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Changes in prevalence of overweight and in body image among Fijian women between 1989 and 1998.

OBJECTIVE: To investigate changes in prevalence of overweight and obesity and in body image among ethnic Fijian women in Fiji during a period of rapid social change and the relationship between changes in body image and BMI. RESEARCH METHODS AND PROCEDURES: The study design was a multiwave cohort study of BMI in a traditional Fijian village over a 9.5-year period from 1989 to 1998. Cohorts were identified in 1989 (n=53) and in 1998 (n=50). Selection criteria included Fijian ethnicity, female gender, age of at least 18 years, and residence in a specific coastal Fijian village in 1989 and 1998, respectively. Assessments consisted of measurement of height and weight, collection of demographic data by written survey, and administration of the Nadroga Language Body Image Questionnaire. RESULTS: The prevalence of overweight and obesity was significantly different between the cohorts, increasing from 60% in 1989 to 84% in 1998 (p=0.014). In addition, the age-adjusted mean BMI was significantly higher in 1998 compared with 1989 (p=0.011). Finally, there were significant between-cohort differences in multiple measures of body image, which were mostly independent of BMI. DISCUSSION: At 84%, the prevalence of overweight and obesity in this community sample of Fijian women is among the highest in the world. The dramatically increased prevalence over the 9.5-year period studied corresponds with rapid social change in Fiji and significant shifts in prevailing traditional attitudes toward body shape.

Adult↗

Body image concerns of gay men: the roles of minority stress and conformity to masculine norms.

The authors hypothesized that gay men's experiences of minority stress and their conformity to masculine norms would be associated with increased body image dissatisfaction and masculine body ideal distress. For this cross-sectional study, 357 gay males completed a Web-based survey, and 2 multiple regression analyses indicated that minority stress factors (i.e., internalized homophobia, expected stigma for being gay, and experiences of physical attack) were associated with body image dissatisfaction and masculine body ideal distress, accounting for 5% and 13% of the variance, respectively. Gay men's conformity to masculine norms was not associated with body image dissatisfaction but did uniquely explain an additional 3% of variance in masculine body ideal distress scores. The utility of the minority stress model, how traditional masculinity may contribute to gender-related presenting concerns, suggestions for developing and evaluating remedial and preventive interventions, limitations, and future research issues are discussed.

Adolescent↗

Anorexia nervosa in male adolescents: body image, eating attitudes and psychological traits.

PURPOSE: To evaluate body image and its relationship with psychological and behavioral traits associated with anorexia nervosa in male patients. METHODS: Thirty male adolescents with anorexia nervosa (AN) were compared with 421 male adolescents from the general population. Body image was evaluated with the Subjective Body Dimensions Apparatus. Eating attitudes were evaluated by the Eating Attitudes Test in its 26-item version (EAT-26). In 19 AN patients and 200 boys from the comparison group, the Eating Disorders Inventory (EDI) was also administered. RESULTS: AN patients had higher mean scores in the EAT-26 and the Body Dissatisfaction scale on the EDI, but not on the other EDI scales. Both groups overestimated all parts of their bodies but AN patients presented a greater overestimation of shoulders (p = .007), hips (p = .01) and thighs (p = .019). Correlations in the anorexic group were high and negative between body overestimation and body mass index and also high but positive between overestimation and the EAT and the Drive for Thinness scale on the EDI. Overestimation did not correlate significantly with other EDI scales. CONCLUSIONS: Male patients with anorexia nervosa overestimate some parts of their bodies more often than controls; this overestimation is related to body mass index, abnormal eating attitudes and drive for thinness, but not to other psychological traits evaluated by the EDI.

Adolescent↗

Perceived touch deprivation and body image: some observations among eating disordered and non-clinical subjects.

The developmental literature suggests that touch, consisting of secure holding and hugging, plays an important role in the formation of body image. We tested the hypothesis that women with anorexia nervosa and/or bulimia nervosa (N = 59), conditions associated with body image problems, report a greater deprivation of tactile nurturance than a sample of non-clinical randomly selected women (N = 140) from the community. Measures of body image included the Drive for Thinness and Body Dissatisfaction subscales of the Eating Disorder Inventory. Perceived touch deprivation was rated on a 10-point scale, previously developed by the author. Analysis of covariance, controlling for the effects of age and body mass index, revealed that the eating disorder group reported greater (p < 0.0001) body image concerns and perceived greater (p < 0.0001) touch deprivation both during their childhood and their current life, than the non-clinical group. Our preliminary empirical findings suggest that touch deprivation may play a role in body image pathologies.

Adult↗

Evaluation of an upper elementary school program to prevent body image, eating, and weight concerns.

Preparing young students to resist the sociocultural pressures that contribute to body image and eating problems in American culture poses a monumental challenge. This project determined if the 11-lesson "Healthy Body Image: Teaching Kids to Eat and Love Their Bodies Too!" curriculum would have a positive effect when presented to upper elementary school children. A controlled study with 415 students measured changes from pretest to posttest related to: 1) body image; 2) knowledge about the biology of size, shape, and restricted hunger or dieting; 3) body size prejudice; 4) media awareness; 5) self-image; and 6) lifestyle behavior. Boys and girls who completed the curriculum showed significant or notable improvement compared to a control group not exposed to the curriculum. Results suggest it is possible to provide children with a knowledge base to use as they face increasing pressures about appearance, weight, and eating in the critical middle school years.

Adolescent↗

Ethnic differences in the prediction of eating and body image disturbances among female adolescent psychiatric inpatients.

OBJECTIVE: The current study examined predictors of eating and body image disturbances in psychiatrically hospitalized female adolescents and investigated whether the predictors differ by ethnicity. METHOD: Participants were 427 (320 Caucasian, 53 Latina, 54 African American) female adolescent psychiatric inpatients. Predictors of eating disorder features (dietary restraint, binge eating, and purging) and body image dissatisfaction (BID) were tested separately for the three ethnic groups. In addition to the eating and BID variables, the following predictor variables were considered: depression, anxiety, impulsivity, negative self-esteem, peer insecurity, and abuse. RESULTS: Caucasians reported significantly higher levels of dietary restraint and BID than Latinas and African Americans, whereas reports of binge eating did not differ by ethnicity. Regression analyses revealed that the predictor variables accounted for significant and substantial amounts of the variance in the four eating and body image domains. Different psychological and social variables predicted eating disorder symptoms and BID across ethnic groups. DISCUSSION: These findings suggest, for psychiatrically hospitalized adolescent females, that different patterns of factors may contribute to the maintenance of eating and body image disturbances across ethnic groups. Future research testing models of the etiology or maintenance of these disturbances needs to include ethnicity to ascertain whether the hypothesized components operate differently by ethnicity.

Adolescent↗

Body-image dissatisfaction among American male and female college students: a computer-based graphical approach.

College students (56 women and 43 men) attending state colleges in the southwestern United States were tested for body-image dissatisfaction using a computer-based graphical body-image task. A reliable relationship between desired stature and desired body-image was observed for the women. Women of large stature showed a greater discrepancy between verbally reported desired stature and redrawn images of desired stature than women of average or smaller than average stature. No reliable discrepancy between desired body-image and verbally reported desired stature was shown by the men.

Adult↗

Marital status, marital satisfaction, and body image dissatisfaction.

OBJECTIVE: This study examined whether married individuals have comparable body image disturbance to nonmarried individuals and whether the quality of a marital relationship is significantly related to body image disturbance in a sample of dieters. METHOD: Measures of marital status, marital satisfaction, and body dissatisfaction were administered to a sample of 16,377 subjects who had tried to lose weight at least once within the previous 3 years. RESULTS: Marital status was not associated with increased body dissatisfaction. Marital satisfaction was significantly related to body dissatisfaction when controlling for age, body mass index, self-esteem, and gender. DISCUSSION: Body dissatisfaction occurs at comparable levels among married and single individuals and the study of marital functioning among eating-disordered individuals represents a large gap in the literature.

Adult↗

Diabetes in urban African Americans. Body image, satisfaction with size, and weight change attempts.

We developed two gender specific sets of body-size silhouettes for evaluating body image in African Americans; 370 clinic-based adult participants with diabetes were queried on body image, perceptions, current efforts to change weight, and psychosocial variables. Comparisons were made by weight group and sex after classification as overweight or not overweight according to body mass index (BMI). Regardless of sex or weight category, perceived current body size was significantly related to BMI. Both men and women who were classified as overweight selected a desired body size that was significantly smaller than their perceived current size. Men, however, were more likely than women to select a larger desired size relative to their current size. Both men and women expected the dietician to favor a body size smaller than their own desired size and felt their designated important adult would choose the same desired size that they selected. Given the importance of cognitive perspectives in understanding weight management, it may be useful to incorporate body image measures into both observational and interventional studies.

Adult↗

Towards the unification of body image disorders.

In the course of this discussion of body image disorders there has been little opportunity to discuss culture bound disorders although of course it should not be overlooked that obesity, anorexia and bulimia nervosa are to some extent culture bound, but prevalent within our own society. There are many different specific syndromes presenting with physical symptoms, often based upon hypochondriacal concern about the body. For example, koro which occurs in South East Asia presents with an overwhelming preoccupation that the penis will retract into the abdomen and hence cause death; there is thus both a fear for virility and a fear for life. Can there be unification of these very different concepts? Although the answer is probably negative, classification becomes more meaningful if epistemological unity is achieved, and phenomenological psychopathology is the most likely root to achieve this. There is therefore a need to concentrate upon the precise description of the patients' own internal experience, using this for categorisation of the symptoms. Objectivity has been held up in medicine as the ideal; however, in order to make progress in this area there is a need to structure subjectivity. Body image, as the concept of the body, is a part of self image; ultimately the only way to explore the self is to study self description using empathy as a diagnostic instrument.

Body Image↗

Body image and health counseling for women.

Body weight and physical fitness are important factors in overall risk for many medical conditions. Many other concerns, however, such as the Western cultural ideal for physical beauty, contribute to the way women think and feel about their bodies. Many American women have a distorted body image and intense levels of dissatisfaction with their bodies. These problems can lead to aberrant eating and dieting behavior, decreased self-esteem, and depressed mood. Physicians must consider these problems and their interrelationships when providing health counseling for female patients.

Adolescent↗

Influence of preconception on body image.

The purpose of this study was to establish whether preconceived body images influence quantitative perceptions of body shape. 59 healthy female subjects were subdivided into four groups by amount of activity and body mass index. The body shape of the same person, dressed differently to appear like a model, a student, and a cook, was classified by reference to an adiposity scale based on line drawings. A significant difference was shown between the representations of the types of occupation, with the model viewed consistently as the slimmest and the cook as the fattest. The obese women classified all three occupational groups as slimmer than the nonobese, and the active groups as slimmer than the inactive. The implications of this work relate to a better understanding of body-image distortion, to treatment for eating disorders, and a recognition that people retain preconceived perceptions developed on the basis of experience.

Adult↗

The Body Uneasiness Test (BUT): development and validation of a new body image assessment scale.

OBJECTIVE: To investigate the psychometric properties of the Body Uneasiness Test (BUT), a 71-item self-report questionnaire that consists of two parts: BUT*A which measures weight phobia, body image concerns, avoidance, compulsive self-monitoring, detachment and estrangement feelings towards one's own body (depersonalization); and BUT*B which looks at specific worries about particular body parts or functions. METHODS: We recruited a clinical sample of 531 subjects (491 females) suffering from eating disorders and a general population sample of 3273 subjects (2016 females) with BMI <25 and Eating Attitudes Test-26 scores under the cut-off 20. RESULTS: The exploratory and confirmatory analyses confirmed a structural five-factor model for BUT*A and an eight-factor model for BUT*B. Internal consistency was satisfactory. The test-retest correlation coefficients were highly significant. Concurrent validity with other tests (Eating Disorder Inventory, EDI-2; Eating Attitudes Test, EAT-26; Symptom Check List, SCL-90R and Coopersmith Self-Esteem Inventory, SEI) was evaluated. Normative values for BUT scores in non-clinical samples of normal-weight non eating disordered subjects, from adolescence to old age, males and females, were calculated. The differences between males and females were highly significant, above all in the 18-39-age range. As for the comparison between women with eating disorders and controls, the results demonstrated a good predictive validity for anorexia nervosa and bulimia nervosa. CONCLUSIONS: The BUT is psychometrically sound. It can be a valuable tool for the screening and the clinical assessment of abnormal body image attitudes and eating disorders.

Adolescent↗

Nonweight-related body image concerns among female eating-disordered patients and nonclinical controls: some preliminary observations.

OBJECTIVE: Eating disorders(ED) have been classically associated with a concern about body shape and size that manifests mainly as an intense fear of weight gain (DSM-IV criteria). To further examine the nature of the body image disturbance in ED, we surveyed the prevalence of nonweight-related body image concerns among ED patients and nonclinical controls. METHOD: We examined 53 women (M +/- SD age: 28.1 +/- 6.8 years) with anorexia nervosa and/or bulimia nervosa (DSM-III-R criteria) and 73 randomly selected nonclinical women (M +/- SD age: 30.2 +/- 6.6 years) from the community. The participants rated (by checking a "Yes" or "No") whether they were satisfied with the appearance of the following body regions: their skin, teeth, jaw, nose, eyes, ears, hair, and height and completed the Drive for Thinness (DT) and Body Dissatisfaction (BD) subscales of the Eating Disorders Inventory (EDI). RESULTS: The frequencies of dissatisfaction with the appearance of various physical attributes among the ED patients versus the nonclinical controls were as follows: skin: 79.2% vs. 52.1%, p =.002; teeth: 62.3% vs. 39.7%, p =. 012; jaw: 24.5% vs. 9.7%, p =.026; nose: 45.3% vs. 24.7%, p =.015; eyes: 22.6% vs. 12.3%, p =.12; ears: 20.8% vs. 2.7%, p =.001; hair: 52.8% vs. 39.7%, p =.14; and height: 28.3% vs. 13.7%, p =.04. As expected, the M +/- SD DT (EDI): 14.0 +/- 6.1 vs.3.5 +/- 4.6, p <. 0001 and the M +/- SD BD (EDI): 19.7 +/- 5.8 vs. 10.1 +/- 7.3, p <. 0001, were both higher in the ED group. Furthermore, greater dissatisfaction with nonweight-related body image was associated with higher DT and BD scores. CONCLUSION: The higher prevalence of dissatisfaction with appearance of most of the nonweight-related physical attributes is probably an indication of the core ego deficits that are often present in ED and an index of the severity of the overall body image disturbance in these patients, and not indicative of another condition (e.g., body dysmorphic disorder) as the current nosology (DSM-IV) suggests.

Adult↗

The body image detection device versus subjective measures of weight dissatisfaction: a validity comparison.

Several procedures have been developed to measure body image distortion. A recently developed device is the Body Image Detection Device (BIDD), which includes a measure of perceptual size distortion (BPI) and subjective ratings of relative weight (SRI). Initial studies have supported the validity and reliability of the BIDD BPI and SRI in mainly bulimic patients, though studies which question the validity of the BIDD (especially the BPI) have appeared. One purpose of the present study was to examine the BIDD's validity in anorectic as well as bulimic patients and to compare both to a psychiatric control group. A second purpose of the study was to compare the validity of the BIDD to alternative measures. Thus, this study also compared the BIDD indices with simple measures of body weight dissatisfaction. The results did not support the validity of the BIDD BPI as a measure of body image disturbance, moderately supported the SRI, and did support the measures of weight dissatisfaction.

Adult↗

Body-image distortion among male and female American and Costa Rican students and female Japanese students.

395 American male and female high school and college students, 286 Costa Rican male and female high school students, and 127 Japanese female college students were tested for body-image distortion using a computer-based body-image distortion task. A reliable negative relationship between stature and body-image distortion was observed. No reliable differences in body-image distortion were observed between different sex or cultural groups.

Adult↗

Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment.

AIMS: To explore the impact of bracing on the perceptions of body image, happiness and satisfaction of adolescents with scoliosis. DESIGN: The study was designed as compare of 134 girls and 16 boys who wore a Boston type brace for scoliosis treatment and a control group of 99 healthy girls and 51 healthy boys. All them were secondary school pupils living in Athens Greece and were interviewed. A semi-structured schedule included general questions, and the Piers-Harris scale was used. Data were analysed using the SPSS/PC+ software, and descriptive statistics, factor analysis and the non-parametric Mann-Whitney U-test. Statistical significance was set at P=0.05 or less. RESULTS: The scoliosis group had a poorer perception of body image in comparison to the control group (P=0.048), while boys with scoliosis (P=0.030) had a better perception of body image than girls with scoliosis. Girls with scoliosis had a statistically significant difference (P=0.0388) in perception of happiness and satisfaction, in comparison with girls in the control group. Cohabitation with the mother seemed to be negatively correlated with body image, happiness and satisfaction perceptions because adolescents with scoliosis who were not living with their mother had a better body image perception (P=0.027) as well as better perceptions of happiness and satisfaction (P=0.047). Nevertheless, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings and problems with health professionals, while 90% of them declared that they wanted to have more opportunities to do this. CONCLUSION: Adolescents with scoliosis face problems during bracing and they need to be supported by health care professionals.

Adolescent↗

Limb loss: alterations in body image.

An estimated 10% of persons older than 70 years have peripheral vascular disease. Peripheral vascular disease includes venous and arterial medical conditions. Peripheral arterial disease (PAD) is a major concern in assessment of patients for loss of limb. With the ever increasing numbers of senior citizens in the United States today, a major public health concern is the management of chronic health problems. Many persons who have progressive PAD as a result of circulatory changes eventually are forced to have a limb amputated. This amputation triggers the realization of the loss of the limb, which directly influences body image. Therefore, management of the effect of limb loss on body image becomes a major nursing consideration in health promotion/health maintenance endeavors by health care professionals. This article explores the concepts of limb loss and body image. The relationship between PAD and limb loss is established. The conceptual link between limb loss and body image alteration is described, with emphasis on the importance of nursing interventions to manage body image alterations. Pathophysiologic conditions leading to PAD and limb loss are reviewed. Nursing implications for management of body image alterations with limb loss are summarized.

Aged↗