Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls

Measurement in sociocultural research on body image: Issues and solutions

Measurement plays a critical role in testing and refinement of sociocultural theories of body image and disordered eating. This paper provides a concise overview of the state of play in relation to measurement in the field, with a particular focus on contemporary measurement challenges and methodological innovations. While traditional measures have advanced our understanding, we emphasise the need for a step-change in practice that incorporates more ecologically valid, inclusive, and intersectional approaches to capture the lived experiences of diverse populations. We discuss how methodologies, including ecological momentary assessment, longitudinal designs, and AI-driven analysis, offer significant potential to enhance research in this area. This paper concludes by identifying research priorities to address key gaps to better define and conceptualise constructs, refine measurement techniques, and expand their applicability. These recommendations will foster a more comprehensive understanding of sociocultural influences on body image in the digital age.

Homophily and gender differences in unhealthy weight control behaviors among adolescents: a longitudinal school-based friendship network study

BACKGROUND

Unhealthy weight control behaviors (UWCBs) are widespread in adolescents and have devastating consequences. Friendship network is potentially an important influence on university students' UWCBs. This study employs social network analysis to investigate the homophily of UWCBs among university students within peer networks and gender differences.

METHODS

A longitudinal study comprising two data collection waves was conducted on 612 undergraduate students from five schools at two universities in Guangdong Province, China, forming five sociometric networks. UWCBs, incorrect self-perception of obesity, depression, and anxiety were measured using standard scales. Descriptive statistics, assortativity tests and network autocorrelation models were utilized for data analysis.

RESULTS

Study recruited 214 (34.8%) males and 398 (65.2%) females, with the UWCBs prevalence of 28.6% (T0) and 30.0% (T1). A significant homophily of UWCBs enhancing with time was identified (ρT0 = 0.255, p = 0.046; ρT1 = 0.394, p = 0.020). Females (β = 0.185, p = 0.027), overweight (β = 0.673, p < 0.001), obesity (β = 0.499, p < 0.001), incorrect self-perception of obesity (β = 0.538, p < 0.001), depression (β = 0.264, p = 0.025) and lower network transitivity (β = -0.375, p = 0.048) were associated with higher level of UWCBs. Additionally, significant homophily in UWCBs was found among females (ρT0 = 0.340, p = 0.035; ρT1 = 0.412, p = 0.026) but not males (ρT0 = -0.031, p = 0.178; ρT1 = -0.065, p = 0.551). Significant gender differences were also observed in others risk factors of UWCBs.

CONCLUSIONS

Our study found significant homophily and gender differences in UWCBs among first-year university students. These findings highlight the importance of considering peer networks and gender in future interventions.

Gender dysphoria in adolescence: examining the rapid-onset hypothesis

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of "rapid-onset" gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

PeerPub: A Device for Concurrent Operant Oral Self-Administration by Multiple Rats

The social environment has long been recognized to play an important role in substance use, which is often modeled in rodents using operant conditioning. However, most operant chambers only accommodate one rodent at a time. We present PeerPub-a unique social operant chamber. PeerPub employs touch sensors to track the licking behavior on drinking spouts. When the number of licks meets a set reinforcement schedule, it dispenses a drop of solution with a fixed volume as a reward at the tip of the spout. A radio frequency identification (RFID) chip implanted in each rat's skull identifies it throughout the experiment. The system is managed by a Raspberry Pi computer. We evaluated PeerPub using Sprague Dawley rats in daily 1 h sessions, where supersac (a glucose and saccharin solution) was provided under a fixed-ratio five schedule. We discovered that male rats consumed more supersac in dual rat conditions compared with single rat conditions. These findings illustrate PeerPub's effectiveness in modeling the interaction between motivated behavior and social context. We expect devices like PeerPub will help highlight the role of social environments in substance use disorder phenotypes. All computer code, 3D design, and build instructions for PeerPub can be found at http://github.com/nijie321/PeerPub.

Biopsychosocial correlates of body satisfaction in 7- to 8-year old children: a cross-sectional and prospective investigation

BACKGROUND

Biopsychosocial factors have been associated with body satisfaction/dissatisfaction and related body image concerns in adolescence; however, few studies have investigated these relationships in middle childhood, an important developmental phase for body satisfaction. This study investigated relationships between a range of biological (body mass index), psychological (child anxiety/depression, self-esteem, and self-oriented and socially prescribed perfectionism) and sociocultural (mother's body dissatisfaction and comments about child's appearance, father's body dissatisfaction and comments about child's appearance, peer teasing and child's media exposure) factors and body satisfaction cross-sectionally and longitudinally in a sample of 7- and 8-year-old children.

METHODS

In this study, participants from the longitudinal Children's Body Image Development Study (in which children had been followed-up annually from 3 years old) were assessed by interview at 7 years old (Time 1; n = 293: girls = 167, boys = 126) and 8 years old (Time 2; n = 222; girls = 126, boys = 96) and their parents completed a questionnaire at each time point.

RESULTS

Multiple regression analyses revealed that child self-esteem, socially prescribed perfectionism, and mother body dissatisfaction in the total sample at 7-years, as well as child self-esteem and mother body dissatisfaction in the total sample at 8-years were significant unique cross-sectional correlates of child body satisfaction. While self-esteem outcomes were replicated at both time points for boys and girls, some differences in patterns were found for other variables in the subsamples of boys versus girls across time points. Prospectively in partial correlations (controlling for Time 1 child body satisfaction), mother's body dissatisfaction predicted later child body satisfaction in boys and child self-esteem predicted later body satisfaction in girls. However, no longitudinal biopsychosocial predictors were identified as contributing unique variance in child body satisfaction from 7- to 8-years old after accounting for Time 1 (7-yearold) child body satisfaction.

CONCLUSIONS

These findings point to important psychosocial factors that are consistently related to body satisfaction in children and could be targets for intervention, but also suggest that a number of biopsychosocial variables develop concurrently with body satisfaction.

Relationship between college lifestyle variables, eating disorder education, and eating disorder risk

Objective: This study examined relationships between eating disorder risk (EDR), lifestyle variables (e.g., exposure to healthy eating media), and differences among male and female college students. Participants: College students (N = 323) completed survey questionnaires (Fall, 2016). Fifty-three participants retook the survey at a later time. Methods: Participants completed a survey measuring EDR using EDI-3 subscales and 10 college lifestyle variables. Female and male EDR and Time 1 and Time 2 EDR were compared. Relationships between EDR and college life-style variables were examined. Results: Exercise, fewer daily meals, less face-to-face interactions, more digital interactions, less exposure to healthy eating media, and having conversations about body image were associated with EDR risk. Male college students showed an increase in EDR over time. Conclusions: Several lifestyle factors predicted EDR in college females and males. These lifestyle factors are modifiable and may be addressed by colleges during orientation and within the campus environment.

Pursuing beauty: socio-cultural and labor-economic determinants of cosmetic surgery consideration among female college students in China

BACKGROUND

Cosmetic surgery has a profound impact on health and other aspects. As a means of enhancing physical attractiveness, it is increasingly being considered by female college students in China. However, current knowledge about the determinants of cosmetic surgery consideration among Chinese female college students still needs to be improved due to the lack of systematic perspectives and large-scale representative data sets. This study aimed to contribute to the literature in these two aspects.

METHODS

We framed cosmetic surgery consideration as a function of two broad sets of determinants: socio-cultural and labor-economic. We used data from a large, nationally representative sample of female college students in China (N = 6658, mean age = 20.3 years).

RESULTS

In terms of socio-cultural oriented factors, we found that family socioeconomic status, peers' cosmetic surgery practices, and media exposure were positively associated with the likelihood of considering cosmetic surgery. In terms of labor-economic oriented factors, we found that self-rated physical appearance, higher grades, and expected income after graduation were positively associated with a higher likelihood of considering cosmetic surgery.

CONCLUSIONS

These findings suggest that the decision-making process for cosmetic surgery among Chinese female college students goes beyond personal factors and is significantly influenced by structural factors.

Global Prevalence of Adolescent Use of Nonprescription Weight-Loss Products: A Systematic Review and Meta-Analysis

Importance

Use of nonprescribed weight-loss products in adolescents is a public health concern that is associated with negative physical and psychological consequences. However, the prevalence of nonprescribed weight-loss product use in adolescents is unknown.

Objective

To determine the global prevalence of nonprescription weight-loss product use in children and adolescents.

Data Sources

Four databases, including MEDLINE, PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health), and EMBASE, were searched for quantitative studies that reported prevalence data on use of nonprescription weight-loss products with no restrictions on publication date. The search was performed December 1, 2020, and updated March 6, 2023.

Study Selection

Studies were included in the meta-analysis if they reported the prevalence of weight-loss product use, were published in English, and included individuals 18 years or younger.

Data Extraction and Synthesis

Data extraction was completed by 2 independent reviewers. Data analysis determined the overall pooled proportion of weight-loss product use in total and during the past week, past 30 days, past year, or lifetime. Inverse variance heterogeneity effect models were used.

Main Outcomes and Measures

The main outcome measure was the prevalence of nonprescription weight-loss product use in adolescents for all included studies and over the past week, past month, past year, or lifetime. Subgroup analysis included separation of groups by sex, specific weight-loss product types, geographical location, and study publication time.

Results

A total of 90 articles (604 552 unique participants) were included in the meta-analysis. Of these, 50 studies (56%) were from North America. The reported prevalence of weight-loss product use in adolescents was 5.5% (96% CI, 5.5%-5.6%) overall. When identifying use of weight-loss products in the general population, prevalence was 2.0% (95% CI, 1.9%-2.1%) in the past week, 4.4% (95% CI, 4.3%-4.5%) in the past month, 6.2% (95% CI, 6.1%-6.3%) in the past year, and 8.9% (95% CI, 8.6%-9.2%) in their lifetime. Use of weight-loss products was higher among girls than boys.

Conclusions and Relevance

This meta-analysis found that use of weight-loss products occurs at high levels in adolescents, especially girls. These findings suggest that, given the ineffectiveness of these products for weight loss coupled with their harmful long-term health consequences, interventions are required to reduce use of weight-loss products in this group.

Family body culture, disordered eating and mental health among young adult females during COVID-19

Different family interactions related to body weight and shape may co-occur and represent a broader 'family body culture'. This may be important in the context of COVID-19 due to a heightened focus on body weight/shape, and many young adults living back with their families. This study aimed to, first, explore relationships between different family body-related interactions to assess the presence of a family body culture, and second, explore relationships between aspects of family body culture, disordered eating and mental health among young adult females during the COVID-19 pandemic. Participants were 233 females aged 18-25 years who completed measures of family body culture (family fat talk; family weight concern; family weight teasing), disordered eating, anxiety and depression. Results showed all aspects of family body culture were significantly, positively related. Engaging in fat talk with family members (self fat talk) was a key correlate of disordered eating, anxiety and depression. Family concern with weight was also significantly associated with disordered eating. Findings suggest that among some families there is a more problematic family body culture with a greater importance placed on body weight and shape through various body-related interactions. Additionally, findings highlight two key aspects of family body culture related to disordered eating and wellbeing among young adult females. Specifically, vocalising critical remarks about one's own body when with family and an environment that may indirectly communicate a high importance of body weight and shape (e.g., via dieting). These should be considered in future family interventions to support healthy eating behaviours.

The whole is more than the sum of its parts: A qualitative investigation of body-dissatisfied college women's experiences of relational body image

Research on relational body image suggests that women's body image changes across their important relationships, with women most at risk for maladaptive body image reporting the most extreme changes. To enrich our understanding of relational body image beyond that offered by prior psychologically-based quantitative research, the present study integrated critical-feminist approaches. Eighteen female-identified university students participated in a one-on-one semi-structured interview. Each participant first completed ratings of her body image across seven important relationships, which the interviewer used to create a graph depicting her relational body image. The interviewer shared the graph with the participant to prompt reflection on her subjective experiences of relational body image and asked her a series of questions. Reflexive thematic analysis, informed by a critical-realist framework, was used to identify themes. One overarching theme, "The Whole Is More than The Sum of Its Parts," demonstrated how relational body image may be understood as a unique configuration of interconnected factors within a specific relationship. Three subthemes then highlighted how interpersonal, idiographic, and systemic factors come together to influence subjective experiences of relational body image. The present results suggest that personalized treatment targets within specific relationships may be a worthwhile focus for future body image interventions.

Independent pragmatic replication of the Dove Confident Me body image program in an Australian Girls Independent Secondary School

Following calls for the independent replication of universal body image programs under diverse conditions, this research aimed to investigate whether the universal co-educational prevention program developed for audiences in the United Kingdom (Dove Confident Me, DCM), was an acceptable and effective intervention when delivered by teachers to adolescent girls attending a single-sex Australian school. Comprising two studies, Study 1, evaluated DCM among Grade 8 students (N = 198) at a single-sex private school, and compared the results with students (N = 208) s from a matched comparison group. No improvements were observed on outcome measures between the comparison and intervention girls over the three time points. Study 2 involved minor modifications to the aesthetics and content of the program, as well as the logistics of delivery. Delivered by teachers to Grade 8 students (N = 242 intervention and N = 354 comparison), there were significant improvements in acceptability of the modified DCM program, yet no interaction effects observed on outcome measures. While the program did no harm, it is possible that there are adjustments to the methods utilized and content of programs that are trialed in efforts to prevent body image concerns and eating disorders in the school setting.

"I don't want them to judge me": Separating out the role of fear of negative evaluation, neuroticism, and low self-esteem in eating disorders

Fear of negative evaluation (FNE) is a transdiagnostic risk factor that has an important role in eating disorder (ED) onset and maintenance, as well as other psychopathologies. However, no research has explored whether FNE has associations with probable ED status when accounting for related vulnerabilities, and whether this relationship changes across gender and weight status. The current study sought out to explore how FNE explains probable ED status above and beyond heightened neuroticism and low self-esteem, with gender and BMI serving as potential moderators of this relationship. Participants were 910 university students (85 % females) aged 18-26 years (M_age = 19.90; SD_age = 2.06) living in Australia, who completed measures of psychological distress, personality, self-esteem, FNE, and ED status. Logistic regression analysis showed that FNE was associated with probable ED status. This relationship was stronger among individuals with underweight and healthy-weight, whilst an interaction with gender was not significant. These findings shed light on the unique role FNE has in probable ED status across gender, which appears to be more pronounced in those with a lower BMI. Therefore, FNE should be considered as a potential target in ED screening and early intervention alongside other important transdiagnostic risk factors.

Why worry with friends? Problem talk and anxiety in late adolescent friendships

INTRODUCTION

This study investigated a theoretically derived peer conversation style, problem anxiety talk, to examine the emotional regulation of anxiety in dyads as a possible mechanism of anxiety contagion that occurs between adolescent friends.

METHODS

In Study 1, 376 late adolescents residing in the United States, ages 17-24 with 68% female, responded to measures of anxiety, worry, friendship quality, depression, co-rumination, and a new measure of problem anxiety talk. In Study 2 problem anxiety talk, stress, anxiety and depression were evaluated in 481 late adolescents, ages 17-24 with 64% female.

RESULTS

Once controlling for worry and co-rumination, problem anxiety talk with a close friend predicted anxiety, stress and depression for both samples of late adolescents. Factor analysis in each sample supported problem anxiety talk as a single factor with high internal consistency.

CONCLUSIONS

Findings indicate that problem anxiety talk is a distinct construct representing interpersonal disclosures between friends involving threat perception, likelihood of negative events, and lack of coping skills; results also indicate that problem anxiety talk is associated with anxiety, stress, worry, and depression. Implications of problem anxiety talk in its potential role in the etiology and spread of anxiety are discussed.

Identifying Future Study Designs for Mental Health and Social Wellbeing Associated with Diets of a Cohort Living in Eco-Regions: Findings from the INSUM Expert Workshop

Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project "Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions" (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions.

The impact of critical comments from teammates on athletes' eating and exercise psychopathology

Critical comments from parents or coaches about weight or shape have been associated with athletes' body dissatisfaction and disordered eating. However, research is yet to explore how critical comments from an athlete's teammates may impact on eating and exercise psychopathology. This study aimed to (1) explore whether athletes who reported receiving a teammate critical comment have higher eating/exercise psychopathology and poorer psychological wellbeing versus matched athletes who have not, (2) determine whether gender differences exist in the perceived severity of critical comments and (3) evaluate the moderating role of gender when establishing the relative importance of explicit teammate critical comments versus implicit teammate influences (e.g., modelling) on eating/exercise psychopathology. Athletes (N = 646, Mage=23 years, n = 391 female) completed a survey exploring explicit/implicit teammate influences, psychological wellbeing (self-esteem, anxiety, depression) and eating/exercise psychopathology. Athletes receiving a teammate critical comment (n = 323) had significantly higher eating/exercise psychopathology, anxiety, and lower self-esteem compared to those who had not (n = 323). Females (n = 196) perceived the severity of the comment to be significantly worse than males (n = 127). Explicit critical comments had a greater influence on athletes' eating/exercise psychopathology versus implicit teammate influences. Disordered eating/compulsive exercise prevention efforts with athlete populations should highlight the detrimental impact that athletes' comments can have on teammates' wellbeing and body satisfaction.

Knowledge sharing of health technology among clinicians in integrated care system: The role of social networks

Promoting clinicians' knowledge sharing of appropriate health technology within the integrated care system (ICS) is of great vitality in bridging the technological gap between member institutions. However, the role of social networks in knowledge sharing of health technology is still largely unknown. To address this issue, the study aims to clarify the influence of clinicians' social networks on knowledge sharing of health technology within the ICS. A questionnaire survey was conducted among the clinicians in the Alliance of Liver Disease Specialists in Fujian Province, China. Social network analysis was conducted using NetDraw and UCINET, and the quadratic assignment procedure (QAP) multiple regression was used to analyze the influencing factors of knowledge sharing of health technology. The results showed that the ICS played an insufficient role in promoting overall knowledge sharing, especially inter-institutional knowledge sharing. Trust, emotional support, material support, and cognitive proximity positively influenced knowledge sharing of health technology, while the frequency of interaction and relationship importance had a negative impact on it. The finding extended the research scope of social network theory to the field of healthcare and will bridge the evidence gap in the influence of the clinicians' social networks on their knowledge sharing within the ICS, providing new ideas to boost knowledge sharing and diffusion of appropriate health technology.

Adaptive body image can be contagious: An examination of college women facing situational body image threats

The present research examined whether and which adaptive body image displays in peers can promote more adaptive body image in self. In two studies, female-identified undergraduates recalled a personally distressing body image event. In Study 1, participants (N = 158) then heard an alleged female-identified peer responding to her own distressing body image event with either self-compassion, self-esteem enhancement, or distraction. Participants across conditions reported increased body acceptance and body image-related self-compassion, and decreased body image distress, but changes did not vary by condition. Study 2 sought to determine which component(s) common to Study 1's conditions explained the benefits participants experienced. Participants (N = 207) listened to an alleged peer: describe body image distress with which she coped adaptively; express body image distress but no adaptive coping; or deny body image distress and relate positively to her body. Hearing a peer cope adaptively with body image distress yielded the greatest body image benefits, whereas hearing a peer deny body image distress was generally least helpful. Results suggest that learning how a peer copes adaptively with body image distress may be most helpful in the face of personal body image distress, and support the overarching theory that adaptive body image may be socially transmissible.

Can more people be "Happy Being Me"? Testing the delivery of a universal body satisfaction program by clinicians and school staff

The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their first year of secondary school in the UK (Year 7 and after comparisons aged 11-12). HBM is a manualised universal prevention programme which aims to improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptomsStudy 1 tested the effectiveness of HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-intervention which was maintained at follow up. There were no significant changes in risk factors.Study 2 compared clinician (n = 172) and teacher (n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising for wider delivery are discussed.

Association between subjective degree of influence in class and thinness among adolescents in Japan

Social status in school, measured by subjective degree of influence in class (DOI), may influence thinness among adolescents. This study examined the association between subjective degree of influence in class and thinness among Japanese adolescents. Data were obtained from the Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, which Was a population-based study targeting 5th, 8th and 11th grade adolescents living in Kochi Prefecture, Japan (N = 9,998). DOI was assessed by adolescents via questionnaire. Weight and height were given by caregivers for 5th grade adolescents, whilst they were self-reported for 8th and 11th grade adolescents. Collected data on weight and height were used to calculate body mass index z-scores of WHO standards. Models included grade, gender, number of friends, household income, location of school and depressive symptoms as covariates. The results showed that both high and low DOI were positively associated with thinness after adjustment for other individual covariates (high DOI, OR = 1.59, 95% CI 1.05-2.43; low DOI, OR = 2.04, 95% CI 1.36-3.06). Further stratification by gender revealed that low DOI was positively associated with thinness (OR = 2.14, 95% CI 1.34-3.44) among boys, but there was no association among girls. Both high and low DOI were associated with the risk of being thin in adolescents. Focusing on DOI for adolescents may be important to address thinness among adolescents. Further studies are needed to examine the causality between DOI and thinness in adolescents.

The socialisation of the adolescent who carries out team sports: a transversal study of centrality with a social network analysis

OBJECTIVES

To analyse the physical activity carried out by the adolescents in the study, its relationship to being overweight (overweight+obese) and to analyse the structure of the social network of friendship established in adolescents doing group sports, using different parameters indicative of centrality.

SETTING

It was carried out in an educational environment, in 11 classrooms belonging to 5 Schools in Ponferrada (Spain).

PARTICIPANTS

235 adolescents were included in the study (49.4% female), who were classified as normal weight or overweight.

PRIMARY AND SECONDARY OUTCOME MEASURES

Physical Activity Questionnaire for Adolescents (PAQ-A) was used to study the level of physical activity. A social network analysis was carried out to analyse structural variables of centrality in different degrees of contact.

RESULTS

30.2% of the participants in our study were overweight. Relative to female participants in this study, males obtained significantly higher scores in the PAQ-A (OR: 2.11; 95% CI: 1.04 to 4.25; p value: 0.036) and were more likely to participate in group sport (OR: 4.59; 95% CI: 2.28 to 9.22; p value: 0.000). We found no significant relationship between physical activity and the weight status in the total sample, but among female participants, those with overweight status had higher odds of reporting high levels of physical exercise (OR: 4.50; 95% CI: 1.21 to 16.74; p value: 0.025). In terms of centrality, differentiating by gender, women who participated in group sports were more likely to be classified as having low values of centrality, while the opposite effect occurred for men, more likely to be classified as having high values of centrality.

CONCLUSIONS

Our findings, with limitations, underline the importance of two fundamental aspects to be taken into account in the design of future strategies: gender and the centrality within the social network depending on the intensity of contact they have with their peers.

Associations between weight talk exposure and unhealthy weight control behaviors among young adults: A person-centered approach to examining how much the source and type of weight talk matters

This study characterized common patterns of weight talk and examined associations with unhealthy weight control behaviors (UWCBs) in young adults. Participants (n = 1298) were from EAT 2018 (Eating and Activity Over Time), a population-based study of emerging adults (mean age = 22.2; 53.6 % women). Latent class analyses (LCA) derived classes based on weight talk exposure for men and women. Generalized linear models examined the association between weight talk classes and extreme/less extreme UWCBs. LCA results revealed 4 patterns of weight talk exposure among young adult women: minimal weight talk (38.8 %), peer weight talk (35.2 %), multi-source weight talk (13.5 %), and parental weight talk (12.6 %). Three classes emerged among men: minimal weight talk (44.0 %), peer weight talk (29.7 %), and multi-source weight talk (26.3 %). Among young adult women, the parental weight talk class reported the highest levels of extreme and less extreme UWCBs. Among young adult men, the multi-source weight talk class reported the highest levels of less extreme UWCBs. Results provide evidence regarding the importance of parental weight talk, even among young adult children, whether or not parental weight talk is accompanied by peer weight talk. Parents have the potential to improve their young adults' weight-related behaviors through avoiding weight talk.

Mixed methods pilot evaluation of interpersonal psychotherapy for body image for adolescents

Body dissatisfaction is common in adolescence and associated with poor outcomes. The aim of this mixed method pilot evaluation was to determine acceptability, feasibility and preliminary efficacy of Interpersonal Psychotherapy for Body Image (IPT-BI), a school-based group intervention for young people with high levels of body dissatisfaction. Eighteen participants (11-13 years, 78% female) took part in two IPT-BI groups (n = 10; n = 8). Feasibility was measured by recruitment and attrition rates; acceptability using a treatment satisfaction questionnaire and focus groups; and clinical outcomes at baseline, each session and post intervention. The majority of young people (72%, n = 18/25) who were referred or expressed interest went on to take part. Average session attendance was 100% and 89%. Participants expressed high levels of treatment satisfaction with 94% (n = 16/17) rating IPT-BI as 'quite helpful' or 'very helpful' and 94% (n = 16/17) stating they would recommend it to others. Preliminary exploration of efficacy showed significant improvements in body image and significant reductions in interpersonal difficulties and appearance-based conversations. Young people valued specific IPT-BI skills (role play, communication strategies), alongside generic therapeutic factors (therapeutic alliance, group cohesion). IPT-BI is feasible and acceptable with promising provisional clinical outcomes indicating the need for a fully powered randomised controlled trial.

First-year college students' weight change is influenced by their randomly assigned roommates' BMI

BACKGROUND

There is ongoing debate about whether friends' greater similarity in Body Mass Index (BMI) than non-friends is due to friend selection, shared environments, or peer influence.

METHODS

First-year college students (n = 104) from a southwestern U.S. university were randomly assigned roommates during the university's housing process, effectively removing friend selection effects. Participant BMI was measured up to four times (T1-T4) across 2015-2016. The influence of roommate baseline BMI (T1) on change in participant BMI over time (T2-T4) was analyzed using a linear mixed effects model adjusted for individual socio-demographics, linear time trends, baseline BMI, and physical clustering of students. A sensitivity analysis examining floormates was also conducted.

RESULTS

Consistent with roommate influence, participants randomized to roommates with a higher BMI gained more weight between times T2 and T4 (β = 0.06; 95% CI = 0.02, 0.10). No shared environment effects (shared campus or floor) were found.

CONCLUSIONS

Randomly assigned roommates influenced each other's weight trajectories. This clarifies that BMI convergence can occur outside of friend selection or shared environments mechanisms.

Relational body image: Preliminary evidence that body image varies within a person from one specific relationship to another

Although social factors influence body image, it remains unknown whether a given individual's body image varies from one specific relationship to another. The present study examined this novel concept of relational body image by investigating the extent to which individuals' body image differs across their relationships with specific others. These differences were expected to arise in part due to differences in how an individual perceives others' personal body preoccupation, others' acceptance of her body, and others' body size relative to her own. Eighty-seven female undergraduates reported on their typical levels of body appreciation, appearance orientation, and intuitive eating with 10 people in their lives, and reported on the characteristics of these others. Intraclass correlations revealed that participants' body image and eating varied across their different relationships. Furthermore, participants perceived differences in others' acceptance of the participant's body, body preoccupation, and body size. Multilevel modelling showed that participants reported more adaptive body image and eating patterns in relationships with others whom they perceived to be relatively more accepting of their body, less body preoccupied, and more similar in size to them. Findings provide initial support for the concept of relational body image.

Reexamination of the psychometric properties of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) and exploration of alternative scoring

OBJECTIVE

The primary aims of this paper were to reexamine the factor structure of the 21-item Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), a measure of Food and Alcohol Disturbance (FAD), and investigate an alternative scoring structure. FAD is the use of disordered eating behaviors within an alcohol use episode to compensate for alcohol-related calories and/or increase effects of alcohol. The new scoring approach captures FAD behaviors based on whether they occurred before, during, or after alcohol use.

METHOD

Participants were 586 young adults (18-30 years; 77.6% female; 55.8% non-Hispanic White) who completed online questionnaires on alcohol use, disordered eating behaviors, and FAD.

RESULTS

Confirmatory factor analyses did not provide unequivocal evidence for any previously proposed factor structures of the CEBRACS. Exploratory factor analysis suggested items capturing FAD "Before" drinking had a two-factor structure (i.e., Alcohol Effects and Compensatory Behaviors), items capturing FAD "During" drinking had a three-factor structure (i.e., Alcohol Effects, Diet & Exercise, and Extreme Weight Control Behaviors [EWCB]), and items capturing FAD "After" drinking had a two-factor structure (i.e., Diet & Exercise & EWCB).

DISCUSSION

The CEBRACS factor structure is not consistent across samples; however, despite suboptimal fit, the original structure remains the best approach to capture FAD behaviors. The alternative scoring reflects FAD behaviors based on when they occur relative to alcohol use. The two scoring approaches provide researchers and clinicians flexibility to describe FAD behaviors in multiple ways using the CEBRACS.

Engaging customers with employees in service encounters

Purpose

Keeping both employees and customers highly engaged has become a critical issue for service firms, especially for high-contact and highly customized services. Therefore, it is essential to engage employees and customers during service interactions for better service outcomes. However, past research on employee and customer engagement has primarily focused on brands and organizations. Little research has concentrated on service interactions as the objects of engagement. To fill this research gap, this study aims to clarify and define service engagement behaviors (SEBs), identify various employee and customer SEBs and develop a model to investigate the relationships between these behaviors.

Design/methodology/approach

A theoretical framework was developed based on social contagion theory and service-dominant (S-D) logic to explore the effects of employee SEBs on customer SEBs through customer perceptions of relational energy and interaction cohesion. Dyadic survey data collected from 293 customer-employee pairs in various high-contact and highly customized service industries were examined through structural equation modeling.

Findings

Results show that employee SEBs (service role involvement, customer orientation behavior and customer empowerment behavior) positively influence relational energy and interaction cohesion, which in turn affect customer SEBs (service exploration behavior and service coordination behavior).

Originality/value

This study represents pioneering research to conceptualize SEBs. Different from the extant literature on engagement, SEBs capture the proactive and collaborative engagement behaviors of employees and customers in service interactions. Various employee and customer SEBs were identified and an empirical model was proposed and tested to investigate the effect of employee SEBs on customer SEBs through relational energy and interaction cohesion.

Female Body Dissatisfaction and Attentional Bias to Body Images Evaluated Using Visual Search

One factor, believed to predict body dissatisfaction is an individual’s propensity to attend to certain classes of human body image stimuli relative to other classes. These attentional biases have been evaluated using a range of paradigms, including dot-probe, eye-tracking and free view visual search, which have yielded a range of – often contradictory – findings. This study is the first to employ a classic compound visual search task to investigate the relationship between body dissatisfaction and attentional biases to images of underweight and with-overweight female bodies. Seventy-one undergraduate females, varying their degree of body dissatisfaction and Body Mass Index (BMI), searched for a horizontal or vertical target line among tilted lines. A separate female body image was presented within close proximity to each line. On average, faster search times were obtained when the target line was paired with a uniquely underweight or with-overweight body relative to neutral (average weight only) trials indicating that body weight-related images can effectively guide search. This congruent search effect was stronger for individuals with high eating restraint (a behavioral manifestation of body image disturbance) when search involved a uniquely underweight body. By contrast, individuals with high BMIs searched for lines more rapidly when paired with with-overweight rather than underweight bodies, than did individuals with lower BMIs. For incongruent trials – in which a unique body was paired with a distractor rather than the target – search times were indistinguishable from neutral trials, indicating that the deviant bodies neither compulsorily “captured” attention nor reduced participants’ ability to disengage their attention from either underweight or with-overweight bodies. These results imply the existence of attentional strategies which reflect one’s current body and goal-directed eating behaviors.

An unfamiliar social presence reduces facial disgust responses to food stimuli

Consumers' emotional responses complement sensory and hedonic ratings in the prediction of food choice and consumption behaviour. The challenge with the measurement of consumption emotions is that emotions are highly context dependent. For emotion evaluations to bring greater insight to food research and development, it is essential that the influence of contextual variables on emotion are quantified. The present study contributes to the discussion with an investigation of the effect of an unfamiliar social presence on affective facial responses to visual food stimuli. Seventy participants (52 female and 18 male) viewed food images of varying acceptability either alone, or in the presence of the researcher. Subjective liking ratings were measured using a labelled affective magnitude scale, and facial muscle activity from zygomaticus major (contracted during smiling), corrugator supercilii (contracted during frowning) and levator labii superioris (contracted during nose wrinkling) were measured with an EMG recording system. Controlling for individual differences in facial expressivity and food image acceptability using linear mixed models, it was found that social context did not predict smiling or frowning muscle activity. Social context did predict the intensity of muscle activity indicative of a disgust response, with participants in the observed condition exhibiting less levator activity than participants in the alone condition. Regardless of social context, each muscle was found to have a relationship with subjective liking, with the direction of effects as expected. The results indicate that emotional stimuli and social context both influence food-evoked facial expression and provides support for the utility of facial EMG in measuring food-evoked emotion.

Evaluating Potential Behavioral Mediators for Increasing Similarity in Friends' Body Size among College Students

College students and their friends become more similar in weight status over time. However, it is unclear which mediators explain this relationship. Using validated survey measures of diet, physical activity, alcohol intake, sleep behaviors, mental health, and food security status, we take a comprehensive look at possible factors associated with excess weight gain that may explain friends’ convergence on body mass index (BMI), waist circumference, waist to hip ratio, and waist to height ratio over time. We use linear mixed models applied to a longitudinal dataset of first-year college students to examine whether these variables satisfy two criteria for potential candidate mediators of friends’ influence on anthropometrics—cross-sectional similarity among friends (n = 509) and longitudinal associations with increasing anthropometrics (n = 428). While friends were similar on some survey measures (such as dining hall use, home cooked meal consumption, fruit intake, alcohol intake, hours of sleep, and stress). Only dining hall use and stress emerged as potential explanations for why friends’ BMI and anthropometric change may be similar. Given that only a few variables satisfied the two criteria as potential mediators, future research may need to consider alternative measurement approaches, including real-time assessments, objective measurements, and alternative factors causing the convergence of friends’ and college students’ body size over time.

The Paradoxical Outcomes of Observing Others' Exercise Behavior on Social Network Sites: Friends' Exercise Posts, Exercise Attitudes, and Weight Concern

This study examined the implications of observing others' exercise behavior on social network sites (SNSs). Social cognitive theory and social comparison theory were used to make predictions about the conditions under which individuals' (N = 232) exposure to exercise-related SNS posts from others in their social network were related to their weight concerns and exercise attitudes. The results revealed a paradox in which observing others' exercise posts was associated with both adaptive and maladaptive responses. The number of exercise-related SNS posts received from members of respondents' social networks was associated with greater weight concern, and this relationship was stronger among respondents who viewed exercise-related posts from network members who were similar to respondents. Yet, among respondents who had a tendency to make appearance-related upward social comparisons, the number of others' exercise-related SNS posts received was associated with pro-exercise attitudes.

Examining similarities in eating pathology, negative affect, and perfectionism among peers: A social network analysis

Friends tend to be more similar than non-friends (i.e., exhibit homophily) in body image concerns and disordered eating behaviors. These similarities may be accounted for by similarities in eating disorder risk factors and correlates. The current study sought to replicate findings of homophily for eating pathology using social network analysis and to test if similarity in eating pathology is present above and beyond homophily for eating disorder risk factors and correlates. College students (n = 89) majoring in nutrition completed a social network assessment and measures of eating pathology (i.e., body dissatisfaction, binge eating, restricting, excessive exercise), negative affect, and perfectionism. Homophily for eating pathology, negative affect, and perfectionism were tested as predictors of friendship ties using exponential random graph modeling, adjusting for gender, year in school, and body mass index. Results did not support homophily for eating pathology. However, restricting was associated with a lower likelihood of friendship ties. Homophily was present for perfectionism, but not for negative affect. Results suggest that eating pathology may influence the propensity to form friendships and account for previous findings of homophily in the literature. Homophily for perfectionism may have also driven previous findings for homophily. More longitudinal work using social network analysis is needed to understand the role that personality plays in peer influences on eating pathology.

Exposure to body focused and non-body focused others over a week: A preliminary investigation of their unique contributions to college women's eating and body image

This study investigated how exposure to non-body focused others (i.e., those who are not preoccupied with their body weight/shape or appearance) and exposure to body focused others uniquely affect young women's eating and body image over a week, within a day, and from one day to the next. For seven consecutive days, 92 female college students completed nightly online questionnaires about their daily experiences. Between-persons, multilevel modelling revealed that higher average levels of exposure to non-body focused others over the week uniquely predicted greater intuitive eating, greater body appreciation, and less dietary restraint, whereas higher average exposure to body focused others predicted these outcomes in the opposite direction. Within-persons, exposure to body focused others did not predict eating and body image, but exposure to non-body focused others did. On days when women had more exposure to non-body focused others than their personal average level or than the previous day's level, eating and body image were better. These findings are the first to suggest that independent of exposure to body focused others, level of exposure to non-body focused others - within and across days - contribute positively to eating and body image.

Exploring Women’s Experiences: Embodied Pathways and Influences for Exercise Participation

It has been well-documented that women face pressures to conform to a slim, toned, and athletic body, becoming “tyrannised” by beauty ideals. Under these contemporary ideologies of perfectionism, women are placed under constant surveillance, evaluation and, objectification and are thus reduced to “being” their bodies. However, there is little known about the potential relationships between different types of exercise, body image, and exercise motivation. With this in mind, this paper contributes towards a small but developing body of research that utilises feminist phenomenology to reveal twelve women’s early embodied motivations for exercising and draws upon material gathered from a three-year ethnography into the embodied experiences of women in fitness cultures. This paper delves into the influences on their continued participation over time and explores how these experiences shape their understandings of the embodied self and the broader constructions of the gendered body. The discussion provided illuminates how early influences on exercise participation and how pressures on women to conform to dominant notions of the “feminine” body are imposed by structural, cultural, historical, and localised forces in ways that affect and shape future physical activity participation, and the physical cultures where these tensions are played out.

Social network analysis for assessing college-aged adults' health: A systematic review

OBJECTIVE

Social network analysis (SNA) is a useful, emerging method for studying health. College students are especially prone to social influence when it comes to health. This review aimed to identify network variables related to college student health and determine how SNA was used in the literature.

PARTICIPANTS

A systematic review of relevant literature was conducted in October 2015.

METHODS

Studies employing egocentric or whole network analysis to study college student health were included. We used Garrard's Matrix Method to extract data from reviewed articles (n = 15).

RESULTS

Drinking, smoking, aggression, homesickness, and stress were predicted by network variables in the reviewed literature. Methodological inconsistencies concerning boundary specification, data collection, nomination limits, and statistical analyses were revealed across studies.

CONCLUSIONS

Results show the consistent relationship between network variables and college health outcomes, justifying further use of SNA to research college health. Suggestions and considerations for future use of SNA are provided.

Friendship as a social mechanism influencing body mass index (BMI) among emerging adults

Background

Social relationships have been proposed as a significant factor shaping obesity risk. The first year of college, a period of major social, behavioral, and weight changes, provides a context well-suited to tracking longitudinally the impact of shifting friendships on weight outcomes. This study sought to identify social mechanisms impacting BMI change among emerging adults.

Methods

An analytic sample of 276 college students (71.0% female, 52.2% non-White) provided repeated reports of relationships and BMI was measured up to four times during 2015–2016. Stochastic actor-oriented models were used to examine change in BMI through social influence and change in friendships over time, controlling for sex and race/ethnicity.

Results

At baseline, mean BMI was 24.2±4.5 kg/m². Overall, mean BMI increased over time; individual decreases in BMI were uncommon. There was a selection effect of BMI: participants with BMIs between 22 and 26 kg/m² were most likely to be nominated as a friend. While participants did not select friends based on BMI similarity, participants who were reported as friends were more likely to experience convergence in BMI over time relative to the BMIs of non-friends (p = 0.015). An increase in BMI (versus stability or a decrease) was more likely for those whose friends had a higher BMI on average compared to participants whose friends had the same or lower BMI (OR = 2.85, 95% CI = 1.22, 6.71).

Conclusion

Analyses indicated BMI affected friend selection, not through students selecting friends with similar BMI, but rather, by students avoiding friends with more extreme BMI levels.

The Peer Context of Dieting: The Relationship between Young Adults' Dieting Frequency and Their Friends' Weight-Related Characteristics

Previous research found that weight-related behaviors and body weight tends to be similar between individuals and peers. Rather little is known how different domains of weight-related behaviors co-evolve in peer networks. Hence, this study explores how young adults' self-reported dieting relates to perceived body weight and weight control behaviors of their peers. A Swedish two-wave panel survey with ego-centric network data was analyzed with negative binomial regression models. Nineteen-year-old men and women in the first wave, and 23-year-olds in the follow-up sample were examined. Men at age 19 showed an increased dieting propensity when being exposed to underweight peers. Compared to men, women's dieting at age 19 was more strongly related to their own body image concerns, and peers' weight-related behaviors like physical exercising and unhealthy eating. The associations between dieting and peers' weight-related characteristics for men and women deteriorated from age 19 to age 23. The findings suggest that women's dieting-in comparison to dieting in men-is more strongly related to the peer context. The decrease in associations between men's and women's dieting and peers' weight-related characteristics from age 19 to age 23 may reflect a weakened importance of the peer context in early adulthood.

School-Level Body Mass Index Shapes Children's Weight Trajectories

BACKGROUND

Embedded within children's weight trajectories are complex environmental contexts that influence obesity risk. As such, the normative environment of body mass index (BMI) within schools may influence children's weight trajectories as they age from kindergarten to fifth grade.

METHODS

I use 5 waves of the ECLS-K-Kindergarten Class 1998-1999 data and a series of multilevel growth models to examine whether attending schools with higher overall BMI influences children's weight status over time.

RESULTS

Results show that, net of child, family, and school sociodemographic characteristics, children who attend schools with higher rates of obesity have increased weight compared to children who attend schools with lower rates of obesity, and this effect increases annually.

CONCLUSIONS

Findings indicate that the overall weight status of schools influence child obesity, and further speak to the importance of school-based intervention programs.

An examination of risk factors that moderate the body dissatisfaction-eating pathology relationship among New Zealand adolescent girls

BACKGROUND

Eating disorders (EDs) and their subclinical variants are important health concerns for adolescent girls, and body dissatisfaction is a more common yet often debilitating experience that typically precedes the development of an ED. Despite this fact, little is known about what makes girls who are dissatisfied with their bodies more likely to engage in pathological eating behaviors. The present study explored eating pathology among a sample of adolescent girls from New Zealand and examined a variety of established risk factors that may moderate the relationship between body dissatisfaction (BD) and eating pathology.

METHODS

Adolescent girls aged between 14 and 18 (N = 231) completed questionnaires assessing eating pathology, BD, negative affect, perfectionism, self-esteem, teasing and sociocultural pressure. Regression analyses tested for moderator effects to examine which variables moderated the relationship between BD and eating pathology.

RESULTS

The analyses indicated that high levels of socially prescribed and self-oriented perfectionism, negative affect, perceived pressure from the media, and low levels of self-esteem all strengthened the relationship between BD and eating pathology.

CONCLUSIONS

The results highlight potential factors that may make adolescent girls who are dissatisfied with their bodies more susceptible to eating pathology.

The Role of Ego Networks in Compulsive Exercise Behavior Among a Sample of College Sorority Women

Background: Compulsive exercise (CE) is a harmful form of exercise that elevates the risk of developing/sustaining clinical eating disorders. College-aged sorority women are especially prone to CE. Due to the pronounced impact social relationships have on college students’ behavior, this study aims to examine personal networks and CE among a sample of sorority women through an egocentric network analysis.Methods: A total of 204 women in a sorority from a large, private university in the southeastern United States completed a cross-sectional survey in spring 2015. Descriptive and regression analyses were conducted on demographic, attribute, and ego network data.Results: Relationships with siblings, significant others, and roommates were protective against CE in this sample. Conversely, body dissatisfaction and exercise frequency predicted CE.Conclusions: Findings suggest that social relationships can impact CE behaviors in this sample. Along with promoting body satisfaction and healthy exercise, public health efforts should focus on facilitating close interpersonal relationships, especially between sorority women and siblings, significant others, and roommates.

Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

PURPOSE

In on-line forums, parents have reported that their children seemed to experience a sudden or rapid onset of gender dysphoria, appearing for the first time during puberty or even after its completion. Parents describe that the onset of gender dysphoria seemed to occur in the context of belonging to a peer group where one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same timeframe. Parents also report that their children exhibited an increase in social media/internet use prior to disclosure of a transgender identity. Recently, clinicians have reported that post-puberty presentations of gender dysphoria in natal females that appear to be rapid in onset is a phenomenon that they are seeing more and more in their clinic. Academics have raised questions about the role of social media in the development of gender dysphoria. The purpose of this study was to collect data about parents’ observations, experiences, and perspectives about their adolescent and young adult (AYA) children showing signs of an apparent sudden or rapid onset of gender dysphoria that began during or after puberty, and develop hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among this demographic group.

METHODS

For this descriptive, exploratory study, recruitment information with a link to a 90-question survey, consisting of multiple-choice, Likert-type and open-ended questions was placed on three websites where parents had reported sudden or rapid onsets of gender dysphoria occurring in their teen or young adult children. The study’s eligibility criteria included parental response that their child had a sudden or rapid onset of gender dysphoria and parental indication that their child’s gender dysphoria began during or after puberty. To maximize the chances of finding cases meeting eligibility criteria, the three websites (4thwavenow, transgender trend, and youthtranscriticalprofessionals) were selected for targeted recruitment. Website moderators and potential participants were encouraged to share the recruitment information and link to the survey with any individuals or communities that they thought might include eligible participants to expand the reach of the project through snowball sampling techniques. Data were collected anonymously via SurveyMonkey. Quantitative findings are presented as frequencies, percentages, ranges, means and/or medians. Open-ended responses from two questions were targeted for qualitative analysis of themes.

RESULTS

There were 256 parent-completed surveys that met study criteria. The AYA children described were predominantly natal female (82.8%) with a mean age of 16.4 years at the time of survey completion and a mean age of 15.2 when they announced a transgender-identification. Per parent report, 41% of the AYAs had expressed a non-heterosexual sexual orientation before identifying as transgender. Many (62.5%) of the AYAs had reportedly been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to the onset of their gender dysphoria (range of the number of pre-existing diagnoses 0–7). In 36.8% of the friendship groups described, parent participants indicated that the majority of the members became transgender-identified. Parents reported subjective declines in their AYAs’ mental health (47.2%) and in parent-child relationships (57.3%) since the AYA “came out” and that AYAs expressed a range of behaviors that included: expressing distrust of non-transgender people (22.7%); stopping spending time with non-transgender friends (25.0%); trying to isolate themselves from their families (49.4%), and only trusting information about gender dysphoria from transgender sources (46.6%). Most (86.7%) of the parents reported that, along with the sudden or rapid onset of gender dysphoria, their child either had an increase in their social media/internet use, belonged to a friend group in which one or multiple friends became transgender-identified during a similar timeframe, or both.

CONCLUSION

This descriptive, exploratory study of parent reports provides valuable detailed information that allows for the generation of hypotheses about factors that may contribute to the onset and/or expression of gender dysphoria among AYAs. Emerging hypotheses include the possibility of a potential new subcategory of gender dysphoria (referred to as rapid-onset gender dysphoria) that has not yet been clinically validated and the possibility of social influences and maladaptive coping mechanisms. Parent-child conflict may also explain some of the findings. More research that includes data collection from AYAs, parents, clinicians and third party informants is needed to further explore the roles of social influence, maladaptive coping mechanisms, parental approaches, and family dynamics in the development and duration of gender dysphoria in adolescents and young adults.

Influence of Food Neophobia Level on Fruit and Vegetable Intake and Its Association with Urban Area of Residence and Physical Activity in a Nationwide Case-Control Study of Polish Adolescents

Among the factors that may influence fruit and vegetable intake, there is a food neophobia level, but the other elements, including physical activity and place of residence, must also be taken into account as interfering ones. The aim of the study was to analyze the association between food neophobia level and the intake of fruits and vegetables in a nationwide case-control study of Polish adolescents (12–13 years), including the influence of gender, the physical activity program participation and the place of residence. The #goathletics Study was conducted among a group of 1014 adolescents, 507 individuals representative for a nationwide physical activity program “Athletics for All” participants (characterized by an active lifestyle) and 507 pair-matched individuals (characterized by sedentary behavior), while 502 were representative for urban and 512 for suburban area. The assessment of food neophobia level was based on the Food Neophobia Scale questionnaire and the assessment of fruit and vegetable intake was based on the validated food frequency questionnaire. It was observed that higher food neophobia level is associated with a lower fruit and vegetable intake, that was stated both for girls and boys, as well as both for individuals characterized by an active lifestyle and those characterized by sedentary behavior, both from urban and suburban area. Food neophobic individuals characterized by an active lifestyle and those from urban areas were characterized by a higher fruit intake than individuals characterized by sedentary behavior and those from suburban areas, from the same food neophobia category. It was found that food neophobia may reduce fruit and vegetable intake, but the physical activity education with peers may reduce the observed influence and should be applied especially in the case of neophobic individuals from suburban areas.

Words with weight: The construction of obesity in eating disorders research

In current public health discourse, obesity is conceptualized as a disease epidemic, with treatment being weight loss. The pursuit of weight loss as a treatment for the “disease” of obesity is in direct contradiction to the history of research in eating disorders, which has demonstrated the risks for the development of eating disorders. In this study, we critically examined the eating disorder literature to explore this contradiction. We analyzed 30 of the top-cited articles in the eating disorder literature between 1994 and 2011, asking: how is the concept of obesity examined in eating disorder research? We identified tensions related to body mass index and the perceived associated risks of lower or higher body mass index, assumptions of the “causes” of fatness (i.e. overeating and inactivity), and the anti-diet voice challenging the prescription of dieting for those in fat bodies. In our analysis, we highlight the problematics of, for instance, prescribing a body mass index range of 20–24 in eating disorder recovery, how many studies in eating disorders do not problematize the presumption that a higher body mass index is necessarily associated with ill health, and a lack of cultural sensitivity and acknowledgment of intersectional spaces of belonging. We discuss these themes in the context of biomedical discourses of obesity contributing to the cultural thin ideal. We argue that biomedical discourses on obesity contribute to the thin ideal nuanced against discourses of healthism that permeate our society. Rather than an ideal of emaciation, it is an ideal of a healthy, productive person, often constructed as morally superior. The moral panic around obesity is evident throughout the eating disorder literature, which is a concern given that we would hope that the aim of eating disorder treatment would be to promote wellness for all—not only those who are thin.

Applications of social network analysis to obesity: a systematic review

People's health behaviours and outcomes can be profoundly shaped by the social networks they are embedded in. Based on graph theory, social network analysis is a research framework for the study of social interactions and the structure of these interactions among social actors. A literature search was conducted in PubMed and Web of Science for articles published until August 2017 that applied social network analysis to examine obesity and social networks. Eight studies (three cross-sectional and five longitudinal) conducted in the US (n = 6) and Australia (n = 2) were identified. Seven focused on adolescents' and one on adults' friendship networks. They examined structural features of these networks that were associated with obesity, including degree distribution, popularity, modularity maximization and K-clique percolation. All three cross-sectional studies that used exponential random graph models found individuals with similar body weight status and/or weight-related behaviour were more likely to share a network tie than individuals with dissimilar traits. Three longitudinal studies using stochastic actor-based models found friendship network characteristics influenced change in individuals' body weight status and/or weight-related behaviour over time. Future research should focus on diverse populations and types of social networks and identifying the mechanisms by which social networks influence obesity to inform network-based interventions.

Disordered eating in college sorority women: A social network analysis of a subset of members from a single sorority chapter

OBJECTIVE

Disordered eating attitudes and behaviors are prevalent among college women, and peers appear to influence current and future eating pathology. Social network analysis (SNA) is an innovative quantitative method to examine relationships (i.e., ties) among people based on their various attributes. In this study, the social network of one sorority was modeled using exponential random graph model (ERGM) to explore if homophily, or the tendency for relationship ties to exist based on shared attributes, was present according to sorority members' disordered eating behaviors/attitudes and their body mass index (BMI).

METHOD

Participants included members of one sorority at a large Southeastern university. All members were included on a roster unless they elected to opt out during the consent process, and 41 (19%) of the members completed the study measures. Participants completed the Social Network Questionnaire developed for this study (degree of "liking" of every member on the roster), the Eating Disorder Examination-Questionnaire (EDE-Q), and a demographics questionnaire in exchange for one hour of community service credit.

RESULTS

The final sample consisted of mostly White women with an average age of 20. Homophily across liking ties was examined based on the EDE-Q Global scale, episodes of binge eating, and BMI. The greater the difference in EDE-Q Global scores, the more likely the participants were to like one another. The greater the difference in BMI, the less likely the participants were to like one another. Binge eating was unrelated to homophily.

DISCUSSION

College sorority women appear to prefer other women with dissimilar levels of disordered eating attitudes, suggesting complex interactions between stigmatized or valued disordered eating attributes. Women with similar BMI were more likely to like one another, confirming past findings.