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PubMed1994

Factor analysis of multiple measures of body image disturbance: are we all measuring the same construct?

Two studies were conducted to determine the overlap among multiple measures of subjective body image disturbance. Study 1 was conducted on 219 adolescent females (ages 14-18 years) who completed seven widely used indices of self-reported body image disturbance. Study 2 involved 162 college females (ages 17-35 years) and six measures of disturbance, five of which were identical with those instruments used in Study 1. Factor analyses indicated the existence of two factors in the adolescent sample, however, one factor was quite strong and accounted for most of the variance. Analyses on the adult subjects revealed the existence of a single body image factor. It was concluded that the measures under investigation largely reflect an underlying single factor of body image, despite their common usage in the literature as indicators of multiple aspects of body image disturbance.

Adolescent↗

PubMedDate not supplied

Body image dimensions and cancer: a heuristic cognitive behavioural model.

The term body image has been associated with a multitude of definitions within psychosocial oncology. It is well known that cancer and cancer treatments often have a negative impact on appearance-related variables. A growing literature has emerged in recent years on the psychological aspects of changed appearance. This work has mainly addressed weight-related appearance and the psychology of eating disorders. A number of themes have emerged from this work. These themes have been strongly influenced by a cognitive behavioural perspective. There seems, however, to have been few attempts to integrate findings from such work with attempts to understand cancer-related appearance changes. This paper outlines some of the key developments within body image psychology and suggests a heuristic cognitive behavioural model that could be applied to the assessment, conceptualisation and treatment of body image disturbance among cancer patients.

Body Image↗

PubMed1999

Body image perception in relation to recent weight changes and strategies for weight loss in a nationally representative sample in the European Union.

OBJECTIVES: To assess body image perception and satisfaction with current body image across the EU and to explore the influence of sociodemographic variables, body-weight change and strategies for losing weight on body image perception. DESIGN: A cross-sectional study in which quota-controlled, nationally representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. SETTING: The survey was conducted in the 15 member states of the EU between March and April 1997. SUBJECTS: The questionnaire was completed by 15,239 subjects (aged 15 years and upwards). Data were weighted by population size for each country and by sex, age and regional distribution within each member state. RESULTS: Just 39% of respondents in the EU were satisfied with their weight and these were more likely to be male (46%) rather than female (31%). Across the EU 29% of Finnish subjects were content with their weight compared with 47% in Belgium and 48% in Luxembourg. The highest percentage of subjects who were content with their body weight was among females who were underweight (58%) and males who were normal weight (66%). A further 20% of underweight females wished to be lighter compared to only 5% of males. Diet was the most frequently selected method for losing weight especially among females wishing to be considerably lighter (27%) while males were as likely to use exercise as diet as a strategy to lose weight. CONCLUSIONS: Geographical and sociodemographical influences on body image perception are evident across the EU. There were clear gender differences in the desire to be thinner with a high proportion of females who were underweight being content to be so.

Adolescent↗

PubMed1990

Body-image distortion among male and female college and high school students, and eating-disordered patients.

For 179 male and female college and high school students, and 26 female eating-disordered patients body-image distortion was measured using a computer-based image-analysis of redrawn images of standardized human figures. Statistical analysis indicated that body-image distortion was the same for all groups. Body-image distortion was significantly and negatively related to weight:height ratio as a function of a simple polynomial. These results suggest this evaluation of distortion of body-image yields a quantitative measure reliably related to weight status but also suggests the technique, and possibly measurement of body-image distortion in general, may not be a valid discriminator between eating-disordered and normal persons.

Adolescent↗

PubMed1998

Study of eating attitudes and body image perception in the preadolescent age.

Eating attitudes and body image have been studied in a group of 109 girls, pupils of the fifth primary school grade (average age 10 years and 8 months). The Children's Eating Attitude Test (ChEAT) has been used in the study of eating attitudes. The mean questionnaire score is 11.38 +/- 8 with a range of 0 to 45. Fourteen girls (12.8%) had a total score higher than 20, making them an eating disorder risk group. A set of seven schematic figures showing silhouettes of girls ranging from very thin to very heavy has been used in the study of body image perception. The girls were supposed to indicate the figure having the highest resemblance to their own figure (self figure), and the figure they would like to have (ideal self figure). The mean value of the current figure was 4.28, and that of the ideal figure 3.95. Satisfaction with their figure was expressed by 46.79% of the girls; 39.45% wanted to be thinner, and 13.45% to be heavier. When these data were compared with BMI, 27.52% (of the total) of the girls wanting to be thinner were found to have a normal BMI, and 11.93% a > 95 centile BMI. Among the girls satisfied with their figure 2 had a low and 2 a high BMI, while 43.12% were within the normal BMI range. Out of the 13.45% of girls wanting to be heavier, 6.42% (of the total) had a low BMI, 6.42% a normal BMI, and 0.92% (one girl) a > 95 centile BMI. The girls were divided into two groups in terms of the ChEAT score: ChEAT+ (anorexia risk) and ChEAT-. The groups differed in terms of body weight and BMI (the ChEAT+ group was heavier); ChEAT+ girls tended to prefer a thinner figure and experienced themselves as being heavier.

Attitude↗

PubMed1991

Disturbed body image in patients with eating disorders.

OBJECTIVE: The authors attempt to answer the question of whether patients with eating disorders experience more distortions in body image than do individuals without eating disorders. METHOD: The study group was composed of 214 women out of 230 patients consecutively admitted to an inpatient eating disorders program. Twelve men and four patients with atypical eating disorders were excluded from study. The 214 patients were divided into three groups: 87 with anorexia nervosa alone, 72 with anorexia and bulimia nervosa, and 55 with bulimia nervosa alone. The comparison group was composed of 61 women drawn from 125 consecutive participants in a survey of university students. Fifty-six men were dropped from the comparison group, along with eight women who fulfilled diagnostic criteria for eating disorders. Each subject used a three-dimensional measure to rate her body size and stated her desired body size at seven points: left biceps, left calf, left thigh, waist, abdomen, hips, and bust. The subjects' measurements at each of these points were taken. Distortion in body image was calculated as the subject's perceived body size divided by her actual body size. All subjects were also given a battery of tests of intelligence, skill, and memory. RESULTS: All three patient groups differed significantly from the comparison group in distortions in body image. Most but not all patients with eating disorders had distortions in their body image. CONCLUSIONS: If replicated, these findings would suggest that the diagnostic criteria regarding disturbance of body image for both anorexia and bulimia need to be revised.

Anorexia Nervosa↗

PubMed2026

Indigenous body image amid rapid social and economic change: A reflexive thematic analysis of Wayuu narratives.

The Wayuu, Colombia's largest Indigenous group, are experiencing rapid social, economic, and technological change, including expanding internet access, educational opportunities, and increasing exposure to globalised media. Though the harmful effects of appearance-idealised media imagery on body image are well documented, indigenous body image research remains unevenly distributed across global contexts, with Latin American Indigenous communities particularly underrepresented. This study explored how Wayuu people understand and experience appearance ideals and body image in the context of expanding digital media exposure and rapid sociocultural and economic change. Five focus groups of up to 9 participants were conducted with 29 Wayuu participants (18-68 years; 23 women, 6 men). Using reflexive thematic analysis, three overarching themes were identified: (1) Intersecting sources of appearance pressure: encompassing influences from social media, Wayuu family expectations, and discrimination from non-Indigenous peers; (2) Negotiating and resisting appearance ideals: from body dissatisfaction and restrictive eating to affirmation of cultural identity as protection; and (3) The changing role of appearance in today's Wayuu culture: participants linked globalised appearance ideals to expanding educational opportunities, migration, digital connectivity, and broader socioeconomic transformations occurring within Wayuu territories. While exposure to global ideals fostered comparison and dissatisfaction, cultural pride and collective belonging appeared to buffer against internalised colonial values. Culturally grounded media literacy and education initiatives co-developed with Wayuu communities could foster critical reflection while strengthening heritage. These results highlight the need for decolonial, community-based approaches to body image research and intervention in Indigenous contexts.

Adolescent↗

PubMed1987

The differential importance of weight and body image among college men and women.

Among a sample of American college students, body image and the degree of desired weight change were associated with academic self-rankings, with social and psychological well-being, and with the development of eating difficulties. The effects of body image and desired weight change on eating disorders were generally found to be greater for women than for men, and their effects on student self-rankings of academic ability, social, and psychological traits were more pervasive for women than for men. The less attractive a woman perceived herself to be and the more weight she wanted to lose, the greater was her overall sense of academic, social, and psychological impairment. Women who had poor body images and who desired to lose weight were more likely to report eating difficulties.

Body Image↗

PubMed2002

An evaluation of the construct of body image.

The two studies reported in this paper were designed to evaluate the efficacy of a multidimensional model of body image that incorporated the dimensions of perception, affect, cognition, and behavior. Study 1 selected items from established measures that were judged to reflect these four dimensions. This four-factor model was then tested in Study 2. The participants for Study 2 were 175 females. The results did not support the hypothesized four-factor model. An exploratory factor analysis revealed a model that consisted of three factors: Cognitions and Affect Regarding Body, Body Importance and Dieting Behavior, and Perceptual Body Image. Below-average-weight respondents rated the Cognitions and Affect Regarding Body factor as more important than did above-average-weight respondents. Below-average-weight respondents overestimated their body size, whereas average-weight and above-average-weight respondents made underestimates, with above-average-weight respondents underestimating their body size to a greater extent than average-weight respondents. The results highlight the multidimensionality of the body image construct and the difficulty in attempting to simplify this construct. Implications of these findings for better understanding problems among people with disturbed body image are discussed.

Adolescent↗

PubMed1999

Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls.

This study explored friendship variables in relation to body image, dietary restraint, extreme weight-loss behaviors (EWEBs), and binge eating in adolescent girls. From 523 girls, 79 friendship cliques were identified using social network analysis. Participants completed questionnaires that assessed body image concerns, eating, friendship relations, and psychological family, and media variables. Similarity was greater for within than for between friendship cliques for body image concerns, dietary restraint, and EWLBs, but not for binge eating. Cliques high in body image concerns and dieting manifested these concerns in ways consistent with a high weight/shape-preoccupied subculture. Friendship attitudes contributed significantly to the prediction of individual body image concern and eating behaviors. Use of EWLBs by friends predicted an individual's own level of use.

Adolescent↗

PubMed2026

Instruments for measuring body image in breast cancer patients: a systematic review of measurement properties.

PURPOSE: To evaluate the psychometric properties of PROMs for measuring body image in breast cancer patients. METHODS: In December 2024, a psychometric systematic review was performed in the nine databases. The COSMIN checklist was employed to evaluate the methodological quality and psychometric properties of the included body image measures. The level of evidence was assessed using the GRADE framework, and final recommendations were formulated for the scale. RESULTS: Thirty-eight articles evaluating fifteen PROMs were included in this review. Structural validity, internal consistency, and hypothesis testing had been most frequently evaluated. Measurement error had not been assessed for all PROMs. Twelve instruments show potential application value but require further research. The BAS-BC, PSPP, and ASI-R are not recommended for use, as these instruments do not meet the strict COSMIN thresholds for full recommendation. CONCLUSION: The BIS can be recommended as a temporary screening tool for assessing body image outcome in clinical practice. The BIRS can be tentatively advised for measuring specific postoperative body image changes. However, further comprehensive studies are required to validate the psychometric properties of existing PROMs.

Female↗

PubMed2000

Clinical implications of body image among rural African-American women.

OBJECTIVE: To increase understanding of body image among rural, African-American women through open-ended interviews. DESIGN: Individuals' perceptions of body image were investigated using open-ended, in-depth interviews that were tape-recorded, transcribed, and analyzed to identify common themes and to compare thematic data across three body mass index categories (obese, overweight, and normal). SETTING: University-affiliated rural community health center. PARTICIPANTS: Twenty-four African-American women, aged 21 to 47 years. MAIN RESULTS: Respondents reported the following common themes: dissatisfaction with current weight; fluctuating levels of dissatisfaction (including periods of satisfaction); family and social pressure to be self-accepting; and social and physical barriers to weight loss. The interviews revealed ambivalence and conflicts with regard to body image and weight. Among these women, there was strong cultural pressure to be self-accepting of their physical shape, to "be happy with what God gave you," and to make the most of their appearance. CONCLUSIONS: The pressure to be self-accepting often conflicted with these obese women's dissatisfaction with their own appearance and weight. Although the respondents believed they could lose weight "if [they] put [their] mind to it," those women wanting to lose weight found that they lacked the necessary social support and resources to do so. The conflicts stemming from social pressures and their own ambivalence may result in additional barriers to the prevention of obesity, and an understanding of these issues can help health care providers better address the needs of their patients.

Adult↗

PubMed2006

Body image and sexual problems in young women with breast cancer.

PURPOSE: The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. BACKGROUND: Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. METHODS: A multi-ethnic population-based sample of 549 women aged 22-50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. RESULTS: Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. CONCLUSIONS: Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer.

Adult↗

PubMed2006

Body image differences among Malay, Samoan, and Australian women.

Comparisons of body attitudes and associated behaviours were undertaken using Malay, Samoan, and Australian female students. The general goal of the research was to determine the degree to which the observed pattern of attitudes and behaviours was attributable to culture. The specific analyses comprised an examination of group differences using standard measures that included the Body Attitudes Questionnaire, the Three-Factor Eating Questionnaire and detailed questions concerning the use of diet and exercise as weight control strategies. The main findings concerned a number of cultural differences, particularly in relation to diet and exercise, that were evident even with the effect of body mass index held constant. These results are interpreted in terms of the efficacy of entrenched cultural beliefs in protecting against introduced, more dominant, cultural values. The Australian sample exhibited the most negative body image, although there was some evidence that Malays and Samoans were influenced by Western ideals of weight and shape. It is proposed that to fully understand the differential meaning of negative body image across cultures and the potential impact of westernisation, both within-group and between-group differences in body size need to be acknowledged.

Adult↗

PubMed1998

The role of family status and ethnic group on body image and eating behavior.

OBJECTIVE: To examine the role of ethnic group and family status on body dissatisfaction and eating behavior. METHOD: One hundred women (Asian mothers and daughters, n = 50; white mothers and daughters, n = 50) completed a questionnaire about their perceived ethnic identity (acculturation), body image, and eating behavior. RESULTS: The results showed no matching between mothers and daughters and no effect of acculturation on body image and eating behavior. However, mothers reported greater body dissatisfaction and white subjects reported higher levels of restrained eating. In addition, the results showed a significant Ethnic Group x Family Status interaction for both body image and eating behavior irrespective of body mass index (BMI). Accordingly, white daughters were found to be the most dissatisfied with their bodies and most concerned with the calorie content of their food, followed by the Asian mothers. White mothers were found to be the most satisfied with their body and Asian daughters were the least concerned with calories. DISCUSSION: The results are discussed in terms of the changing nature of media images in both Asian and white cultures and the impact of the transition between these two cultures.

Acculturation↗

PubMedDate not supplied

Comparison of the effects of walking and weight training programs on body image in middle-aged women: an experimental study.

Purpose. This study was conducted to determine the effect of a resistive training intervention on body image in middle-aged women compared to an exercise walking program. Another purpose was to develop two multivariate models to explain improvement in body image among the lifters and walkers. Design. A pretest-posttest experimental design with random assignment of subjects to two exercise groups was employed. Setting. Subjects trained in their own homes and were tested at the university. Subjects. Participants were 60 women recruited from the local community with an average age of 42.5 +/- 4.2 years. Intervention. Subjects were randomly assigned to a resistive training or exercise walking program, both of which were three days per week and 12 weeks in duration. Measures. Body cathexis was assessed using the Body Cathexis Scale; cardiovascular endurance was measured using the one-mile walk test, and muscular strength was assessed using standard weight training procedures. Results. After completion of the exercise interventions, lifters showed greater muscular strength than walkers, and walkers displayed greater cardiorespiratory endurance than lifters, as expected. Lifters also improved significantly more in body image than the walkers. Conclusions. Participation in a three-day-per-week resistive training program seems to improve body image in middle-aged women more than participation in a three-day per week walking program. Further, it appears that hard work and fitness improvements contribute significantly toward positive changes in body image.

Adult↗

PubMed1999

Body image, perceived pubertal timing, and adolescent mental health.

PURPOSE: To examine the impact of gender, racial-ethnic group, and perceived pubertal timing on body image and adolescent mental health. METHOD: A three-stage, area probability sample was selected which included 877 teens (13-18 years) with diverse social and demographic characteristics. Interviews in English or Spanish were conducted in person. The content emphasized emotional distress and problematic behavior, exposure to social stressors, coping resources and behaviors, and socioeconomic and demographic characteristics of the adolescent and his or her family. RESULTS: Girls were more depressed and had lower self-esteem than boys, but not after controlling for body image. Hispanics were more depressed and had lower self-esteem than other racial-ethnic groups, a difference that remained when controlling for body image. African-Americans had the most positive body image, a finding that could not be attributed to higher self-esteem or fewer depressive symptoms. The impact of perceived pubertal timing on body image varied considerably by gender and across racial-ethnic group. CONCLUSIONS: Negative feelings about their bodies contribute to the higher prevalence of depressive symptomatology and lower self-esteem among girls. African-Americans appear to take pride in their bodies in a manner that sets them apart from other teenagers, suggesting they hold a different ideal. Relative to teenagers of other racial-ethnic backgrounds, Hispanics may be at elevated risk for mental health problems.

Adolescent↗

PubMed2005

Men, muscles, and body image: comparisons of competitive bodybuilders, weight trainers, and athletically active controls.

OBJECTIVES: To investigate body image and psychosocial adjustment among competitive bodybuilders, non-competitive weight trainers, and athletically active men. METHODS: Participants were 40 men in each of the three groups who were assessed on body composition and multiple facets of body image evaluation, investment and anxiety, eating attitudes, and social self esteem. RESULTS: Relative to the other two groups, competitive bodybuilders had greater body mass due to fat-free body mass. Although groups did not differ in their situational body image discomfort, competitive bodybuilders and weight trainers had a more positive global appearance evaluation and were more psychologically invested in their physical appearance. Compared with active controls, men in both weightlifting groups were more satisfied with their upper torso and muscle tone. Competitive bodybuilders reported more mid torso satisfaction than the other two groups. Competitive bodybuilders also wished to be significantly heavier than controls did and reported higher social self esteem but greater eating disturbance. CONCLUSIONS: The findings suggest that competitive bodybuilders as a group are not more "muscle dysmorphic" than either non-competitive weight trainers or physically active men who do not train with weights.

Adult↗