermore, it has been shown that participants dissatisfied with their body weight less often met dietary recommendations. These findings can help dietitians, nutritionists and healthcare professionals to provide age-specific and gender-specific nutrition strategies to promote healthy lifestyle among school-going adolescents.

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

BACKGROUND/AIM

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

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION

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

Examining Body Appreciation and Disordered Eating in Adolescents of Different Sports Practice: Cross-Sectional Study

This cross-sectional study aimed to examine the associations between body appreciation, body functionality and disordered eating in a large adolescent sample of different levels and types of sports practice. Method: The sample consisted of 1412 adolescents (59.8% were girls). The ages ranged from 15 to 18 years old, with a mean age of 16.9 (SD = 0.5) for girls and 17.0 (SD = 0.4) for boys. Participants completed an anonymous questionnaire assessing the nature of sports participation, body appreciation, body functionality, self-esteem, body dissatisfaction, internalisation of sociocultural beauty ideals and disordered eating. A two-way ANOVA was employed to test the differences in body image concerns, body appreciation, perceived physical fitness and disordered eating behaviours in gender groups and groups of different sport types and levels. Multiple linear regression analyses were performed to predict disordered eating behaviours of different study variables. Results: Participants of leisure and competitive sports reported greater body appreciation, self-esteem and lower body dissatisfaction compared to non-participants. No differences in body appreciation and disordered eating were observed in adolescents involved in weight-sensitive and less weight-sensitive sports. Body appreciation and body functionality were associated with lower disordered eating in adolescent girls not participating in sports, leisure exercisers and participants of competitive sport as well as in boys participating in competitive sports, controlling for body mass index. Adolescent boys demonstrated greater body appreciation compared to girls. Conclusions: The results of this study support the knowledge of the protective role of positive body image preventing dysfunctional eating in adolescent girls of various sports practice and in competitive sports involved boys. Disordered eating prevention and clinical treatment programs for adolescents of different physical activity might benefit from including education about body appreciation and functionality.

Associations between Body Appreciation and Disordered Eating in a Large Sample of Adolescents

Body appreciation is one of the main facets of a positive body image. The present study aimed to examine the psychometric properties of the Lithuanian version of the Body Appreciation Scale-2 (BAS-2-LT) and test the associations between body appreciation and disordered eating in a large sample of adolescents of both genders. Method: The sample consisted of 1412 adolescents (40.2% were boys). The ages ranged from 15 to 18 years (92.4% were 17), with a mean age of 16.9 (SD = 0.5) for girls and 17.0 (SD = 0.4) for boys. Participants completed the BAS-2-LT alongside the measures of body dissatisfaction, disordered eating, body mass index, self-esteem, body functionality, and participation in sports. Linear regressions were used to test the associations between study variables and disordered eating. Results: BAS-2-LT replicated the original one-dimensional structure in girls and boys. Invariance across genders was established. The instrument showed good internal consistency and temporal stability. Body appreciation was negatively correlated with higher levels of body mass index, body dissatisfaction, and disordered eating. Positive associations were observed between body appreciation, self-esteem, body functionality, and sports participation. Higher levels of body appreciation decreased the risk of disordered eating behaviors in both genders. Conclusions: The results of the present study support the psychometric properties of BAS-2-LT. Body appreciation is associated with lower disordered eating in adolescent girls and boys. These findings present empirical support for the development of interventions programs that promote positive body images and aim to prevent disordered eating in adolescent boys and girls.

Validation of the Lithuanian version of the Eating Disorder Examination Questionnaire 6.0 in a student sample

BACKGROUND AND OBJECTIVES

The Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) is one of the most broadly used self-report tools that assesses attitudes and behaviors associated with eating disorders (EDs). The aim of the present study was to examine the reliability, validity, and factor structure of the Lithuanian version of the EDE-Q 6.0 (LT-EDE-Q 6.0) in a nonclinical student sample.

MATERIALS AND METHODS

A sample of 382 students (mean age 24.0 ± 6.4) participated in the study. The students completed a self-report questionnaire measuring the risk of EDs (LT-EDE-Q 6.0), body image (LT-MBSRQ-AS), quality of life (LT-WHOQOL-BREF), and self-esteem (RSES). Cronbach's alpha assessed the internal consistency of the EDE-Q 6.0. Pearson's correlations were used for the analyses of the construct and concurrent validity with the subscales of LT-MBSRQ-AS, LT-WHOQOL-BREF, and RSES. Intraclass correlation coefficients (ICC) were calculated for assessing test-retest reliability.

RESULTS

The mean score of the LT-EDE-Q 6.0 in the mixed sample was 1.5 ± 1.02. For women and men, the general mean scores were higher than in the majority of the samples of Western Europe but lower than in the United States. Acceptable internal consistency for the four subscales (0.75-0.88) and the LT-EDE-Q 6.0 general score (0.94) was obtained. Test-retest reliability was good to excellent for all subscales (0.66-0.91) and for the items that assessed essential behavioral features of EDs (0.84-0.90, except item 14 ICC = 0.4). The LT-EDE-Q 6.0 scores had adequate concurrent validity. However, the original 4-factor structure or other proposed models of EDE-Q were not obtained by CFA.

CONCLUSIONS

The results of the current study support the applicability, validity, and reliability of the LT-EDE-Q 6.0 in a nonclinical Lithuanian student sample. However, we recommend assessing the general scale score without the application of the subscales. The Lithuanian version of this instrument should be further investigated with clinical samples to identify clinically diagnosed cases.

Validation of the Lithuanian Version of the Sociocultural Attitudes towards Appearance Questionnaire-4 (SATAQ-4) in a Student Sample

The Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) is one of the most broadly used self-report tools that assess the general role of sociocultural influences on body image and appearance-related internalization. The present study aimed to examine the reliability, validity, and factor structure of the Lithuanian version of the SATAQ-4 (LT-SATAQ-4), as a screening self-report instrument for assessing the role of sociocultural influences on body image. A mixed-gender sample (N = 1850) of undergraduate students (88.7%) and graduate students (11.3%) from different state universities and colleges participated in this study (average age 21.6 ±5.0). The students completed a self-report online questionnaire. Intraclass correlation coefficients (ICCs) were calculated for assessing test-retest reliability. The construct validity of the Lithuanian Sociocultural Attitudes Towards Appearance Questionnaire-4 (LT-SATAQ-4) was studied performing exploratory factor analysis (EFA), and then confirmatory factor analysis (CFA). The mean scores for the LT-SATAQ-4 subscales ranged from 1.6 ± 0.9 (Pressure subscale: Peers) to 2.7 ± 1.2 (Internalization subscale: Thin/Low Body Fat). Test-retest reliability was good to excellent for the general and subscale scores (0.85-1.00) except for the Pressure subscale: Peers (0.60). The original 5-factor structure was confirmed by EFA and CFA. Good to excellent internal consistency for each subscale (attempted 0.9 and more) and for the LT-SATAQ-4 global scale (0.91) was obtained. The LT-SATAQ-4 scores had adequate concurrent validity with the measures of the body image, disordered eating, self-esteem, and body mass index. The results support the psychometric properties of the LT-SATAQ-4 and its' use in Lithuanian student samples. The Lithuanian SATAQ-4 is a useful measure to examine the pressures to internalize appearance ideals in Lithuanian-speaking samples of young individuals.

Peer Victimization in Overweight Adolescents and Its Effect on Their Self-Esteem and Peer Difficulties

This study has three objectives: to examine whether adolescents who perceive themselves as overweight differ from others in terms of offline victimization at school, cybervictimization, self-esteem, and difficulties relating to peers; to examine the possible effects of offline and cybervictimization on self-esteem and difficulties relating to peers; and to examine the possible moderating role of perceiving oneself as overweight on those effects. Previously validated questionnaires were applied to a sample of 3145 adolescents in Asturias (Spain). Descriptive, inferential, correlational, and structural equation analyses were performed. Adolescents who perceived themselves as overweight reported being victims of both offline victimization and most forms of cybervictimization to a greater extent than those who did not perceive themselves as overweight. They also reported lower self-esteem and more peer difficulties (shyness or social anxiety). In both groups of adolescents, victimization and cybervictimization were correlated with each other, both types of victimization had direct, negative effects on self-esteem, and self-esteem in turn had a direct, negative effect on peer difficulties. Furthermore, offline victimization had a direct, positive effect on peer difficulties. Perceiving oneself as overweight moderated the effect of self-esteem on peer difficulties. In adolescents perceiving themselves as overweight, low self-esteem was a stronger risk factor of peer difficulties than in the rest of the adolescents. With high overall self-esteem there were no significant differences in peer difficulties between the adolescents perceiving themselves as overweight and the rest of the adolescents.

Body Image and Disturbed Eating Attitudes and Behaviors in Sport-Involved Adolescents: The Role of Gender and Sport Characteristics

Disordered eating in adolescents who participate in sports is an issue of great concern. However, very few studies have examined the prevalence of sport-related determinants of disturbed eating attitudes and behaviours (DEABs) in sport-involved adolescents. The present study aims to assess body image and DEABs in the sample of adolescents involved in a sport of different characteristics (competitive sport, leisure sport; weight-sensitive and less-weight-sensitive sport) and to compare the results with those of the controls. A total sample of 732 adolescents (437 (59.4%) were female) participated in the study. The participants ranged in age from 16 to 19 years (mean = 17.2, SD = 0.6). Study participants completed a questionnaire assessing sports characteristics, body image, disordered eating, and health-compromising eating behaviours. Analysis of covariance was used to test the differences of major study variables between controls and weight-sensitive and less-weight-sensitive leisure and competitive sports groups. There was no significant difference observed in DEABs between the sports groups. Competitive athletes reported more satisfaction with body image than controls. The girls participating in weight-sensitive leisure sports reported higher overweight preoccupation and greater DEABs compared to those participating in less-weight-sensitive leisure sports. Boys participating in weight-sensitive leisure sports reported a greater drive for muscularity-related behaviour compared to those participating in less-weight-sensitive leisure sports. There was no observed interaction between gender and weight sensitivity in the competitive sports group. Adolescents involved in a competitive sport demonstrated greater body image satisfaction and did not seem to present a greater risk for DEABs than controls. Special prevention attempts for lowering body image concerns and DEABs should be addressed for adolescents participating in a weight-sensitive leisure sports.

Are Adolescent Body Image Concerns Associated with Health-Compromising Physical Activity Behaviours?

The present study aimed to assess the-prevalence of health-compromising eating and physical activity behaviours, and to test their associations with physical activity, internalisation of sociocultural attitudes towards appearance, and body image in a sample of adolescents of both genders. A total sample of 736 adolescents (437 or 59.4% were girls) participated in the study. The participants ranged in age from 16 to 19 years (x = 17.2, SD = 0.6). The sample completed a questionnaire measuring body mass index, the risk of eating disorders, body image, internalisation of sociocultural ideals of appearance, health-compromising eating behaviours (HCEB), and health-compromising weight control related to physical activity behaviours (HCPAB). Logistic regressions were used to assess the associations between the study variables and predictors of HCEB and HCPAB. The results of the study showed a relatively high prevalence of HCEB with a significantly higher prevalence in girls and participants with a higher BMI. The study also demonstrated that the prevalence of adolescent HCPAB was higher than HCEB. The internalisation of sociocultural attitudes towards appearance and body image concerns were higher in the HCEB and HCPAB groups. Female gender (OR = 1.88; 95% PI = 1.10⁻3.18), HCPAB (OR = 1.19; 95% PI = 1.10⁻1.28), a preoccupation with being overweight (OR = 3.43; 95% PI = 2.52⁻4.66), and body weight evaluation as too high (OR = 2.40; 95% PI = 1.57⁻3.68) were significant predictors of HCEB. More frequent physical activity (OR = 3.02; 95% PI = 1.76⁻5.17), HCEB (OR = 1.22; 95% PI = 1.11⁻1.32), and perceived pressures to conform to popular beauty ideals (OR = 1.51; 95% PI = 1.12⁻2.03) predicted higher HCPAB. HCPAB is an important variable associated with adolescents' body image, physical activity, and weight control. The results of the present study are important for health promotion and education programs addressing adolescents' healthy lifestyle, weight control, and body image concerns.