Body dissatisfaction predicts poor behavioral weight loss treatment adherence in overweight Mexican American women

Body image and physical activity in Latinas

Women with negative body image engage in less physical activity. The purpose of this study is to examine the relationship between body image and physical activity in Latinas participating in a lifestyle program. Participants (age 43.8 ± 10.1 years and BMI 30.4 ± 5.2 kg/m2) were enrolled in a 12-month culturally and linguistically adapted, individually tailored, intervention focused on increasing moderate-to-vigorous intensity physical activity (MVPA). Longitudinal assessments were conducted on body image dissatisfaction (BID) using the Figure Rating Scale, MVPA using the 7-day PAR interview, and objectively measured body weight. Pre-intervention BID did not significantly predict MVPA change. Participants experienced considerable reduction in BID. Greater MVPA engagement and weight loss were independently related to BID reduction. Acculturation did not moderate these relationships. Body image improved in Latinas participating in a cognitive and behavioral physical activity intervention regardless of weight loss and acculturation level.

Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study

PURPOSE

The main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients.

METHODS

Two studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years.

RESULTS

In Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape.

CONCLUSIONS

The present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body. Level of evidence III, well-designed cohort.

Association of weight and shape concern with weight change and weight-related behaviors in behavioral weight loss treatment

Weight and shape concern (WSC) is a facet of negative body image that is common among individuals with overweight/obesity seeking behavioral weight loss treatment (BWL), but remains understudied. This secondary analysis evaluates associations between WSC, weight change, and weight-related behaviors among individuals in a 24-week BWL. Adults (n = 32) with body mass index 25-50 kg/m2 completed a baseline WSC questionnaire, measured weight at 12 and 24 weeks, measured physical activity via accelerometer, and completed 24-hour dietary recalls. Adherence to self-monitoring dietary intake and weight were assessed. A series of linear mixed models were used to evaluate associations between baseline WSC and weight change, as well as weight-related behaviors. Results revealed no significant effect of WSC on weight change. There were significant WSC x time interactions, such that those rating WSC "very important" decreased self-weighing and the "low importance" group decreased their caloric intake during treatment. The "pretty important" group had greater minutes of activity than the "low importance" group. Findings indicated that WSC may impact weight-related behaviors that contribute to BWL success. This trial was pre-registered on ClinicalTrials.gov (NCT03739151).

Efficacy and mechanisms of change in exposure-based and cognitive stand-alone body image interventions in women with overweight and obesity

OBJECTIVE

Body dissatisfaction is highly prevalent in overweight and obesity, while evidence for the efficacy of body image interventions is still scarce. This interventional pilot study investigates the efficacy and mechanisms of change of two stand-alone body image interventions in women with overweight and obesity.

METHODS

Women with overweight and obesity (n = 76) were randomly assigned to five weekly sessions of either a mirror exposure (ME) or a cognitive restructuring intervention (CR) or to a wait-list control group (WCG). Primary outcome measures were self-reported body dissatisfaction and interview-based shape concerns; depression, self-esteem and emotional eating served as secondary outcome measures. Experimental paradigms were used prior to and after the interventions to analyze possible mechanisms of change: (a) Implicit Associations Tests to assess weight-related attitudes (b) eye-tracking experiments to assess visual processing of body pictures and (c) a thought-sampling procedure to assess body-related cognitions and arousal.

RESULTS

According to intent-to-treat analyses using linear mixed-models, both interventions lead to significant improvements in body image, while there were no changes in the WCG. Different mechanisms of change were identified.

CONCLUSIONS

Both types of interventions might be effective in the reduction of self-reported body dissatisfaction and interview-based shape concerns in overweight and obesity. However, as different mechanisms drive the effects, future research should clarify which individual might best benefit from which intervention.

Body Image Software Programs

The assessment of body image has evolved in recent decades through the development of various software programs. However, it is not yet known whether this technological advance has resulted in refined evidence or whether this assessment development has been extensively applied in the field. This study reviewed the body image software programs developed and applied from 2000 to 2020. Searches were systematically conducted in four scientific databases. A total of 35 articles were selected, and 13 body image software programs were identified. The main features comprising the variability of the software were the pattern of body stimuli presentation (avatars x real body x body drawings) and the procedures of body image manipulation (whole body adjustment x adjustment of separate body parts). Heterogeneity was prevalent among the studies reviewed and prevented a favorable conclusion regarding the use of software compared to other body image assessment strategies.

Examining the utility of nonlinear machine learning approaches versus linear regression for predicting body image outcomes: The U.S. Body Project I

Most body image studies assess only linear relations between predictors and outcome variables, relying on techniques such as multiple Linear Regression. These predictor variables are often validated multi-item measures that aggregate individual items into a single scale. The advent of machine learning has made it possible to apply Nonlinear Regression algorithms-such as Random Forest and Deep Neural Networks-to identify potentially complex linear and nonlinear connections between a multitude of predictors (e.g., all individual items from a scale) and outcome (output) variables. Using a national dataset, we tested the extent to which these techniques allowed us to explain a greater share of the variance in body-image outcomes (adjusted R²) than possible with Linear Regression. We examined how well the connections between body dissatisfaction and dieting behavior could be predicted from demographic factors and measures derived from objectification theory and the tripartite-influence model. In this particular case, although Random Forest analyses sometimes provided greater predictive power than Linear Regression models, the advantages were small. More generally, however, this paper demonstrates how body image researchers might harness the power of machine learning techniques to identify previously undiscovered relations among body image variables.

Examination of the factorial model of a scale developed to assess body satisfaction in the Brazilian context: a study with people 18 to 40 years old

PURPOSE

Confirmatory factor analysis was employed to investigate an instrument developed to assess body satisfaction of Brazilian women and men and to identify participants' body satisfaction level.

METHODS

Brazilian young adults completed the Body Satisfaction Situational Scale and a sociodemographic questionnaire. A total of 1481 individuals (female = 1035; male = 446) aged between 18 and 40 years old participated in the study. Factorial, convergent and discriminant validity and reliability were evaluated. An invariance test was performed across sexes using multi-group analysis. The prevalence of body satisfaction among participants was calculated using the final models of the instrument.

RESULTS

The complete model of the scale (23 items and four factors) was invariant across sexes, but it did not fit the samples even after refinement. Therefore, a theoretical investigation of the scale content was performed based on literature. Thus, a reduced model composed of two factors and ten items was found for each sex. These models showed good validity and reliability to independent samples. About prevalence, most of the women were not at all satisfied with body fat and most of the men were slightly satisfied with body musculature. Further, women and men were moderately satisfied with their face, hair, and skin.

CONCLUSION

A reduced model of the instrument for women and another for men showed adequate indices of construct validity and reliability to samples. The most participants were not very satisfied with their bodies. The results can be useful to develop protocols aiming to promote body satisfaction.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Body shape concerns across racial and ethnic groups among adults in the United States: More similarities than differences

This study evaluated the relationship between race/ethnicity and body shape concerns among adults in the U.S. and evaluated if this relationship varied by Body Mass Index (BMI) and gender. Data were collected from U.S. adults (N = 2,212) using a national online survey panel designed to approximate the US census data. Gender, age, race/ethnicity, BMI and body shape concerns (Body Shape Questionnaire) were assessed. Analysis of variance was utilized to evaluate the race/ethnicity and BSQ association and if the relationship varied by gender and BMI category. The sample (65 % White, 13 % Black/African American, 16 % Latino/Hispanic/Mexican American and 6 % Asian/Pacific Islander) was 50 % female; mean age of 44.2 years (SD = 16.8); BMI of 27.4 (SD = 6.7). A gender by BMI category interaction (p < .01) revealed no difference in BSQ scores by gender when BMI < 18, but higher BSQ scores among women for all other BMI groups. A main effect of race/ethnicity revealed BSQ scores were equally high across racial/ethnic groups, except individuals who identified as White (M = 42.0, SD = 19.7) reported higher BSQ than those identified as Asian/Pacific Islander (M = 37.4, SD = 17.4). Body shape concerns are common among US adults. Individuals of racial/ethnic minority status may experience similar gender- and BMI-related differences in body shape concerns as White individuals.

Vocal arousal: a physiological correlate of body distress in women with overweight and obesity

PURPOSE

Numerous studies highlight the relevance of body image in the development and maintenance of overweight and obesity mostly using self-reported data. Given the importance of physiological assessment methods, the present study aimed at investigating vocally encoded emotional arousal as a correlate of body distress in women with overweight and obesity.

METHODS

Cognitions of women with overweight and obesity (OW; n = 22) as well as normal weight controls (NW; n = 22) were assessed by means of a thought-sampling procedure during a mirror exposure and a control condition. Fundamental frequency (f0) as a marker of vocally encoded emotional arousal as well as verbalized body-related cognitions were analyzed during this experimental task.

RESULTS

A stronger increase in f0 between the control and the mirror exposure condition was found in OW compared to NW. Furthermore, there were significant positive correlations between vocally encoded emotional arousal and various measures of body image.

CONCLUSION

The findings support the utility of vocally encoded emotional arousal as an objective physiological correlate of the evaluative dimension of body image in women with overweight and obesity.

LEVEL OF EVIDENCE

Level I, experimental study.

Considering BMI, Body Image and Desired Weight Change for Suitable Obesity Management Options

With prevalence of obesity increasing worldwide, understanding body image in individuals with excessive weight is important, as unawareness of weight excess can prevent weight loss attempts. We explored the associations among measured and self-reported body mass index (BMI), body image and body satisfaction among Spanish females and males with overweight or obesity, with a special focus in discriminating individuals who are and are not satisfied with their body and wish or not to change their appearance. Just unifying all individuals with excessive weight may lead to uncover or deny different realities and to develop unfitted clinical management options. Updating findings for the Spanish population, we found that most participants correctly estimated their weight, but 3 in 10 underestimated it. Similarly, their body images corresponded to adults with overweight or obesity who desired to be thinner, but in average they reported a perceived body just slightly overweight and a moderate satisfaction with their body. Complementing the existing evidence, BMI and sex-gender interacted for influencing body weight estimation and desired weight change. In addition, three different subgroups were found for desired change of weight and size, depending on their BMI and body satisfaction. Discovering and considering different subjective realities and corporeal experiences among individuals with weight excess will help professionals to develop appropriate therapeutic interventions. Thus, the personal experiences that individuals have with obesity, instead of obesity itself, should be considered for disentangling management efforts.

The role of disgust in body image disturbance: Incremental predictive power of self-disgust

The relationship between disgust and symptoms of disorders characterized by body image disturbance (BID) is increasingly being examined. In cognitive-behavioral models of psychopathology, disgust may function as a negative emotional response to perceived body defects, leading to avoidance and compulsive behavior. Little research has examined the role of self-disgust - a form of disgust that may be particularly relevant to the body. The present study is a descriptive analysis of the association between BID and self-disgust, controlling for other related variables. Two non-clinical samples completed measures of BID, self-disgust, negative affect, anxiety sensitivity, disgust propensity, and disgust sensitivity. Although BID was associated with all three forms of disgust at the bivariate level, in multivariate analyses self-disgust emerged as a unique predictor of BID, above and beyond all included variables, although effect sizes were small. Potential implications for understanding, preventing, and treating body image-related disorders are discussed.

Body dissatisfaction and its relationship with overweight, sedentary behavior and physical activity in survivors of breast cancer

OBJECTIVES

This study aimed to verify the prevalence of body satisfaction in breast cancer survivors and the association of this variable with overweight, sedentary behavior and physical activity in this population.

STUDY DESIGN

This is a cross-sectional study realized in Presidente Prudente-Brazil. Breast cancer survivors participated in this study. Questionnaires were used to obtain data on socioeconomic status, body dissatisfaction, sedentary behavior and level of physical activity. The association between body dissatisfaction and the independent variables was verified through binary logistic regression in the unadjusted model and model adjusted by socioeconomic level.

RESULTS

A total of 102 breast cancer survivors participated in this study with a mean age of 58.2 (±10.3) years. The prevalence of body dissatisfaction was 75.7%. Body dissatisfaction was higher in women with higher BMI (pvalue = 0.003) and in woman with high sedentary behavior (p-value = 0.049). Women with overweight had 7.87 times more chance of presenting body dissatisfaction. Women who reported hormone therapy were approximately 3 times more likely to be dissatisfacted with their body.

CONCLUSION

Body dissatisfaction was associated with lower age, high sedentary behavior and overweight in breast cancer survivors in the unadjusted analysis. When adjusted for socioeconomic status, only the variables of overweight and hormone therapy were associated with body dissatisfaction.