Body Image and Sex: A Dyadic Examination of Body Esteem and Sexual Inhibition, Obsession, and Harmony

How each individual within a relationship views their body may play a role in how they experience their sexual interactions. Previous research found associations between body image and sexual well-being at an individual level, but very little research has examined a dyadic association between body image and sexual and relational well-being. Using a nationally representative sample of 2,177 newlywed couples, this study used an Actor-Partner Interdependence Mediation Model (APIMeM) to estimate actor and partner associations between body esteem and relationship satisfaction, using sexual styles - inhibited, obsessed, or harmonious - as potential mediators. Findings showed both actor and partner effects. Body esteem was positively associated with own and partner's sexual harmony. Both men's and women's body esteem were negatively associated with women's sexual inhibition. A positive association between body esteem and own relationship satisfaction remained even when accounting for sexual mediators. Additional findings are discussed. These findings indicate that an individual's comfort with the body may be associated with sexual and relational well-being for both partners.

Discrepancies in self-reported and measured anthropometric measurements and indices among older Australians: prevalence and correlates

Background

Anthropometric measurements and indices such as weight, height and Body Mass Index (BMI) are often used to assess overall health and nutritional status. Clinicians and epidemiologists often rely on self-reported weight and height to measure BMI. Differences between self-reported and measured weight and height can lead to differences between self-reported and measured BMI, biasing relative risks of diseases associated with differential BMI.

Methods

Applying regression analysis to a large nationally representative survey data with contemporaneous self-reports and measurements on 3412 individuals aged 65 or over, we provided estimates of the difference between self-reports and measurements of weight, height and BMI for older Australians, analysing demographic, socioeconomic and health correlates of estimated differences.

Results

We found both males and females underestimated weight, overestimated height and underestimated BMI and there was some evidence these differences increased with age. There was also evidence that these differences were associated with high levels of education and household composition.

Conclusion

Although average differences were small, for many individuals the differences may be significant, indicating measurements should be taken in clinically focused research and practice. This is important as systematic underestimation of BMI in older adults can have implications for estimating the size of populations at risk of many health conditions, including diabetes, hypertension and functional limitations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14326-y.

Body Dissatisfaction, Distorted Body Image and Disordered Eating Behaviors in University Students: An Analysis from 2017-2022

University students, as young adults, are at risk for Body Dissatisfaction (BD) and Distorted Body Image (DBI), which are related to Disordered Eating Behaviors (DEBs). This study aimed to assess changes in the prevalence of these three conditions over six years; and the associations between them. Data was collected through an annual online survey from 2017 to 2022 at a private university in Mexico City. Students between 18-30 years old were invited to participate. Body image-related variables were assessed by the Stunkard's Silhouettes and Body Mass Index, by self-reported height and weight. Disordered Eating Behaviors were measured by the Brief Disordered Eating Behaviors Questionnaire. A median of 250 students participated per year, with a median age of 21 years old. The prevalence was 63.5-71.7% for BD, 40.4-49.1% for DBI, and 25-38.3% for DEBs. DEBs and BD showed associations during the whole period (OR from 3.6 to 15.9, p ≤ 0.001); as well as DBI with DEBs (OR from 1.9 to 3.3, p < 0.05). Alterations in Body Image and eating behaviors are common conditions, mainly in women and in the young population. Therefore, it is important to promote screening for these conditions, as they usually remain undiagnosed, their prevalence is increasing worldwide, and their impact on physical and mental health has already been acknowledged.

Race, Ethnicity, and Age Differences in Social Relationships and Obesity: Findings From the National Survey of American Life

ObjectiveThe purpose of this study was to examine race, ethnicity, and age differences in the association between social relationships and body weight in a nationally representative sample of African American, Caribbean Black, and non-Hispanic White adults. Methods: Data were drawn from the 2001-2003 National Survey of American Life (N = 5684). Multiple linear regressions were conducted to examine the links between race, ethnicity, and age with social relationships and weight. Results: Although African American respondents had higher BMI than non-Hispanic White respondents, Caribbean Black respondents did not differ from White respondents in BMI. Emotional support from family members was both positively and negatively associated with weight depending on age, race, and ethnicity. Discussion: Social relationships are an important contributing factor to obesity and obesity-related risks in adults. Study findings demonstrate the intersection of race, ethnicity, and age and how these complex relationships influence the association between social relationships and body weight.

Body Image Distress and Its Associations From an International Sample of Men and Women Across the Adult Life Span: Web-Based Survey Study

BACKGROUND

Previous research on body image distress mainly relied on samples that were small, generally homogeneous in age or sex, often limited to one geographical region, and were characterized by a lack of comprehensive analysis of multiple psychosocial domains. The research presented in this paper extends the international literature using the results of the web-based Global Health and Wellbeing Survey 2015. The survey included a large sample of both men and women aged ≥16 years from Australia, Canada, New Zealand, the United Kingdom, or the United States.

OBJECTIVE

The main objectives of this study are to examine body image distress across the adult life span (≥16 years) and sex and assess the association between body image distress and various psychosocial risk and protective factors.

METHODS

Data were extracted from the Global Health and Wellbeing Survey 2015, a web-based international self-report survey with 10,765 respondents, and compared with previous web-based surveys conducted in 2009 and 2012.

RESULTS

The body image distress of young Australians (aged 16-25 years) significantly rose by 33% from 2009 to 2015. In 2015, 75.19% (961/1278) of 16- to 25-year-old adults reported body image distress worldwide, and a decline in body image distress was noted with increasing age. More women reported higher levels of body image distress than men (1953/3338, 58.51% vs 853/2175, 39.22%). Sex, age, current dieting status, perception of weight, psychological distress, alcohol and other substance misuse, and well-being significantly explained 24% of the variance in body image distress in a linear regression (F_15,4966=105.8; P<.001).

CONCLUSIONS

This study demonstrates the significant interplay between body image distress and psychosocial factors across age and sex.

Low Self-Perception of Malnutrition in Older Hospitalized Patients

Background

Studies focusing on self-perception of nutritional status in older hospitalized patients are lacking. We aimed to examine the self-perception of body weight and nutritional status among older hospitalized patients compared to their actual body weight and nutritional status based on medical assessment.

Materials and Methods

This observational cross-sectional study investigated 197 older participants (mean age 82.2±6.8 years, 61% women) who were consecutively admitted to the geriatric acute care ward. Body weight status and nutritional status were assessed using WHO-BMI classification and Mini Nutritional Assessment-Short Form (MNA-SF), respectively. Self-perceived body weight status and nutritional status were assessed with a standardized questionnaire. A follow-up was performed with a short telephone interview after three months.

Results

According to MNA-SF, 49% and 35% were at risk of malnutrition and malnourished, respectively. There was no agreement between self-perceived nutritional status and objective nutritional status according to MNA-SF (Kappa: 0.06). A slight agreement was found between subjective body weight status and objective body weight status according to WHO-BMI classification (Kappa: 0.19). A total of 184 patients completed the 3 months follow-up and additional 9 patients died during this time, of which 7 and 2 were malnourished and at risk of malnutrition according to MNA-SF, respectively. Of those who were malnourished and at risk of malnutrition based on MNA-SF and died during follow-up, 67.7% did not realize their malnutrition. Compared to the patients with normal nutritional status during hospitalization, malnourished patients based on MNA-SF had higher rates of unplanned hospital readmission and further weight loss and more often reported health deterioration and experienced death within three months after discharge.

Conclusion

No agreement between self-perceived nutritional status and objective nutritional status among older hospitalized patients was found. Our study highlights the need to raise knowledge about the issue of malnutrition and increase awareness of health risks associated with malnutrition among older hospitalized patients.

Gender differences in factors associated with body weight misperception

OBJECTIVE

Gender analysis in health research is important to strengthen our health system. The current study aimed to explore factors related to body weight misperception in a national sample of the general Korean population.

DESIGN

Cross-sectional study.

SETTING

South Korea, general population.

PARTICIPANTS

12,900 adults enrolled from the Seventh Korea National Health and Nutrition Examination Survey (2016-2018).

RESULTS

Disadvantageous socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being overweight and as underweight despite being of a healthy weight, mainly in men. Favourable socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being underweight and as overweight despite being of a healthy weight, mainly in women. Living in an urban area was an independent predictor of men's misperception of themselves as being of a healthy weight despite being overweight and women's misperception of themselves as being underweight despite being of a healthy weight. Physical inactivity was a predictor of most misperceptions in women. Psychological variables, such as stress and depression, were not significant predictors of misperception.

CONCLUSIONS

The current study highlighted the gender differences in factors related to body weight misperception. These differences suggested that more sophisticated policies should be formulated to identify solutions to health problems related to body weight.

Race, Obesity, and Mental Health Among Older Adults in the United States: A Literature Review

Rising rates of obesity among older adults in the United States are a serious public health concern. While the physical health consequences of obesity are well documented, the mental health consequences are less understood. This is especially the case among older adults in general and among racial and ethnic minority older adults in particular. Available studies document a link between obesity and a variety of mental health disorders. However, findings from this body of evidence are inconsistent, especially when race and ethnicity are considered. This article examines research on obesity and mental health among older adults and identifies risk factors, causal mechanisms, and methodological approaches that help clarify the equivocal nature of the literature. Promising research and future directions include studies that consider a wide array of contextual factors and population heterogeneity.

Body image, body dissatisfaction and weight status of Pacific adolescents from different ethnic communities: a cross-sectional study in New Caledonia

Objective(s): The prevalence of adolescent obesity is high among the various ethnic groups native to the Pacific region (European, Melanesian and Polynesian). An important factor of weight gain or loss is body size satisfaction; however, little is known about adolescent body self-perception in the Pacific region.Design: Body dissatisfaction was evaluated using the Stunkard Figure Rating Scale in a sample of 699 adolescents from rural and urban areas of New Caledonia. The socio-demographic factors associated with higher body dissatisfaction were determined by multiple linear regression modeling.Results: Our results showed a high rate of body dissatisfaction (over 70%) in the adolescents. Body dissatisfaction was strongly related to the body mass index z-score. Melanesians boys had higher body dissatisfaction scores when they felt 'too thin' while Melanesian girls showed lower body dissatisfaction when they felt 'too fat.'.Conclusion: These results showed that social pressure for thinness or musculature may be different among adolescents living in New Caledonia. These results should be taken into account in education overweight prevention programs.

Determinação do estado nutricional: qual o valor de peso e altura autorreferidos?

Introdução: Altas prevalências de sobrepeso e obesidade são descritas em diferentes populações. No entanto, grande parcela da população tem percepções imprecisas sobre seu peso corporal e, consequentemente, sobre a classificação nutricional. Objetivo: Comparar a percepção autorreferida do peso corporal frente à classificação nutricional baseada na aferição realizada por profissional de saúde em amostra representativa da população de cidade de grande porte do sudeste brasileiro. Material e métodos: Foi realizado estudo transversal por inquérito populacional em cidade de médio porte do sudeste brasileiro, sendo a coleta de dados realizada de junho/2014 a abril/2016. Utilizou-se amostragem domiciliar em três estágios e aproximadamente 4.800 domicílios foram visitados, a partir dos quais, 1.032 participantes foram aleatoriamente selecionados e incluídos na pesquisa. Resultados: A média de idade dos participantes foi de 44±13,2 anos, sendo 53,2% indivíduos do sexo feminino. Com base no autorrelato de peso e altura e cálculo do índice de massa corporal (IMC), observou-se que 58,7% da população se encontravam com excesso de peso. Dos 521 indivíduos que foi possível realizar a avaliação do peso e altura por profissionais de saúde vimos que ao se comparar a classificação nutricional baseada no autorrelato com aquela obtida a partir de dados mensurados pelos profissionais, observou-se que o número de casos de obesidade foi 7,1% maior. Conclusão: Diante dos dados do presente estudo, a autopercepção do excesso de peso pode não ser adequada como ferramenta para avaliação de populações em risco para obesidade/sobrepeso, além disso, os resultados reforçam a necessidade de educação sobre o uso do IMC assim como da importância das orientações por profissionais de saúde.

Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans

Environmental stressors, such as perceived discrimination (PD), are linked to Binge Eating Disorder (BED). The current study investigated the association between PD and BED among African Americans, and the variation in such an association based on gender. Data of the National Survey of American Life (NSAL), 2001⁻2003, with a nationally-representative sample of African American adults, were used (n = 3516). The independent variable in the study was PD. The dependent variable was BED, measured using the Composite International Diagnostic Interview (CIDI). Socio-demographics (age, education, employment, and marital status) were covariates, and gender was the moderator variable. Survey logistic regressions with and without gender × PD interaction terms were used for data analysis. In the pooled sample, PD was associated with higher odds of BED, net of socio-demographic factors. Models also showed a significant gender × PD interaction term suggesting a stronger association between PD and BED for women, compared to men. Gender specific models showed an association between PD and BED among female, but not male, African Americans. Although a link may exist between PD and BED among African Americans, the magnitude of this association depends on gender, with a stronger association among females than males. This finding is in line with the literature that has shown gender-specific consequences of environmental stress for African Americans.

"Feeling More Self-Confident, Cheerful and Safe". Experiences from a Health-Promoting Intervention in Community Dwelling Older Adults - A Qualitative Study

OBJECTIVES

Studies show that regular exercise in combination with nutritional support can be effective in managing sarcopenia, which is age-related involuntary loss of skeletal muscle mass and strength. Qualitative investigations of participants' experiences from interventions in this domain are scarce. In this study, we explored older persons' experiences from an intervention designed to prevent sarcopenia, with the aim of capturing the participants' thoughts and opinions.

DESIGN

A qualitative study embedded in the multicenter randomized clinical trial The Vitality and Vigor in the Elderly study, VIVE2. Focus group interviews were conducted. Manifest and latent content analyses were performed.

PARTICIPANTS

Community dwelling older adults (n=20) 71-86 years of age with minor limitations in mobility.

RESULTS

The experiences from the intervention were categorized and interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The theme encompasses the categories psychological effects of participating in the intervention, physical effects of participating in the intervention, the importance of social support and the importance of a tailored set-up. The participants described their motives for participating in the intervention as being based on concerns regarding the negative health effects of continuing a sedentary lifestyle, difficulties of getting started on their own and lack of confidence in accomplishing change on their own. Participants also expressed that one main objective for participating was to lose weight.

CONCLUSION

In this study we have captured the experiences of older adults with minor mobility limitations who participated in a lifestyle intervention. The experiences are interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The central understanding of the participants' experiences was that the intervention affected them in several ways, both psychologically and physically, and that supporting factors included the social support, which became a prerequisite for success. A noticeable finding was the discrepancy between the motive of the participants, to lose weight, and the aim of the study, to improve muscle function. The expectation to lose weight seems to reflect what is commonly known as to be healthy. To our knowledge, at least in Sweden, there are no campaigns or public information highlighting the risks of sarcopenia and the complex issue of if, and when weight loss is desirable for older individuals. This finding highlights the importance of providing such information to this target group. The findings in this study provide valuable knowledge for research teams, practitioners and decision makers when designing and setting objectives for health-promoting interventions for older individuals.

A comparative study on perception of body weight of women from different socioeconomic levels

The purpose of the study was to evaluate perception of body weight (PBW) of women who live in two different regions of the Antalya provincial center in Turkey with different socioeconomic status (SES) and whose ages range from 50 to 65. A cross-sectional survey was conducted. Association with PBW was investigated using multiple logistic regression analyses; correct PBW of women in middle SES was 0.28 times more than those in upper-middle and upper SES. Health professionals should take unemployed women with high body mass index and low SES as a target group.

Misperception of weight status in the pacific: preliminary findings in rural and urban 11- to 16-year-olds of New Caledonia

Background

Adolescent obesity is prevalent in Pacific region ethnic groups (European, Melanesian and Polynesian) living in both urban and rural areas. Although body perception is an important factor of weight gain or loss, little is known about the body self-perceptions of Pacific region adolescents. This study therefore evaluated adolescent perceptions of body weight according to ethnicity (European, Melanesian or Polynesian), socioeconomic status (low, intermediate or high) and living area (rural or urban) in New Caledonia.

Methods

Sociodemographic and anthropomorphic data from 737 adolescents (351 boys and 386 girls) with ages ranging from 11 to 16 years were collected and analysed. The International Obesity Task Force (IOTF) standards were used to define weight status as normal-weight, underweight or overweight/obese. Weight perception was assessed from detailed questionnaires, with adolescents rating their own weight with the following descriptors: ‘about the right weight’, ‘too heavy’, or ‘too light’.

Results

Results showed that only 8.5% of normal-weight adolescents (7% boys and 10% girls) identifying themselves as ‘too heavy’. Normal-weight Melanesian adolescents were less likely than their European counterparts to assess themselves as too heavy (OR = 0.357). However, half the overweight/obese adolescents underestimated their weight status (53% boys and 48% girls). Weight misperception was associated with ethnicity, socioeconomic status and living area, with gender-specific differences.

Conclusions

The results of this study suggest that these sociodemographic factors should be taken into account when designing public health policies and health education school programmes in New Caledonia and, more broadly, the Pacific region.

Discrepancy between Actual and Perceived Weight Status in Rural Patients: Variations by Race and Gender

The study's goal was to determine if differences in weight misperception by race and/or gender occur within a sample of economically disadvantaged rural patients with diabetes and/or hypertension. Diabetic and hypertensive patients were enrolled in the study from a network of federally qualified health centers (FQHCs) in the rural South. Multivari-ate logistic regression analysis suggests that, even when controlling for age, education level, employment status, and poverty, rural African American patients with chronic disease are more likely than their White counterparts to misperceive their weight status (OR = 1.709, p = .037). This difference in perceived weight occurred despite the absence of an underlying difference in actual weight status between African American and White patients (p = .171). In addition, rural men were much more likely than rural women to misperceive their weight status (OR = 2.688, p < .001). Implications for intervention development and implementation are discussed.

Self- Perception of Body Weight Status in Older Dutch Adults

INTRODUCTION

OBJECTIVES

The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored.

DESIGN

A cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands.

PARTICIPANTS

1295 men and women aged 60-96 years.

MEASUREMENTS

Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status.

RESULTS

The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status.

CONCLUSION

Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.

Relationships Between Body Areas Satisfaction, Exercise, and Mood in Obese African American Women

Despite a rate of morbid obesity that is 2.5 times that of European American women, African American women have higher body areas satisfaction than any other ethnicities. Previous research suggested differences in African American women’s attitudes toward body image may contribute to a lack of motivation to engage in weight management behaviors, such as physical activity. In addition, factors such as self-efficacy, self-regulation, and mood have been shown to affect healthy behavior participation but have not been studied among obese African American women. This study investigated if changes from baseline to posttreatment in self-efficacy and self-regulation for exercise and mood mediatedthe association between changes in body areas satisfaction and physical activity. The study used archival data consisting of 109 obese African American women who participated in a 6-month weight management intervention. The relationship between changes in body areas satisfaction and physical activity was mediated by changes in self-regulation for exercise and mood but not by change in self-efficacy for exercise. These findings may help in devising treatments targeted at this population. Implications are discussed.

Self-perceived vs actual and desired weight and body mass index in adult ambulatory general internal medicine patients: a cross sectional study

BACKGROUND

No study has compared patients' self-reported heights and weights (and resultant self-reported body mass indexes [BMIs]) with their actual heights, weights, and BMIs; their self-perceived BMI categories; and their desired weights and BMIs and determined rates of clinicians' documented diagnoses of overweight and obesity in affected patients in a single patient group. The objectives of this study were to make these comparisons, determine patient factors associated with accurate self-perceived BMI categorization, and determine the frequency of clinicians' documented diagnoses of overweight and obesity in affected patients.

RESULTS

A total of 508 consecutive adult general internal medicine outpatients (257 women, 251 men; mean age, 62.9 ± 14.9 years) seen at Mayo Clinic in Rochester, Minnesota, between November 9 and 20, 2009, completed a questionnaire in which they reported their heights, weights, self-perceived BMI categories ("underweight," "about right," "overweight," or "obese"), and desired weights. These self-reported data were compared to actual heights, actual weights, and actual BMI categories (measured after the questionnaire was completed). Overall, 70% of the patients were overweight or obese. The average self-reported weight was significantly lower than the average actual weight (80.3 ± 20.1 kg vs 81.9 ± 21.1 kg; P < .001). The average self-reported BMI was significantly lower than the average actual BMI (27.6 ± 5.7 kg/m(2) vs 28.3 ± 6.1 kg/m(2); P < .001). Overall, 32% of patients had obesity; however, only 6% perceived they were obese. Accuracy of self-perceived BMI category decreased with higher actual BMI category (P < .001 for trend). Female sex, higher education level, smoking status, and lower BMI were associated with higher accuracy of self-perceived BMI category. Desired weight loss increased with higher self-perceived and actual BMI categories (P < .001 for trends). Of the 165 patients who actually were obese, only 40 (24%) had obesity documented as a diagnosis in their medical records by their clinicians. Statistical tests used were the paired t test, the Pearson χ2 test, the Cochrane-Armitage trend test, the Wald test of marginal homogeneity, analysis of variance, and univariate and multivariate logistic regression.

CONCLUSIONS

Many obese patients inaccurately perceive their BMI categories; accuracy decreases with increasing BMI. Clinicians should inform patients of their BMIs and prescribe treatment plans for those with overweight and obesity.

Early-life social origins of later-life body weight: the role of socioeconomic status and health behaviors over the life course

Using the 1957-2004 data from the Wisconsin Longitudinal Study, we apply structural equation modeling to examine gender-specific effects of family socioeconomic status (SES) at age 18 on body weight at age 65. We further explore SES and health behaviors over the life course as mechanisms linking family background and later-life body weight. We find that early-life socioeconomic disadvantage is related to higher body weight at age 65 and a steeper weight increase between midlife and late life. These adverse effects are stronger among women than men. Significant mediators of the effect of parents' SES include adolescent body mass (especially among women) as well as exercise and SES in midlife. Yet, consistent with the critical period mechanism, the effect of early-life SES on late-life body weight persists net of all mediating variables. This study expands current understanding of life-course mechanisms that contribute to obesity and increase biological vulnerability to social disadvantage.

Estado nutricional e autopercepção da imagem corporal de idosas de uma Universidade Aberta da Terceira Idade

O objetivo foi avaliar a associação entre o estado nutricional e a insatisfação da autoimagem corporal de idosas matriculadas no curso Alimentação, Nutrição e Terceira Idade da UnATI/UERJ. Realizou-se estudo seccional, com entrevista semiestruturada com todas as idosas (≥60 anos), obtendo-se informações referentes à percepção da imagem corporal (escala de nove silhuetas de Stunkard), indicadores socioeconômicos, de saúde, demográficos e cálculo do índice de massa corporal (IMC). Os dados foram analisados por meio de teste qui-quadrado e a regressão linear simples (nível de significância=5%). Verificou-se que 50,0% eram eutróficas; 6,0% se encontravam na categoria de baixo-peso e 44,0% apresentavam sobrepeso (p=0,425). Quanto à percepção da imagem corporal, 74,0% (n=37;p=0,0049) estavam insatisfeitas com o corpo, principalmente pelo excesso (89,2%). Das pessoas que manifestaram insatisfação por baixo-peso, a maioria era eutrófica. Já entre as insatisfeitas por excesso, 30,2% não apresentavam excesso de peso. As silhuetas 2 e 3 foram apontadas como ideais por metade das entrevistadas, ainda que a autopercepção de 62,0% das idosas tenham sido as silhuetas 4 e 5. A barriga e membros, principalmente inferiores, foram as partes do corpo que as idosas menos gostavam (78,0%). A classificação na escala das silhuetas da imagem real aumenta conforme aumenta o IMC (p<0,001). Em relação à imagem ideal ocorre o oposto (p<0,001). Indivíduos com IMC elevado tendem a ser mais insatisfeitos com sua imagem corporal e essa insatisfação pode estar relacionada ao excesso de peso. Esse fato merece mais aprofundamento sobre os determinantes e os significados desta insatisfação na complexa relação corpo, beleza, saúde e envelhecimento.

Predicting adherence of adults to a 12-month exercise intervention

BACKGROUND

The purpose of this study was to (a) examine demographic, psychosocial, and physiological predictors of exercise adherence in a yearlong exercise intervention and (b) describe the trajectory of adherence over time.

METHODS

Participants were 51 men and 49 women aged 40 to 75 years. The supervised and home-based intervention consisted of 60 minutes/day, 6 days/ week of moderate-to-vigorous intensity exercise. Three adherence measures were used: (1) minutes/week, (2) MET-hours/week, and (3) change in cardiopulmonary fitness (VO2max). Predictors of adherence were determined separately by sex using mixed models and multivariable regression.

RESULTS

Participants performed 287 ± 98 minutes/week of moderate-to-vigorous activity with 71% adhering to at least 80% (288 minutes/week) of the prescription. Men adhered better than women (P < .001). Among women, adiposity-related variables were significantly related to poorer adherence on all 3 measures (P < .05). A less consistent pattern was observed among men but in follow-up analyses, adiposity was associated with fewer MET-hours/week of exercise. Social support, pain, and perceived benefits were predictive in some models. Men and nonobese women experienced peak adherence at 4 to 6 months, while obese women peaked during months 0 to 3.

CONCLUSIONS

When provided with supervision and support, previously sedentary men and women can achieve and maintain high levels of aerobic activity.

Differential perceptions of body image and body weight among adults of different socioeconomic status in a sub-urban population

This study explored the association of socioeconomic status with individuals' perception of their body image (BI) and body weight (BW) among adults in a sub-urban Nigerian population. The cross-sectional sample comprised 1521 residents (775 males and 746 females) of the town of Nnewi. Perceived BI was assessed using figural representations of different sizes for males and females. Perceived BW was determined by presenting participants with BW category options to choose from. Body mass index (BMI) was calculated from objectively measured BW and height using standardized procedures. Actual BW categories were derived from participants' BMIs using WHO criteria. Perceived BI and BW differed from actual BW among unskilled and non-tertiary males (p<0.001) and female (p<0.001 to p<0.04) in all BW categories whereas these variables differed (p<0.001) among skilled and tertiary males and females in normal weight, overweight and obese categories. Perceived BW differed (p<0.001) from actual BW among unskilled and non-tertiary males in underweight, overweight and obese categories whereas these variables differed (p<0.001) among unskilled and non-tertiary females, skilled and tertiary males and females in overweight and obese categories. Underweight 'unskilled' and 'non-tertiary' males perceived their BI to be different from their actual BW (p<0.001). Overweight and obese 'skilled' and 'unskilled', and 'tertiary' and 'non-tertiary', males and females perceived their BI and BW to be different from their actual BW (p<0.001). Significant differences in perceived BI existed between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.005), overweight males, and between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.008), normal-weight females. The 'skilled' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.41-0.64; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.96; p=0.03) than the 'unskilled' participants. The 'tertiary' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.40-0.63; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.95; p=0.02) than the 'non-tertiary' participants. After adjusting for possible confounders, all the risks became insignificant except for perception of BI by the 'skilled' participants (OR 0.70, 95% CI 0.50-0.99; p=0.04). Individuals in the different occupational and educational categories perceived their BI differently but their BW similarly. Given the same BMI, age, perceived ideal BI and sex, only occupation is found to be associated with perception of BI.

Clarifying the positive association between education and prostate cancer: a Monte Carlo simulation approach

Using the 1993-2011 data from the Wisconsin Longitudinal Study (N = 5,218), we examine prostate cancer screening, mortality after the diagnosis, and health behaviors as potential mechanisms explaining the paradoxical association between men's higher education and higher prostate cancer risk. Our study combines within-cohort longitudinal hazard models predicting a prostate cancer diagnosis with Monte Carlo simulations estimating the joint effects of socioeconomic differences in prostate cancer screening and mortality after the diagnosis. Our findings strongly suggest that higher utilization of prostate cancer screening and lower mortality after the diagnosis are important explanations for higher prostate rates among more educated men. In addition to applying an innovative method to the issues of prostate cancer incidence and survival, our results have potentially important implications for the current debate about the utility of prostate cancer screening as well as for accurate predictions of future mortality and morbidity trends in the expanding older population.

Preventive care in relation to obesity: an analysis of a large, national survey

BACKGROUND

Reports from the 1990s observed lower receipt of preventive care services among obese individuals, but a few recent studies in older adults and Department of Veterans Affairs (VA) patients have failed to do so. Additional studies, using population-based samples, are needed to understand whether disparities in care by obesity continue to exist in the U.S.

PURPOSE

To investigate whether receipt of preventive care services varies in relation to BMI.

METHODS

This study used data from the 2008 and 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state-based national telephone survey of non-institutionalized U.S. adults, to examine associations between receipt of preventive services (influenza and pneumococcal vaccination; cholesterol and HIV screening; fecal occult blood test; colonoscopy/sigmoidoscopy, mammogram, and Pap) and BMI category (normal, 18.5-24.9; overweight, 25-29.9; obese Class I, 30-34.9; obese Class II, 35-39.9; and obese Class III, ≥40), after adjusting for confounding factors.

RESULTS

Receipt was lower for mammography and Pap testing (6.1 and 5.6 percentage points, respectively, relative to normal weight women) in obese Class III women. For immunizations, cholesterol screening, and colon cancer screening, receipt was similar or greater in overweight and obese individuals.

CONCLUSIONS

This study suggests that for most services, obese individuals received as much if not more preventive health care as normal-weight individuals. Although these findings are reassuring, the evidence for disparities for cervical and breast cancer screening in obese women demonstrates that efforts to ensure more equitable service delivery are still needed.

The role of early-life socioeconomic status in breast cancer incidence and mortality: unraveling life course mechanisms

OBJECTIVES

We examine (a) how breast cancer onset and survival are affected by various dimensions of early-life socioeconomic status (SES) and (b) the extent to which women's characteristics in adulthood mediate the associations between early-life conditions and breast cancer.

METHOD

We apply Cox regression models and a decomposition analysis to the data from the 4,275 women in the Wisconsin Longitudinal Study.

RESULTS

Higher levels of mothers' education and early-life family income were associated with a greater risk of breast cancer incidence. The effect of mothers' education was mediated by women's adult SES and reproductive behaviors. Fathers' education was related negatively to breast cancer mortality, yet this effect was fully mediated by women's own education.

DISCUSSION

This study identifies mechanisms linking early-life social environment to breast cancer onset and mortality. The findings emphasize the role of social factors in breast cancer incidence and survival.

Factors associated with parental recognition of a child's overweight status--a cross sectional study

Background

Very few studies have evaluated the association between a child's lifestyle factors and their parent's ability to recognise the overweight status of their offspring. The aim of this study was to analyze the factors associated with a parent's ability to recognise their own offspring's overweight status.

Methods

125 overweight children out of all 1,278 school beginners in Northern Finland were enrolled.

Weight and height were measured in health care clinics. Overweight status was defined by BMI according to internationally accepted criteria. A questionnaire to be filled in by parents was delivered by the school nurses. The parents were asked to evaluate their offspring's weight status. The child's eating habits and physical activity patterns were also enquired about. Factor groups of food and physical activity habits were formed by factor analysis. Binary logistic regression was performed using all variables associated with recognition of overweight status in univariate analyses. The significant risk factors in the final model are reported using odds ratios (ORs) and their 95% confidence intervals (CIs).

Results

Fifty-seven percent (69/120) of the parents of the overweight children considered their child as normal weight. Child's BMI was positively associated with parental recognition of overweight (OR 3.59, CI 1.8 to 7.0). Overweight boys were less likely to be recognised than overweight girls (OR 0.14, CI 0.033 to 0.58). Child's healthy diet (OR 0.22, CI 0.091 to 0.54) and high physical activity (OR 0.29, CI 0.11 to 0.79) were inversely related to parental recognition of overweight status.

Conclusions

Child's healthy eating habits and physical activity are inversely related to parental recognition of their offspring's overweight. These should be taken into account when planning prevention and treatment strategies for childhood obesity.

A comparative analysis of Type 2 diabetes and binge eating disorder in a bariatric sample

An emerging literature has illuminated an important link between Type 2 diabetes mellitus (DM) and binge eating disorder (BED) within obese cohorts. However, prior work has not examined this relationship specifically in a weight loss surgery (WLS) sample or fully explored potential psychosocial factors associated with this co-occurrence. Therefore, the present investigation sought to identify socio-demographic (i.e. age, education, BMI, ethnicity, gender, age of obesity onset) and psychological (i.e. depressive symptoms, hedonic hunger/food locus of control beliefs, severity of binge eating-related cognitions) correlates of the co-occurrence of Type 2 DM and BED among bariatric surgery candidates. An archival sample of 488 patients seeking surgical treatment for clinical obesity completed a standard battery of pre-operative psychosocial measures. The presence of BED was evaluated using a semi-structured clinical interview based on the DSM-IV TR (APA, 2000) and was further corroborated by responses on the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R; Spitzer, Yanovski, & Marcus, 1993). Results indicated that 8.2% of the sample was classified as having both Type 2 DM and BED concurrently. A multivariate logistic regression model revealed that in addition to other psychological (e.g., binge eating-related cognitions, hedonic hunger) and demographic variables (i.e. male gender), African American ethnicity (OR=3.3: 1.41-7.73) was a particularly robust indicator of comorbid status. Findings support and extend previous health disparity research urging greater attention to the needs of traditionally underserved, at-risk populations seeking treatment for obesity complicated by dysregulated eating and metabolism. Additionally, these preliminary results underscore the relevance of considering the potential benefits of providing quality comprehensive pre- and post-operative psychological care among bariatric patients towards optimizing both short- and long-term health and well-being.

The Stigma of Obesity

Obesity is widely recognized as a health risk, but it also represents a disadvantaged social position. Viewing body weight within the framework of stigma and its effects on life chances, we examine how perceived weight-based discrimination influences identity and physical health. Using national survey data with a 10-year longitudinal follow-up, we consider whether perceptions of weight discrimination shape weight perceptions, whether perceived weight discrimination exacerbates the health risks of obesity, and whether weight perceptions are the mechanism explaining why perceived weight discrimination is damaging to health. Perceived weight discrimination is found to be harmful, increasing the health risks of obesity associated with functional disability and, to a lesser degree, self-rated health. Findings also reveal that weight-based stigma shapes weight perceptions, which mediate the relationship between perceived discrimination and health.

Association between weight perception and socioeconomic status among adults in the Seychelles

BACKGROUND

Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously.

METHODS

Based on a population-based survey (n = 1255) in the Seychelles, weight and height were measured and self-perception of one's own body weight, education, occupation, and income were assessed by a questionnaire. Individuals were considered to have appropriate weight perception when their self-perceived weight matched their actual body weight.

RESULTS

The prevalence of overweight and obesity was 35% and 28%, respectively. Multivariate analysis among overweight/obese persons showed that appropriate weight perception was directly associated with actual weight, education, occupation and income, and that it was more frequent among women than among men. In a model using all three SES indicators together, only education (OR = 2.5; 95% CI: 1.3-4.8) and occupation (OR = 2.3; 95% CI: 1.2-4.5) were independently associated with appropriate perception of being overweight. The OR reached 6.9 [95% CI: 3.4-14.1] when comparing the highest vs. lowest categories of SES based on a score including all SES indicators and 6.1 [95% CI: 3.0-12.1] for a score based on education and occupation.

CONCLUSIONS

Appropriately perceiving one's weight as too high was associated with different SES indicators, female sex and being actually overweight. These findings suggest means and targets for clinical and population-based interventions for weight control. Further studies should examine whether these differences in weight perception underlie differences in cognitive skills, healthy weight norms, or body size ideals.

Contributions of weight perceptions to weight loss attempts: differences by body mass index and gender

Previous studies have consistently observed that women are more likely to perceive themselves as overweight compared to men. Similarly, women are more likely than men to report trying to lose weight. Less is known about the impact that self-perceived weight has on weight loss behaviors of adults and whether this association differs by gender. We conducted a cross-sectional analysis among an employee sample (n=899) to determine the association of self-perceived weight on evidence-based weight loss behaviors across genders, accounting for body mass index (BMI) and demographic characteristics. Women were more likely than men to consider themselves to be overweight across each BMI category, and were more likely to report attempting to lose weight. However, perceiving oneself to be overweight was a strong correlate for weight loss attempts across both genders. The effect of targeting accuracy of self-perceived weight status in weight loss interventions deserves research attention.