Body satisfaction, weight gain and binge eating among overweight adolescent girls

Body Image and High-Risk Weight and Shape Control Behaviors Among Transgender and Nonbinary Young Adults: The Role of Sexual Assault

Purpose: Transgender and nonbinary (TNB) populations experience disproportionate rates of sexual assault. Despite evidence from cisgender samples linking sexual assault exposure to body image concerns and disordered eating behaviors, such as weight and shape control behaviors (WSCBs), little is known about these relationships in TNB people. The purpose of this study was to assess associations among past-year sexual assault exposure, body areas satisfaction, body weight esteem, and high-risk WSCBs in a sample of TNB young adults. Methods: A sample of 714 participants completed a cross-sectional online survey. Multivariable linear and logistic models were fit to determine associations between constructs of interest. Natural effects mediation analyses assessed for potential mediation of the relationship between sexual assault and WSCBs by body areas satisfaction and body weight esteem. Analyses were stratified by three gender identity categories. Results: Past-year sexual assault exposure was associated with significantly decreased body areas satisfaction, but only for nonbinary participants. No significant association was found between sexual assault and body weight esteem. Sexual assault was associated with significantly increased risk for WSCBs across gender identity categories. No mediation of these relationships by body areas satisfaction and body weight esteem was observed. Conclusion: Findings support clinical consideration of WSCBs in TNB survivors of sexual assault. Results suggest that multiple factors, including body image and sexual assault, may contribute separately to disordered eating behaviors in TNB young adults.

Online Health Communities' Portrayal of Obesity on Social Media Platforms in South Africa

The rapidly increasing prevalence of obesity in South Africa, intertwined with extensive changes in diet, life expectancy, and nutritional status has led to a complex framing of obesity on social media. This has prompted the prioritization of media-based social and behavior change communication interventions leveraging social media for obesity prevention. This study was conducted to understand how obesity is constructed and represented on social media in South Africa. A media review of Facebook and Twitter platforms in South Africa was conducted over a six-month period using Meltwater software for data collection. The search yielded 13 500 posts and tweets. Data were cleaned and coded in Microsoft Excel. Content and framing analysis were performed to add insight into the nature of obesity discourse on social media. Portrayals of obesity on social media were dominated by stigmatizing imagery blaming individuals for unhealthy lifestyles, poor diets, and lack of physical activity. Future media-based social and behavior change communication interventions for obesity prevention can leverage social media to reach the broader public and insights into media portrayals of obesity have the potential to influence the shape and development of these behavioral interventions.

Unraveling the meaning of weight misperception in a sample of college students: Unaware or body satisfied?

Weight misperception has been seen as a threat to public health. We aimed to understand the meaning of weight misperception by examining associations of weight perception with body satisfaction and body awareness along with healthy ideals and culturally normative body ideals. Undergraduates with higher weights at a Mid-South University (n = 166) completed survey measures that included: weight status perception ("How do you think of yourself in terms of weight?"), self-reported weight and height (used to indicate awareness), current and ideal body size using Figure Rating Scales (FRS), three measures of body satisfaction (difference between current and ideal figures on FRS, Appearance Evaluation subscale of the Multidimensional Body Self-Relations Questionnaire, Body Dissatisfaction subscale of the Eating Disorder Inventory-3). Height and weight were also measured. Thirty percent (n = 49) of participants perceived themselves as 'healthy' weight and 70 % (n = 117) perceived themselves as above healthy weight. In bivariate analyses, there were no significant differences in identification of healthy or culturally normative body ideals by weight perception group. A series of logistic regression models were run to examine associations between weight perception and both BMI awareness and body satisfaction. In unadjusted and adjusted models, increased body satisfaction was associated with reduced odds of perceiving oneself above healthy weight (OR: 0.25, p < 0.001); BMI awareness was not associated with weight misperception. Findings suggest that weight misperception reflects body satisfaction, and not a lack of awareness of body weight/size, definitions of healthy bodies, or culturally normative body ideals. "Correcting" individuals who perceive their bodies as about right has the potential to cause great harm and should be eliminated as a public health goal.

Long-term impact of psychological factors and social interactions on obesity of female nationals in the United Arab Emirates

OBJECTIVE

Along with rapid economic growth, the United Arab Emirates (UAE) has undergone enormous sociocultural changes. Consequently, sociocultural and psychological factors, along with malnutrition and physical inactivity, have contributed to the high obesity rate. The objective of this study is to assess the long-term impact of these new emerging factors on obesity among women in the UAE via mathematical modeling.

METHODS

A differential equation model was developed considering psychological/social factors in population dynamics. It predicts the long-term prevalence of obesity among women in the UAE under these factors by 2070. Computer simulations and a sensitivity analysis of the model were conducted to measure the impact of these factors on obesity.

RESULTS

The model predicts the following: 80.07% of female UAE nationals will become overweight or have obesity and 60.19% will have obesity by 2070, and the population with abnormal eating behavior will increase to 15% by 2070. Psychological/social factors aggravate the obesity problems and can cause abnormal eating behavior to develop with little effect on weight reduction.

CONCLUSIONS

The obesity rate of female UAE nationals will continue to rise by 2070. Rising abnormal eating behavior caused by psychological/social factors is an emerging issue and should be recognized as a sign of escalating obesity problems in the UAE.

Prospects for new drugs to treat binge-eating disorder: Insights from psychopathology and neuropharmacology

BACKGROUND

Binge-eating disorder (BED) is a common psychiatric condition with adverse psychological and metabolic consequences. Lisdexamfetamine (LDX) is the only approved BED drug treatment. New drugs to treat BED are urgently needed.

METHODS

A comprehensive review of published psychopathological, pharmacological and clinical findings.

RESULTS

The evidence supports the hypothesis that BED is an impulse control disorder with similarities to ADHD, including responsiveness to catecholaminergic drugs, for example LDX and dasotraline. The target product profile (TPP) of the ideal BED drug combines treating the psychopathological drivers of the disorder with an independent weight-loss effect. Drugs with proven efficacy in BED have a common pharmacology; they potentiate central noradrenergic and dopaminergic neurotransmission. Because of the overlap between pharmacotherapy in attention deficit hyperactivity disorder (ADHD) and BED, drug-candidates from diverse pharmacological classes, which have already failed in ADHD would also be predicted to fail if tested in BED. The failure in BED trials of drugs with diverse pharmacological mechanisms indicates many possible avenues for drug discovery can probably be discounted.

CONCLUSIONS

(1) The efficacy of drugs for BED is dependent on reducing its core psychopathologies of impulsivity, compulsivity and perseveration and by increasing cognitive control of eating. (2) The analysis revealed a large number of pharmacological mechanisms are unlikely to be productive in the search for effective new BED drugs. (3) The most promising areas for new treatments for BED are drugs, which augment noradrenergic and dopaminergic neurotransmission and/or those which are effective in ADHD.

Self-Reported Total Screen Time and Viewing Modes Are Associated with Body Dissatisfaction, Disordered Eating, and Cosmetic Surgery Intentions among Young Adults

While numerous studies have shown that media exposure is linked to body dissatisfaction and disordered eating behavior, limited research has examined these associations by screen-viewing mode. This study examined associations of total screen-time and screen-viewing modes with body dissatisfaction, disordered eating, and cosmetic surgery intention among young adults. Men (n = 3466) and women (n = 7300), aged 19 to 34 years, self-reported their screen-time on various TV viewing modes, and their body dissatisfaction, overeating, disordered weight control behaviors, and cosmetic surgery intentions. We fit linear, logistic, and multivariate models to examine cross-sectional associations between total screen-time and screen-viewing modes and body dissatisfaction, disordered eating, and cosmetic surgery intention. Handheld viewing was associated with body dissatisfaction for women only, and online viewing was associated with greater body dissatisfaction among both men (βˆ = 0.40; 95% CI, 0.15 to 0.65) and women (βˆ = 0.25; 95% CI, 0.10 to 0.40). Downloaded viewing was associated with higher odds of overeating behaviors among both men (OR = 1.24; 95% CI, 1.10 to 1.40) and women (OR = 1.21; 95% CI, 1.12 to 1.32), respectively. Although total screen time was associated with greater cosmetic surgery intention for both men (βˆ = 0.24; 95% CI, 0.09 to 0.39) and women (βˆ = 0.43; 95% CI, 0.28 to 0.58), sex differences were found for the viewing modes. Our results suggest that different viewing modes may be differently associated with men and women’s body image, disordered eating behavior, and cosmetic surgery intention. Future research should consider all modes of screen-viewing in our media environment.

Eating disorders and their relationship with menopausal phases among a sample of middle-aged Lebanese women

Objectives

The objective of our study was to evaluate the association between the transition to menopause, body dissatisfaction, and abnormal eating habits (restrained eating, binge eating, and orthorexia nervosa) in a sample of middle-aged Lebanese women.

Methods

A cross-sectional study conducted between July 2019 and January 2020 enrolled 1001 women aged 40 years and above from all Lebanese governorates. Data were collected by face-to-face interviews with all participants. The Body dissatisfaction subscale of the Eating Disorder Inventory‑second version was used to assess body dissatisfaction, whereas the Binge Eating Scale, Dutch Restrained Eating Scale, ORTO-15, Dusseldorf Orthorexia Scale (DOS), and Teruel Orthorexia Scale (TOS) were used to assess eating disorders (binge eating, restrained eating and orthorexia nervosa respectively. Multivariable analysis of covariance (MANCOVA) was used to compare multiple measures among the three menopausal phases, after adjustment over potential confounding variables (age, monthly income, body mass index, marital status, education level, and body dissatisfaction).

Results

Postmenopause was significantly associated with more orthorexia nervosa tendencies (lower ORTO-15 scores) than premenopause (β = − 1.87; p = 0.022). Perimenopause was associated with more binge eating (β = 1.56; p = 0.031), and less orthorexia nervosa (as measured by the DOS) than premenopause, with this association tending to significance (β  = − 1.10; p = 0.051). Furthermore, higher body dissatisfaction was significantly associated with higher restrained eating (β = 0.02; p < 0.001), binge eating (β = 0.48; p < 0.001), and orthorexia nervosa as measured by ORTO-15 (β = − 0.17; p < 0.001) and TOS (β = 0.08; p = 0.002), but not DOS.

Conclusion

Our study showed that menopausal stages are associated with some disordered eating behaviors (binge eating and orthorexia nervosa) among middle-aged women. Those results may serve as a first step towards spreading awareness among women within this age group regarding eating attitudes. Moreover, healthcare professionals should screen for the presence of disordered eating during those women’s routine visits to the clinics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01738-6.

Psychiatric comorbidity associated with weight status in 9 to 10 year old children

BACKGROUND

Paediatric overweight and obesity (OW/OB) constitute a serious public health concern. Given that psychological problems may be key contributors to the onset and maintenance of paediatric obesity, the present study examined past and current psychiatric comorbidities across the weight spectrum during middle childhood among a nationally representative sample.

METHODS

Participants were 11 708 9- to 10-year-old children (31.6% with OW/OB) and their caregivers who participated in the first wave of data collection in the Adolescent Brain Cognitive Development (ABCD) study. Logistic regressions were used to examine the association between weight status (i.e., underweight, healthy weight, OW, OB) and likelihood of current/past psychiatric diagnoses.

RESULTS

Compared to healthy weight children, those with OW/OB were more likely to have current/past major depressive disorder and binge eating disorder. Relative to healthy weight children, those with OB were more likely to have prior separation anxiety disorder, current specific phobia and oppositional defiant disorder; those with OW were more likely to have PTSD; and those with underweight were more likely to have ADHD.

CONCLUSIONS

Results suggest cross-sectional associations among negative emotionality, binge eating, and OW/OB, and highlight the need for ongoing prospective research to investigate directionality of associations and mechanisms of effects.

A prospective examination of relationships between social media use and body dissatisfaction in a representative sample of adults

This study examined the temporal sequence of the relationship between social media use and body dissatisfaction in adults. A representative sample of adults (19-92 years old; M = 52.83, SD = 13.43; 62.02% women, 37.98% men) completed measures of social media use, body dissatisfaction, age, gender, BMI, and demographic variables in 2015, 2016, 2017, 2018 and 2019 (N = 6258) in the New Zealand Attitudes and Values Study. In the full sample, higher social media use was significantly associated with higher body dissatisfaction one year later, as was higher body dissatisfaction with higher social media use one year later after controlling for body dissatisfaction/social media use (T-1), gender, age, BMI, ethnicity, relationships status, and SES. Effects were small. The prospective pathway from social media use to body dissatisfaction was significant in all age groups but the reverse relationship was only significant in the middle aged and older groups. Both pathway directions were significant in women but only the pathway from body dissatisfaction to social media use was significant in men. The research has limitations and replication is required. However, findings suggest raising awareness about how to use social media positively across the broad community, not merely in adolescents, may be worthwhile.

Risk of disordered eating in emerging adulthood: media, body and weight-related correlates among Hungarian female university students

Background

University years often are accompanied by dramatic lifestyle changes resulting in an elevated risk of disordered eating among females. We examined the associations of disordered eating with body image, weight and media-related variables.

Methods

Hungarian female university students (n = 261, mean age = 22.0 years; SD = 2.2 years) were the study participants using online data collection. The Eating Attitude Test-26 (EAT-26) was used to assess levels of and risk for disordered eating.

Results

Twenty-four percent of the sample displayed disordered eating: students with family's eating disorders (OR = 4.73 [1.34-16.67], p < 0.05), body satisfaction (OR = 0.23 [0.07-0.70], p < 0.01), engagement in sporting (OR = 4.46[1.77-11.27], p < 0.01) and past slimming (OR = 5.63 [2.07-15.27], p < 0.001) were particularly at risk. Multiple linear regression indicated that dieting was associated with a higher score among sporting students (β = 0.18, p < 0.001) and internalization of media messages (β = 0.18, p < 0.001). BMI was a predictor of dieting (β = 0.15, p < 0.01) and oral control (β = -0.34, p < 0.001); social media addiction for bulimia (β = 0.17, p < 0.01).

Conclusions

Our paper highlights the role of body dissatisfaction, sporting and slimming tendencies, sociocultural attitudes toward appearance, and family's eating pathology in understanding female university students' disordered eating. There is a limited role that social media plays in part, due to possible age-related experiences and skills related to coping with a variety of social pressures.

I Look at my whole body and i feel better: attentional bias, emotional and psychophysiological response by pure exposure treatment in women with obesity

Obesity is one of the most important health problems nowadays. In addition to the direct physical consequences, it is also a risk factor in the development of psychological (Eating disorders, body dissatisfaction, depression, anxiety, etc.) and social problems. Among there, body dissatisfaction is key for development and maintenance of such problems.

OBJECTIVE

to deepen the effectiveness of the body exposure treatment, both in its pure form and guided modality in subjective, psychological and attentional levels in people with body dissatisfaction and obesity.

METHODS

Evaluations were carried out in a total of 16 women with obesity and body dissatisfaction at the beginning and end of 6 treatment sessions of pure exposure in front of the mirror. The changes experienced at the subjective level (questionnaires and subjective discomfort during the sessions) and psychophysiological (eye-tracking and heart rate) were analyzed.

RESULTS

Pure exposure treatment reduces negative thoughts and emotions towards the body itself, as well as the experienced discomfort towards the most conflictive parts. Selective attention to those parts of the body classified as uglier by the participants (especially the rear view of the body) show a decrease in physiological reactivity.

CONCLUSIONS

Pure exposure treatment seems to be effective in reducing subjective and psychological symptoms associated with body dissatisfaction in people with obesity, this technique could be considered a good choice for the treatment of body dissatisfaction. This step is essential to guarantee the long-term therapeutic success of any other treatment (nutritional or/and physical activity) in the future.

Disordered Eating Behaviors Are Associated with Gestational Weight Gain in Adolescents

Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents’ offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge–purge behaviors. The main events were GWG and offspring’s birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg; adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (β = 0.67, p = 0.039), compensatory (β = 0.65, p = 0.044), and binge–purge behaviors (β = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.

Self-Esteem and Binge Eating among Adolescent Boys and Girls: The Role of Body Disinvestment

Although low self-esteem and body disinvestment have been recognized as potential risk factors for disordered eating, no studies have explored how these factors may work together to predict binge eating in adolescents. Therefore, we hypothesized a path model for girls and boys separately to investigate whether the body’s investment dimensions (feelings towards the body, physical touch, body care, body protection) mediate the relationship between self-esteem and binge eating, and age moderate such relationships. Participants were 1046 Italian students aged between 11 and 19 years (472 girls, M_age = 14.17; 574 boys, M_age = 14.60) screened through self-report measures. Both models showed an acceptable fit (males: χ²₍₂₂₎ = 30.441; RMSEA = 0.026; CFI = 0.99; TLI = 0.97; SRMR = 0.023; females: χ²₍₂₂₎ = 34.723; RMSEA = 0.35; CFI = 0.98; TLI = 0.95; SRMR = 0.029). Negative body feelings and reduced body protection fully mediated the relationship between self-esteem and binge eating, regardless of gender. Our findings highlight the importance of interventions promoting body emotional investment to reduce adolescents’ vulnerability to binge eating.

Momentary associations between stress and physical activity among children using ecological momentary assessment

Chronic and acute stress may have a detrimental effect on children's physical activity. Research on stress as a predictor of children's physical activity has mostly focused on stress between children, rather than how children's within-day variation in stress may predict physical activity. The current study assessed the within- and between-effects of stress on subsequent physical activity in three different time windows using ecological momentary assessment (EMA) and accelerometry. Children (N = 190; M_{Baseline Age} =10.1±0.9, 53% female, 56% self-identified Hispanic/Latino) completed six semi-annual assessment bursts across three years. During each burst, participants responded to up to seven (weekend) or three (weekday) randomly prompted EMA surveys on smartphones for seven days and wore a waist-worn accelerometer. Multi-level structural equation modeling examined within- and between-subjects effects of stress as a predictor of children's subsequent moderate-to-vigorous physical activity (MVPA) in the 15, 30, and 60 minutes following the EMA prompt. Latent variables were created for within- and between-subjects stress were comprised of three EMA stress items. Higher than average levels of stress (within-subjects) significantly predicted lower MVPA in the subsequent 15, 30 and 60 minutes (ps < .05). Between-subjects stress was not significantly associated with subsequent MVPA (ps > .05). Results indicate that elevated momentary stress predicts less subsequent MVPA. These findings suggest that within-day fluctuations in stress may be a barrier for children engaging in physical activity. Childhood physical activity promotion and interventions should consider the role of children's stress, aim to reduce the stress children experience throughout the day, and incorporate stress coping strategies.

Integrating needs-supportive delivery into a laboratory-based randomised controlled trial for adolescent girls with overweight and obesity: Theoretical underpinning and 12-week psychological outcomes

When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity.

Body Appreciation in Light of Psychological, Health- and Weight-Related Variables Among Female Adolescents

Recent research has begun to focus on positive body image and how this can be supported in adolescence. Body appreciation is a key element of positive body image, and has been associated with self-reported health status, weight-related concern, family factors and psychological variables such as self-esteem. In this study we explored these associations among Hungarian adolescent females. Female high school students from two major towns in Csongrád county, Hungary (N = 454; age range from 14 to 20; M = 16.3 years, SD = 1.2) completed questionnaires assessing body appreciation, self-esteem, optimism, life satisfaction and health- and weight-related variables. Analyses revealed that body appreciation was most strongly related to self-esteem, as well as being positively associated with life satisfaction, self-perceived health, being in control of diet, and engagement in sport. Conversely, binge drinking, engaging in slimming behaviors and having eating disorders in the family were negatively associated with body appreciation. These findings provide some indications of factors that might be targetted in health education programs aiming to promote positive body image and to develop resilience against body dissatisfaction in this demographic group. Such programs should also include information of nutrition and media literacy.

In the eye of the swiper: a preliminary analysis of the relationship between dating app use and dimensions of body image

BACKGROUND

Dating apps are largely visual platforms and based on evaluations of the attractiveness of users. Thus, engaging with this type of social media may be associated with body image concerns.

OBJECTIVE

This study aimed to explore the relationship between dating app use and body image.

METHODS

College students (n = 170, 50% females) reported on dating app use, as well as body shame, surveillance, body satisfaction, media ideal internalization, and controllability beliefs related to weight/shape.

RESULTS

Among males, frequent checking of dating apps was positively correlated with body shame and negatively with beliefs regarding weight/shape controllability. Media internalization was negatively correlated with experiencing negative feelings when using dating apps, and positively with positive feelings. Few associations emerged among females.

CONCLUSION

Dating app use seems most tightly associated with body image concerns among males.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Body areas satisfaction and body mass in adolescents: mediating effects of actual-ideal body weight discrepancies

PURPOSE

This study aims at investigating prospective associations between body areas satisfaction (BAS), actual (objectively measured)-ideal body weight discrepancy, actual (self-reported)-ideal body weight discrepancy and BMI among adolescents from the general population.

METHODS

Data were collected at three measurement points: baseline (T1), 2-month follow-up (T2), 13-month follow-up (T3) among 1011 adolescents (59.3% girls) aged 13-19 years (M = 16.30, SD = 0.82) with BMIs ranging from 15.20 to 38.78 (M = 20.01, SD = 3.33). Adolescents completed questionnaires regarding BAS (T1), actual and ideal body weight (T2). Body weight and height were measured objectively (T1 and T3).

RESULTS

Adolescents satisfied with most areas of their bodies had lower levels of actual (objectively measured)-ideal body weight discrepancy, which in turn predicted higher BMI, while lower levels of actual (self-reported)-ideal body weight discrepancy predicted lower BMI. No moderating effect of gender was found.

CONCLUSIONS

Actual-ideal weight discrepancies may operate in complex manner prompting opposite effects on BMI.

LEVEL OF EVIDENCE

Level III, longitudinal study without control group.

Body image in and out of the lab: Correspondence between lab-based attentional bias data and body shape dissatisfaction experiences in daily life

Accumulating lab-based studies have identified attentional biases in processing of negative appearance-related information among individuals with elevated trait body shape and weight dissatisfaction (BD). How these biases translate into experiences of BD in daily life remains unclear and, hence, was the focus of the present study. Thirty-eight women aged between 18-40 years completed a baseline survey and modified dot-probe task with both fat and thin appearance-related stimuli in a laboratory setting. Participants also downloaded a smartphone app that prompted them 10 times per day for 7 days to rate current body dissatisfaction. Results revealed that heightened BD in daily life tended to be transitory, and followed by a substantially lower rating of BD by the next survey (∼1-2 h later). For individuals with elevated trait BD and facilitated attention towards thin body images, this reduction in state BD was more gradual. Surprisingly, delayed disengagement towards thin body images was associated with greater reduction in state BD. Consistent with the hypothesis, moderating effects were not observed when initial state BD level was low. Susceptibility for immediate, short-term attentional biases towards appearance-related information may be a vulnerability factor for the prolonged persistence of negative body image experiences in daily life.

Body satisfaction and body weight in under- and healthy-weight adolescents: mediating effects of restrictive dieting, healthy and unhealthy food intake

PURPOSE

Theoretical models, such as the transdiagnostic model of eating disorders highlight the role of cognitive factors (e.g., the way people perceive their bodies) and their associations with maladaptive weight management behaviors resulting in underweight. This paper aims at testing the indirect association of adolescent's body satisfaction and body mass index (BMI) through restrictive dieting, healthy eating or unhealthy eating as well as moderating role of adolescent's weight status.

METHODS

The study was conducted in 16 public middle and high schools in Central and Eastern Poland. A sample of 1042 under- and healthy-weight white adolescents aged 13-20 (BMI: 12.63-24.89) completed two self-reported questionnaires (fruit, vegetable, and energy-dense food intake) with a 11-month interval. Weight and height were measured objectively. Multiple mediation analysis and moderated multiple mediation analysis were conducted to test the study hypotheses.

RESULTS

Adolescents less satisfied with their bodies were more likely to diet restrictively and at the same time ate more unhealthy energy-dense food rather than healthy food, which in turn predicted lower BMI. No moderating effects of weight status were found.

CONCLUSIONS

Low body satisfaction is a risk for restrictive diet and unhealthy food intake. Prevention programs may target under- and healthy-weight adolescents who are highly dissatisfied with their bodies, have a high intake of energy-dense food and apply a restrictive diet at the same time.

LEVEL OF EVIDENCE

Level III: longitudinal cohort study.

Predictors of One-Year Change in How Youth Perceive Their Weight

Overall, perceptions of being at "about the right weight" appear advantageous for youth physical and mental health, regardless of BMI classification, whereas perceptions at either extreme (overweight or underweight) may negatively impact health behaviours and mental health. Instead of considering weight misperceptions as problematic, some researchers have proposed that underestimations of weight status may offer resiliency among individuals with overweight or obesity. Promoting "about right" WPs and preventing change to overweight or underweight perceptions may offer an effective public health strategy for supporting youth health over time. However, limited prospective evidence exists on factors that shape perceptions of weight status over time. The current study examined modifiable predictors of one-year change in weight perception among youths. We used 2-year linked data of 18,112 grade 9-12 students from Year 3 (Y₃:2014-2015) and Year 4 (Y₄:2015-2016) of the COMPASS study. Generalized Estimating Equation models tested screen use, physical activity, and bullying victimization as predictors of change from perceptions of "about the right weight" to "overweight" or "underweight" perceptions, adjusting for Y₃ covariates (body mass index, ethnicity, and grade) and school cluster. Results support the value of team sports among females and resistance exercise among males as protective against changes to overweight or underweight perceptions over one year. Also, various forms of bullying victimization predicted overweight perceptions in males and females. Watching TV/movies or messaging/texting for over 2 hours/day was associated with overweight and underweight perceptions, respectively, in females only. Playing video/computer games for over 2 hours/day was associated with overweight perceptions in males and underweight perceptions in females. Findings support the potential of bullying prevention, limiting certain screen use, and supporting engagement in team sports for females and resistance exercise for males as strategies to maintain perceptions of being at "about the right weight."

Examining psychosocial correlates of physical activity and sedentary behavior in youth with and without HIV

The objectives of this study were to examine differences in physical activity behaviors as a function of human immunodeficiency virus (HIV) status and sex, to test differences in physical activity self-efficacy (PASE), body weight satisfaction (BWS), and enjoyment of physical activity as a function of HIV status, and to determine if PASE, BWS, and enjoyment are associated with daily physical activity (daily PA), muscle strengthening activities, and sedentary behavior of youth with and without HIV. A total of 250 HIV positive (HIV+) and HIV negative (HIV-) youth from Botswana aged 12–23 years (Mean = 17.87, SD = 2.24) participated in the study. The HIV+ group (n = 88) was recruited from a previous 12-month antiretroviral therapy (ART) and nutrition intervention study. The HIV- group (n = 162) was randomly selected from public junior and senior (secondary) high schools in and around Gaborone. Participants’ PASE, BWS, enjoyment of physical activity, daily PA, muscle strengthening, body mass index (BMI), and sedentary behavior were obtained using items from the Youth Risk Behavior Surveillance Survey. Multivariate analysis of variance (MANOVA) showed that the HIV- group (M = 1.20, SE = 0.06, CI = 1.08 to 1.32) had significantly higher daily PA than the HIV+ group (M = 0.99, SE = 0.08, CI = 0.82 to 1.15). The HIV- group (M = 0.91, SE = 0.06, CI = 0.79 to 1.03) also reported participating significantly more in muscle strengthening activities than the HIV+ group (M = 0.63, SD = 0.08, CI = 0.47 to 0.78). Multiple regression analyses showed that higher PASE (p < .001) and greater enjoyment of PA (p < .01) were predictive of higher daily PA. HIV- participants had higher PASE but lower BWS compared to HIV+ participants. Sex and age differences were observed in muscle strengthening activities and sedentary behavior. This study supports previous findings on the association of efficacy beliefs to daily PA and muscle strengthening activities. The findings have implications for PA interventions aimed at health promotion and mitigation of the effects of living with HIV/AIDS.

Looking at the Figures: Visual Adaptation as a Mechanism for Body-Size and -Shape Misperception

Many individuals experience body-size and -shape misperception (BSSM). Body-size overestimation is associated with body dissatisfaction, anxiety, depression, and the development of eating disorders in individuals who desire to be thinner. Similar symptoms have been noted for those who underestimate their muscularity. Conversely, individuals with high body mass indices (BMI) who underestimate their adiposity may not recognize the risks of or seek help for obesity-related medical issues. Although social scientists have examined whether media representations of idealized bodies contribute to the overestimation of fat or underestimation of muscle, other scientists suggest that increases in the prevalence of obesity could explain body-fat underestimation as a form of renormalization. However, these disparate approaches have not advanced our understanding of the perceptual underpinnings of BSSM. Recently, a new unifying account of BSSM has emerged that is based on the long-established phenomenon of visual adaptation, employing psychophysical measurements of perceived size and shape following exposure to "extreme" body stimuli. By inducing BSSM in the laboratory as an aftereffect, this technique is rapidly advancing our understanding of the underlying mental representation of human bodies. This nascent approach provides insight into real-world BSSM and may inform the development of therapeutic and public-health interventions designed to address such perceptual errors.

Weight underestimation and body size dissatisfaction among black African adults with obesity: Implications for health promotion

BACKGROUND

Body image perception has an impact on modifiable cardiovascular disease (CVD) risk, lifestyle and psychological health in many populations.

AIM

To assess weight discordance (underestimating own weight) and body size dissatisfaction (perceiving body size as either 'too small' or 'too large') among overweight and obese South Africans, the associated factors and the implications for health promotion.

SETTING

A rural community and an urban township in two provinces of South Africa.

METHODS

An ancillary study within a prospective cohort involving 920 adults aged 35-78 years. Information on body image perception, anthropometry, risk factors and weight change were obtained on year 4 follow-up. Obesity was described as having a body mass index (BMI) 25 kg/m2. Descriptive and multivariate analyses were undertaken.

RESULTS

Most obese and overweight adults, respectively, underestimated their own weight (85% vs. 79%) and considered their body sizes as either 'too large' (59%) or 'too small' (57%). Those who perceived CVD threat, compared with those who did not, were 3.0 times more likely to be dissatisfied with their body sizes (p 0.0001) and 1.6 times more likely to underestimate their own weight (p 0.001). Those who indicated their willingness to lose weight were seven times more likely to be dissatisfied with their body sizes and unlikely to have discordant weight status (p = 0.0002).

CONCLUSION

Body size dissatisfaction and weight underestimation were influenced by perceived threat of CVD and the willingness to lose weight. Obesity prevention should leverage on perceived CVD threat messaging and self-motivation for attaining a healthy weight.

Extracurricular Activity Involvement and Body Image in Youth with Obesity: The Mediating Role of Social Life

Background: Youth with severe obesity are vulnerable to body dissatisfaction. Extracurricular activity (ECA) involvement has been linked to positive social interactions and body image in community samples; however, these links remain to be tested in clinical samples of youth with severe obesity. The present study explored ECA involvement [both physical and nonphysical activities (PAs)] in a clinical sample of youth with obesity to determine whether ECA involvement was related to body image (appearance and weight esteem) and social life (i.e., social experiences with peers). Methods: Participants were 209 adolescents (Mean age = 15.05; 50.2% female) who completed a baseline assessment at a tertiary care weight management program. Results: Of the participants, 70.3% of youth reported participating in PAs, and 56.5% reported participating in non-PAs. As hypothesized, weight esteem and social life were higher in those who participated in PA vs. those who did not. Mediation analyses revealed that social life positively mediated the relationship between PA participation and weight esteem. Conclusions: Social life may be a mechanism by which PA participation is positively related to weight esteem in youth with severe obesity. Findings could inform weight management programs for youth with obesity who are at risk for social inclusion and body dissatisfaction.

Differences in risk factors for binge eating by socioeconomic status in a community-based sample of adolescents: Findings from Project EAT

OBJECTIVE

Binge eating is prevalent across socioeconomic status (SES) groups, but it is unclear whether risk factors for binge eating vary by SES. This study examined the prevalence of several risk factors for binge eating by SES and SES as a potential moderator of these risk factors.

METHOD

Participants included 2,179 individuals involved in Project EAT during early/middle adolescence (EAT-I) and 5 years later during late adolescence/emerging adulthood (EAT-II). Risk ratios were computed using modified Poisson regression of incident EAT-II binge eating on EAT-I risk factors among participants of high and low SES. Interactions between each risk factor and SES were tested.

RESULTS

Among higher SES adolescents, overweight/obesity (RR = 3.2; 95% CI: 1.8, 5.7), body dissatisfaction (RR = 2.6; 95% confidence intervals (CI): 1.2, 5.5), dieting (RR = 4.0; 95% CI: 2.0, 8.2), and family weight-teasing (RR = 2.3; 95% CI: 1.3, 4.3) predicted increased risk for binge eating. Among adolescents from low-SES backgrounds, overweight/obesity (RR = 1.5; 95% CI: 0.9, 2.5), dieting (RR = 2.2; 95% CI: 1.2, 3.9), and food insecurity (RR = 1.4; 95% CI: 0.7, 2.7) predicted increased risk for binge eating. Moderator analyses revealed that overweight/obesity, body dissatisfaction, dieting, and family weight-teasing were stronger risk factors in the high-SES group than the low-SES group; interactions with food insecurity could not be examined given the low prevalence of food insecurity in the high-SES group.

DISCUSSION

Risk factors for binge eating may vary by SES, suggesting the potential utility of modifying intervention and prevention methods based on SES. In particular, the role of food insecurity must be addressed.

Does dissatisfaction with, or accurate perception of overweight status help people reduce weight? Longitudinal study of Australian adults

BACKGROUND

With studies around the world suggesting a large proportion of people do not recognise that they are overweight (or feel satisfied with being overweight), this fuels the view that such 'misperceptions' need to be 'corrected'. However, few longitudinal studies have examined the consequences of under-perceived weight status, nor over-perceived weight status (when a person feels overweight when they are not) and weight-related satisfaction on trajectories in body mass index (BMI).

METHODS

Five-year BMI trajectories were examined among 8174 participants in an Australian nationally representative cohort. Each person was classified into groups according to their neighbourhood socioeconomic circumstances, baseline BMI and answers to "how satisfied are you with your current weight?" and "do you consider yourself to be… acceptable weight / underweight / overweight?" Gender-specific multilevel linear regressions were used to examine five-year BMI trajectories for people in each group, adjusting for potential confounders.

RESULTS

At baseline, weight-related dissatisfaction and perceived overweight were generally associated with higher mean BMI for men and women, regardless of whether they were classified as 'normal' or overweight by World Health Organization (WHO) criteria. Mean BMI did not decrease among people classified as overweight who perceived themselves as overweight, or expressed weight-related dissatisfaction, regardless of where they lived. Among men and women with 'normal' BMI at baseline but expressing weight-related dissatisfaction, mean BMI increased disproportionately among those living in disadvantaged areas compared to their counterparts in affluent areas. Similarly, mean BMI rose disproportionately among people in disadvantaged areas who felt they were overweight despite having a 'normal' BMI by WHO criteria, compared to people with the same over-perceptions living in affluent areas. These differences exacerbated pre-existing socioeconomic inequities in mean BMI.

CONCLUSIONS

No evidence was found to suggest accurate recognition of overweight or expressing weight-related dissatisfaction leads to a lower BMI. However, there was evidence of an increase in mean BMI among people who felt dissatisfied with, or over-perceived their 'normal' weight, especially in socioeconomically disadvantaged areas. Correction of under-perceptions may not drive weight loss, but circumstances contributing to over-perception and dissatisfaction with weight status may contribute to increased weight gain and exacerbate socioeconomic inequities in BMI.

Appearance comparison and other appearance-related influences on body dissatisfaction in everyday life

Although appearance comparisons, self-monitoring, and appearance-related comments have been linked to body dissatisfaction in prior studies, the combined and unique influences of these variables on state body dissatisfaction in daily life has yet to be explored. The present study addressed this gap, and also evaluated whether these state-based effects were stronger for individuals with trait-level body image disturbances (internalization and body dissatisfaction). Eighty-four women completed baseline measures of trait internalization and body dissatisfaction, and then reported momentary experiences of body dissatisfaction, appearance self-monitoring, appearance-related comments, and appearance-based comparisons at up to 10 random times daily for seven days. Multilevel analyses confirmed that both appearance comparisons and commentary (both negative and positive) were predictive of changes in state body dissatisfaction when modelled individually as well as in a combined (full) model. Appearance self-monitoring was not a significant predictor, either individually or in the full model. These within-person relationships were not moderated by individual differences in trait body dissatisfaction and internalization of appearance standards. Accordingly, experiences of body dissatisfaction in daily life may be a common reaction to negative appearance comments and unflattering comparisons, yet positive comments and/or efforts to avoid appearance-based comparisons may have a positive effect on one's body image.

Sexual orientation disparities in eating disorder symptoms among adolescent boys and girls in the UK

Much of the research on sexual orientation disparities in eating disorder behaviors has been conducted in the USA, Canada, and Australia. Data on the associations of sexual orientation and eating disorder symptoms among adolescents in the UK are lacking. Participants were children from the Avon Longitudinal Study of Parents and Children, a youth cohort born 1991-1992 (n = 5048; 53% female; 12% sexual minority). Sexual orientation was assessed at 16 years. Eating disorder symptoms were assessed at 14 and 16 years. Multivariable regression models (adjusting for BMI, ethnicity, socioeconomic status) examined associations between sexual orientation and (1) odds of past-year purging and binge eating, and (2) mean differences in body dissatisfaction, pressure to increase muscularity (boys only), and Dutch Eating Behavior Questionnaire subscales. At age 14, gay and bisexual boys and mostly heterosexual girls reported greater body dissatisfaction than their same-gender heterosexual peers. All sexual minority boys and mostly heterosexual girls reported greater mean dysfunctional eating behaviors than their same-gender heterosexual peers. At age 16, gay and bisexual boys had 12.5 times the odds of heterosexual boys of binge eating; mostly heterosexual boys had over three times the odds of reporting binge eating. Sexual minority girls had over twice the odds of heterosexual girls of purging and binge eating. By mid-adolescence, sexual minority youth in the UK had elevated risk for eating disorder symptoms, suggesting the need for early prevention efforts.

A Pilot Study of the Lifestyle Questionnaire for Weight Management Shows Scores Significantly Associate With Weight Trajectory

Context. An instrument is needed to facilitate a brief, but effective, counseling interaction between a patient and a provider. Such an instrument should raise patients' awareness of their behavioral patterns and indicate their likelihood of weight loss statistically. Objective. To determine if the Lifestyle Questionnaire-Weight Management (LQ-WM) contains statistical properties that discriminate subjects' weight trajectories. Design and Participants. A convenience sample of 269 college students at Utah Valley University in Orem, Utah, were administered the LQ-WM and a weight history questionnaire. Main Outcome Measure. A Lifestyle Score was created by subtracting the amount of self-reported unhealthy behaviors from the amount of healthy behaviors in the previous week. Results. The Lifestyle Score was significantly different among subjects who reported recently losing, maintaining, or gaining weight recently (P < .001) and in the previous year (P < .05). The Lifestyle Score was also significantly different among individuals losing weigh rapidly, moderately, and slowly (P < .05). Conclusions. This pilot study of the statistical properties of the LQ-WM supports that higher Lifestyle Scores associate with weight loss cross-sectionally. Future studies should examine its statistical properties longitudinally and with diverse samples to assess its suitability for clinical practice.

Gender-Specific Body Areas Satisfaction and Body Weight Status in Adolescents: Mediating Effects of Physical Activity, Fruit and Vegetable Intake, and Energy-Dense Food Intake

Background

Body satisfaction is one of the key modifiable cognitive determinants of eating behaviours, physical activity, and body mass index (BMI). As the sociocultural models suggest, low body satisfaction may explain unhealthy eating and exercise behaviours. Importantly, body satisfaction levels and body areas that individuals focus on vary across genders. This study aims at investigating links between the global index of body areas satisfaction (BAS), gender‐specific BAS, fruit and vegetable (F&V) intake, energy‐dense foods intake, moderate‐to‐vigorous physical activity (MVPA), and BMI.

Methods

In all, 1,254 adolescents completed questionnaires and had their weight and height objectively measured with 2‐ and 13‐month follow‐ups. Indirect effects of three indices of BAS were tested in three models (male‐specific BAS amongst boys; female‐specific BAS amongst girls; the global BAS index in the total sample).

Results

Higher levels of all three BAS indices indirectly predicted lower BMI, with higher MVPA mediating this effect. In addition, higher energy‐dense foods intake mediated higher global BAS–higher BMI relationship in the total sample. Thus, the global index of BAS acts as double‐edged sword, predicting both higher MVPA and energy‐dense foods intake.

Conclusion

BAS may operate in a complex manner, predicting behaviours which may have opposite effects on BMI.

The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years

OBJECTIVE

The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood.

METHOD

The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points.

RESULTS

The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image.

DISCUSSION

Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape.

Psychological Aspects of Obesity in Children and Adolescents

Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers.

Brazilian Version of the Body Appreciation Scale (BAS) for Young Adolescents

The present study developed a Brazilian adaptation of the BAS for young adolescents, testing its factor structure by the Confirmatory Factor Analysis (CFA), concurrent and criterion validity, and its internal consistency. Participants were 347 adolescents (171 male and 176 female, aged between 10 and 13 years old). Three psychologists experts in psychological evaluation and three teachers of Portuguese of elementary school also participated for the adaptation stage of the items in order to be properly understood by the sample age group. There were few changes from the version culturally adapted for the Brazilian adult population. Cronbach's alpha coefficients were satisfactory for the general population and both sexes (.804; female =.851; male =.752). The one-factor model of the BAS was confirmed by the confirmatory factor analysis with good indicators for the measurements of adjustment to the model, χ2 = 77.9; GFI = 0.967; NFI = 0.940, CFI = 0.979; TLI = 0.968; RMSEA;.038). The convergent validity analyzes revealed significant correlations between BAS scores and BMI (r = -.230; p < .001) and between the first and body image satisfaction (r = .309; p < .001). The BAS version for Brazilian young adolescents had adequate levels of validity and reliability, keeping the one-dimensional structure which indicates its use in Brazilian adolescent's samples.

Body Size Misperception and Overweight or Obesity among Saudi College-Aged Females

The aim of the study was to investigate the associations between perceived and desired body size and overweight and obesity among college-aged females. A multistage stratified cluster random sample was used to select 907 healthy females from a major Saudi public university. The Stunkard Figure Rating Scale (FRS) was used for body size assessment. Overweight/obesity classification was based on BMI less than or equal to/greater than 25 kg/m2. Overweight plus obesity prevalence was 28.1%. There were significant differences between females with overweight/obesity and those without overweight/obesity in both perceived and desired body size scores. Compared with only 4% of females without overweight/obesity, 37% of the participants with overweight/obesity scored higher than five (median) in the FRS. The perceived body size correlated more strongly with many of the selected variables than did the desired body size, especially with BMI (r=0.679; p < 0.001), body weight (r=0.652; p < 0.001), and weight loss attempts (r=0.466; p < 0.001). Also, there was a significant relationship between BMI and weight loss attempts (r=0.370; p < 0.001). BMI and weight loss attempts appear to predict the perceived body size and the discrepancy between perceived and desired body size scores. Psychosocial and lifestyle factors that might influence female's body misperception need to be addressed in future studies.

Effects of exposure to bodies of different sizes on perception of and satisfaction with own body size: two randomized studies

Body dissatisfaction is prevalent among women and associated with subsequent obesity and eating disorders. Exposure to images of bodies of different sizes has been suggested to change the perception of 'normal' body size in others. We tested whether exposure to different-sized (otherwise identical) bodies changes perception of own and others' body size, satisfaction with body size and amount of chocolate consumed. In Study 1, 90 18-25-year-old women with normal BMI were randomized into one of three groups to complete a 15 min two-back task using photographs of women either of 'normal weight' (Body Mass Index (BMI) 22-23 kg m-2), or altered to appear either under- or over-weight. Study 2 was identical except the 96 participants had high baseline body dissatisfaction and were followed up after 24 h. We also conducted a mega-analysis combining both studies. Participants rated size of others' bodies, own size, and satisfaction with size pre- and post-task. Post-task ratings were compared between groups, adjusting for pre-task ratings. Participants exposed to over- or normal-weight images subsequently perceived others' bodies as smaller, in comparison to those shown underweight bodies (p < 0.001). They also perceived their own bodies as smaller (Study 1, p = 0.073; Study 2, p = 0.018; mega-analysis, p = 0.001), and felt more satisfied with their size (Study 1, p = 0.046; Study 2, p = 0.004; mega-analysis, p = 0.006). There were no differences in chocolate consumption. This study suggests that a move towards using images of women with a BMI in the healthy range in the media may help to reduce body dissatisfaction, and the associated risk of eating disorders.

A cross-sectional model of eating disorders in Argentinean overweight and obese children

Despite the fact that past research identified childhood obesity as an antecedent of eating disorders, not all obese children further develop this pathology. With this regard, our first purpose was to isolate which characteristics differentiate overweight children who have an eating disorder from those who have not. Second, considering that there is little evidence collected in Latin American countries, we provided overweight children data from an Argentinean sample. Specifically, we investigated if weight-teasing, perfectionism, disturbed eating attitudes and behaviors, and body image dissatisfaction are related to the occurrence of an eating disorder in 100 school-aged overweight/obese children (37 girls and 63 boys; mean age 10.85, SD 0.88). Participants completed self-report instruments and were interviewed between 1 and 2 months later to confirm the presence of eating disorders. Seventeen percent participants confirmed to have an eating disorder. Further, the multivariate logistic analysis revealed that perfectionism (Exp β = 1.19) and disturbed eating attitudes and behaviors (Exp β = 4.78) were jointly associated with the presence of an eating disorder. These results were maintained even when the overall model was adjusted for covariates such as age, gender, body mass index, and school type. Weight-teasing and body image dissatisfaction did not contribute to the multivariate model. Prevalence rates of ED and model findings were discussed.

Examining Two Prevailing Models of Loss of Control Eating Among Community-Based Girls

OBJECTIVE

Cognitive-behavioral and interpersonal models of loss of control (LOC) eating have been underexplored in adolescents.

METHODS

By using data from community-based adolescent girls assessed annually over 4 years, the cognitive-behavioral (n = 416) and interpersonal (n = 418) models were examined by using a regression-based bootstrapping approach.

RESULTS

Body dissatisfaction at 14 years prospectively predicted LOC eating at 18 years, both directly (direct effect = -0.039; SE = 0.017; P = 0.02) and indirectly via dieting (indirect effect = -0.010; 95% CI: -0.022 to -0.003). Interpersonal functioning at 14 years was negatively associated with negative emotionality at 17 years, which, in turn, was prospectively associated with LOC eating at 18 years (indirect effect = 0.001; 95% CI: -0.001 to -0.0003); however, the direct association between age 14 interpersonal functioning and age 18 LOC eating was not significant (direct effect = -0.001; SE = 0.001; P = 0.47).

CONCLUSIONS

These findings support the cognitive-behavioral model, and partially support the interpersonal model, with the latter findings implying that over time, negative emotionality may promote LOC eating independent of the effects of prior social functioning. Prevention and early intervention efforts for LOC eating may benefit from integrating these theoretical frameworks.

Relationship of pressure to be thin with gains in body weight and fat mass in adolescents

BACKGROUND

Sociocultural pressure to be thin is commonly reported by adolescents; yet, to what extent such pressure is associated with weight gain has not been evaluated longitudinally.

OBJECTIVE

Examine whether pressure to be thin was positively associated with weight and fat gain in adolescents.

METHODS

Participants were 196 healthy adolescent (age 15 ± 1 years old) girls (65%) and boys of varying weights (BMI 25 ± 7 kg/m² ) studied at baseline and 1-year follow-up. At baseline, adolescents and their mothers reported pressure to be thin by questionnaire. At baseline and follow-up, BMI was calculated, and fat mass was assessed with air displacement plethysmography. Multiple regression was used to examine associations between baseline pressure to be thin and 1-year changes in BMI and fat mass.

RESULTS

Accounting for multiple covariates, including baseline BMI or fat, adolescent-reported pressure from parents and peers and mother-reported pressure toward their teen were associated with greater gains in either adolescent BMI or fat (ps < .05). Adolescent weight status was a moderator of multiple effects (ps < .05).

CONCLUSIONS

Parental and peer pressure to be thin were associated with increases in BMI and fat mass during adolescence, particularly in heavier adolescents. Further research is necessary to clarify how this association operates reciprocally and to identify underlying explanatory mechanisms.

Cross-sectional and Prospective Examination of Weight Misperception and Depressive Symptoms Among Youth with Overweight and Obesity

This study aims to determine the association between weight misperception (considering oneself average or underweight) and depressive symptoms among youth with overweight/obesity. Linear regression models (adjusted for age, BMI, parental education, percent poverty) were used to examine cross-sectional (wave II, 1996, n = 3898, M _age = 15.9, SD = 0.13) and longitudinal (from wave II to IV, 1996-2008/2009, n = 2738, M _age = 28.5, SD = 0.06) associations between weight misperception and depressive symptoms (Center for Epidemiologic Studies-Depression Scale) in a subsample of White, Black, Asian, Hispanic, and Multi-racial male and female youth with overweight/obesity participating in the National Longitudinal Study of Adolescent Health. Average BMI was 29.0 (0.16) at wave II and 35.7 (0.23) at wave IV. Thirty-two percent misperceived their weight status as average weight (n = 1151, 30 %) or underweight (n = 99, 3 %). In fully adjusted cross-sectional models, White (β = -1.92, 95 % CI = -2.79, -1.06) and Multi-racial (β = -4.43, 95 % CI = -6.90, -1.95) youth who perceived themselves as average weight had significantly lower depressive symptoms compared to accurate weight-perceivers. In fully adjusted longitudinal models, White youth (β = -0.41, 95 % CI = -0.81, -0.004) who perceived themselves as average weight had significantly lower depressive symptoms 12 years later. Findings suggest that weight misperception may be protective against depression among White adolescents and young adults with overweight/obesity. Clinical and population interventions should consider potential harmful effects of correcting weight misperceptions on the mental health of youth with overweight/obesity.

Exposure to teasing on popular television shows and associations with adolescent body satisfaction

OBJECTIVE

This study uses a novel mixed methods design to examine the relationship between incidents of teasing in popular television shows and body satisfaction of adolescent viewers.

METHODS

Survey data were used to identify 25 favorite television shows in a large population-based sample of Minnesota adolescents (N=2793, age=14.4years). Data from content analysis of teasing incidents in popular shows were linked to adolescent survey data. Linear regression models examined associations between exposure to on-screen teasing in adolescents' own favorite shows and their body satisfaction. Effect modification by adolescent weight status was tested using interaction terms.

RESULTS

Teasing on TV was common, with 3.3 incidents per episode; over one-quarter of teasing was weight/shape-related. Exposure to weight/shape-related teasing (β=-0.43, p=0.008) and teasing with overweight targets (β=-0.03, p=0.02) was inversely associated with girls' body satisfaction; no associations were found for boys. Findings were similar regardless of the adolescent viewer's weight status.

CONCLUSIONS

Families, health care providers, media literacy programs and the entertainment industry are encouraged to consider the negative effects exposure to weight stigmatization can have on adolescent girls.

Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review

The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively.

Parental perception of child weight and inflammation: Perceived overweight is associated with higher child c-reactive protein

Self-perceived overweight and weight discrimination are associated with inflammation in adulthood. We test whether there is an intergenerational association of parent perception of child overweight on higher levels of child c-reactive protein (CRP), a marker of inflammation implicated in stress. Data were from the National Health and Nutrition Examination Survey 2005-2014 (N=4988). Parents reported their perception of their child's weight; CRP was assayed from children's blood samples. Children whose parents perceived them as overweight had higher CRP levels than children who were perceived about the right weight; perceived underweight was also associated with higher CRP (F(2,4977)=9.23, p<.001). These associations were independent of the child's objective weight status and waist circumference and held when the sample was limited to children with objective overweight and obesity. These results suggest an intergenerational transfer of the psychological perception of body weight from parents to the inflammatory health of their child.