Hazards of attempted weight loss

Weight and perceptions of body image in women and men in a Sydney sample

Using a modification of the distorting camera technique, 50 obese women (body mass index (BMI; kg/m2 35.1 +/- 1.1), 40 obese men (BMI 38.2 +/- 1.5) and their respective normal weight controls estimated their body size. The obese women, control women and obese men overestimated their body size, whilst control weight men were accurate. The control men were satisfied with their body size, control women less so and the obese were unsatisfied. Whilst the control women considered themselves overweight (BMI 26.7 +/- 0.8 compared to actual BMI 23.1 +/- 0.5, P less than 0.001) their preferred and actual body sizes were identical. There were no differences between obese subjects and controls in the sizes they considered healthy and attractive. The accepted normal size range for a woman was lower than that accepted for men. Older men (both obese and normal weight) accepted larger sizes for women than younger men. These results show that the obese overestimated their body size and supports the notion that there is social pressure on women to strive towards a slimmer ideal, whilst overweight men are more accepted.

Improving the body image, eating attitudes, and behaviors of young male and female adolescents: a new educational approach that focuses on self-esteem

OBJECTIVE

This study examines the effect of an interactive, school-based, self-esteem education program on the body image and eating attitudes and behaviors of young male and female adolescents following the program and after 12 months.

METHOD

All 470 eligible students (63% female) aged 11-14 years volunteered to participate. The intervention group students participated in the program, whereas the control group students received their scheduled personal development and health class.

RESULTS

The program significantly improved the body satisfaction of the intervention students and significantly changed aspects of their self-esteem; social acceptance, physical appearance, and athletic ability became less important for the intervention students and more important for control students. Female intervention students rated their physical appearance as perceived by others significantly higher than control students and allowed their body weight to increase appropriately by preventing the age increase in weight-losing behaviors of the control students. One year after the intervention, body image and attitude changes were still present. These findings also held for the 116 students (63% females) with low self-esteem and higher anxiety, who were considered at risk for the development of eating disorders. These students also had significantly lower drive for thinness and greater body satisfaction following the intervention and the decreased importance of physical appearance to their self-esteem was present at 12 months. Control at-risk students significantly decreased their body weight, whereas the weight of the intervention at-risk students significantly increased. The intervention program was effective, safe, having no effect on measures of students' anxiety or depression, and was rated highly by students.

DISCUSSION

This is the first controlled educational intervention to successfully improve body image and to produce long-term changes in the attitudes and self-image of young adolescents. This new approach to prevent the development of eating disorders by improving self-esteem may be effective, particularly if reinforced by teachers and family.

Body image disturbances and their change with videofeedback in anorexia nervosa

Disturbance in the way the body is experienced is a diagnostic criterion for anorexia nervosa, and impedes recovery. A method relatively free of external prompts, to reduce the potential for experimentally induced biases, evaluated body image distortions (BID) in 18 patients with anorexia nervosa soon after admission to an inpatient unit, and 18 normal controls, before and after a videofeedback session. The BID were assessed in the affective and self/social domains by visual analogue scales in which the instructional set oriented subjects to (a) the sensation of fatness (Affective Response, AR), and (b) size compared with other young women (Comparative Size Response, CSR). The AR and CSR were significantly greater than normal in anorexia but decreased significantly with videofeedback, while values for controls were stable. The AR and CSR were only partially independent, indicating overlap of the domains. In anorexia only, the responses were related to two DSM-IV diagnostic criteria for anorexia, fear of gaining weight and health-weight concerns, as well as to drive for thinness and body dissatisfaction. Fear of gaining weight occupied a central position in determining the magnitudes of BID and the other measures, including anxiety and depression.

The behavioural epidemiology of weight control

Excess body weight is associated with increased health risk, but there are also risks to health related to weight-control practices. While representative population data are available on the anthropometry of body weight and its sociodemographic correlates in Australia, less is known about the population prevalence and correlates of weight-control behaviours. We examine the prevalence of overweight and obesity, and low body weight, in the Australian population, using data from studies in which height and weight have been objectively measured; we describe the sociodemographic correlates of overweight and obesity; we outline relevant aspects of Australian health-system and private-sector approaches to body weight control; and we describe the findings of Australian studies of weight-control practices and related beliefs and attitudes. These findings relate mainly to women, particularly younger women, and little is known about the weight-control practices of Australian men. We suggest research which may promote a better understanding of weight-control practices in the Australian population.