Gender Differences in Internal Beliefs About Weight and Negative Attitudes Towards Self and Others

Weight control beliefs in the treatment of binge-eating disorder: Why might they matter?

OBJECTIVE

The belief in personal control over weight (BCWeight) is positively associated, while the belief in control over healthy lifestyle with weight acceptance (BCLifestyle) is negatively associated with disordered eating, body dissatisfaction, and low self-esteem. This study examined how weight control beliefs are impacted by cognitive behavior therapy (CBT) for binge-eating disorder (BED) that provides evidence and choice regarding weight management options; and assessed whether changes in weight control beliefs are associated with treatment outcomes.

METHOD

Participants were 57 patients consecutively referred to an outpatient eating disorder clinic from 2013-2017 for BED treatment. Using retrospective self-reported program-evaluation data, baseline to post-CBT changes in weight control beliefs were evaluated, as well as whether these changes were associated with the change in the drive for thinness, body dissatisfaction, fear of loss of control over eating, and self-esteem.

RESULTS

BCLifestyle significantly increased over CBT; BCWeight significantly decreased. Increases in BCLifestyle were associated with the reduced drive for thinness, body dissatisfaction, and fear of loss of control overeating. Decreases in BCWeight were associated with improved self-esteem.

DISCUSSION

BED CBT that provides science on weight management options is associated with positive changes in weight control beliefs, which are associated with measures of recovery from BED.

PUBLIC SIGNIFICANCE STATEMENT

Cognitive behavior therapy (CBT) for binge-eating disorder decreases the belief that one can and should control one's weight, and increases the belief that one should strive for a healthy lifestyle and accept one's weight. These changes in beliefs are associated with improved treatment outcomes. CBT that gives patients evidence on different weight management options addresses patient obesity concerns and is related to positive change in weight control beliefs.

Is Fitspiration the Healthy Internet Trend It Claims to Be? A British Students' Case Study

The increasingly popular #fitspiration community on Instagram aims to promote body positivity and inspire health in its followers. However, fitspiration accounts often endorse unattainable, overly fit body ideals. The aim of this study is to explore the effects of viewing fitspiration photos on body image and fit-ideal internalisation. We compared 109 British students’ (18–50 years-old) responses on state self-esteem, mood satisfaction, body satisfaction and fit-ideal internalisation before and after viewing fitspiration photos. Online questionnaires exposed students to either five male or five female fitspiration photos, respectively for their given gender. Photos were sourced from public Instagram accounts. This study also examined the influence age and Instagram usage have on body image. Exposure to fitspiration photos produced a significant reduction in state self-esteem, mood satisfaction and fit-ideal internalisation, but had no significant influence on body satisfaction. Age had no effect on body image; however, gender impacted mood satisfaction and fit-ideal internalisation. Instagram usage influenced fit-ideal internalisation, with specific Instagram factors, such as how the importance of a photo’s “likes” were negatively associated with state self-esteem, mood and body satisfaction. Unexpectedly, Instagram frequency use and posting were related to higher levels of state self-esteem. Detailed explanations of the findings and potential future research opportunities are also discussed.

A Meta-Analysis of Heavyweight and Self-Esteem

This study is a meta-analysis of the relation of heavyweight and self-esteem. We examined this relation in studies thatfocused on participants' actual body weight (assessed by physical measures or self-reports of weight and height) and studies thatfocused on self-perceived degree of heavyweight or body dissatisfaction. The overall mean effect size was moderate (r = -.18, d = -.36), with lower self-esteem associated with heavier weight. The correlation between self-esteem and weight was higher for studies of self-perceived weight than for studies of actual weight. Consistent with predictions about cultural and group differences, effect sizes were smaller for low socioeconomic status (SES) samples, ethnic minority samples, and nonclinical samples than for high SES, nonminority, and clinical samples, respectively. In addition, effect sizes were larger for women than for men and for high school and college students than for children. Discussion centered on cultural, group, and individual differences that may influence the consequences on self-esteem of violating standards for appropriate body weight.

Development and Validation of the Beliefs About Personal Weight Survey Among African American Women

The purpose of this study was to develop the Beliefs about Personal Weight Survey among African American women. Sixty-five items were developed from literature and sample participants to characterize beliefs about personal weight in 3 domains: descriptors, causes, and consequences. The items were administered to 150 community-dwelling African American women, 18 to 40 years old, recruited from 5 sites. Factor analysis supported a 4-factor solution with the following dimensions: overweight acceptance, overweight concern, conventional weight regulation, and circumstantial weight regulation. These factors were significantly associated with weight management behaviors and body mass index. Profile analysis indicated distinct factor belief profiles by 3 weight categories.

The Relationships of Body Image, Feminism and Sexual Orientation in College Women

In this study, 409 undergraduate women completed surveys about their own body image, feminism and sexual orientation as well as their attitudes about others, that is, attitudes about weight in others, attitudes about feminism and attitudes about lesbians and gay men. There was a significant relationship between the three external measures of fat attitudes, attitudes towards feminism and attitudes towards lesbians and gay men, and it is argued that each of these three variables reflects some degree of political liberalism. We also found that the relationship between own identity and attitudes towards others was significant for feminism and sexual orientation, but non-significant for own body image and attitudes about fatness in others. Thus, the results of this study imply that fat people as a group have still not formed the kind of political or social cohesiveness that has been so advantageous to other oppressed groups, such as women or gay men and lesbians.

Adolescents and Eating Disorders:

Little is known about the incidence and prevalence of eating disorders among adolescents of color who are poor or identify themselves as gay or lesbian. Among American women, eating disturbances are equally as common among Native, Asian, or Hispanic Americans as they are among Caucasians. African Americans were at higher risk of developing eating disorders than were Hispanic and Asian Americans. Media and gender-role body stereotype and body dissatisfaction are strongly linked and have been shown to be the strongest predictors of disordered eating. As these youth adopt Western values about beauty, they may be at increased risk for developing eating disorders.

Effects of nutrition education on weight gain prevention: a randomized controlled trial

Background

Body weight (BW) reduction through energy restriction is ineffective at impacting the obesity epidemic. Shifting from an obesity treatment to weight gain prevention focus may be more effective in decreasing the burden of adult obesity.

Methods

This was a 1-year randomized controlled trial of weight gain prevention in healthy premenopausal women, aged 18–45 y, with a body mass index (BMI) of >18.5 kg/m². Eighty-seven women were randomized to a weight gain prevention intervention delivered by a registered dietitian (RDG) or counselor (CSG), or to a control (CON) group. Eighty-one women (mean ± SD, age: 31.4 ± 8.1 y; BW: 76.1 ± 19.0 kg; BMI: 27.9 ± 6.8 kg/m²) completed baseline testing and were included in intention-to-treat analyses; anthropometric, blood pressure, dietary intake and physical activity measurements and biochemical markers of health were measured every three months. Data were analyzed using repeated measures ANCOVA, with significance at P < 0.01.

Results

Sixty-two percent of women met the weight gain prevention criteria (BW change within ±3 %) after one year; this did not differ by group assignment. Body fat % was lower in the RDG versus CSG and CON groups at all intervals (P < 0.001). Systolic blood pressure increased from month 6 to 9 and decreased from month 6 to 12 in the CON group (P < 0.001), with a significant group x time interaction (P < 0.01). Estimated carbohydrate intake (%) was higher in the RDG vs. CON group at month 9 (P < 0.01); fat intake (%) was lower in the RDG vs. CON group and CSG vs. CON group at months 3 and 9, respectively (P < 0.01). Estimated fruit intake (svgs/d) was higher in the RDG vs. CON group at months 3, 6, 9 and 12 (P < 0.01), and non-meat protein sources (svgs/d) was higher in the RDG vs. CSG and CON groups at month 3 (P < 0.001). Estimated energy, macronutrient and food group intakes did not change over time.

Conclusions

A majority of all participants maintained BW over one year and were able to do so regardless of whether they received nutrition education. Additional studies that include a variety of clinical outcomes are needed to evaluate further aspects of nutrition education on weight gain prevention and health status over the long term.

Connecting with The Biggest Loser: an extended model of parasocial interaction and identification in health-related reality TV shows

This study investigates audience responses to health-related reality TV shows in the setting of The Biggest Loser. It conceptualizes a model for audience members' parasocial interaction and identification with cast members and explores antecedents and outcomes of parasocial interaction and identification. Data analysis suggests the following direct relationships: (1) audience members' exposure to the show is positively associated with parasocial interaction, which in turn is positively associated with identification, (2) parasocial interaction is positively associated with exercise self-efficacy, whereas identification is negatively associated with exercise self-efficacy, and (3) exercise self-efficacy is positively associated with exercise behavior. Indirect effects of parasocial interaction and identification on exercise self-efficacy and exercise behavior are also significant. We discuss the theoretical and practical implications of these findings.

Attitudes towards obesity in the Swedish general population: the role of one's own body size, weight satisfaction, and controllability beliefs about obesity

This study examined the associations of different socio-demographic and psychological factors with attitudes towards obesity. Individuals with different weight status (N=2436) were drawn from an annual population-based survey in Sweden, and data on attitudes towards obesity (ATOP) and predictor variables were assessed in 2008. The strongest predictor of ATOP was controllability beliefs about obesity (β=0.83). Thus, greater controllability beliefs about obesity predicted more negative attitudes. Sex and weight satisfaction were also independently associated with ATOP. However, there was no, or only a weak, association between weight satisfaction and ATOP among individuals with normal weight or overweight. And the higher the weight satisfactions of individuals with obesity, the more positive were their attitudes. It seems that stigma-reduction strategies in the general public should address the uncontrollable factors in the aetiology of obesity. However, more research is needed to understand the underlying causes of people's attitudes towards obesity.

Surviving breast cancer: women's experiences with their changed bodies

In this study, we explored women's experiences with their bodies following treatment for breast cancer. Eleven women who had been treated for the disease (M(time since treatment)=4.45 years) were interviewed. Data were collected and analyzed using interpretative phenomenological analysis (Smith et al., 2009). Four main themes emerged from the data: changing visibly and invisibly; experiencing intense thoughts and emotions; meaning of the body: a vehicle of health, well-being, and social expression; and managing and dealing with physical changes. Overall, the women experienced various physical changes that shaped, mostly in a negative way, their perceptions, thoughts, attitudes, feelings, and beliefs about their bodies. The women described attempts to make positive lifestyle behavior choices (e.g., diet, participate in physical activity), and used other strategies (e.g., wigs, make-up, clothes) to manage their appearances and restore positive body-related experiences. Based on these findings, it is important to be cognizant of women's body image concerns following breast cancer given the poignant and lasting effects they can have on their psychosocial and emotional well-being.

No clear winner: effects of The Biggest Loser on the stigmatization of obese persons

Previous research has largely ignored the question of whether watching reality weight-loss TV shows influences viewers to form a negative obesity stereotype. This study examines antecedents and outcomes of watching The Biggest Loser with the Orientation1-Stimulus-Orientation2-Response (O-S-O-R) model. The study found that individuals who are more concerned with their weight (O1) watch more episodes of The Biggest Loser (S). Meanwhile, consumption of The Biggest Loser leads to greater perceived locus of weight control (O2), indicating that body weight is under personal control. Perceived locus of weight control, in turn, significantly predicts the attribution of obesity to personal responsibility (R). Ultimately, attributing obesity to personal responsibility leads to the formation of anti-fat attitudes (R). This study offers an integrative theoretical framework to investigate media effects on the formation of an obesity stigma by using the O-S-O-R model. The results imply that certain lifestyle transformation media, such as The Biggest Loser, might reinforce the notion that individuals control their own weight and thus further amplify the obesity stigma.

Exploring Body Comparison Tendencies

This study examined similarities and differences in women’s and men’s comparison tendencies and perfection beliefs when evaluating their face, body shape, and physical abilities, as well as how these tendencies and beliefs relate to their body esteem. College students (90 women and 88 men) completed the Body Esteem Scale and answered questions concerning their social comparison and temporal comparison tendencies related to face, body shape, and physical abilities evaluations as well as personal perfection body beliefs. As predicted, women were more likely than men to compare their face and bodies to other same-sex persons whom they perceived as having either similar or better physical qualities than themselves in those body domains, with their most likely comparison tendency being upward social comparison. More men than women held body perfection beliefs for all three body domains, and men were most likely to rely on future temporal comparison when evaluating their body shape. Comparison tendencies and perfection beliefs also were differentially related to women’s and men’s body esteem: Whereas women relied on self-critical social comparison strategies associated with negative body esteem, men’s comparison strategies and perfection beliefs were more self-hopeful. Implications for practitioners treating body image issues are discussed.

Oppressive Beliefs at Play: Associations among Beauty Ideals and Practices and Individual Differences in Sexism, Objectification of Others, and Media Exposure

In recent years, beauty ideals and practices have been explained almost exclusively using evolutionary psychological frameworks, to the exclusion of more proximate factors such as psychosocial and individual psychological variables. To overcome this limitation, we examined the associations among sexist beliefs, objectification of others, media exposure, and three distinct beauty ideals or practices. Across three studies, a total of 1,158 participants in a British community sample completed a series of scales that measured their attitudes toward women, hostility toward women, benevolent sexism, hostile sexism, their tendency to objectify others, media exposure, and endorsement of the thin ideal and (for women) body dissatisfaction (Study 1); height preferences in an other-sex partner (Study 2); and endorsement of cosmetic use (Study 3). Across the three studies, results supported the idea that sexist beliefs predicted beauty ideals and practices, although the strength of these associations varied according to the ideal or practice in question. These results support feminist critiques that beauty ideals and practices in Western societies are linked with sexist attitudes. Furthermore, our results suggest that programmes aimed to reduce or eliminate sexist attitudes, or that promote more gender egalitarian attitudes, may result in healthier beauty ideals and practices.

Gender Differences in Domain-Specific Self-Esteem: A Meta-Analysis

This meta-analysis examines gender differences in 10 specific domains of self-esteem across 115 studies, including 428 effect sizes and 32,486 individuals. In a mixed-effects analysis, men scored significantly higher than women on physical appearance ( d = 0.35), athletic ( d = 0.41), personal self ( d = 0.28), and self-satisfaction self-esteem ( d = 0.33). Women scored higher than men on behavioral conduct ( d = −0.17) and moral–ethical self-esteem ( d = −0.38). The gender difference in physical appearance self-esteem was significant only after 1980 and was largest among adults. No significant gender differences appeared in academic, social acceptance, family, and affect self-esteem. The results demonstrate the influence of reflected appraisals on self-esteem.

Sociocultural Influence and Appearance-Based Rejection Sensitivity Among College Students

The present research examined the influence of parents, peers, and the media in predicting college students' Appearance-based Rejection Sensitivity (Appearance-RS)—the degree to which individuals anxiously expect to be rejected based on their physical appearance. Given that women are socialized to be more appearance-focused than men, women were hypothesized to show greater Appearance-RS in response to sociocultural influences than men. A survey was administered to 220 students at a large public university in the United States. Overall, women showed greater sensitivity to appearance rejection than men. Specifically, perceptions of peer conditional acceptance based on appearance were associated with Appearance-RS among women. In addition, the more women and men internalized media ideals and felt media pressure to look attractive, the more sensitive they were to appearance rejection. No significant effects of parental influence were found. Thus, peer conditional acceptance predicted Appearance-RS among women, and media influence predicted Appearance-RS among women and men.

Beyond muscles: unexplored parts of men's body image

Thus far the study of men's body image has been largely restricted to the dimensions of adiposity and muscularity. The aim of this study was to investigate in a systematic way multiple aspects of men's body images, in particular, head hair, body hair, height and penis size, in addition to body weight and muscularity. Questionnaires were completed online by 200 heterosexual men. It was found that men were dissatisfied with all six aspects of their bodies, and worried primarily about body weight, penis size and height. In addition, aspects of weight, muscularity, height and penis size, but not head or body hair, were related to overall appearance self-esteem. It was concluded that men's body image is both multi-faceted and complex.

Size acceptance as a grief process: observations from psychotherapy with lesbian feminists

Based on observations from my psychotherapy practice, I apply Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, and acceptance) to the process a woman goes through when she learns about size acceptance and lets go of the unrealistic wish to make her body size conform to fat-phobic societal ideals of female beauty. Clients' presentations, therapeutic interventions, and countertransference are discussed for each stage. Lesbian feminists are likely to embrace size acceptance politics but may retain negative feelings about their own body size. In the bargaining stage, they may confound health concerns with body image issues, and it is important in their therapy to provide a holding environment that can tolerate ambivalence. My own depression stage was marked by countertransference that caused me to avoid the topic of body image with my clients. Therapists can help women in the size acceptance grief process by exploring their own evolving feelings about body image, bringing up the topic, and providing a non-judgmental holding environment.

A prospective study of factors that lead to body dissatisfaction during pregnancy

This study examined changes in body image and predictors of body dissatisfaction during pregnancy. It was expected that higher levels of depression, social comparison tendencies, teasing, societal pressure to be thin and public self-consciousness would predict body dissatisfaction prospectively. Healthy pregnant women (n=128) completed questionnaires on three occasions during their pregnancies reporting on a total of four time points: 3 months prior to pregnancy (retrospectively reported), in the early to mid-second trimester, the late-second/early-third trimester, and the latter part of the third trimester. For the most part women reported adapting to the changes that occurred in their body; however, women were most likely to experience higher levels of body dissatisfaction in early to mid-second trimester. Findings related to predictors of body dissatisfaction revealed that both social and psychological factors contributed to body image changes in pregnancy. Implications of the findings are discussed.

Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults

OBJECTIVE

This study evaluated the relation among weight-based stigmatization, ideological beliefs about weight, and psychological functioning in an obese, treatment-seeking sample.

RESEARCH METHODS AND PROCEDURE

Ninety-three obese, treatment-seeking adults (24 men and 69 women) completed a battery of self-report questionnaires measuring psychological adjustment, attitudes about weight, belief in the controllability of weight, and the frequency of weight-based stigmatization.

RESULTS

Weight-based stigmatization was a common experience for participants. Frequency of stigmatizing experiences was positively associated with depression, general psychiatric symptoms, and body image disturbance, and negatively associated with self-esteem. Further, participants' own negative attitudes about weight problems were associated with their psychological distress and moderated the relation between the experience of stigmatization and body image.

DISCUSSION

Weight-based stigmatization is a common experience for obese individuals seeking weight loss treatment and appears to contribute to poor mental health adjustment. The negative effects of these experiences are particularly damaging for those who hold strong antifat beliefs.

Der Einfluss von Models in der Werbung auf das Körperselbstbild der Betrachter/innen

Zusammenfassung. In der vorliegenden Studie wurde untersucht, ob die Betrachtung von Werbeinseraten mit Models das Körperselbstbild bei Frauen und Männern verändern kann. Den 124 weiblichen und männlichen Teilnehmern (Altersmittelwert: 30 Jahre; Range 18 bis 60 Jahre) der Studie wurden entweder Werbeinserate ohne Models (Kontrollgruppe), Werbeinserate mit weiblichen und männlichen Models (Experimentalgruppe 1) oder Werbeinserate mit Models ausschließlich des eigenen Geschlechts (Experimentalgruppe 2) präsentiert. Die Ergebnisse der Untersuchung zeigen unter anderem, dass weibliche Teilnehmer beider Experimentalgruppen eine größere Diskrepanz zwischen ihrem realen und idealen Körperschema wahrnehmen und auch stärker davon ausgehen, dass andere Frauen ein dünneres Ideal anstreben als Frauen der Kontrollgruppe. Bei männlichen Teilnehmern konnten dagegen keine bedeutsamen Unterschiede in der Körperwahrnehmung zwischen Männern der Experimentalgruppen und der Kontrollgruppe festgestellt werden. Diese Ergebnisse werden in Bezug auf zum Teil konträre Ergebnisse einer aktuellen amerikanischen Studie und hinsichtlich ihrer gesellschaftlichen Relevanz diskutiert.

Body image across the adult life span: stability and change

By far, the majority of studies investigating body image in adults have drawn samples from college populations within a very narrow age range. The purpose of the present paper is to review empirical research on the body image of adults older than the typical college student. There are marked changes in appearance across the adult life span, especially for women, which lead to the expectation of concomitant changes in body image. In fact, the review found that body dissatisfaction was remarkably stable across the adult life span for women, at least until they are quite elderly. In contrast, the importance of body shape, weight and appearance decreased as women aged, underscoring an important distinction between evaluation and importance of the body. However, there are many large gaps and limitations in the current literature that will need to be addressed before a more complete understanding of the development of body image across the adult life span is achieved.

Gender differences in implicit weight identity

OBJECTIVE

This study examined gender differences in explicit and implicit attitudes toward overweight and explicit and implicit weight identity.

METHOD

Normal weight women (n=22) and men (n=20) and overweight women (n=20) and men (n=21) completed the Implicit Association Test and portions of the Eating Disorders Questionnaire.

RESULTS

Although explicit and implicit anti-fat attitudes were ubiquitous, gender differences emerged for weight identity. Both men and women provided accurate explicit appraisals of their weight status. However, men implicitly identified themselves as light regardless of actual weight status. Women's implicit weight identity was associated with their actual weight status, explicit weight appraisal, and implicit self-esteem.

DISCUSSION

These findings may provide additional insight into why men are underrepresented among those seeking weight loss and why women are at increased risk for developing eating disorders.

The measurement of dietary restraint, disinhibition and hunger: an examination of the factor structure of the Three Factor Eating Questionnaire (TFEQ)

OBJECTIVE

To conduct separate factor analyses of the Three Factor Eating Questionnaire (TFEQ-R, TFEQ-D and TFEQ-H) scales and provide initial evidence of the construct validity of the obtained solutions.

DESIGN

A cross-sectional survey with a 12 month retest of a subsample of subjects.

SUBJECTS

A total of 553 undergraduate university women with a mean age of 25.0 y. The retest sample comprised 64 subjects with a mean age at retest of 25.7 y.

MEASUREMENTS

In addition to the TFEQ, age, body mass index (BMI), satisfaction with current weight, nutrition knowledge and current exercise level were recorded.

RESULTS

Three restraint (strategic dieting behaviour, attitude to self-regulation, avoidance of fattening foods), three disinhibition (habitual susceptibility, emotional susceptibility, situational susceptibility) and two hunger constructs (internal locus for hunger, external locus for hunger) were identified. Initial evidence of the validity of these constructs was provided.

CONCLUSION

The explanation of disordered eating behaviour is likely to be refined more by specific constructs, such as those presented, rather than by the more general constructs measured by the original TFEQ-R, TFEQ-D and TFEQ-H scales. Further examination of the factor structures presented is therefore encouraged.

The effect of weight-loss dieting on cognitive performance and psychological well-being in overweight women

This study investigated the effect of a weight reduction diet on cognitive performance and psychological well-being among overweight women. A total of 42 women undertook a 12-week weight reduction diet while 21 women maintained their usual diet and exercise habits for 12 weeks. All women completed neuropsychologcial tests of speed of information processing, executive function, working memory, immediate and delayed recall and recognition, and verbal ability. They also completed measures of weight locus of control, dieting beliefs, self-esteem, mood and dysfunctional attitudes, before and after the 12-week interval. Being on the diet had a minimal impact on cognitive performance and a positive effect on emotional eating, feelings of depression and dysfunctional attitudes. A sense of control over weight and eating behaviour increased among the dieters, but an internal locus of control was negatively related to self-esteem.

The health at any size paradigm for obesity treatment: the scientific evidence

Traditional weight loss (TWL) treatments have been unsuccessful at reducing the prevalence of obesity in the population. Health-care professionals and consumers have criticized TWL treatments as being detrimental to the obese person's health. Consequently, an alternative approach to obesity treatment, the health at any size (H@AS) paradigm, has been proposed. The H@AS paradigm is based on the philosophy that once diet restrictions and barriers to activity have been removed, the individual will develop healthier eating and activity patterns that lead to a naturally healthy body weight. This paper reviews the philosophical foundation and the scientific data that support and oppose the H@AS paradigm and compares it with that of TWL treatments.