Internet-Delivered Targeted Group Intervention for Body Dissatisfaction and Disordered Eating in Adolescent Girls: A randomized controlled trial

This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were 73 girls (mean age=14.4 years, SD=1.48) who self-identified as having body image or eating problems and were randomly assigned to an intervention group (n=36) (assessed at baseline, post-intervention and at 2- and 6-months follow-up) or a delayed treatment control group (n=37) (assessed at baseline and 6–7 weeks later). Clinically significant improvements in body dissatisfaction, disordered eating, and depression were observed at post-intervention and maintained at follow-up. Internet delivery was enthusiastically endorsed. The program offers a promising approach to improve body image and eating problems that also addresses geographic access problems.     

Y's Girl: Increasing body satisfaction among primary school girls

To date, effective body image interventions for preadolescent school girls are lacking. The present study sought to evaluate the effectiveness of Y's Girl, a published body image curriculum specifically tailored for preadolescent school girls. A sample of 60 Grade 6 girls with a mean age of 11.25 (range of 11–12) years were allocated either to an intervention or control group and completed baseline and posttest measures of body image, thin-ideal internalization, body comparison, self-esteem, peer factors, and disordered eating. Findings revealed that, compared to the control group, girls receiving the intervention reported improved body image, thin-ideal internalization, body comparisons, and self-esteem at posttest 1 week after the intervention ended. Furthermore, changes in body satisfaction were moderated by initial levels of risk-factors. These findings provide initial support for Y's Girl as an effective, affordable body image intervention for preadolescent girls which can be implemented by teachers.     

Impact of a healthy body image program among adolescent boys on body image,negative affect,and body change strategies

This study evaluated the effectiveness of a healthy body image program. In total, 421 adolescent boys completed a five-session intervention program or a wait list control group. There were no differences between the intervention and the control group at post-intervention or any of the follow-up times. Boys in the intervention group who were one standard deviation above the mean on body dissatisfaction at baseline, demonstrated a reduction in negative affect in the intervention group at post-test and 6 months follow-up. Prevention programs need to target boys who are at risk of adopting health risk behaviors, rather than being universally applied.     

Is BodyThink an efficacious body image and self-esteem program? A controlled evaluation with adolescents

This study aimed to evaluate the efficacy of BodyThink, a widely disseminated body image and self-esteem program. Participants were 277, grade 7 students from 4 secondary schools in Australia. The intervention group (62 girls, 85 boys) participated in BodyThink during four 50-min lessons, while the control group (65 girls, 65 boys) received their usual classes. All participants completed baseline, postintervention and 3-month follow-up questionnaires. For girls, the intervention group reported higher media literacy and lower internalization of the thin ideal compared to the control group. For boys, the intervention group reported higher media literacy and body satisfaction than the control group. Although some positive outcomes were observed, it would be valuable to find ways to enhance the impact of BodyThink, especially in light of its wide dissemination. Suggestions for improving BodyThink are presented.     

Effects of a 6-week circuit training intervention on body esteem and body mass index in British primary school children

Research examining the impact of physical activity on children's body image has been limited and equivocal. The current researchers examined the effect of 6-week circuit-based training on body esteem and body mass index (BMI) in 68 British children (34 boys and 34 girls, aged 10–11 years, 16% overweight, 7% obese). The Body Esteem Scale for Children (BES-C) was administered to both the intervention group and control group, pre, post and 6 weeks post the intervention. BMI was directly assessed from height and body mass pre- and post-intervention. The results of this study revealed that, as compared to the control group, participation in 6-week circuit training significantly improved body esteem scores post-intervention. However, these scores were not sustained 6 weeks post-intervention. The improvement in body esteem scores from pre- to post-intervention was greater for girls as compared to boys. Additionally, BMI decreased significantly in the intervention group compared to the control group.     

Adolescent body image and psychosocial functioning

Researchers have highlighted the significance of a poor body image in the development of dysfunctional eating but have systematically investigated few other outcomes. The authors examined the relationships between different aspects of body image and psychosocial functioning. Participants were 245 boys and 173 girls from Grades 8 and 9 (M age = 13.92 years, SD = 0.69 years). Respondents completed measures of physical attractiveness, body satisfaction, body image importance, body image behaviors, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and same-sex and opposite-sex relations. Whereas girls tended to report a more negative body image than did boys, the relevance of body image to self-esteem was similar for boys and girls. Concern about others' evaluation of their bodies was especially important in understanding low female self-esteem, whereas for boys, ratings of general attractiveness most strongly predicted self-esteem. The authors found a negative body image to be unrelated to symptoms of negative affect but to be strongly associated with poor opposite-sex peer relationships, especially among boys. A negative body image also affected same-sex relations among girls.     

BodiMojo: Effective Internet-based promotion of positive body image in adolescent girls

This study tested the efficacy of an Internet-based health promotion program, BodiMojo, designed to promote positive body image in adolescents. Participants were 178 students (mean age 15.2 years, 67.6% ethnic minority) in three public high schools. Intervention groups used BodiMojo for four weekly health class periods, while controls participated in their usual health curriculum. Body image measures were given at baseline, post-intervention, and 3 months. Girls reported decreased body dissatisfaction (p < .05), decreased physical appearance comparison (p < .05), and increased appearance satisfaction (p < .05), relative to controls. Effects were not maintained at 3-month follow-up. No significant differences were found between the intervention and control groups with boys. Moderation analyses suggested positive effects for diverse adolescents as well as those who were overweight or indicated baseline high body dissatisfaction. BodiMojo appears to be modestly effective in decreasing body image concerns among adolescent girls in the short term.     

Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program

This study was a controlled evaluation of a comprehensive school-based universal prevention program involving male and female students, parents, teachers, school administrators and local public health professionals. A total of 982 male and female Grades 6 and 7 middle school students (and 91 teachers/school administrators) completed self-report surveys at baseline on measures of body satisfaction, internalization of media ideals, size acceptance, disordered eating, weight-based teasing, weight loss and muscle-gaining behaviours, and perceptions of school climate (teachers only). Eighty-four percent of the students repeated the surveys immediately following the 8-month school-wide intervention and 71% again 6 months later. Repeated measures ANCOVAs revealed that participation in the Healthy Schools-Healthy Kids (HS-HK) program had a positive influence by reducing the internalization of media ideals among male and female students and by reducing disordered eating among female students. The program was also associated with reductions in weight-loss behaviours among the students, although this effect was lost by the 6-month follow-up. When the intervention students were sub-divided into low versus high-risk groups, the high-risk group appeared to benefit most from the intervention with significant reductions in internalization of media ideals, greater body satisfaction, and reduced disordered eating over time. There were no intervention effects for teachers. Challenges of engaging teachers in prevention are discussed.     

Risk Factors for Disordered Eating During Early and Middle Adolescence: A Two Year Longitudinal Study of Mainland Chinese Boys and Girls

Even though reliable eating disorder risk factors have been identified among adolescent girls, little is known about predictors of increased vulnerability within specific phases of adolescence or among adolescent boys, particularly in highly populated non-Western contexts. In this study, early and middle adolescent boys (n?=?1,271) and girls (n?=?1,415) from Chongqing, China completed validated measures of eating disorder pathology and putative risk factors at baseline and 2 years follow-up. Multivariate models for boys of each age group indicated increases in disordered eating at follow-up were predicted by higher initial body mass index, negative affect and body dissatisfaction levels as well as attendant increases in perceived appearance pressure from mass media, body dissatisfaction, negative affect between assessments. High baseline levels of reported appearance pressure from parents and dating partners contributed, respectively, to prediction models of younger and older boys. More distinct constellations of significant predictors emerged in multivariate models of early versus middle adolescent girls. Together, findings indicated body dissatisfaction and negative affect were fairly robust risk factors for exacerbations in disturbances across samples while risk factors such as perceived pressure from desired/prospective dating partners were salient only during particular phases of adolescence.     

Drive for muscularity and disordered eating among French adolescent boys: a sociocultural model

The pursuit of muscularity is an important body image concern among boys which has been described within sociocultural models of risk for eating disorders. This study explored a sociocultural model of disordered eating in which drive for thinness and pursuit of muscularity were both pathways to disordered eating among French adolescent boys. A sample of 146 adolescents completed a questionnaire assessing drive for thinness, drive for muscularity, media-ideal internalization, appearance comparison, and sociocultural pressure. The model was a good fit to the data and both drive for thinness and the pursuit of muscularity were related to disordered eating. Furthermore, internalization and appearance comparison mediated the relationships between pressure to increase muscle and both drive for muscularity and drive for thinness. Longitudinal research could help clarify the role of the pursuit of muscularity in the development of disordered eating and extreme body shape changing behaviors.     

Gender differences in preschool children’s declared and behavioral compliance with pedestrian rules

The study examined gender differences in compliance with pedestrian rules among preschool children. Two groups of 5-year-old boys and girls containing a total of 162 children participated in the study. First, the children’s compliance was assessed during crossing and walking by observing their pedestrian behaviors. Then, each child was interviewed on pedestrian-danger appraisal, rule knowledge, rule compliance, and rule internalization. As hypothesized, the results showed that girls’ behaviors were more compliant than those of boys. However, boys were more compliant than girls in looking at the surrounding environment as they traveled and before crossing. Girls said they were more compliant with rules, had better knowledge of rules, and exhibited greater rule internalization than boys. Danger appraisals, however, were found to be comparable for boys and girls. Moreover, declared compliance was linked to behavioral compliance among girls but not among boys. These findings suggest that girls and boys have different motives for obeying safety rules. The results are discussed in regard to the origins of gender differences in traffic-rule compliance.     

Body image and strategies to lose weight and increase muscle among boys and girls.

This study examined factors that influence body image and strategies to either lose weight or increase muscle among children. Participants were 237 boys and 270 girls. Body mass index (BMI), body dissatisfaction, cognitions and behaviors to both lose weight and increase muscles, as well as self-esteem and positive and negative affect, were evaluated. Self-esteem was associated with body satisfaction, positive affect predicted strategies to lose weight and increase muscles, and negative affect predicted body dissatisfaction and cognitions to lose weight and increase muscles. Boys were more likely to focus on changing muscles. Respondents with higher BMIs were more focused on losing weight butnot muscle. The discussion focuses on health risk behaviors related to eating and exercise among children.     

Disordered eating behaviors and body image in a longitudinal pilot study of adolescent girls: What happens 2 years later?

We assessed the prospective association of risk factors for eating and body image disturbances after a 2-year follow-up in a community sample of Spanish adolescent girls. The participants included 128 Spanish girls aged 12–14, who took part in a 28-month prospective study. Aspects assessed were eating attitudes (Eating Attitudes Test), influence of the body shape model (questionnaire on influences of the aesthetic body shape model), extreme weight-control behaviors (Eating Disorder Examination-Questionnaire), body image (Body Image Questionnaire) and Body Mass Index (BMI). BMI, extreme weight-control behaviors and body image problems emerged as potential predictors of an increase in eating disturbances. An increased influence of the thinness model was significantly associated with reduced body satisfaction and body image problems. Preventive programs are needed to contribute reducing the impact of sociocultural influences with regard to thinness, the use of extreme weight-control behaviors and overweight in adolescents.     

Effectiveness of an Internet Dissonance-Based Eating Disorder Prevention Intervention Among Body-Dissatisfied Young Chinese Women

Body image disturbances are widespread in highly populated, rapidly developing Asian nations such as China, but there are severe shortages of practitioners qualified to treat these issues. In such contexts, validated online interventions offer a potentially viable approach for addressing the lack of treatment resources. In this study, we evaluated effects of the eBody Project, an online, dissonance-based eating disorder prevention program, on functioning among body-dissatisfied young Chinese women. Participating women were randomly assigned to the 6-week eBody Project intervention (n = 191) versus an education brochure control condition (n = 181). Self-report assessments of eating disorder risk factors (body dissatisfaction, thin ideal internalization, depressive symptoms, restrained eating), self-esteem, body appreciation, and disordered eating were completed at baseline, posttreatment, and a 6-month follow-up. There were no intervention differences on outcomes before treatment but eBody Project women experienced significantly larger improvements on all outcomes following treatment and/or at follow-up compared to controls; corresponding effect sizes were small to medium. Results indicated the eBody Project program is a promising intervention for young women at risk for eating disorders in China and provide foundations for broad implementation in low- and middle-income countries where resources for in-person therapy and supervision are limited or unavailable altogether.     

A randomized trial to evaluate the course of effects of a program to prevent adolescent depressive symptoms over 12 months

Although few prevention studies have been designed to investigate the course of prevention effects over time, it seems that the effects on depressive symptoms increase from post-intervention to 6-month follow-up but then decrease with longer lags to follow-up. Furthermore, previous prevention studies have found differential intervention effects for boys and girls without testing possible explanations for this effect. The present randomized control group study with 301 8th-grade students examined the effects of a depression prevention program from baseline until 12-month follow-up. As expected, while positive intervention effects were found on girls’ depressive symptoms, no such effects were found on boys’ depressive symptoms. Further, the positive intervention effects on girls’ depressive symptoms increased to the 6-month follow-up and remained stable through the 12-month follow-up, while depression symptoms in control-group girls increased from 6-month to 12-month follow-up. Further exploratory analyses revealed that neither baseline conduct problems nor cognitive or social knowledge of the prevention program at 12-month follow-up alone explained the sex effect. However, some limited evidence was found indicating that total knowledge (cognitive and social) might partially explain the effect but there was significant variability remaining to be explained.     

Body image and disordered eating prevention in girls’ sport: A partner-driven and stakeholder-informed scoping review of interventions

Despite the evidenced benefits of participating in organized sport, adolescent girls consistently report lower rates of sport participation, worse sport experiences, and higher dropout rates, compared to boys. Body image concerns have been linked to this gender disparity and established as a critical predictor of disordered eating, thus necessitating effective prevention efforts to mitigate the negative impacts of body image concerns and disordered eating for adolescent girls. In partnership with the National Eating Disorder Information Centre (NEDIC; Canada), the present scoping review was conducted to examine the nature and characteristics of sport-specific body image and disordered eating interventions for adolescent girls. Fourteen studies were identified through various search strategies. Over half of the studies demonstrated modest yet worthwhile effects on various body image and disordered eating outcomes. Intervention characteristics (i.e., frequency, modes of delivery, topics, material, outcomes measured) varied across initiatives. Fifty-nine national, provincial, and local sport system representatives were consulted as stakeholders and provided practical input to the results of the scoping review. Sport stakeholders favoured the delivery of a multidimensional, multicomponent program, with a combination of evidence-based techniques. This synthesis of knowledge will shape the development and dissemination of future programs, and contribute to the development of equitable sport participation opportunities for Canadian girls.     

Manipulation of thinness and restricting expectancies: further evidence for a causal role of thinness and restricting expectancies in the etiology of eating disorders.

To test the eating disorder expectancy theory contention that expectancies for reinforcement from thinness play a causal role in body dissatisfaction and eating disorder symptoms, the authors manipulated expectancies in 2 studies. Participants were exposed to either a psychoeducational intervention or an experimental manipulation of thinness and restricting expectancies. Study 1 participants were symptomatic college women who attended 3 experimental sessions and 1 follow-up session, each 1 week apart. Study 2 participants were high school girls who received the 3 experimental sessions clustered into 2 meetings; they completed symptom measures at baseline and at follow-up. In both samples, the thinness expectancy manipulation produced greater declines in thinness expectancies and body dissatisfaction than did the psychoeducational intervention. For high school girls, the thinness expectancy manipulation also produced a greater decline in overall eating-disordered attitudes. These results provide further support for the role of expectancies in the etiology of eating-disordered behaviors.     

Eating pathology among adolescent girls with attention-deficit/hyperactivity disorder

The authors investigated prospectively assessed eating pathology (body image dissatisfaction and bulimia nervosa symptoms) among an ethnically and socioeconomically diverse sample of adolescent girls with attention-deficit/hyperactivity disorder-combined type (ADHD-C; n=93), ADHD-inattentive type (ADHD-I; n=47), and a comparison group (n=88). The sample, initially ages 6-12 years, participated in a 5-year longitudinal study (92% retention rate). After statistical control of relevant covariates, girls with ADHD-C at baseline showed more eating pathology at follow-up than did comparison girls; girls with ADHD-I were intermediate between these two groups. Baseline impulsivity symptoms, as opposed to hyperactivity and inattention, best predicted adolescent eating pathology. With statistical control of ADHD, baseline peer rejection and parent- child relationship problems also predicted adolescent eating pathology. The association between punitive parenting in childhood and pathological eating behaviors in adolescence was stronger for girls with ADHD than for comparison girls. Results are discussed in terms of the expansion of longitudinal research on ADHD to include female-relevant domains of impairment, such as eating pathology.     

Gender Traits and Self-Concept as Indicators of Problem Eating and Body Dissatisfaction Among Children

The present study was designed to examine the role of gender traits, body mass index (BMI), and self-concept in predicting levels of problem eating and body dissatisfaction among both girls and boys aged between 8 and 10 (85% were Anglo-Australian Caucasian, 15% were Caucasians from non-English backgrounds). Two hundred and two children completed questionnaires, which examined problem-eating attitudes and behaviors, body dissatisfaction, gender traits, and self-concept. Children's height and weight were measured to determine children's BMI. Gender traits predicted problem eating for boys but not for girls. Self-concept was found to predict problem eating for both boys and girls. BMI was also a predictor of problems for girls. The only predictor of body dissatisfaction for boys and girls was BMI. The findings are discussed in light of previous research, which has been conducted, on adolescents. Further studies are needed to understand more fully the development of problem eating and body dissatisfaction before the onset of puberty and adolescence.     

Social Comparison and Body Image: Attractiveness Comparisons to Models and Peers Among Adolescent Girls and Boys

Relations among body image satisfaction and social comparisons to either same-sex peers or media models were examined in 2 studies of adolescent boys and girls. In the first study, 9th and 10th graders described their conceptions of attractiveness for same- and opposite-sex adolescents. These attractiveness attributes were then used in Study 2 in which 7th- and 10th-grade boys and girls reported on social comparisons to models/celebrities and same-sex peers. Body dissatisfaction was also assessed. The results confirmed that both same-sex peers and models/celebrities were the targets of social comparisons for physical attributes, but comparisons on personal and social attributes were more likely directed toward same-sex peers. For boys and girls, weight comparisons to both peer and model targets were primary correlates of body dissatisfaction. In addition, shape comparisons reported by the girls and facial comparisons endorsed by the boys also related to body dissatisfaction. Gender differences in social comparison indicated that girls reported more social comparisons across targets and attributes. Results are discussed in terms of the role of social comparison and peer context for body image during adolescence.