Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis

This study uses prospective data from a survey of 1,177 adolescent girls to examine whether emotional eating, binge eating, abnormal attitudes to eating and weight, low self-esteem, stress, and depression are associated with dietary restraint or body dissatisfaction. In analyses that included both restraint and body dissatisfaction as independent predictors, restraint was associated only with more negative attitudes to eating, whereas body dissatisfaction was significantly associated with all the adverse outcomes. These results cast doubt on the proposition that restrained eating is a primary cause of bulimic symptoms, emotional eating, and psychological distress seen in individuals who are trying to control their weight, and rather suggest that body dissatisfaction is the key factor.     

Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation.

Because little is known about the predictors of binge eating (a risk factor for obesity), a set of putative risk factors for binge eating was investigated in a longitudinal study of adolescent girls. Results verified that binge eating predicted obesity onset. Elevated dieting, pressure to be thin, modeling of eating disturbances, appearance overvaluation, body dissatisfaction, depressive symptoms, emotional eating, body mass, and low self-esteem and social support predicted binge eating onset with 92% accuracy. Classification tree analysis revealed an interaction between appearance overvaluation, body mass, dieting, and depressive symptoms, suggesting qualitatively different pathways to binge eating and identifying subgroups at extreme risk for this outcome. Results support the assertion that these psychosocial and biological factors increase risk for binge eating.     

A comparison of retrospective self-report versus ecological momentary assessment measures of affective lability in the examination of its relationship with bulimic symptomatology

Affective lability has been linked to several maladaptive behaviors ( [Anestis et?al., 2009] and [Coccaro, 1991]). Methodology for measuring affective lability varies and includes retrospective self-report and ecological momentary assessment (EMA). In this study, we sought to test these methodologies by examining which better predicted binge eating episodes and general eating disorder symptoms in a sample (n = 131) of women diagnosed with bulimia nervosa (BN). We hypothesized that, while the two forms of measurement would be correlated with one another and predict binge eating episodes, EMA affective lability would be the stronger predictor. Results supported several hypotheses. Specifically, both EMA affective lability and retrospective self-report affective lability significantly predicted global eating disorder symptoms, even when controlling for depression, age, body mass index, and level of education, EMA affective lability exhibited a significantly stronger correlation with binge eating episodes than did retrospective self-report affective lability, and EMA affective lability predicted number of binge eating episodes on any given day controlling for the same list of covariates. Limitations include the use of a clinical sample that may limit the generalizability of our findings. Findings highlight the importance of affect in such behavior.     

Overconcern with weight and shape is not the same as body dissatisfaction: evidence from a prospective study of pre-adolescent boys and girls

Overconcern with weight and shape and body dissatisfaction have both emerged as significant predictors of disordered eating. However, it is unclear how these constructs relate to each other, and if each has different antecedents and consequences. This study aimed to identify prospective predictors of each construct and to determine their relative importance in predicting dietary restraint and binge eating. Eight- to 13-year-old boys and girls (N = 259) were assessed at baseline and one-year follow-up, using a range of measures that included the Child Eating Disorder Examination. Psychosocial variables predicted overconcern with weight and shape whilst objective weight predicted body dissatisfaction. Body dissatisfaction and weight and shape concern predicted restraint, and weight and shape concern and restraint predicted binge eating. Findings provide support for the theoretical differences between body dissatisfaction and overconcern with weight and shape, and highlight the importance of focusing on specific body image variables.     

A Preliminary Investigation of Body Dissatisfaction and Eating Disorder Symptomatology with Bisexual Individuals

Body dissatisfaction and eating disorder symptomatology were examined in bisexual individuals (n?=?139 women, n?=?37 men) and compared to lesbian/gay (n?=?51 women, n?=?96 men) and heterosexual individuals (n?=?82 women, n?=?34 men) in a U.S. online sample. Age, body mass index (BMI), income, and exercise frequency served as covariates. MANCOVA results showed a significant gender by sexual orientation interaction and significant main effects of gender and sexuality. Univariate tests were used to explore multivariate results. ANCOVA results for body dissatisfaction showed a significant gender by sexual orientation interaction. Post-hoc comparisons revealed higher levels of body dissatisfaction among all groups compared to heterosexual men. ANCOVA results for eating disorder symptomatology showed a significant main effect of sexual orientation. Post-hoc comparisons revealed higher levels of eating disorder symptoms among bisexual compared to heterosexual individuals. For bisexual men, gay community involvement, maladaptive social comparison, drive for muscularity, self-esteem, gender role orientation, and body dissatisfaction were explored as predictors of eating disorder symptomatology while controlling for age, BMI, exercise frequency, and income in a hierarchical regression analysis. The same factors, minus body dissatisfaction, were explored as predictors of body dissatisfaction in bisexual men. For bisexual women, similar factors, with the exception of drive for muscularity, were explored. Drive for muscularity predicted body dissatisfaction and exercise frequency predicted eating disorder symptomatology in bisexual men. BMI and self-esteem predicted body dissatisfaction in bisexual women; gay community involvement and body dissatisfaction predicted eating disorder symptomatology.     

Gender differences in the relationships between bullying at school and unhealthy eating and shape‐related attitudes and behaviours

Background. Previous research has found links between being a victim of bullying and reporting more unhealthy eating behaviours and cognitions, particularly in girls. However, little is known about the factors that might mediate these relationships. Aim. The present study compared the relationships between bullying, emotional adjustment, restrained eating, and body dissatisfaction in adolescent boys and girls. Sample/method. Self‐report data were collected from a sample of 11‐ to 14‐year‐olds (N= 376) on experiences of bullying, emotional symptoms, and unhealthy eating and shape‐related attitudes and behaviours. Results. Bullying, emotional symptoms, restrained eating, and body dissatisfaction were all correlated. Emotional symptoms were found to significantly mediate the relationships between verbal bullying with body dissatisfaction in girls but not in boys. Conclusions. Findings suggest that the experience of being verbally bullied places adolescent girls at risk of developing emotional problems which can then lead to body dissatisfaction. Longitudinal research is necessary to disentangle these pathways in more detail to facilitate the development of informed interventions to support children who are being bullied.     

Latent structure of dieting among female high-school students in Japan

The purpose of the present study was (1) to clarify whether individuals could be classified in terms of dieting using latent class analyses; and (2) to review the resulting classes were related to body dissatisfaction, body mass index, depressive mood, and binge eating. The present sample comprises 441 Japanese high-school girls. The optimal solution consisted of three latent classes: (1) unhealthy dieter (27%); (2) healthy dieter (39%); and (3) nondieter (34%). Inclusion in the unhealthy dieter class was predicted by body dissatisfaction and the girls in this class showed a high frequency of binge eating, while that in the other classes was not associated with any variable. This study identifies three classes with regard to dieting among female high-school students in Japan.     

Disordered Eating and Body Dissatisfaction in Transgender and Gender-Expansive Adults: An Evaluation and Integration of the Gender Minority Stress and Resilience and Tripartite Influence Models

Transgender and gender-expansive (TGE) people, including transgender and nonbinary individuals, experience elevated rates of body dissatisfaction and disordered eating compared to cisgender individuals, but little is known about why. To address this research gap, we compared the ability of TGE-specific factors as proposed in the gender minority stress and resilience (GMSR) model, general psychological factors contained in the tripartite influence (TI) model, and an integration of these frameworks to explain body dissatisfaction and disordered eating among TGE individuals. Regression analyses were conducted to test the models’ abilities to explain experiences reported in a survey of 93 U.S. TGE adults, including 43 transgender women respondents (46.2%) and 31 transgender men respondents (33.3%). Participants were diverse with regard to age (M = 34.19, SD = 12.02) and ethnoracial background (e.g., 29.0% Hispanic/Latinx, 17.2% Black/African American, 6.5% American Indian/Alaska Native; 5.4% multiracial). Results demonstrated both models’ abilities to explain body dissatisfaction and disordered eating independently, except for the relationship between body dissatisfaction and the thinness-oriented TI model. An integration of the models better explained body dissatisfaction and disordered eating compared to either model alone. Notably, some findings did not align with the two frameworks, suggesting existing models may not adequately describe pathways through which disordered eating emerges in TGE populations. Specifically, body dissatisfaction showed no significant relationship with disordered eating and was not well explained by the TI model, and higher gender identity pride was related to greater disordered eating symptoms. Implications for clinical care and future research are discussed.     

Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status

An interactive model of perfectionism, perceived weight status, and self-efficacy was tested on 406 women to predict the bulimic symptoms of binge eating and inappropriate compensatory behaviors separately. This longitudinal study assessed hypothesized vulnerabilities of high perfectionism and low self-efficacy and the stressor of feeling overweight at Time 1 and then gathered weekly assessments of binge eating, vomiting, laxative use, fasting, and diet pill use for 11 weeks. As predicted, results showed that perfectionism, weight perception, and self-efficacy interacted to prospectively predict binge eating. In particular, women high in perfectionism who felt they were overweight and who had low self-efficacy reported the most number of weeks of binge eating. This interactive model did not predict inappropriate compensatory behaviors. Future directions and clinical implications are discussed.     

Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem

An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms ( [Bardone et?al., 2000] and [Vohs et?al., 1999] ) has received mixed support. This study aimed to replicate the cross-sectional model in a clinical sample of women with eating disorders, and to investigate whether the model could predict changes in binge eating and purging at the end of treatment. Eating disorder outpatients (n = 353) completed measures of perfectionism, weight/shape concern, self-esteem, and bulimic symptoms at pre-treatment and discharge. Contrary to the hypotheses, the three-way interaction did not predict binge eating or purging cross-sectionally or prospectively as a moderator of psychotherapy outcome. It was concluded that the robustness of the interactive model seems questionable and may be impacted by an inadequate conceptualization of the perfectionism construct.     

BODY DISSATISFACTION AND DISORDERED EATING AMONG COLLEGE WOMEN IN CHINA, SOUTH KOREA, AND THE UNITED STATES: CONTRASTING PREDICTIONS FROM SOCIOCULTURAL AND FEMINIST THEORIES

Body dissatisfaction and disordered eating were compared across groups of college women from China ( n = 109), South Korea ( n = 137), and the United States ( n = 102). Based on cultural differences in the amount of exposure to Western appearance standards, particularly the thin-body ideal, sociocultural theory ( Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999 ) would predict that body dissatisfaction and disordered eating would be highest in the U.S. sample and lowest in the Chinese sample. In contrast, based on the speed and pervasiveness of changes in women's roles, feminist theory ( Bordo, 1993 ; Jeffreys, 2005 ) would predict that body dissatisfaction and disordered eating would be highest in the Korean sample and lowest in the U.S. sample. Multidimensional measures indicated the highest levels of body dissatisfaction and disordered eating in the Korean sample and the lowest levels in the U.S. sample, indicating that predictions derived from feminist theory were a better fit to the data than predictions derived from sociocultural theory. Results indicated that theoretical understandings of body dissatisfaction must recognize not only differences between Western and non-Western cultures, but also differences among non-Western cultures.     

Unique associations between young adult men's emotional functioning and their body dissatisfaction and disordered eating

Research on emotional functioning, body dissatisfaction, and disordered eating in males is predominated by studies of negative affect and emotion regulation. Other aspects of emotional functioning, namely emotion recognition and attentional biases toward emotional stimuli, have received little empirical attention. The present study investigated the unique associations between different aspects of men's emotional functioning and their disordered eating attitudes, muscularity dissatisfaction, and body fat dissatisfaction. Results from 132 male undergraduates showed that muscularity dissatisfaction was uniquely associated with both emotion regulation difficulties and an attentional bias toward rejecting faces. Body fat dissatisfaction was not uniquely associated with any aspect of emotional functioning. Disordered eating was uniquely associated with emotion regulation difficulties. Collectively, the results indicate differences in the patterns of associations between men's emotional functioning and their body dissatisfaction and disordered eating.     

Binge eating as escape from self-awareness

This article proposes that binge eating is motivated by a desire to escape from self-awareness. Binge eaters suffer from high standards and expectations, especially an acute sensitivity to the difficult (perceived) demands of others. When they fall short of these standards, they develop an aversive pattern of high self-awareness, characterized by unflattering views of self and concern over how they are perceived by others. These aversive self-perceptions are accompanied by emotional distress, which often includes anxiety and depression. To escape from this unpleasant state, binge eaters attempt the cognitive response of narrowing attention to the immediate stimulus environment and avoiding broadly meaningful thought. This narrowing of attention disengages normal inhibitions against eating and fosters an uncritical acceptance of irrational beliefs and thoughts. The escape model is capable of integrating much of the available evidence about binge eating.     

Body dissatisfaction, bulimic symptoms, and clothing practices among college women

Clothing use may be a behavioral avoidance strategy for individuals with body dissatisfaction and eating pathology. The authors administered the Body Image Avoidance Questionnaire (J. C. Rosen, D. Srebnik, E. Saltzberg, & S. Wendt, 1991), the Bulimia Test-Revised (M. Thelen, J. Farmer, S. Wonderlich, & M. Smith, 1991), and the Body dissatisfaction subscale of the Eating Disorder Inventory (D. M. Garner, M. P. Olmstead, & J. Polivy, 1983) to undergraduate college women from two universities (N = 540). Results indicated that women who were more dissatisfied with their bodies (beta = .396) and had greater disordered eating behaviors (beta = .378) were more likely to engage in clothing-related appearance-management behaviors (p < .001), including wearing apparel to camouflage their bodies; avoiding revealing, brightly colored, or tightly fitting clothing; and avoiding shopping for clothing. These findings suggest that the presence of certain clothing-related appearance-management behaviors may be a warning sign that an individual is at risk for developing an eating disorder or may currently have an eating disorder.     

Looking at Body Image: The Organization of Self-Knowledge About Physical Appearance and Its Relation to Disordered Eating

This study examined the organization of self-knowledge, with special attention to beliefs about physical appearance, in three groups of college-aged women: high body dissatisfaction with symptoms of disordered eating; high body dissatisfaction with no symptoms of disorder; and low body dissatisfaction. In the nondisordered, dissatisfied group, negative beliefs about physical appearance were organized in the self-structure in a way that isolated those beliefs and might minimize their impact and importance. This group also displayed adaptive types of self-concept organization (evaluative integration for those with important negative self-beliefs and compartmentalization for those with important positive beliefs) and effective coping strategies. Features of self-structure that characterize the nondisordered,dissatisfied group may provide a useful model for helping individuals with disordered eating cope with their negative physical appearance beliefs.     

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.     

Weight-based discrimination,body dissatisfaction and emotional eating: The role of perceived social consensus

Objective: Discrimination can have a negative impact on psychological well-being, attitudes and behaviour. This research evaluates the impact of experiences of weight-based discrimination upon emotional eating and body dissatisfaction, and also explores whether people's beliefs about an ingroup's social consensus concerning how favourably overweight people are regarded can moderate the relationship between experiences of discrimination and negative eating and weight-related cognitions and behaviours.

Research methods and procedures: 197 undergraduate students completed measures about their experiences of weight-based discrimination, emotional eating and body dissatisfaction. Participants also reported their beliefs concerning an ingroup's attitude towards overweight people.

Results: Recollections of weight-based discrimination significantly contributed to emotional eating and body dissatisfaction. However, the relationships between experiencing discrimination and body dissatisfaction and emotional eating were weakest amongst participants who believed that the ingroup held a positive attitude towards overweight people.

Discussion: Beliefs about ingroup social consensus concerning overweight people can influence the relationships between weight-based discrimination and emotional eating and body dissatisfaction. Changing group perceptions to perceive it to be unacceptable to discriminate against overweight people may help to protect victims of discrimination against the negative consequences of weight-based stigma.     

Evidenzbasierte Diagnostik und Psychotherapie bei Essstörungen

Along with the specific eating-related symptoms, eating disorders are associated with substantial psychological, social and medical sequelae. Overvaluation of body shape and weight and corresponding body dissatisfaction are a central feature of anorexia nervosa (AN) and bulimia nervosa (BN); additionally, these features are also a common symptom in individuals with binge eating disorder (BED). Regarding treatment, cognitive behavioral therapy (CBT) focuses on the distinctive features of the disorder, such as nutritional management and normalization of food intake, alteration of body image disturbances and negative feelings towards one’s body and alteration of the functional relationship between stress, negative emotions and pathological eating behavior. Interpersonal psychotherapy (IPT) instead focuses on the alteration and reduction of interpersonal problems. Following the German S3 guidelines, CBT should be the treatment of choice for BN and BED. Given the scarce empirical evidence of treatment effectiveness for AN, no specific treatment recommendation can be made for AN; however, psychotherapy and not medication should be the treatment of choice.     

EVALUATION OF A STRUCTURAL MODEL OF OBJECTIFICATION THEORY AND EATING DISORDER SYMPTOMATOLOGY AMONG EUROPEAN AMERICAN AND AFRICAN AMERICAN UNDERGRADUATE WOMEN

This study evaluated a structural equation model of objectification theory among European American (EA;  n  = 408) and African American women (AA;  n  = 233). Modeling results indicated a particularly strong association between thin-ideal internalization/body monitoring and eating disorder symptoms, with weaker relationships among body dissatisfaction, depression, anxiety, and eating disorder symptoms. The measurement model was not equivalent for EAs and AAs; however, the structural model was invariant, suggesting that the relationships among these variables may be similar for both groups. Thus, objectification theory does appear to be applicable to AA women, although specification of relevant constructs and refinement of assessment instruments is warranted.     

Susceptibility for thin ideal media and eating styles

This study examined the relations between susceptibility for thin ideal media and restrained, emotional and external eating, directly and indirectly through body dissatisfaction. Thin ideal media susceptibility, body dissatisfaction and eating styles were measured in a sample of 163 female students. Structural equation modelling was used for analyses, controlling for BMI. Higher susceptibility for thin ideal media was directly related to higher scores on all eating styles, and indirectly related to higher restrained and emotional eating through elevated levels of body dissatisfaction. So, thin ideal media susceptibility was not only related to restraint through body dissatisfaction, but also directly. Emotional eaters might be more vulnerable for negative affect, whereas external eaters might be more sensitive to external cues in general.