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.     

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.     

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.     

Bulimic symptoms and body image dissatisfaction in college women: more affected by climate or race?

The authors examined bulimic symptoms and body image dissatisfaction (BID) in a sample of college women. No differences were found in comparisons of bulimic symptoms or BID between Southern and Northern White women, and both groups reported similar levels of awareness and internalization of sociocultural aesthetic standards of appearance. Southeastern Black women reported (a) significantly lower levels of bulimic symptoms in comparison with White women from the North and (b) lower levels of BID in comparison with White women from both Southern and Northern regions. Further, Southeastern Black women were significantly less likely to be aware of and endorse mainstream standards of appearance in comparison with both groups of White women. Findings support the hypothesis that having a positive body image and less susceptibility to mainstream aesthetic standards of appearance may reduce the risk of eating disorder pathology in Black women.     

Bulimic Symptoms and Body Image Dissatisfaction in College Women: More Affected by Climate or Race?

The authors examined bulimic symptoms and body image dissatisfaction (BID) in a sample of college women. No differences were found in comparisons of bulimic symptoms or BID between Southern and Northern White women, and both groups reported similar levels of awareness and internalization of sociocultural aesthetic standards of appearance. Southeastern Black women reported (a) significantly lower levels of bulimic symptoms in comparison with White women from the North and (b) lower levels of BID in comparison with White women from both Southern and Northern regions. Further, Southeastern Black women were significantly less likely to be aware of and endorse mainstream standards of appearance in comparison with both groups of White women. Findings support the hypothesis that having a positive body image and less susceptibility to mainstream aesthetic standards of appearance may reduce the risk of eating disorder pathology in Black women.     

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.     

Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study

Objective

Use classification tree analysis with lagged predictors to determine empirically derived cut-points for identifying adolescent girls at risk for future onset of threshold, subthreshold, and partial eating disorders and test for interactions between risk factors that may implicate qualitatively distinct risk pathways.

Method

Data were drawn from a prospective study of 496 adolescent girls who completed diagnostic interviews and surveys annually for 8 years.

Results

Body dissatisfaction emerged as the most potent predictor; adolescent girls in the upper 24% of body dissatisfaction showed a 4.0-fold increased incidence of eating disorder onset (24% vs. 6%). Among participants in the high body dissatisfaction branch, those in the upper 32% of depressive symptoms showed a 2.9-fold increased incidence of onset (43% vs. 15%). Among participants in the low body dissatisfaction branch, those in the upper 12% of dieting showed a 3.6-fold increased incidence onset (18% vs. 5%).

Conclusion

This three-way interaction suggests a body dissatisfaction pathway to eating disorder onset that is amplified by depressive symptoms, as well as a pathway characterized by self-reported dieting among young women who are more satisfied with their bodies. It may be possible to increase the effectiveness of prevention programs by targeting each of these qualitatively distinct risk groups, rather than only individuals with a single risk factor.     

Testing a Moderated Mediation Model of Objectification Theory among Black Women in the United States: The Role of Protective Factors

Recent studies find that Black women experience rates of eating pathology and body dissatisfaction comparable to those of White women. Abundant research suggests that objectification theory could help explain the development and maintenance of eating disorder (ED) symptoms among diverse women. However, research on the applicability of objectification theory to ED symptoms in Black women is equivocal. Specifically, some have suggested that body surveillance might operate differently for Black women. Thus, the current study examined ethnic-racial identity (ERI) commitment and body appreciation as moderators of the mediated associations among body surveillance, body shame, and ED symptoms. Black women (n?=?175) in the United States completed measures of body image, ERI commitment, and ED symptoms. Consistent with objectification theory, body shame mediated the association between body surveillance and ED symptoms. Contrary to our hypothesis, ERI commitment did not moderate the link between body surveillance and body shame. However, body appreciation was a significant moderator, such that the strength of the relation between body surveillance and ED symptoms via body shame was weakened at high levels of body appreciation. Future work should consider interventions that foster body appreciation in Black women.

     

An ecological momentary assessment of the effects of weight and shape social comparisons on women with eating pathology, high body dissatisfaction, and low body dissatisfaction

This research examined the effects of naturally occurring appearance comparisons on women's affect, body satisfaction, and compensatory cognitions and behaviors. Using ecological momentary assessment, women with high body dissatisfaction and eating pathology (EPHB), high body dissatisfaction (HB), or low body dissatisfaction (LB) recorded their reactions to appearance-focused social comparisons. EPHB and HB women made more upward appearance comparisons than LB women. All women experienced negative emotions and cognitions after upward comparisons, including increased guilt, body dissatisfaction, and thoughts of dieting. EPHB women were most negatively affected by comparisons; they experienced more intense negative emotions, more thoughts of dieting/exercising, and an increase in eating-disordered behavior after upward comparisons. HB women experienced more negative affective consequences and thoughts of dieting than LB women. Results are consistent with social comparison theory and provide important information that may be used to inform eating disorder treatment and prevention efforts.     

Body Dissatisfaction and Eating Disorder Symptomatology: A Latent Structural Equation Modeling Analysis of Moderating Variables in 18-to-28-Year-Old Males

ABSTRACT. Although body dissatisfaction is recognized as the strongest risk factor for eating disturbances, a majority of young males are body dissatisfied, but do not concomitantly report severe levels of eating disorder symptomatology. The present investigation was designed to examine five theoretically relevant variables (i.e., body checking, emotional dysregulation, perfectionism, insecure-anxious attachment, and self-esteem) as potential moderators of the relationship between body dissatisfaction and two critical components of male eating disorder symptomatology: drive for muscularity and bulimic behaviors. Data collected from 551 Italian males between 18 and 28 years old were analyzed using latent structural equation modeling. The authors found that emotional dysregulation, body checking, insecure-anxious attachment and perfectionism intensified the relationship between body dissatisfaction and each criterion variable representing male eating disorder symptomatology; the interactions accounted respectively for an additional 2%, 7%, 4% and 5% of variance in drive for muscularity and for an additional 6%, 4%, 5%, and 2% of the variance in bulimic behaviors. By contrast self-esteem weakened this relationship and the interactions accounted for an additional 3% of the variance in both drive for muscularity and bulimic behaviors. Implications of these findings for prevention and treatment of male eating disturbances are discussed.     

Body dissatisfaction and irrational beliefs

To test the hypothesis that the irrational evaluative beliefs, postulated by Rational-Emotive Behavior Therapy, are associated with body dissatisfaction, 94 women (21 diagnosed with an eating disorder, 38 with high body dissatisfaction but without an eating disorder, and 35 with low body dissatisfaction) completed the Survey of Personal Beliefs and the Eating Disorders Inventory. Analysis showed no significant difference in body dissatisfaction between the Eating Disordered and High Body Dissatisfaction subgroups. No significant correlations between body dissatisfaction and irrational beliefs were found for the Eating Disordered subgroup. For the High Body Dissatisfaction subgroup, significant but low correlations were found between scores on body dissatisfaction and irrational standards for self and others and with negative self-rating. In terms of irrational beliefs the Eating Disordered and High Body Dissatisfaction subgroups showed a significantly greater tendency towards Catastrophizing, Low Frustration Tolerance, and Negative self-rating, compared to the controls, without any significant difference between the former two groups. The Eating Disordered subgroup but not the High Body Dissatisfaction subgroup differed significantly from the controls in terms of more Self-directed demands.     

Perfectionistic self-presentation, body image, and eating disorder symptoms

A specific model for eating disorder symptoms involving perfectionistic self-presentation and two different moderators (i.e., body image evaluation and body image investment) was tested. Participants completed measures of perfectionistic self-presentation, body image dysfunction, and eating disorder symptoms. Findings indicated that all three dimensions of perfectionistic self-presentation were associated with eating disorder symptoms. Results also showed that perfectionistic self-presentation predicted eating disorder symptoms in women who were dissatisfied with their bodies, but that it did not predict eating problems in women who liked their bodies and felt there was little or no discrepancy between their actual and ideal appearances. Body image investment did not moderate the relationship between perfectionistic self-presentation and eating disorder symptoms, suggesting that ego-involvement alone is insufficient to promote eating disturbance in the context of perfectionism. The importance of self-presentation components of perfectionism and specific body image difficulties in predicting eating disorder symptoms are discussed.     

An evaluation of the reliability and construct validity of eating disorder measures in White and Black women

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.     

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.     

FEMINIST IDENTITY, GENDER TRAITS, AND SYMPTOMS OF DISTURBED EATING AMONG COLLEGE WOMEN

This study explored relationships among feminist identity, gender traits, and symptoms of disturbed eating. Seventy-one college women completed the following: weight-related questions, Feminist Identity Development Scale, Personal Attributes Questionnaire, Figure Rating Scale, and Eating Disorders Inventory. Identification with feminist values negatively correlated with body dissatisfaction, bulimic symptoms, and feelings of ineffectiveness. Identification with stereotypical masculine traits was inversely related to perfectionist tendencies and feelings of ineffectiveness, but was unrelated to body concerns. These results suggest factors promoting body dissatisfaction and disturbed eating may have less impact on college women identifying with feminist values, such as commitment to nonsexist roles and personal empowerment.     

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.     

Teasing, acculturation, and cultural conflict: psychosocial correlates of body image and eating attitudes among South Asian women

The current study examined sociocultural correlates of body dissatisfaction and maladaptive eating attitudes among 74 South Asian American women. Participants completed measures assessing three forms of teasing--general appearance, weight/shape, and ethnic--as well as thin-ideal internalization, acculturation, cultural conflict, body dissatisfaction, and maladaptive eating attitudes. Results indicated that all three types of teasing and cultural conflict were significantly related to body dissatisfaction and maladaptive eating attitudes. Cultural conflict was found to mediate the relationship between ethnic teasing and body dissatisfaction. Neither thin-ideal internalization nor acculturation was significantly associated with either body dissatisfaction or maladaptive eating attitudes. However, body dissatisfaction was found to mediate the relationship between weight/shape teasing and maladaptive eating attitudes. Implications of these findings and possible future directions for research on South Asian American women are discussed.     

Role of Sexual Orientation and Gender-Related Traits in Disordered Eating

This study was designed to examine the role of both sexual orientation and gender-related personality traits in disordered eating attitudes and behavior, including body dissatisfaction. Self-report measures assessing negative and positive gender traits,body dissatisfaction, drive for thinness, dietary restraint, and bulimic symptoms were administered to 266 participants (64 lesbians, 73 heterosexual women, 69 gay men, and 60 heterosexual men; 85% Anglo-Australian Caucasians, 15% Caucasians from Non-English-speaking backgrounds). Consistent with previous research, gay men scored significantly higher than heterosexual men on body dissatisfaction and dietary restraint, whereas lesbians scored significantly lower in comparison to the heterosexual women on body dissatisfaction, drive for thinness, dietary restraint, and bulimia. For men, the additional amount of variance accounted by the gender traits was significantly higher than that accounted for by sexual orientation. For the women, the gender traits also accounted for an additional significant amount of variance; however, overall the amount of variance accounted for by sexual orientation was greater. However, for both men and women, irrespective of their sexual orientation, it was higher scores on negative femininity that predicted higher levels of disordered eating. These results are consistent with previous studies that have found support for the femininity hypothesis in disordered eating.     

An examination of body tracing among women with high body dissatisfaction

Within eating disorder treatment programs, a body tracing activity is often used to address body dissatisfaction and overestimation of body size; however, the effects of this activity have never been empirically evaluated. This research examined the effects of body tracing on body dissatisfaction and mood among 56 female participants assigned to either a body tracing or control group. Scores were collected on trait body dissatisfaction and a series of Visual Analogue Scales (VAS). Results showed that trait body dissatisfaction moderated the relationship between group and levels of state appearance dissatisfaction and anxiety. These results suggest that individuals experiencing higher levels of trait body dissatisfaction demonstrated greater state body dissatisfaction following participation in the body tracing activity. Individuals with lower trait body dissatisfaction experienced greater anxiety after drawing a human body. These findings have potential implications for the use of this strategy in the treatment of eating disorder patients.     

Mediators in the dissonance eating disorder prevention program

Previous research has supported thin-ideal internalization as a partial mediator of the effects of the dissonance eating disorder prevention program. The current study replicated previous findings and examined an additional mediator, body dissatisfaction, hypothesized to account for partial intervention effects. As a secondary goal, we developed a more rigorous and accurate test of mediation that accounted for the temporal, causal interplay between mediator and outcome, and controlled for “reverse mediation”. Results from a sample of 71 high-risk females (M age = 19.8, SD = 1.3) who participated in a four-week dissonance intervention supported thin-ideal internalization as a partial mediator of the effects of the dissonance intervention on bulimic symptoms, even after controlling for body dissatisfaction as a second mediator. Furthermore, results supported body dissatisfaction as a partial mediator for bulimic symptoms after controlling for thin-ideal internalization. Significant “reverse mediation” effects suggested the reciprocal influence of some risk factors for bulimia nervosa and bulimic symptoms. These results contribute to our understanding of the mediators in the dissonance intervention, which can help refine eating disorder prevention programs.