Exploring the integration of thin-ideal internalization and self-objectification in the prevention of eating disorders

Analyses of thin-ideal internalization and self-objectification were conducted within the context of a cognitive dissonance based eating disorder prevention program implemented in an undergraduate sorority. Participants completed self-report assessments at baseline (n = 177), post-intervention (n = 169), 5-month (n = 159), and 1-year follow-up (n = 105). Cross-sectional path analysis indicated that thin-ideal internalization and self-objectification predict each other and both predict body dissatisfaction, which in turn, predicts eating disorder symptoms. A longitudinal examination conducted using hierarchical linear modeling indicated that participants showed significant reductions in thin-ideal internalization, self-objectification, body dissatisfaction, and eating disorder symptoms after participating in the prevention program. Reductions of symptoms were maintained 1-year post-intervention, with the exception of self-objectification, which was significantly reduced up to 5-months post-intervention. Collectively, results suggest that targeting both thin-ideal internalization and self-objectification simultaneously within eating disorder prevention programs could increase the reduction of eating disorder symptoms.     

Appearance-related teasing,body dissatisfaction,and disordered eating: A meta-analysis

A meta-analysis was conducted to determine the relationship between appearance and weight-based teasing and three outcome measures: body dissatisfaction, restrictive eating, and bulimic behaviors. Four meta-analyses were conducted. Fifty effect sizes (N = 10,618) resulted in a moderate effect size of .39 for the relationship between weight teasing and body dissatisfaction; 24 effect sizes (N = 7190) resulted in an effect size of .32 for the relationship between appearance teasing and body dissatisfaction; 20 effect sizes (N = 4792) resulted in an effect size of .35 for the relationship between weight teasing and dietary restraint; and 22 effect sizes (N = 5091) resulted in an effect size of .36 for the relationship between weight teasing and bulimic behaviors. Significant moderators that emerged were teasing measure type, publication type, study type, age group, and gender. The findings offer further support for the inclusion of strategies in body image and eating disorders’ prevention and intervention programs that focus on handling negative, appearance-related commentary.     

Body dissatisfaction and disordered eating attitudes in 7- to 11-year-old girls: Testing a sociocultural model

We examined the sociocultural model of body dissatisfaction and disordered eating attitude development in young girls for the first time. According to the model, internalizing an unrealistically thin ideal body increases the risk of disordered eating via body dissatisfaction, dietary restraint, and depression. Girls aged 7–11 years (N = 127) completed measures of thin-ideal internalization, body dissatisfaction, dieting, depression, and disordered eating attitudes. Participants’ height and weight were measured and their body mass index calculated. Thin-ideal internalization predicted disordered eating attitudes indirectly via body dissatisfaction, dietary restraint, and depression; it also predicted disordered eating attitudes directly. Path analyses showed that a revised sociocultural model fit well with the data. These data show that a sociocultural framework for understanding disordered eating and body dissatisfaction in adults is useful, with minor modifications, in understanding the development of related attitudes in young girls.     

A structural equation model of intuitive eating with adolescents

IntroductionThe tendency to eat by paying attention and respecting the body's hunger and satiety cues is called intuitive eating. This eating behavior has been linked to positive health and well-being outcomes.ObjectiveThe purpose of this study was to test a global model linking intuitive eating with self-esteem, body esteem, media influence and including fear of negative appearance evaluation in adolescents’ boys and girls.MethodIn total, 740 adolescent high school students (51.5% girls; M age = 14, SD = 1.5) completed self-report questionnaires with measures of intuitive eating, body esteem, self-esteem, media influence and fear of negative appearance evaluation.ResultsStructural equation modeling revealed an overall excellent fit for the final four-variable model excluding the fear of negative appearance evaluation variable. Mediation analyses showed an indirect relationship between intuitive eating and body esteem via media influence, for girls but not for boys. Body esteem mediated the relationship between intuitive eating and self-esteem, for girls and boys.ConclusionA new model is proposed where intuitive eating is associated with self-esteem through body esteem and media influence. These findings suggest that regulating attitudes and behaviors toward food may be related to higher psychological well-being.     

Multidimensional body image comparisons among patients with eating disorders,body dysmorphic disorder,and clinical controls: A multisite study

Body image disturbance is considered a core characteristic of eating disorders and body dysmorphic disorder (BDD), however its definition has been unclear within the literature. This study examined the multidimensional nature of body image functioning among individuals with either anorexia nervosa (AN; n = 35), bulimia nervosa (BN; n = 26), or BDD (n = 56), relative to female (n = 34) and male (n = 36) psychiatric controls. Participants were recruited from 10 treatment centers in the United States and England and completed psychometrically validated and standardized self-report measures of body image. Overall, the AN, BN, and BDD groups were characterized by significantly elevated disturbances in most body image dimensions relative to their gender-matched clinical controls. There was variability, however, in the comparisons among the three groups of interest, including foci of body dissatisfaction and body image coping patterns. On omnibus indices of body image disturbance and body image quality of life, patients with BDD reported more body image impairment than those with eating disorders. Although AN, BN, and BDD are characterized by body image disturbances, similar and partially distinctive cognitive, behavioral, and emotional elements of body image functioning exist among these groups. The study's empirical and clinical implications are considered.     

The effects of fat talk on body dissatisfaction and eating behavior: The moderating role of dietary restraint

Although research suggests that fat talk, the normalized conversations that involve degrading one's body shape/weight and size, can increase body dissatisfaction and disordered eating behavior, the extent to which dietary restraint may moderate these relationships remains uncertain. A pilot study (N = 30) comparing online videos with researcher-developed vignettes as prospective manipulations for fat talk exposure suggested use of the vignettes as potent yet subtle stimuli. In the main study, women undergraduates (N = 116) were randomized to read a fat talk or neutral vignette and then completed standardized measures of body dissatisfaction and dietary restraint while being concurrently presented with food stimuli. Results suggest significant moderation effects for dietary restraint: whereas fat talk exposure was associated with increased body dissatisfaction among low dietary restrainers, it appeared to reduce food consumption among high dietary restrainers. Findings highlight the importance of individual differences in shaping responses to fat talk.     

Prevention programme for eating disturbances in adolescents. Is their effect on body image maintained at 30 months later?

We assessed changes in the body image of Spanish adolescents who participated in a programme aimed at preventing disordered eating, with a 30-month follow-up. 254 girls and 189 boys aged 12–14 were assigned to a control group (n = 201) or one of two possible experimental conditions: media literacy programme (ML, n = 143) and media literacy plus nutrition awareness programme (ML + NUT, n = 99). Body image was assessed with the Body Image Questionnaire (Qüestionari d’Imatge Corporal; QÜIC). Pre-test, post-test, 7- and 30-month follow-up measurements were taken. Linear model analyses were carried out with a 2 × 3 × 3 ANOVA (sex × group × phase), adjusted by the baseline level. At 30-month follow-up, ML and ML + NUT participants showed fewer body problems and more body satisfaction than the control group. There is a need for prevention programmes addressing eating and body image disturbances that involve both boys and girls.     

Positive fantasies or negative contrasts: The effect of media body ideals on restrained eaters’ mood,weight satisfaction,and food intake

Although viewing media body ideals promotes body dissatisfaction and problematic eating among women (e.g., extreme restraint/overeating), some argue that women only report such negative effects because they think that they are meant to (i.e., demand characteristics). Because restrained eaters are trying to lose weight, they might be vulnerable to such media exposure. However, because of demand characteristics, evidence is mixed. Therefore, we minimized demand characteristics and explored whether media body ideals would trigger restrained eaters to report negative (negative mood, weight dissatisfaction) or positive (positive mood, weight satisfaction) effects. We also hypothesized that this change (negative or positive) would encourage food intake. Restrained and unrestrained eaters (n = 107) memorized media or control images. Restrained eaters exposed to media images reported decreased weight satisfaction and increased negative mood, but their food intake was not significantly affected. Perhaps paying advertent attention to the images caused goal-related negative affect, which triggered restraint.     

Appearance commentary from romantic partners: Evaluation of an adapted measure

The purpose of this study was to evaluate the psychometric properties of the Verbal Commentary on Physical Appearance Scale (VCOPAS; Herbozo & Thompson, 2006b) after modifying it to capture appearance feedback given by romantic partners (VCOPAS-P). Women participants (N = 248) completed the VCOPAS-P, as well as measures of disordered eating, body image dissatisfaction, relationship quality, and socially desirable responding. Exploratory factor analysis identified the best factor structure for the VCOPAS-P, which contained three factors similar to the VCOPAS. Correlations between the VCOPAS-P subscales and measures of disordered eating, body image dissatisfaction, relationship quality, and social desirability responding demonstrated convergent and discriminant validity of the VCOPAS-P. There was a significant positive correlation between the negative comments subscale of the VCOPAS-P and the measures of body dissatisfaction and weight concern (measured by the EDE-Q). Additionally, VCOPAS-P subscales reflecting positive comments about appearance and weight were associated with greater relationship satisfaction.     

Media literacy as a prevention intervention for college women at low- or high-risk for eating disorders

This study examined whether the media literacy program, ARMED, is an effective prevention intervention for college women at low- or high-risk for an eating disorder. Changes in eating disorder risk factors were assessed in low- (n = 26) and high-risk (n = 19) women participating in a two-session media literacy intervention as compared to low- (n = 31) and high-risk (n = 16) controls. Women at high-risk for an eating disorder reported significant decreases in body dissatisfaction, drive for thinness, feelings of ineffectiveness, and internalization of societal standards of beauty after participating in ARMED, whereas control participants did not. No significant decreases in perfectionism, physical appearance comparisons, or awareness of societal standards of beauty were reported among high-risk participants. Changes in eating disorder risk factors were not found among low-risk participants, regardless of treatment condition. Findings suggest that media literacy may be an effective secondary prevention intervention for eating disorders.     

Parenting to prevent body dissatisfaction and unhealthy eating patterns in preschool children: A Delphi consensus study

Interventions to prevent body dissatisfaction and unhealthy eating patterns are needed in early childhood. Identifying effective parenting strategies would be useful for parents and prevention researchers. To develop expert consensus, an online Delphi study was conducted with experts (N = 28, M_age = 44.34) who rated statements describing potential parenting strategies gleaned from a systematic literature search. If 90–100% rated a statement as either Essential or Important, it was endorsed as a guideline. From a total of 335 statements 153 were endorsed. Despite some areas of disagreement, including whether parents should weigh their child or discourage weighing, experts were able to reach consensus on a wide range of issues, such as how to discuss healthy eating with children. The developed guidelines provide a novel and required resource for parents, and a framework for researchers developing interventions to prevent the onset of body dissatisfaction and unhealthy eating patterns in early childhood.     

Body dissatisfaction,engagement in body change behaviors and sociocultural influences on body image among Chinese adolescents

Body dissatisfaction and body image disorders are becoming increasingly prevalent in developing non-Western countries such as China, but there is a lack of research examining the sociocultural factors that in other contexts have been associated with these problems. The current study investigated body dissatisfaction, engagement in body change behaviors, and sociocultural pressures on body image, and the relationships between these variables among 517 adolescent males (N = 219) and females (N = 298) in China. Females reported greater body dissatisfaction than males, and males reported using strategies to increase their muscle bulk more often than females. Males reported pressure from a variety of sociocultural sources to increase their muscles or weight, while females reported pressure from the media to lose weight. For males body dissatisfaction was predicted by pressure from peers to increase their muscle bulk, while for females pressure to lose weight from peers, adult relatives, and the media was likely to increase body dissatisfaction. Pressure from the media and adult relatives was also predictive of body change behaviors in both males and females. The findings are discussed in relation to previous research in both Western and non-Western contexts.     

More than just body weight: The role of body image in psychological and physical functioning

The current study examined BMI and body image dissatisfaction as predictors of physical and mental health-related quality of life (HRQL) and psychosocial functioning in a sample of 414 undergraduate students (mean age = 21.5, SD = 4.9; mean BMI = 23.6, SD = 5.2). In men and women, higher BMI was correlated with body image dissatisfaction and physical HRQL, but not with any measures of psychosocial functioning, whereas higher body image dissatisfaction was associated with poorer physical HRQL and psychosocial functioning. Furthermore, body image dissatisfaction was observed to mediate the relationship between BMI and physical HRQL in men and women. Interestingly, in this model, higher BMI predicted increased self-esteem. These findings suggest that body image dissatisfaction may be an important target for health interventions.     

Étude de validation de la version française de l’Échelle d’Estime Corporelle (Body Esteem Scale) chez les adolescentes et les jeunes adultes

IntroductionThe literature of body image suggests that many women and young women suffer from body dissatisfaction and this dissatisfaction is an important risk factor for the development of eating disorders.ObjectiveThe aim of the study was to validate the French female version of the Body Esteem Scale (BES; Mendelson et al., 2001).MethodThis self-administered questionnaire assesses body esteem and includes three subscales: “Weight”, “Appearance” and “Attribution”. The questionnaire was given to a sample of 835 adolescent girls and young adults (mean age = 16.62 ± 1.50).ResultsExploratory factorial analysis yielded three factors “Weight”, “Appearance” and “Desire to modify and negative affect associated with the general appearance”, somewhat similar to those of the original validation study. The goodness-of-fit of the three factors model was satisfactory. Correlations were found between the three subscales of the BES, BMI and general self-esteem.ConclusionThe French version of the BES shows satisfactory psychometric properties and provides a useful tool for better understanding the psychological aspects of attitudes towards one's body. In France, very few questionnaires are available to measure body attitudes, despite the fact that the body dissatisfaction affects many adolescent girls and represents a risk factor for the development of eating disorders.     

Testing the Tripartite Influence Model of body image and eating disturbance among Hungarian adolescents

We tested the Tripartite Influence Model of body image and eating disturbance on two separate samples of Hungarian boys (n = 145) and girls (n = 225), aged 10–16 years. Our results supported the model among Hungarian adolescents; however we found notable gender differences. The associations were stronger in girls compared to boys; moreover, internalization and body dissatisfaction mediated the relationship between appearance-related sociocultural influences and self-esteem only in girls. BMI and weight perception were also involved in the model, and we could present evidence that the sociocultural influence and the weight perception predict independently body dissatisfaction. Our data are in line with previous results; however, further exploration of gender, age, and culture-related differences in the pattern of associations may contribute to the refinement of intervention programs.     

Athletic-ideal and thin-ideal internalization as prospective predictors of body dissatisfaction,dieting, and compulsive exercise

Although internalization of the thin ideal has been extensively researched and is now regarded as a risk factor for eating disturbance, endorsement of the firm, athletic body ideal has received only minimal attention. This short-term longitudinal study explored whether internalization of two aspects of the current cultural ideal (thinness and athleticism) prospectively predicted three potentially deleterious outcomes: body dissatisfaction, dieting, and compulsive exercise. Undergraduate women (N = 231) completed self-report measures at the beginning of the academic year and again 7 months later (N = 156 at Time 2). Athletic-ideal internalization predicted change in compulsive exercise over the 7-month study period but not body dissatisfaction or dieting; thin-ideal internalization predicted change in all three outcomes. When both internalization measures were tested simultaneously, neither contributed unique variance. Results suggest that athletic-ideal internalization is not as detrimental as thin-ideal internalization.     

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.     

Randomized Controlled Trial of an Internet-Based Cognitive-Behavioral Treatment Program for Binge-Eating Disorder

Binge-eating disorder (BED) is a prevalent health condition associated with obesity. Few people with BED receive appropriate treatment. Personal barriers include shame, fear of stigma, geographic distance to mental health services, and long wait-lists. The aims of this study were to examine the efficacy of an Internet-based cognitive-behavioral intervention for adults with threshold BED (DSM-IV) and to examine the stability of treatment effects over 12 months. Participants were randomly assigned to a 16-week Internet-based cognitive-behavioral intervention (n = 69) or a wait-list condition (n = 70). Binge-eating frequency and eating disorder psychopathology were measured with the Eating Disorder Examination–Questionnaire and the Eating Disorder Examination administered over the telephone. Additionally, body weight and body mass index, depression, and anxiety were assessed before and immediately after treatment. Three-, 6-, and 12-month follow-up data were recorded in the treatment group. Immediately after the treatment the number of binge-eating episodes showed significant improvement (d = 1.02, between group) in the treatment group relative to the wait-list condition. The treatment group had also significantly reduced symptoms of all eating psychopathology outcomes relative to the wait-list condition (0.82 ≤ d ≤ 1.11). In the treatment group significant improvement was still observed for all measures 1 year after the intervention relative to pretreatment levels. The Internet-based intervention proved to be efficacious, significantly reducing the number of binge-eating episodes and eating disorder pathology long term. Low-threshold e-health interventions should be further evaluated to improve treatment access for patients suffering from BED.     

What works in secondary schools? A systematic review of classroom-based body image programs

Governments, schools, and curriculum authorities are increasingly recognizing that body image during adolescence is a public health issue that warrants attention in the school setting. After 30 years of eating disorder prevention research, and given the current interest in this area, it seems timely to review the research on interventions to improve body image in schools. We reviewed universal-selective, classroom-based programs that have been conducted since the year 2000, among adolescents, and found 16 eligible intervention programs. Seven of these programs were effective in improving body image on at least one measure, from pre to post test, though effect sizes were small (d = 0.22–0.48). These effective programs were conducted among younger adolescents 12.33–13.62 years, and included activities focusing on media literacy, self esteem, and the influence of peers. Implications for school personnel and curriculum authorities are discussed, and we provide recommendations for a strategic approach to future research in this area.     

Factor structure of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) among adolescent boys in China

There is considerable evidence that mass media portrayals of body image contribute to body dissatisfaction, yet the assessment of perceived media influences has been examined fleetingly in highly populated, non-Western cultures, particularly among young males. This research examined the factor structure of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) among adolescent boys in China. In an initial exploratory factor analysis (N = 719), a four factor solution emerged with components reflecting General Pressure-Internalization, Sources of Appearance Information, Pressure-Internalization of an Athletic Ideal, and Pressure to be Thin. Subsequently, confirmatory factor analyses in a new sample (n = 749) assessed fits of the derived four factor model, a three factor variant, and alternatives reflecting “Western” and “Malay” SATAQ-3 solutions. The derived four factor solution had the most acceptable structure across several fit indices. Patterns of correlation with other self-report measures also provided preliminary support for the validity of the derived solution.