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Van Dyne A, Washington N, Villodas M, Cronan T. Racial and Ethnic Disparities in Weight Loss Behaviors Among US College Students. Psychol Res Behav Manag 2023; 16:857-873. [PMID: 36960414 PMCID: PMC10028297 DOI: 10.2147/prbm.s395357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose Weight loss behaviors are prevalent among college students and are associated with adverse physical and psychological outcomes, such as an elevated risk of developing an eating disorder. While cross-ethnic differences have been reported, no consistent pattern has emerged. The purpose of this study was to examine racial and ethnic differences in weight loss behaviors among female and male college students. Patients and Methods The American College Health Association-National College Health Assessment (ACHA-NCHA) II-C survey data from the collection periods from 2015 to 2019 was used. A total of 426,425 students participated in the survey. Most participants were White (60%) and female (68.5%). Information on students' age, body mass index (BMI), and self-rated health was also collected. Logistic regression analyses were performed to determine cross-ethnic differences in weight loss methods among female and male students. Results Students' weight loss behaviors were assessed and included dieting, exercising, vomiting or taking laxatives, and the use of diet pills in the past 30 days. More than half of the participants attempted to lose weight through exercise (53.5%), and 40.3% of students dieted to lose weight in the past month. Purging and the use of diet pills were endorsed by 2.9% and 2.8% of the participants, respectively. With few exceptions, male students from racial and ethnic minority backgrounds were more likely to engage in extreme weight control practices (ie, vomiting or taking laxatives, taking diet pills) than White male students, while female students from racial and ethnic minority backgrounds were less likely to use diet and exercise as weight loss methods than White female students. For all outcomes, Biracial/Multiracial and Hispanic/Latino male students were more likely to attempt weight loss than White male students. Biracial/Multiracial female students more frequently endorsed extreme weight control behaviors than White female students. Conclusion The results of the present study add to the growing body of literature on the relationship between race and ethnicity and weight loss behaviors. The findings indicate the need for tailored educational and intervention programs on college campuses.
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Affiliation(s)
- Angelina Van Dyne
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Nicole Washington
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Miguel Villodas
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Terry Cronan
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Correspondence: Terry Cronan, Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA, Tel +1619 594-6915, Fax +1619 594-1247, Email
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Ethnic/racial and gender differences in disordered eating behavior prevalence trajectories among women and men from adolescence into adulthood. Soc Sci Med 2022; 294:114720. [PMID: 35033795 PMCID: PMC8821169 DOI: 10.1016/j.socscimed.2022.114720] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Disordered eating behaviors (DEB) are highly prevalent and are associated with negative long-term health outcomes. Extant research on DEB prevalence trajectories has predominantly focused on white women, thereby lacking both gender and ethnic/racial diversity, which may lead to preventive interventions that are not optimally timed for socially minoritized groups. The purpose of this study was to identify patterns in DEB trajectories from adolescence to adulthood across intersecting gender and ethnic/racial identities. METHODS Participants (n = 1314) were from Project EAT (Eating and Activity in Teens and Young Adults), a population-based sample in the United States. Unhealthy weight control behaviors and binge eating were assessed across four waves at 5-year intervals. Gender-stratified generalized estimating equations (GEE) analyses were applied to examine ethnic/racial and gender differences in the prevalence trajectories of two forms of DEB (unhealthy weight control behaviors and binge eating). RESULTS Hispanic/Latina young women reported heightened prevalence of unhealthy weight control behaviors and binge eating during adolescence (82.4% and 31.1%) relative to women with other ethnic/racial identities (44-70.2% and 8.8-18.2%) at any other developmental time point. Black/African American women reported linear increases in unhealthy weight control behaviors from adolescence (46.6%) to adulthood (65.5%), with nearly 20% greater prevalence relative to white women (44.6%) during adulthood. Among men, prevalence of unhealthy weight control behaviors was higher among Hispanic/Latinos (60.7-68.0%) and Asian Americans (41.9-56.7%) relative to Black/African American (24.6-36.9%) and white men (25.7-34.9%). Similarly, Hispanic/Latino young men reported up to ten or more times higher prevalence of binge eating during adolescence (22.8%) and adulthood (26.8%) relative to men from other ethnic/racial identities at any other time point (1.7-12.3%). CONCLUSIONS Ethnic/racial disparities in DEB prevalence vary across development, DEB subtype, and by gender. Targeted preventive interventions, or interventions that address these different trajectories, that are optimally timed may reduce these disparities.
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Han S. Asian Values, Intergenerational Conflict, Needs, and Attachment in Asian/Asian American Women’s Disordered Eating. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000020903561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
I tested a path model that integrated cultural and psychological factors as predictors of disordered eating among Asian and Asian American college women. Asian values of honoring family through achievement and conformity to norms, and intergenerational family conflict due to acculturation gap were the cultural predictors. Psychological needs thwarting and anxious parental attachment were the indirect psychological factors through which the cultural factors predicted disordered eating. Two-hundred forty-four Asian and Asian American women participated in an online survey. Structural equation modeling analysis results indicated that the Asian value of honoring family through achievement and intergenerational family conflict were indirectly associated with both binge eating and restricted eating via thwarted psychological needs, but not via anxious parental attachment. The Asian value of conformity to norms was directly associated with restricted eating. These cultural factors need to be addressed when treating disordered eating among Asian/Asian America women.
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Durocher E, Gauvin L. Adolescents' Weight Management Goals: Healthy and Unhealthy Associations with Eating Habits and Physical Activity. THE JOURNAL OF SCHOOL HEALTH 2020; 90:15-24. [PMID: 31813165 DOI: 10.1111/josh.12848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 08/17/2018] [Accepted: 08/30/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study aims to quantify associations between one's weight management goal and eating behaviors and physical activity among teenagers. METHODS Weighted logistic regressions were performed predicting healthy behaviors from weight goal separately for boys and girls while controlling for age, body mass index, socioeconomic indicators, school type, and region using data from the 2010 to 2011 Enquête québécoise sur la santé des jeunes du secondaire, a survey of a representative sample of Quebec adolescents (N = 32,040). RESULTS About 18%, 31%, 19%, and 34% of boys and 32%, 34%, 5%, and 25% of girls were respectively trying to lose weight, maintain their weight, gain weight, and not trying to do anything about their weight. Trying to lose weight was associated with lower likelihood of eating breakfast daily (boys: odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.61, 0.84 girls: OR = 0.61; 95% CI = 0.54, 0.70). Among girls, trying to lose weight was also associated with higher likelihood of consuming at least 5 portions of fruits and vegetables (OR = 1.20; 95% CI = 1.04, 1.37), lower likelihood of drinking sugar-sweetened beverages daily (OR = 0.77; 95% CI = 0.66, 0.90). Each weight-related goal was associated with unhealthy behaviors but most of them were also associated with adoption of healthier ones. CONCLUSION Having a weight related goal cannot inherently be thought of as health promoting goal.
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Affiliation(s)
- Elyse Durocher
- Faculty of Health Sciences, University of Ottawa, 125 University (418A), Ottawa, Ontario, Canada, K1H 8M5
| | - Lise Gauvin
- École de santé publique de l'Université de Montréal, Researcher & Associate Scientific Director, Population Health Research, Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 St-Denis Street, 1st Floor, S01-118, Montréal Québéc, Canada, H2X 0A9
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Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019. [PMID: 28646354 DOI: 10.1007/s10802-017-0322-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.
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Jones CL, Fowle JL, Ilyumzhinova R, Berona J, Mbayiwa K, Goldschmidt AB, Bodell LP, Stepp SD, Hipwell AE, Keenan KE. The relationship between body mass index, body dissatisfaction, and eating pathology in sexual minority women. Int J Eat Disord 2019; 52:730-734. [PMID: 30882921 PMCID: PMC7010242 DOI: 10.1002/eat.23072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Eating pathology is more prevalent among women compared to men, but prevalence and correlates associated with eating pathology likely vary among subgroups of women. This study examines prevalence and correlates of restrictive and weight control-related eating pathology in sexual minority women. METHOD Data were collected from the Pittsburgh Girls Study (PGS). Participants reported on sexual orientation, and race, and body mass index (BMI) was derived from interviewer collected height and weight. Participants completed the Body Image Measure and the Eating Attitudes Test-26. RESULTS Sexual minority women reported higher BMIs [F (1, 862) = 14.69, p < .001], higher levels of body dissatisfaction [F (1, 960) = 3.12, p < .01], and higher levels of eating pathology [F (1, 950) = 14.21, p < .001] than heterosexual women. Body dissatisfaction mediated the relationship between BMI and eating pathology, and levels of associations were not attenuated by sexual minority status. Race moderated the association between sexual orientation and eating pathology; compared to all other groups, White sexual minority women had the highest level of eating pathology. Discussion Results indicate that White sexual minority women have higher levels of eating pathology than Black sexual minority women and both Black and White heterosexual women. Future studies that draw from larger and more diverse, community-based samples are needed.
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Affiliation(s)
- Cherrelle L. Jones
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Jillianne L. Fowle
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Rimma Ilyumzhinova
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Johnny Berona
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Kimberley Mbayiwa
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lindsay P. Bodell
- Department of Psychology, University of Western Ontario, London, Ontario
| | - Stephanie D. Stepp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kate E. Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
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Albeeybe J, Alomer A, Alahmari T, Asiri N, Alajaji R, Almassoud R, Al-Hazzaa HM. Body Size Misperception and Overweight or Obesity among Saudi College-Aged Females. J Obes 2018; 2018:5246915. [PMID: 29951311 PMCID: PMC5987306 DOI: 10.1155/2018/5246915] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 01/17/2018] [Accepted: 02/22/2018] [Indexed: 11/23/2022] Open
Abstract
The aim of the study was to investigate the associations between perceived and desired body size and overweight and obesity among college-aged females. A multistage stratified cluster random sample was used to select 907 healthy females from a major Saudi public university. The Stunkard Figure Rating Scale (FRS) was used for body size assessment. Overweight/obesity classification was based on BMI less than or equal to/greater than 25 kg/m2. Overweight plus obesity prevalence was 28.1%. There were significant differences between females with overweight/obesity and those without overweight/obesity in both perceived and desired body size scores. Compared with only 4% of females without overweight/obesity, 37% of the participants with overweight/obesity scored higher than five (median) in the FRS. The perceived body size correlated more strongly with many of the selected variables than did the desired body size, especially with BMI (r=0.679; p < 0.001), body weight (r=0.652; p < 0.001), and weight loss attempts (r=0.466; p < 0.001). Also, there was a significant relationship between BMI and weight loss attempts (r=0.370; p < 0.001). BMI and weight loss attempts appear to predict the perceived body size and the discrepancy between perceived and desired body size scores. Psychosocial and lifestyle factors that might influence female's body misperception need to be addressed in future studies.
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Affiliation(s)
- Jumanah Albeeybe
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Abdulaziz Alomer
- Department of Orthopedics, King Saud University Medical City, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Tasneem Alahmari
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Nawal Asiri
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Reema Alajaji
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Reem Almassoud
- College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research, Health Science Research Center, Princess Nourah Bint Abdulrahman University, P.O. Box 93216, Riyadh 11673, Saudi Arabia
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Intersectionality of Ethnicity/Race and Gender in the Phenomenology of African American College Students’ Presenting Problems: a Profile Analysis Using Nonmetric Multidimensional Scaling. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2018. [DOI: 10.1007/s10447-018-9326-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Gay JL, Monsma EV, Hein KD. Weight Management Behaviors Among Mexican American Youth: Cross-Sectional Variation by Timing of Growth and Maturation. Am J Health Promot 2017; 32:392-399. [PMID: 29214820 DOI: 10.1177/0890117116689160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the association between growth and maturation with weight management behaviors (WMBs) among Mexican American youth. DESIGN A cross-sectional design was used to measure timing of growth and maturation as well as WMBs. SAMPLE Students were recruited through physical education classes in south Texas schools. The sample included 623 participants (52.3% female; 49.8% with weight ≥85th percentile) in grades 4 through 12. Students in middle school were purposely oversampled to examine questions around timing of growth and maturation. MEASURES Growth was measured as maturity offset, an estimate of age at peak height velocity (PHV). Maturity offset is derived from chronological age, height, and sitting height measurements. Participants were classified as pre-PHV or post-PHV. Girls also were categorized as premenarche or early, average, or late maturing based on age at menarche. Weight was measured to calculate body mass index (BMI) percentile. Weight management behavior and timing of menarche were self-reported via a survey. ANALYSIS Descriptive characteristics were calculated for boys and girls separately. χ2 Tests of proportion were used to test WMB by BMI percentile. Logistic regression analyses were conducted to examine the likelihood of engaging in WMB by maturity offset and, for girls, timing of menarche. RESULTS Students with weight ≥85th percentile were more likely to describe themselves as overweight and report trying to lose weight through exercise or calorie restriction ( P < .0001). A 1-year increase in maturity offset was associated with youth being 31% more likely to perceive themselves as overweight but less likely to report calorie restriction (odds ratio [OR] = 0.87). Average maturing girls were more likely than premenarcheal girls to exercise, restrict calories, or fast to lose weight (OR = 3.27, 2.11, and 3.27, respectively). CONCLUSION Mexican American youth are engaging in WMB, even when their weight status is <85th percentile. The appropriateness of weight management counseling may need to consider a child's stage of growth.
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Affiliation(s)
- Jennifer L Gay
- 1 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Eva V Monsma
- 2 Department of Physical Education and Athletic Training, College of Education, University of South Carolina, Columbia, SC, USA
| | - Katie Darby Hein
- 1 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
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10
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Watson RJ, Adjei J, Saewyc E, Homma Y, Goodenow C. Trends and disparities in disordered eating among heterosexual and sexual minority adolescents. Int J Eat Disord 2017; 50:22-31. [PMID: 27425253 PMCID: PMC5768430 DOI: 10.1002/eat.22576] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 05/19/2016] [Accepted: 05/26/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual (LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups. METHOD We use pooled data from the 1999 to 2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used crosstabs, logistic regression, and interactions in regression models, stratified by sex. RESULTS The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian adolescents and heterosexual females. DISCUSSION The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:22-31).
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Affiliation(s)
| | | | | | | | - Carol Goodenow
- Independent Research/Evaluation Consultant, Northborough, MA
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11
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Siconolfi DE, Kapadia F, Moeller RW, Eddy JA, Kupprat SA, Kingdon MJ, Halkitis PN. Body Dissatisfaction in a Diverse Sample of Young Men Who Have Sex With Men: The P18 Cohort Study. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1227-39. [PMID: 26370403 PMCID: PMC4791207 DOI: 10.1007/s10508-015-0592-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 06/02/2015] [Accepted: 06/30/2015] [Indexed: 06/05/2023]
Abstract
Young men who have sex with men (YMSM) may be at greater risk for body dissatisfaction, compared to their heterosexual peers. However, differences within YMSM populations are understudied, precluding the identification of YMSM who are at greatest risk. This study examined body dissatisfaction in a racially/ethnically diverse sample of YMSM ages 18-19 in New York City. Using cross-sectional data from the baseline visit of a longitudinal cohort study of YMSM (N = 591), body dissatisfaction was assessed using the Male Body Attitudes Scale. Three outcomes were modeled using linear regression: (1) overall body dissatisfaction, (2) muscularity dissatisfaction, and (3) body fat dissatisfaction. Covariates in the models included race/ethnicity, sexual orientation, BMI, gay community affiliation, and internalized homonegativity. White YMSM experienced greater body dissatisfaction across the three models. Internalized homonegativity was a statistically significant predictor of dissatisfaction across the three models, though its association with body dissatisfaction was relatively small. The findings point to future avenues of research, particularly qualitative research to explore demographic and cultural nuances in body attitudes among YMSM.
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Affiliation(s)
- Daniel E Siconolfi
- Department of Health, Behavior & Society, Johns Hopkins University, Baltimore, MD, USA
| | - Farzana Kapadia
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY, USA
- NYU Global Institute of Public Heath, 41 East 11th Street, 7th Floor, New York, NY, 10003, USA
| | - Robert W Moeller
- Department of Psychology, Middlebury College, Middlebury, VT, USA
| | - Jessica A Eddy
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY, USA
| | - Sandra A Kupprat
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY, USA
| | - Molly J Kingdon
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY, USA.
- NYU Global Institute of Public Heath, 41 East 11th Street, 7th Floor, New York, NY, 10003, USA.
- Langone School of Medicine, New York University, New York, NY, USA.
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Talleyrand RM, Gordon AD, Daquin JV, Johnson AJ. Expanding Our Understanding of Eating Practices, Body Image, and Appearance in African American Women: A Qualitative Study. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798416649086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Researchers consistently have supported the notion that African American women experience greater body satisfaction and are less likely to engage in unhealthy restrictive eating practices due to broader and more flexible body image norms in the African American community. Yet empirical evidence also suggests that African American women experience high rates of binge-eating behaviors and obesity. The purpose of this qualitative study was to gain a deeper understanding of the factors that influence body image norms, eating practices, and overall appearance of African American women aged 25 years and older. Using consensual qualitative research as the guiding method, 11 semistructured interviews were conducted with African American women who self-identified as struggling with body and weight concerns. Five domains were identified: (a) participants’ perceptions of their body image, (b) challenges with body image, (c) participants’ perceptions of eating attitudes and behaviors, (d) role of food, and (e) perceptions of overall appearance. Implications for research and practice are included.
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Affiliation(s)
| | | | - Jewelle V. Daquin
- George Mason University, Fairfax, VA, USA
- Senior Clinician at Fairfax-Falls Church CSB, Fairfax, VA
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Zullig KJ, Matthews-Ewald MR, Valois RF. Weight perceptions, disordered eating behaviors, and emotional self-efficacy among high school adolescents. Eat Behav 2016; 21:1-6. [PMID: 26697720 DOI: 10.1016/j.eatbeh.2015.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/27/2015] [Accepted: 11/11/2015] [Indexed: 11/24/2022]
Abstract
Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts.
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Affiliation(s)
- Keith J Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506-9190, United States.
| | | | - Robert F Valois
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States
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14
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Austin SB, Ziyadeh NJ, Calzo JP, Sonneville KR, Kennedy GA, Roberts AL, Haines J, Scherer EA. Gender expression associated with BMI in a prospective cohort study of US adolescents. Obesity (Silver Spring) 2016; 24:506-15. [PMID: 26813530 PMCID: PMC4730912 DOI: 10.1002/oby.21338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/05/2015] [Accepted: 08/23/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the relationship between gender expression (GE) and BMI in adolescence. METHODS Repeated measures of weight-related behaviors and BMI were collected from 1996 to 2011 via annual/biennial self-report surveys from youth aged 10 to 23 years (6,693 females, 2,978 males) in the longitudinal Growing Up Today Study. GE (very conforming [referent], mostly conforming, nonconforming) was assessed in 2010/11. Sex-stratified, multivariable linear models estimated GE group differences in BMI and the contribution of sexual orientation and weight-related exposures to group differences. Models for males included interaction terms for GE with age. RESULTS In females, mostly conforming youth had 0.53 kg m(-2) and nonconforming had 1.23 kg m(-2) higher BMI; when adding adjustment for sexual orientation and weight-related exposures, GE group estimates were attenuated up to 8% and remained statistically significant. In males, mostly conforming youth had -0.67 kg m(-2) and nonconforming had -1.99 kg m(-2) lower BMI (age [in years]) interactions were between -0.09 and -0.14 kg m(-2) ; when adding adjustment for sexual orientation and weight-related exposures, GE group estimates were attenuated up to 11% and remained statistically significant. CONCLUSIONS GE is a strong independent predictor of BMI in adolescence. Obesity prevention and treatment interventions with youth must address ways that gender norms may reinforce or undermine healthful behaviors.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston
| | - Najat J. Ziyadeh
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston
| | - Jerel P. Calzo
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston
| | | | - Grace A. Kennedy
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston
| | - Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston
| | - Jess Haines
- University of Guelph, Guelph, Ontario, Canada
| | - Emily A. Scherer
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH
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15
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Gonsalves D, Hawk H, Goodenow C. Unhealthy weight control behaviors and related risk factors in Massachusetts middle and high school students. Matern Child Health J 2015; 18:1803-13. [PMID: 24357083 DOI: 10.1007/s10995-013-1424-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Unhealthy weight control behaviors may be precursors to clinical eating disorders; therefore, it is important to identify these actions, and what may trigger them, as early as possible. We used 2009 and 2011 Massachusetts Youth Health Survey data for middle and high school students. We studied age, sex, and race disparities related to unhealthy weight control behaviors in conjunction with other risk factors such as body mass index (BMI), body weight perception, involvement in bullying, and depressive symptoms. The surveys were completed in public schools. Bivariate and multinomial regression analyses were conducted to assess associations between weight control behaviors and BMI categories, body weight perception, bullying involvement, and depressive symptoms. Poor body weight perception, bullying involvement, and depressive symptoms were associated with significantly elevated odds of reporting unhealthy weight control behaviors in both middle and high school students. Most patterns were consistent for middle and high school students, with obesity and bullying involvement being prevailing risks for high school students. Though females were more likely to report unhealthy weight control behaviors we also showed the rarely presented prevalence of male involvement in disordered eating behaviors including those who perceived themselves to be underweight. Health education classes and school-based interventions may be two strategies to help prevent the development of unhealthy weight control behaviors. Continuation of youth surveys that gather data on weight control behaviors and known risk factors is essential for observing changes in behaviors over time.
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Affiliation(s)
- Diane Gonsalves
- Health Survey Program, Bureau of Health Information, Statistics, Research, and Evaluation, Massachusetts Department of Public Health, 250 Washington Street, 6th Floor, Boston, MA, 02108, USA,
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Valls M, Callahan S, Rousseau A, Chabrol H. Troubles du comportement alimentaire et symptomatologie dépressive : étude épidémiologique chez les jeunes hommes. Encephale 2014; 40:223-30. [DOI: 10.1016/j.encep.2013.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 05/15/2013] [Indexed: 11/24/2022]
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Abstract
Sociocultural models of eating disorders emphasize the role of internalization of media standards of beauty in eating pathology but rarely examine (a) how racial and cultural factors may be related to women of color’s tendency to endorse Western media beauty ideals or (b) these women’s risk of developing body dissatisfaction and disordered eating issues. This study of Asian/Asian American women ( N = 587) investigated the roles of perceived racial discrimination, ethnic identity, and racial/ethnic teasing in relation to self-esteem, internalization of Western standards of beauty, and body dissatisfaction as predictors of disordered eating in a structural model. Results indicated that, when controlling for body mass, perceived racial discrimination, ethnic identity, and racial/ethnic teasing significantly predicted disordered eating and its correlate variables through direct and indirect links. The findings suggest racial and cultural factors may complement sociocultural models in understanding disordered eating issues among Asian/Asian American women.
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18
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Epperson AE, Song AV, Wallander JL, Markham C, Cuccaro P, Elliott MN, Schuster MA. Associations Among Body Size, Body Image Perceptions, and Weight Loss Attempts Among African American, Latino, and White Youth: A Test of a Mediational Model. J Pediatr Psychol 2014; 39:394-404. [DOI: 10.1093/jpepsy/jst096] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lydecker JA, Hubbard RR, Tully CB, Utsey SO, Mazzeo SE. White public regard: associations among eating disorder symptomatology, guilt, and White guilt in young adult women. Eat Behav 2014; 15:76-82. [PMID: 24411755 DOI: 10.1016/j.eatbeh.2013.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 08/02/2013] [Accepted: 10/09/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE As a novel investigation of the role of White racial identity, the current study explored the link between White guilt and disordered eating. PARTICIPANTS Young adult women (N=375), 200 of whom self-identified as White. METHODS Measures assessed disordered eating, trait guilt, White guilt, and affect. RESULTS White guilt is interrelated with disordered eating, particularly bulimic symptomatology. Distress tolerance and tendency to experience negative affect moderated the relation between White guilt and several disordered eating variables. CONCLUSIONS Exploration of White guilt in clinical and research settings can inform understanding and treatment of disordered eating.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States.
| | - Rebecca R Hubbard
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States
| | - Carrie B Tully
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States
| | - Shawn O Utsey
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States; Department of African American Studies, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States; Department of Pediatrics, Virginia Commonwealth University, P.O. Box 842018, Richmond, VA, United States
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20
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Cragun D, Ata RN, Debate RD, Thompson JK. Gender comparisons of unhealthy weight-control behaviors among sixth-Graders. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:450-454. [PMID: 23352933 DOI: 10.1016/j.jneb.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 08/21/2012] [Accepted: 09/10/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine gender differences in unhealthy weight-control behaviors (UWCB) and identify key psychosocial and demographic correlates of UWCB among sixth-graders. METHODS A cross-sectional survey was completed by 146 boys and 153 girls at a middle school. Secondary data analyses included bivariate tests and multivariable logistic regression. RESULTS Forty-seven percent of participants reported 1 or more UWCB, with no differences by gender (P = .75). Factors common to boys and girls included: lower global self-esteem; lower body-esteem; and greater negative parental modeling among participants who engaged in UWCB compared to those who did not. However, multivariable models revealed gender differences. Among boys, body mass index, negative parental modeling, and global self-esteem retained statistically significant associations with UWCB after controlling for other variables in the model, whereas race and weight-related body-esteem remained significant for girls. CONCLUSIONS AND IMPLICATIONS This research highlights the need for gender-specific UWCB prevention programs implemented in late childhood and early adolescence.
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Affiliation(s)
- Deborah Cragun
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
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21
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Calzo JP, Corliss HL, Blood EA, Field AE, Austin SB. Development of muscularity and weight concerns in heterosexual and sexual minority males. Health Psychol 2013; 32:42-51. [PMID: 23316852 DOI: 10.1037/a0028964] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine the development of muscularity and weight concerns among heterosexual and sexual minority males in adolescence. METHOD Participants were 5,868 males from the Growing Up Today Study, a U.S. prospective cohort spanning ages 9-25 years. Generalized estimating equations were used to test sexual orientation differences in the development of muscularity concerns, weight gain attempts, and weight and shape concern. RESULTS Desire for bigger muscles increased slightly each year across adolescence (β = .10, 95% C.I. = .09, .11) regardless of sexual orientation, but gay and bisexual participants reported greater desire for toned muscles than completely and mostly heterosexual males (β = .39, 95% C.I. = .21, .57). Desire for toned muscles did not change with age. Attempts to gain weight increased threefold across adolescence, with up to 30% reporting weight gain attempts by age 16. Although underweight males (the smallest weight status class) were most likely to attempt to gain weight, most of the observed weight gain attempts were by healthy (69%) and overweight/obese (27%) males, suggesting that most attempts were medically unnecessary and could lead to overweight. Sexual minority participants were 20% less likely to report weight gain attempts than completely heterosexual participants. Weight and shape concern increased with age, with gay and bisexual participants experiencing a significantly greater increase than heterosexual males. CONCLUSIONS Sexual orientation modifies the development and expression of male weight and muscularity concerns. The findings have implications for early interventions for the prevention of obesity and eating disorder risk in heterosexual and sexual minority males.
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Affiliation(s)
- Jerel P Calzo
- Division of Adolescent and Young Adult Medicine, Children’s Hospital Boston, Boston, Massachusetts 02115, USA.
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22
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Wang ML, Peterson KE, Richmond TK, Spadano-Gasbarro J, Greaney ML, Mezgebu S, McCormick M, Austin SB. Family physical activity and meal practices associated with disordered weight control behaviors in a multiethnic sample of middle-school youth. Acad Pediatr 2013; 13:379-85. [PMID: 23830023 DOI: 10.1016/j.acap.2013.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 04/13/2013] [Accepted: 04/21/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Family practices around weight-related behaviors can shape children's development of disordered weight control behaviors (DWCB), such as vomiting, taking laxatives, or taking diet pills without a prescription. This study examined family meal and physical activity (PA) practices associated with DWCB among a multiethnic sample of youth. METHODS We assessed self-report data on frequency of family sit-down dinners, types of parental involvement in their children's PA, and DWCB are from 15,461 6th to 8th grade girls and boys in 47 middle schools participating in the Massachusetts Healthy Choices Study at baseline (2005). RESULTS Youth who had family sit-down dinners every day had lower odds of DWCB (girls: odds ratio [OR] 0.3; 95% confidence interval [CI] 0.2-0.5; boys: OR 0.6; 95% CI 0.4-0.9) than youth who never had family sit-down dinners. Similar effect estimates were found for youth who had family sit-down dinners most days. Parental provision of rides to and from a PA event was also found to be protective against DWCB among girls (OR 0.7; 95% CI 0.5-0.9). In contrast, parental participation in PA with their children was associated with increased risk for DWCB (girls: OR 1.4; 95% CI 1.0-1.8; boys: OR 1.9; 95% CI 1.4-2.4). These associations did not differ by race/ethnicity or weight status. CONCLUSIONS Programs emphasizing the importance of family meals may be beneficial in preventing DWCB in youth of all ethnicities. Further research is needed on how various methods of parental involvement in their children's PA are associated with DWCB.
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Affiliation(s)
- Monica L Wang
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA.
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Austin SB, Nelson LA, Birkett MA, Calzo JP, Everett B. Eating disorder symptoms and obesity at the intersections of gender, ethnicity, and sexual orientation in US high school students. Am J Public Health 2013; 103:e16-22. [PMID: 23237207 PMCID: PMC3558764 DOI: 10.2105/ajph.2012.301150] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We examined purging for weight control, diet pill use, and obesity across sexual orientation identity and ethnicity groups. METHODS Anonymous survey data were analyzed from 24 591 high school students of diverse ethnicities in the federal Youth Risk Behavioral Surveillance System Survey in 2005 and 2007. Self-reported data were gathered on gender, ethnicity, sexual orientation identity, height, weight, and purging and diet pill use in the past 30 days. We used multivariable logistic regression to estimate odds of purging, diet pill use, and obesity associated with sexual orientation identity in gender-stratified models and examined for the presence of interactions between ethnicity and sexual orientation. RESULTS Lesbian, gay, and bisexual (LGB) identity was associated with substantially elevated odds of purging and diet pill use in both girls and boys (odds ratios [OR] range = 1.9-6.8). Bisexual girls and boys were also at elevated odds of obesity compared to same-gender heterosexuals (OR = 2.3 and 2.1, respectively). CONCLUSIONS Interventions to reduce eating disorders and obesity that are appropriate for LGB youths of diverse ethnicities are urgently needed.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine at Boston Children's Hospital, Boston, MA 02115, USA.
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24
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Austin SB, Richmond TK, Spadano-Gasbarro J, Greaney ML, Blood EA, Walls C, Wang ML, Mezgebu S, Osganian SK, Peterson KE. The contribution of school environmental factors to individual and school variation in disordered weight control behaviors in a statewide sample of middle schools. Eat Disord 2013; 21:91-108. [PMID: 23421693 DOI: 10.1080/10640266.2013.761080] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated the contribution of school environmental factors to individual and school variation in disordered weight control behaviors (DWCB). Analyses were based on self-report data gathered from 18,567 middle-school students in 2005 and publicly available data on school characteristics. We observed large differences across schools in percent of students engaging in DWCB in the past month, ranging from less than 1% of the student body to 12%. School-neighborhood poverty was associated with higher odds of DWCB in boys. Preventive strategies need to account for wide variability across schools and environmental factors that may contribute to DWCB in early adolescence.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Massachusetts 02115, USA.
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25
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Wang ML, Walls CE, Peterson KE, Richmond TK, Spadano-Gasbarro J, Greaney ML, Blood E, Mezgebu S, McCormick MC, Subramanian SV, Bryn Austin S. Dietary and physical activity factors related to eating disorder symptoms among middle school youth. THE JOURNAL OF SCHOOL HEALTH 2013; 83:14-20. [PMID: 23253286 DOI: 10.1111/j.1746-1561.2012.00742.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Dietary and physical activity (PA) behaviors can predict disordered weight control behaviors (DWCB) among youth. This study examines dietary and PA correlates of DWCB and differences by race/ethnicity and weight status in a diverse sample of youth. METHODS Self-reported data on dietary weight management behaviors, strengthening/toning exercises, moderate-to-vigorous physical activity, and DWCB (vomiting, taking laxatives, and/or taking diet pills without a prescription) were obtained from 15,260 sixth to eighth graders in 47 middle schools participating in the Massachusetts Healthy Choices Study at baseline (2005). Generalized estimating equations were used to estimate odds of DWCB associated with dietary and PA behaviors and to examine for differences by race/ethnicity and weight status, adjusting for covariates and clustering of individuals within schools. RESULTS Disordered weight control behaviors were reported by 3.6% of girls and 3.1% of boys. Youth who engaged in strengthening/toning exercises 7 days per week versus 0-3 days per week had increased odds of DWCB (girls odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.3 - 3.0; boys OR = 1.5; 95% CI = 1.0 - 2.2). Dietary weight management behaviors were associated with increased odds of DWCB (girls OR = 1.2; 95% CI = 1.1 - 1.3; boys OR = 1.3; 95% CI = 1.2 - 1.4) for each additional behavior. These associations did not differ by race/ethnicity or weight status. CONCLUSIONS Persons promoting healthy dietary and PA behaviors among youth should consider the co-occurrence of strengthening/toning and dietary weight management behaviors with DWCB and the consistency in these associations across racial/ethnic and weight status groups.
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Affiliation(s)
- Monica L Wang
- Division of Preventive & Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Calzo JP, Sonneville KR, Haines J, Blood EA, Field AE, Austin SB. The development of associations among body mass index, body dissatisfaction, and weight and shape concern in adolescent boys and girls. J Adolesc Health 2012; 51:517-23. [PMID: 23084175 PMCID: PMC3479441 DOI: 10.1016/j.jadohealth.2012.02.021] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine how the associations among body mass index (BMI) and body dissatisfaction and weight and shape concern evolve from late childhood through late adolescence in boys and girls. METHODS We analyze data from subjects aged 9-18 years from the Growing Up Today Study, a national prospective cohort of U.S. youth (n = 16,882, yielding 59,750 repeated-measures observations during five waves of data collection). Generalized additive models produced curves of association for body dissatisfaction and weight concern across BMI percentiles. Generalized estimating equations (adjusting for correlated within-subject repeated measures, sibling clusters, pubertal maturation, and region of residence) tested main and interactive effects of BMI, age, and gender. RESULTS Girls above the 50th BMI percentile reported greater body dissatisfaction than girls below the 50th percentile. By contrast, boys who reported the most body dissatisfaction were either above the 75th BMI percentile (approaching overweight) or below the 10th percentile (approaching underweight). Body dissatisfaction increased with age for both girls and boys, but the gender-specific patterns of BMI effects remained constant. Male and female participants in the overweight/obese BMI range reported the greatest weight concern, but among older adolescents (particularly girls), healthy weight became increasingly associated with greater weight and shape concern. CONCLUSIONS Body dissatisfaction and weight and shape concern intensify across adolescence, but associations between the constructs and BMI remain gender specific. Findings have important implications for eating disorder risk assessment and prevention.
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Affiliation(s)
- Jerel P Calzo
- Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
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Austin SB. A public health approach to eating disorders prevention: it's time for public health professionals to take a seat at the table. BMC Public Health 2012; 12:854. [PMID: 23043459 PMCID: PMC3519713 DOI: 10.1186/1471-2458-12-854] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Accepted: 10/08/2012] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. DISCUSSION The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. SUMMARY There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders.
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Affiliation(s)
- S Bryn Austin
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA.
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Talleyrand RM. Disordered Eating in Women of Color: Some Counseling Considerations. JOURNAL OF COUNSELING AND DEVELOPMENT 2012. [DOI: 10.1002/j.1556-6676.2012.00035.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Neumark-Sztainer D, Wall MM, Larson N, Story M, Fulkerson JA, Eisenberg ME, Hannan PJ. Secular trends in weight status and weight-related attitudes and behaviors in adolescents from 1999 to 2010. Prev Med 2012; 54:77-81. [PMID: 22024221 PMCID: PMC3266744 DOI: 10.1016/j.ypmed.2011.10.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 08/09/2011] [Accepted: 10/02/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine secular trends from 1999 to 2010 in weight status and weight-related attitudes and behaviors among adolescents. METHODS A repeated cross-sectional design was used. Participants were from Minneapolis/St. Paul middle schools and high schools and included 3072 adolescents in 1999 (mean age 14.6 ± 1.8) and 2793 adolescents in 2010 (mean age 14.4 ± 2.0). Trends in weight-related variables were examined using inverse probability weighting to control for changes in socio-demographics over time. RESULTS The prevalence of obesity among boys increased by 7.8% from 1999 to 2010, with large ethnic/racial disparities. In black boys the prevalence of obesity increased from 14.4% to 21.5% and among Hispanic boys, obesity prevalence increased from 19.7% to 33.6%. Trends were more positive among girls: weight status did not significantly increase, perceptions of overweight status were more accurate, the use of healthy weight control behaviors remained high, dieting decreased by 6.7%, unhealthy weight control behaviors decreased by 8.2% and extreme weight control behaviors decreased by 4.5%. CONCLUSIONS Trends indicate a need to intensify efforts to prevent obesity and other weight-related problems, particularly for boys from ethnic/racial minorities. The decreases in unhealthy weight control behaviors among girls are encouraging.
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Affiliation(s)
- Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA.
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Neumark-Sztainer D, Wall M, Larson NI, Eisenberg ME, Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study. ACTA ACUST UNITED AC 2011; 111:1004-11. [PMID: 21703378 DOI: 10.1016/j.jada.2011.04.012] [Citation(s) in RCA: 460] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 01/04/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood. OBJECTIVE To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood. DESIGN Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999-2010). PARTICIPANTS/SETTING The study population included 2,287 young adults (55% girls, 52% nonwhite). The sample included a younger group (mean age 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age 15.9±0.8 at baseline and 26.2±0.9 years at follow-up). STATISTICAL ANALYSES PERFORMED Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline. RESULTS In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors 10 years later. Tracking was particularly consistent for the older girls and boys transitioning from middle adolescence to middle young adulthood. CONCLUSIONS Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts before the onset of harmful behavioral patterns as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood.
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Affiliation(s)
- Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Austin SB. The blind spot in the drive for childhood obesity prevention: bringing eating disorders prevention into focus as a public health priority. Am J Public Health 2011; 101:e1-4. [PMID: 21493926 DOI: 10.2105/ajph.2011.300182] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Public health attention to childhood obesity has increased in tandem with the growing epidemic, but despite this intense focus, successes in prevention have lagged far behind. There is a blind spot in our drive for childhood obesity prevention that prevents us from generating sufficiently broad solutions. Eating disorders and the constellation of perilous weight-control behaviors are in that blind spot. Evidence is mounting that obesity and eating disorders are linked in myriad ways, but entrenched myths about eating disorders undermine our ability to see the full range of leverage points to target in obesity preventive intervention studies. Our efforts to prevent childhood obesity can no longer afford to ignore eating disorders and the assemblage of related behaviors that persist unabated.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
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Fay K, Economos C, Lerner RM, Becker AE, Sacheck J. The association between sports participation and athletic identity with eating pathology among college-aged males and females. Eat Weight Disord 2011; 16:e102-12. [PMID: 21989094 DOI: 10.1007/bf03325315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The current study examined associations among sports participation (SP), athletic identity (AI), weight status, and eating pathology, and whether these relations differed by gender. Data come from male and female first-year college students who participated in the Tufts Longitudinal Health Study (TLHS) between 1999-2007 (N=712). Relations among SP, AI, actual and perceived weight statuses, Eating Disorders Inventory (EDI) subscale scores, and indices of body shape concern and restrictive eating were examined with hierarchical ordinary least squares (OLS) regression. Associations between SP and eating pathology among females were moderated by perceived weight status. By contrast, relations between males' EDI subscales scores and SP were moderated by ethnicity, as well as by actual weight status. Our findings support that sports participation alone neither promotes nor protects against eating pathology among males and females.
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Affiliation(s)
- K Fay
- Institute for Applied Research in Youth Development, Tufts University, Medford, MA 02155, USA.
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Austin SB, Spadano-Gasbarro J, Greaney ML, Richmond TK, Feldman HA, Osganian SK, Hunt AT, Mezgebu S, Peterson KE. Disordered weight control behaviors in early adolescent boys and girls of color: an under-recognized factor in the epidemic of childhood overweight. J Adolesc Health 2011; 48:109-12. [PMID: 21185534 PMCID: PMC3139467 DOI: 10.1016/j.jadohealth.2010.05.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 05/19/2010] [Accepted: 05/21/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Ethnic disparities in childhood overweight are well-documented. In addition, disordered weight control behaviors (DWCB) have been linked to overweight and weight gain in multiple ways, but little is known about DWCB in youth of color, especially boys. We examined the distribution and determinants of ethnic and gender disparities in DWCB in early adolescents. METHODS In fall 2005, 47 Massachusetts middle schools participating in the Healthy Choices overweight prevention study administered a self-report baseline survey assessing student sociodemographics, height, weight, and DWCB (vomiting or use of laxatives or diet pills in the past month to control weight). Data from 16,978 girls and boys were used in multivariate logistic regression models to estimate the odds of DWCB in youth of color compared with their white peers, controlling for individual- and school-level factors. RESULTS Among white youth, 2.7% of girls and 2.3% of boys reported DWCB. The odds of DWCB were elevated 2-10 times in most ethnic groups relative to whites. Disparities were attenuated but persisted after controlling for multiple individual- and school-level factors. CONCLUSIONS Ethnic disparities in DWCB must be considered in efforts to address the epidemic of childhood overweight.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA.
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Baugh E, Mullis R, Mullis A, Hicks M, Peterson G. Ethnic identity and body image among black and white college females. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2010; 59:105-109. [PMID: 20864436 DOI: 10.1080/07448481.2010.483713] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study examines ethnic identity and body image in black and white college females. PARTICIPANTS Researchers surveyed 118 students at 2 universities, 1 traditionally white and 1 historically black. METHODS Correlations and multivariate analysis of variance (MANOVA) were used to investigate the relationship between race, ethnic identity, and body dissatisfaction. RESULTS There was no relationship between a woman's ethnic identity and her body dissatisfaction. Although white women scored higher on body dissatisfaction measures, women in both groups who had higher body dissatisfaction scores also choose smaller ideal body types. Results suggest that identification with an ethnic group may not shield women from being dissatisfied with their bodies. CONCLUSION Colleges and universities should be aware that many women could experience body dissatisfaction and develop diverse programs that target women from different ethnic groups.
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Affiliation(s)
- Eboni Baugh
- Department of Child Development and Family Relations, East Carolina University, Greenville, North Carolina 27858, USA.
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Abstract
OBJECTIVE To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). METHOD Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? RESULTS Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). DISCUSSION We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.
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Affiliation(s)
- Pamela K Keel
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, Florida 32306-4301, USA.
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Associations between smoking and extreme dieting among adolescents. J Youth Adolesc 2009; 38:1364-73. [PMID: 19779812 DOI: 10.1007/s10964-009-9421-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2009] [Accepted: 05/22/2009] [Indexed: 10/20/2022]
Abstract
This study examined the association between cigarette smoking and dieting behaviors and trends in that association among US adolescents in grades 9-12 between 1999 and 2007. Youth Risk Behavior Survey datasets were analyzed using the multivariable logistic regression method. The sample size of each survey year ranged from 13,554 to 15,273 with girls representing 49-51% of the sample (N = 71,854). About 62% of the entire study participants were whites and 14% were blacks. Prevalence estimates of current smoking and corresponding 95% confidence intervals were computed across four comparison groups formed by gender and body weight. Extreme dieting was an independent predictor of smoking. Extreme dieters showed a higher variability of smoking behavior than their peers. The magnitude of the association between smoking and extreme dieting became smaller in recent years among adolescents but remained unchanged among non-overweight girls over that same time period. When adolescent smoking behavior is examined, the intensity of dieting behavior should be considered within its association with other co-occurring unhealthy behaviors.
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