Body image, risk factors for eating disorders and sociocultural influences in Spanish adolescents

Prevalence of body weight dissatisfaction among adolescents: a systematic review

Objective:

To identify the prevalence of weight dissatisfaction among adolescents aged 10-19 years and stratify the analysis by sex.

Data source:

A literature review of cross-sectional studies among healthy adolescents was performed. The U.S. National Library of Medicine/National Institutes of Health (PubMed), Ovid^® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and American Psychological Association (PsycINFO^®) databases were searched between May 2019 and January 2020.

Data synthesis:

Initially, 3,700 records were identified, and 10 papers were obtained through other sources. After the removal of duplicates, 1,732 records were screened based on the titles and abstracts, and 126 were preselected for full-text analysis. After the application of the eligibility criteria, 34 papers were included in the present review. The studies were published between 1997 and 2020. The sample size ranged from <150 to >103,000 adolescents. The prevalence of weight dissatisfaction ranged from 18.0 to 56.6% in both sexes (10.8-82.5% among boys and 19.2-83.8% among girls).

Conclusions:

Based on the findings of the present systematic review, the prevalence of weight dissatisfaction is high among adolescents, especially girls. Such information can contribute to the planning of health and education programs addressing the issue of weight in adolescents.

Testing of a model for risk factors for eating disorders and higher weight among emerging adults: Baseline evaluation

Although a range of risk factors have been identified for disordered eating and weight status, the breadth of risk factors have been rarely considered within a single, comprehensive model. The robustness of these findings across countries also remains an open question. The present study sampled 6272 participants aged 18-30 years from eight countries in an attempt to evaluate combined and unique predictors for these two conditions, and to explore possible cross-country differences in these models. Participants completed a range of demographic, biological, behavioral, psychological, and sociocultural measures to test a comprehensive model of the contributions of these predictors for disordered eating and weight-related constructs (binge eating, body mass index, compensatory behaviors, dietary restraint, drive for muscularity, and drive for leanness). Structural invariance testing within a multigroup path analysis framework revealed that a single model across the eight countries provided poor model fit. Freeing of 22% of parameters across countries provided excellent fit and a satisfactory compromise for country-invariant and country-variant parameters in the model. Overall, predictors accounted for between 15% and 60% of variance in the outcome measures, with lowest explained variance for the disordered eating outcomes. Significant unique contributions to prediction were observed for each of the five risk factor variable types and across the eight countries. Thus, the findings show strong support for this model as an explanatory framework of both disordered eating and weight status.

Relationship between Adherence to the Mediterranean Diet and Body Composition with Physical Fitness Parameters in a Young Active Population

The current study aimed at analyzing the relationship between body composition, adherence to the Mediterranean diet (MD), and physical fitness (PF) in a young active population. A total of 1198 athletes (boys = 875; girls = 323) enrolled in different municipal sports schools participated in this study. Data on adherence to the MD (KIDMED questionnaire), anthropometric measurements, and PF (20 m shuttle run test, handgrip strength, vertical jump and forced spirometry) were collected. Results show that the pubertal boys had a higher score in the KIDMED test than the prepubertal ones (+0.38, p = 0.28). Moreover, boys with better adherence to the MD had significantly higher results in handgrip strength (+12.20 regarding low MD group and +9.13 regarding medium MD group, p < 0.05), as well as in forced vital capacity (FVC) (+0.66 regarding low MD group and 0.29 regarding medium MD group, p < 0.05). No differences were found in the girls. Finally, the result of the KIDMED test is a variable with a positive and significant relationship with cardiorespiratory fitness, along with the FVC, percentage of fat mass, and performance in the vertical jump (p < 0.05). It is concluded that adherence to the MD could show a relationship with various PF variables in boys and could be a predictor of cardiorespiratory fitness in both cases.

Dissatisfaction with body weight and nutritional status among adolescents: population-based study in the city of Campinas, São Paulo, Brazil

The aim of this study was to investigate nutritional status and estimate the prevalence of weight dissatisfaction among adolescents 10 to 19 years. Population-based cross-sectional study was conducted in two-stage in Campinas, Brazil. Nutritional status was classified based on percentiles of body mass index for age recommended by the World Health Organization. Weight dissatisfaction was determined by desire to gain or lose weight. Prevalence rates and 95% confidence intervals were calculated for nutritional status and weight (dis)satisfaction. The Rao-Scale chi-squared test was used for the determination of associations with sociodemographic variables. 822 adolescents were analyzed with mean age of 14.1 years. 64.7% of the boys and 75.4% of the girls were classified as normal weight, whereas 30.5% and 22.2% with excess weight, respectively. Among the boys dissatisfied with their weight, 34.5% were normal weight, 45.3% were classified as overweight and 77.1% with obesity. Whereas the girls dissatisfied with their weight, 52.0% were classified as normal weight, 63.6% as overweight and 75.2% with obesity. The prevalence of excess weight was high, especially among the boys and younger adolescents (10-14 years). Weight dissatisfaction was more prevalent among the girls and older adolescents (15-19 years).

Mediterranean Diet, Physical Fitness and Body Composition in Sevillian Adolescents: A Healthy Lifestyle

Childhood and adolescent obesity has become one of the most vital challenges to overcome in the present age. Physical fitness, physical activity and the Mediterranean diet (MD) are valuable tools for its prevention and treatment. The main objective of this study is to analyze the associations between health-related physical fitness components, body composition and adherence to the MD in 917 adolescents aged from 13- to 16-years-old. The ALPHA-Fitness Test was used to measure physical fitness and body composition, and the Adherence to the Mediterranean Diet (KIDMED) questionnaire was employed to assess the adherence to the MD. The associations between variables were tested according to gender and age a generalized linear model (GLM) univariate analysis (two factors) and one-way analysis of variance (ANOVA, with Bonferroni posthoc). As to the body composition and physical fitness variables, significant differences were obtained in both genders but not in relation to the adherence to the MD. The boys performed better in the physical fitness tests. Age was a determinant factor in adherence to the MD in the total sample, lowering as the age of the sample increases. Both the boys and girls who had a significantly higher performance in the endurance test were those who showed high/medium adherence to the MD. It is concluded that higher levels of cardiovascular endurance in boys and girls are associated with a medium and high adherence to the MD.

Are normal-weight adolescents satisfied with their weight?

CONTEXT AND OBJECTIVE

The high prevalence of obesity has led to public policies for combating it. People with normal weight may gain greater awareness of this issue and change their perceptions of their weight. The aim of this study was to evaluate the prevalence of body weight dissatisfaction among normal-weight adolescents, according to demographic and socioeconomic variables, health-related behavior and morbidities.

DESIGN AND SETTING

Population-based cross-sectional study that used data from a health survey conducted in the city of Campinas, São Paulo, in 2008-2009.

METHODS

The prevalence and prevalence ratios of weight dissatisfaction were estimated according to independent variables, by means of simple and multiple Poisson regression.

RESULTS

573 normal-weight adolescents aged 10 to 19 years (mean age 14.7 years) were analyzed. The prevalence of weight dissatisfaction was 43.7% (95% confidence interval, CI: 37.8-49.8). Higher prevalences of weight dissatisfaction were observed among females, individuals aged 15 to 19 years, those whose households had eight or more domestic appliances, former smokers, individuals who reported alcohol intake and those who had one or more chronic diseases. Lower prevalence of dissatisfaction was observed among adolescents living in substandard housing. Among the normal-weight adolescents, 26.1% wished to lose weight and 17.6% wished to gain weight.

CONCLUSION

The results from this study indicate that even when weight is seen to be within the normal range, a high proportion of adolescents express dissatisfaction with their weight, especially females, older adolescents and those of higher socioeconomic level.

Weight misperception, self-reported physical fitness, dieting and some psychological variables as risk factors for eating disorders

The aims of the current study were to explore possible gender differences in weight misperception, self-reported physical fitness, and dieting, and to analyze the relationship between these variables and others, such as self-esteem, body appreciation, general mental health, and eating- and body image-related variables among adolescents. In addition, the specific risk for eating disorders was examined, as well as the possible clusters with respect to the risk status. The sample comprised 655 students, 313 females and 342 males, aged 16.22 ± 4.58. Different scales of perceived overweight, self-reported physical fitness and dieting together with the Body Mass Index (BMI) were considered along with instruments such as the International Physical Activity Questionnaire (IPAQ), General Health Questionnaire (GHQ-28), Self-Esteem Scale (SES), Body Appreciation Scale (BAS) and Eating Disorders Inventory-2 (EDI-2). Since some gender differences were found with respect to these adolescent groups, it is necessary to design prevention programs that not only focus on traditional factors such as BMI or body image, but also on elements like weight perception, self-reported fitness and nutritional education.

Body image and quality of life in a Spanish population

Purpose

The aim of the current study was to analyze the psychometric properties, factor structure, and internal consistency of the Spanish version of the Body Image Quality of Life Inventory (BIQLI-SP) as well as its test–retest reliability. Further objectives were to analyze different relationships with key dimensions of psychosocial functioning (ie, self-esteem, presence of psychopathological symptoms, eating and body image-related problems, and perceived stress) and to evaluate differences in body image quality of life due to gender.

Patients and methods

The sample comprised 417 students without any psychiatric history, recruited from the Pablo de Olavide University and the University of Seville. There were 140 men (33.57%) and 277 women (66.43%), and the mean age was 21.62 years (standard deviation = 5.12). After obtaining informed consent from all participants, the following questionnaires were administered: BIQLI, Eating Disorder Inventory-2 (EDI-2), Perceived Stress Questionnaire (PSQ), Self-Esteem Scale (SES), and Symptom Checklist-90-Revised (SCL-90-R).

Results

The BIQLI-SP shows adequate psychometric properties, and it may be useful to determine the body image quality of life in different physical conditions. A more positive body image quality of life is associated with better self-esteem, better psychological wellbeing, and fewer eating-related dysfunctional attitudes, this being more evident among women.

Conclusion

The BIQLI-SP may be useful to determine the body image quality of life in different contexts with regard to dermatology, cosmetic and reconstructive surgery, and endocrinology, among others. In these fields of study, a new trend has emerged to assess body image-related quality of life.

Perception of weight and psychological variables in a sample of Spanish adolescents

BACKGROUND

This study explored the relationship between body mass index (BMI) and weight perception, self-esteem, positive body image, food beliefs, and mental health status, along with any gender differences in weight perception, in a sample of adolescents in Spain.

METHODS

The sample comprised 85 students (53 females and 32 males, mean age 17.4 ± 5.5 years) with no psychiatric history who were recruited from a high school in Écija, Seville. Weight and height were recorded for all participants, who were then classified according to whether they perceived themselves as slightly overweight, very overweight, very underweight, slightly underweight, or about the right weight, using the question "How do you think of yourself in terms of weight?". Finally, a series of questionnaires were administered, including the Irrational Food Beliefs Scale, Body Appreciation Scale, Self Esteem Scale, and General Health Questionnaire.

RESULTS

Overall, 23.5% of participants misperceived their weight. Taking into account only those with a normal BMI (percentile 5-85), there was a significant gender difference with respect to those who perceived themselves as overweight (slightly overweight and very overweight); 13.9% of females and 7.9% of males perceived themselves as overweight (χ(2) = 3.957, P < 0.05). There was a significant difference for age, with participants who perceived their weight adequately being of mean age 16.34 ± 3.17 years and those who misperceived their weight being of mean age 18.50 ± 4.02 years (F = 3.112, P < 0.05).

CONCLUSION

Misperception of overweight seems to be more frequent in female adolescents, and mainly among older ones. Misperception of being overweight is associated with a less positive body image, and the perception of being very underweight is associated with higher scores for general psychopathology.

Alexithymia and its relationships with body checking and body image in a non-clinical female sample

The aim of the present study was to evaluate in a non-clinical sample of undergraduate women, the relationships between alexithymia, body checking and body image, identifying predictive factors associated with the possible risk of developing an Eating Disorder (ED). The Toronto Alexithymia Scale (TAS-20), Body Checking Questionnaire (BCQ), Eating Attitudes Test (EAT-26), Body Shape Questionnaire (BSQ), Interaction Anxiousness Scale (IAS), Rosenberg Self-Esteem Scale (RSES) and the Beck Depression Inventory (BDI) were completed by 254 undergraduate females. We found that alexithymics had more consistent body checking behaviors and higher body dissatisfaction than nonalexithymics. In addition, alexithymics also reported a higher potential risk for ED (higher scores on EAT-26) when compared to nonalexithymics. Difficulty in identifying and describing feelings subscales of TAS-20, Overall appearance and Specific Body Parts subscales of BCQ as well as lower self-esteem was associated with higher ED risk in a linear regression analysis. Thus, a combination of alexithymia, low self-esteem, body checking behaviors and body dissatisfaction may be a risk factor for symptoms of ED at least in a non-clinical sample of university women.

Are there gender-specific pathways from early adolescence psychological distress symptoms toward the development of substance use and abnormal eating behavior?

The aim of the present longitudinal community study was to test whether psychological distress at 13 years of age predicted reported substance use problems in boys and abnormal eating behavior in girls 2 years later. The sample consisted of 500 male and 576 female students. The use of substances was evaluated using a semi-structured interview, psychological distress with the General Health Questionnaire (GHQ) and eating psychopathology with the Eating Attitudes Test (EAT-40), and the Bulimic Investigatory Test Edinburgh (BITE). Controlling the effect of initial substance use problems, psychological distress predicted later reported substance use problems in males. Girls with an initial score above the cut-off point on the GHQ were two times more likely to be at risk of having an eating disorder 2 years later. Therefore, psychological distress might take different developmental pathways in males and females, leading toward eating problems in the latter versus substance use in the former.

Preferences for Female Body Weight and Shape in Three European Countries

Abstract. Body mass index (BMI) and body shape as measured by the waist-to-hip ratio (WHR) are important components in judgments of women's bodily attractiveness. The relative importance of each of these cues was examined in three countries: Britain, Spain, and Portugal. Male participants from Britain, Spain, and Portugal, respectively, were asked to rate a set of images of real women with known BMI and WHR. The results showed that, regardless of the cultural setting, BMI was the primary determinant of women's physical attractiveness, with consistent preferences for relatively slender women. WHR emerged as a significant predictor of attractiveness judgments for the Spanish and Portuguese groups (with preferences for low WHRs, indicative of a curvaceous female body), but not the British group. These findings are discussed in terms of the different cultural values ascribed to participants in the three countries.