Mechanisms of action during a dissonance-based intervention through 14-month follow-up: The roles of body shame and body surveillance

Shame and eating disorders symptoms: A meta-analysis

OBJECTIVE

Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach.

METHOD

In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted.

RESULTS

Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating.

DISCUSSION

Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.

Body surveillance as a prospective risk factor for depressive symptoms in low-income adolescent girls from the United States

Adolescent girls who engage in frequent self-objectification often report a greater number of depressive symptoms. Although concurrent associations between self-objectification and depression are well-documented, it is less clear if objectification contributes to the course of symptoms. The current study examined: (a) whether body surveillance is prospectively related to depressive symptoms over a 1-month period in a sample of 150 low-income adolescent girls in the United States, and; (b) whether receiving certain types of weight-relevant information (i.e., learning one's weight is much higher than estimated) moderates this association. Heightened body surveillance at baseline predicted greater symptom severity one month later, but the strength of this relationship depended on what type of weight information girls received. Among girls high in body surveillance, those who found out their actual weight was much higher than they estimated subsequently reported more severe depressive symptoms; those who learned their actual weight was consistent or lower than they estimated reported fewer depressive symptoms. For girls low in body surveillance, weight-relevant information was not significantly related to the subsequent severity of depressive symptoms. Findings highlight the potential utility of assessing and addressing heightened body surveillance in depression interventions for adolescent girls.

Integrating eating disorder and weight gain prevention: a pilot and feasibility trial of INSPIRE

PURPOSE

The current study adapted evidence-based prevention programs to promote positive health behaviors among racially and ethnically diverse young adult women. Two successful programs (The Body Project and the Healthy Weight Intervention) were integrated to evaluate their feasibility, acceptability, and preliminary efficacy in reducing risk for both eating pathology and weight gain. Intervention features extended the previous prevention efforts by emphasizing broad appearance ideals to enhance relevancy for women of color and incorporating distress tolerance and emotion regulation skills training.

METHOD

Individuals were excluded if they met criteria for an eating disorder diagnosis and/or obesity, as this was a prevention project. 27 young adult women participated (M age = 18.59; SD = 1.01). The following racial/ethnic groups were represented: 48.1% White, 25.9% Asian, 22.2% Black, and 3.7% Latina. After each meeting, participants completed satisfaction measures and therapists assessed intervention feasibility. Participants also completed comprehensive questionnaires at pretest (baseline), posttest (8 weeks), and 4-week follow-up.

RESULTS

Descriptive statistics and content analyses of open-ended questions indicated that the intervention was both acceptable and feasible. Hierarchical linear models evaluating within-subject change over time indicated reductions in several risk factors that were sustained at follow-up: eating pathology, appearance dissatisfaction, thin-ideal internalization, restrained eating, negative affect, emotion dysregulation, and fat intake. BMI did not change from pretest to posttest; however, BMI increased from posttest to follow-up (mean weight increase = 0.34 kg).

CONCLUSION

Results suggest that a prevention program designed to be more culturally sensitive is feasible and acceptable. Findings provide preliminary support for reducing the risk of eating pathology and promoting positive health behaviors.

LEVEL OF EVIDENCE

Time series with intervention, Level IV.

TRIAL REGISTRATION

ClinicalTrails.gov ID: NCT03317587.

Focusing on one's own appearance leads to body shame in women but not men: The mediating role of body surveillance and appearance-contingent self-worth

Previous research has shown that some appearance-focused situations lead to increased self-objectification, especially among women. The present research explored, with an experimental design, whether the simple fact of thinking about one's own physical appearance increases body shame through body surveillance and appearance-contingent self-worth in men and women. Our main prediction was that focusing on one's own appearance would increase both women's body surveillance and appearance-contingent self-worth, and that both variables in turn would increase women's body shame. Among men, while we expected body surveillance and appearance-contingent self-worth to be related to body shame, we believed that thinking about their physical appearance would be less likely to increase their body surveillance and appearance-contingent self-worth. Spanish young men (n = 123) and women (n = 140) were randomly assigned to an appearance group, in which they wrote about their appearance, or a personality group, in which they wrote about their personality. The results confirmed our prediction for women. Among men, the indirect effects were not significant, and focusing on one's own appearance did not increase body surveillance or appearance-contingent self-worth. Since body shame has been associated with pervasive negative consequences, knowledge about its antecedents has practical and theoretical significance.