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Obesity and body image: an evaluation of sensory and non-sensory components.

Body image in 38 obese and normal weight subjects was measured using a video TV monitor. Tasks included a continuous task where subjects manipulated the size of their body image on a TV screen, and a discrete task, where they judged the accuracy of their TV image which was presented as either too heavy or too thin. Subjects viewed their images in both regular street clothes and with minimal clothing. Results from the continuous task revealed that obese subjects overestimated body size. All subjects were more accurate on trials in which the initial image was adjusted in the heavier direction. On the discrete task, a signal detection analysis revealed sensory sensitivity differences between obese and normal weight subjects. Obese subjects were better at detecting distortion caused by a too thin image, but were inferior in detecting a too heavy distortion. No significant differences were obtained in response criteria or between clothing conditions.

Adult↗

Body image and steroid use in male bodybuilders.

This study was designed to examine the association between body image and eating-related attitudes among male bodybuilders in relation to two athletic comparison groups, runners and martial artists. It was also of interest to examine whether steroid use may be associated with body image disturbances in athletes. The volunteer sample of 139 male athletes recruited from fitness centers comprised 43 bodybuilders, 48 runners, and 48 martial artists (tae kwon do practitioners). Standardized measures of body dissatisfaction, drive for thinness, drive for bulk, bulimia, self-esteem, depression, maturity fears, and perfectionism as well as questionnaires designed to measure attitudes toward steroids, and rates of steroid use were administered in a manner that encouraged disclosure. Bodybuilders reported significantly greater body dissatisfaction, with a high drive for bulk, high drive for thinness, and increased bulimic tendencies than either of the other athletic groups. In addition bodybuilders reported significant elevations on measures of perfectionism, ineffectiveness, and lower self-esteem. They also reported the greatest use of anabolic steroids and most liberal attitudes towards using steroids. Steroid users reported that the most significant reason for using steroids was to improve looks. Steroid users reported an elevated drive to put on muscle mass in the form of bulk, greater maturity fears, and enhanced bulimic tendencies than nonusers. The results suggest that male bodybuilders are at risk for body image disturbance and the associated psychological characteristics that have been commonly reported among eating disorder patients. These psychological characteristics also appear to predict steroid use in this group of males.

Adolescent↗

Body image, psychological functioning, and parental feedback regarding physical appearance.

OBJECTIVE: To investigate the role of parental appearance-related commentary, body image, and psychological functioning in females and males. METHOD: Retrospective reports of teasing and appearance-based feedback were assessed, along with current levels of body image and overall psychological functioning. RESULTS: Women and men did not differ in their reports of comments received from mothers, however, women received significantly more appearance-related messages from fathers. Correlational analyses demonstrated significant relationships between feedback and body satisfaction for women, but not for men. Regression analyses indicated that fathers' and mothers' teasing about weight were predictive of daughters' body image. For both males and females, psychological functioning was significantly predicted from the combination of mothers' and fathers' feedback regarding appearance. DISCUSSION: The findings further support an emerging theoretical model of appearance-related commentary as a factor in body image disturbance and overall psychological functioning.

Adult↗

Multidisciplinary management of altered body image in the patient with an ostomy.

Many clinical studies have found patients with ostomies to be a group facing multiple adjustment demands. One of these demands is coping with a significant change in body image. At the Medical College of Wisconsin, a team approach has been initiated; the ET nurse, the psychologist, and the surgeon deal with body image concerns together. Problems requiring counseling have included difficulty with personal acceptance, personal and social body-image disruption, sexual concerns, reduced self-care skills, and the management of surgical complications. This article represents a study employing a methology of selected case presentations. Cases were chosen to outline the types of problems encountered and were selected from referrals made for psychologic intervention by the surgeon and ET nurse. The patients included four women and three men, ranging in age from 22 to 79 years. Data were compiled by examining the records of the surgeon, ET nurse, and psychologist. The primary needs revolved around personal or social acceptance of altered body image. By addressing these needs in a straightforward, time-limited manner, postsurgical counseling was delivered effectively for these patients. In conclusion, we have demonstrated the multidisciplinary approach to be successful in facilitating adaptation to an altered body image.

Adult↗

The relationship between body image and quality of life in treatment-seeking overweight women.

OBJECTIVE: To test the impact of body image on quality of life in overweight and obese people; to evaluate longitudinally the relationship between changes in body image, anthropometrical measurements and quality of life. DESIGN: A cross-sectional study and a longitudinal study in a sub-sample after 6 months. SUBJECTS: 308 women in the cross-sectional study and 56 in the longitudinal study, aged 21-65, with body mass index (BMI) > 25 kg/m2 and selected from people who had been sought treatment for overweight in our Institute from 1998 to 2001. MEASUREMENTS: Body weight, body height, waist and hip circumferences. The ORWELL 97 questionnaire to evaluate the obesity related quality of life (ORQL) and the BUT questionnaire to assess the body image (BI) were used. RESULTS: The BUT score was the variable that explained the greatest amount of variance of ORWELL 97 both in cross-sectional and longitudinal studies. Despite no significant differences in athropometrical variables were found between subjects who dropped out and those who did not, psychometrical scores were significantly better in patients still in treatment in follow-up. CONCLUSION: BI is related to subjective ORQL independently of anthropometrical measurements both at baseline and after treatment. Better psychometrical scores in people still in treatment after 6 months suggest that BI could be considered one of the variables which influence compliance to the treatment program, this fact needs more investigations and could be of interest in obesity treatment outcome studies.

Adult↗

Perceived changes in sexual functioning and body image following weight loss in an obese female population: a pilot study.

This study assessed perceived changes in sexual behavior and body image after weight loss in a clinically obese population. Thirty-two women enrolled in a hospital-based multidisciplinary weight management program completed retrospective questionnaires about their sexual functioning and body image before and after weight loss. Subjects reported significant increases in the frequency of their sexual activity. Subjects also perceived significant improvements in their body image. These findings suggest that obese people experience positive changes in sexual functioning and body image after weight loss.

Body Image↗

Explanations of body image disturbance: a test of maturational status, negative verbal commentary, social comparison, and sociocultural hypotheses.

OBJECTIVE: A number of hypotheses have been offered to explain the development and/or maintenance of body image disturbance. In this study, four factors which have been hypothesized to lead to body image problems were tested: maturational status (early physical development), negative verbal commentary (a history of being teased regarding physical appearance), behavioral social comparison, and awareness/internalization of sociocultural pressures. METHODS: One hundred sixty-two college females completed measures designed to index these four influences. Predictors were regressed onto multiple measures of body image and two indices of eating disturbance. RESULTS: Even with self-esteem and level of obesity removed as influences, social comparison and societal factors were significant predictors of body dissatisfaction and eating disturbance. Negative verbal commentary also explained a small part of the variance, however, maturational status did not contribute uniquely in any analysis. DISCUSSION: The findings offer further support for emerging theories of body image and eating disturbance.

Adolescent↗

Preliminary test of two hypotheses of body image disturbance.

The present study compared the ability of two hypotheses of body image disturbance, social comparison and negative verbal commentary (teasing), to explain variance associated with body dissatisfaction and eating disturbance. Female undergraduates (n = 146) completed measures of eating disturbance, body dissatisfaction, self-esteem, depression, history of being teased about physical appearance, frequency of appearance comparison, and importance of various individuals as appearance comparison targets. Utilizing multiple regression analyses, levels of self-esteem and depression were first entered to remove a general distress/negative affectivity variable from the analyses. The results indicated that specific teasing about weight/size, but not general appearance, was a significant and consistent predictor of body dissatisfaction and eating disturbance. In addition, the importance of others as comparison targets, but not general comparison frequency, also predicted unique variance after the removal of the general distress factor. The findings are discussed with regard to the need for longitudinal analyses of predictors of body image and eating disturbance, particularly the possible importance of negative verbal commentary as a developmental precursor to adult levels of dysfunction.

Adolescent↗

Teasing, body image, and self-esteem in a clinical sample of obese women.

This study examined the relationship of physical-appearance-related teasing history to body image and self-esteem in a clinical sample of adult obese females. The frequency of being teased about weight and size while growing up was negatively correlated with evaluation of one's appearance and positively correlated with body dissatisfaction during adulthood. Self-esteem was unrelated to teasing history but covaried significantly with body image measures. Subjects with early-onset obesity reported greater body dissatisfaction than did subjects with adult-onset obesity. The findings suggest that being teased about weight/size while growing up may represent a risk factor for the development of negative body image and that self-esteem and body image covary.

Adult↗

Restraint, body image and food attitudes in children from 12 to 18 years.

Body image, dietary restraint, attitudes to food and food intake pattern were assessed in a survey of 348 London schoolchildren from three age groups. The data revealed striking sex differences in body image, restraint and food attitudes, even in the youngest age group (12 to 13 years). The majority of girls felt too fat, attempted to restrict their food intake, and expressed guilt about eating. The boys expressed much less concern in all these areas. No differences were found across the age groups. The results suggested that normal English girls experience significant levels of distress over eating and weight.

Adolescent↗

Disordered eating patterns, body image, self-esteem, and physical activity in preadolescent school children.

OBJECTIVE: Eating disorders have been typically defined as an "adolescent problem." As a result of emerging evidence which indicated this health problem to be evident in the prepubescent age range, this study aimed to establish prevalence and factors associated with eating/dieting, physical activity, and body image among a nonclinical, naturalistically-derived sample of preadolescent (aged 10 and 11) school children (n = 61). METHOD: This cohort of children, which represented the entire grade 6 class of a suburban Elementary school, was measured for body image satisfaction [silhouettes], a participation in activity index, a self-worth scale and a measure of eating attitudes & behavior [Eating and Me scale [E & M]]. RESULTS: The longitudinal assessment of body image [3 measures over 9 months] indicated signs of stability of "actual" assessments of body image for males, but marked changes for females who preferred to be ideally "chunkier" in stature over time. Physical activity was only implicated with bulimia for the male sub-group. The E & M scale reported a Cronbach's alpha of .76, with two factors [bulimia; drive for thinness/anorexia] representing 65% of the total variance. Moderate internal validity [r .58] between body dissatisfaction on the E & M scale and the silhouette measure was observed. DISCUSSION: These results demonstrated that body image views and concerns appeared before puberty, that gender differences prevailed with respect to eating/dieting, activity and body image, and that the E & M scale has emerged as a promising research tool. The longitudinal nature of this study of eating disorders also promotes the need for qualitative research methodology and attention to pre-pubertal cognitive/perceptual processes.

Anorexia↗

Suicidal tendencies and body image and experience in anorexia nervosa and suicidal female adolescent inpatients.

BACKGROUND: The aim of this study was to assess the relationship between body image and suicidal tendencies in anorexia nervosa (AN). METHODS: Three groups of hospitalized female adolescents--nonsuicidal AN, suicidal psychiatric and nonsuicidal psychiatric patients, as well as a community control group with no psychiatric disturbances were compared with regard to suicidal tendencies (in the form of attitudes to life and death), body image and experience, depression and anxiety. RESULTS: The AN and suicidal patients showed less attraction to but more repulsion by life, and more attraction to and less repulsion by death compared with the other two groups. The AN and suicidal patients were also different from either one or both control groups in showing more negative attitudes and feelings towards their bodies, lower sensitivity to body clues, less body control, and elevated depression and anxiety. These between-group differences in suicidal tendencies were retained after controlling for age, body mass index, the different body image dimensions, anxiety and depression. CONCLUSIONS: Our findings suggest that female AN inpatients with no evidence of overt suicidal behavior demonstrate elevated suicidal tendencies that are similar to those of suicidal psychiatric inpatients. These self-destructive tendencies are highly associated with a pervasive sense of disturbance of body image and experience.

Adolescent↗

Body image in early-onset obese patients.

In a group of early-onset-obesity obese patients eating behaviour, body image and psychological condition were assessed by the Eating Disorder Inventory, the Three Factor Eating Questionnaire, the Body Shape Questionnaire and the Body Attitude Questionnaire. These evaluations were carried out prior to and at long-term follow-up after biliopancreatic diversion when body weight had steadily fallen towards normal values. The aim was to establish the influence of actual body weight and shape over body image. A notable improvement in eating behaviour and overall psychological conditions was observed, while the parameters assessing body image remained substantially unchanged, indicating that early-onset-obesity postobese subjects, despite having obtained normal or nearly normal weight conditions, are still much more dissatisfied with their body weight and somatic morphology than never-obese subjects with very similar actual body weights.

Adult↗

Lifestyle factors related to postpartum weight gain and body image in bottle- and breastfeeding women.

OBJECTIVE: To explore the relationship of lifestyle variables to postpartum weight gain and body image attitudes of bottle- and breastfeeding women. DESIGN: Mail survey of new mothers at approximately 4 months postpartum. SETTING: Southwestern community. PARTICIPANTS: One hundred one bottle-feeding women (69% white, 20% Hispanic, 11% other) and 106 breastfeeding women (76% white, 19% Hispanic, 5% other) without diabetes. Bottle- and breast-feeding women did not differ on gestational weight gain or weight gain sustained postpartum. MAIN OUTCOME MEASURES: Postpartum weight gain (relative to prepregnancy weight) and body image attitudes. RESULTS: Feeding method (breast or bottle) was not associated with postpartum weight gain in the sample as a whole. Bottle-feeding mothers with higher postpartum gains exercised less, had higher fat intake habits, and were more dissatisfied with body image than mothers with lower gains. Breast-feeding mothers with higher and lower gains did not differ on any lifestyle factors. Overall lifestyle and psychologic skill in managing emotions were related negatively to postpartum body image dissatisfaction in both groups of women. CONCLUSIONS: Breastfeeding women did not differ from bottle-feeding women in sustained postpartum weight gain. In bottle-feeding women, lifestyle factors were associated with levels of weight gain. Lifestyle-focused programs for weight management would potentially benefit these women.

Adaptation, Psychological↗

Body image disturbances in young adults with cancer. Implications for the oncology clinical nurse specialist.

The impact of the diagnosis of cancer and its treatments on the body image of young adults (18-29 years) diagnosed with cancer is relatively unknown. This descriptive comparative study examined body image scores of young adults diagnosed with cancer and young adults without cancer. The conceptual framework for this study was taken from body image and developmental theory. Secord and Jourard's body cathexis/self-cathexis scales and a demographic sheet were mailed to 162 young adults diagnosed with cancer and to 150 young adults without cancer. A t test was used to compare the mean scores between the two groups. A statistically significant difference was found between the mean scores reported by the young adults diagnosed with cancer for the body cathexis and self-cathexis scales. The self-cathexis and body cathexis scores indicated that the young adults diagnosed with cancer had a more positive body image than the young adults without cancer. The mean scores were also compared in relation to the demographic data collected using t tests and analysis of variance. Within the group diagnosed with cancer, male subjects demonstrated a more secure body-cathexis (p value of 0.012) and married subjects demonstrated a more secure self-cathexis than the single subjects did (p value of 0.04). No statistically significant difference was found within the group without cancer related to demographic variables. Implications for the oncology clinical nurse specialist are explored.

Adolescent↗

[Body mass index and body image perception in a Mexican adult population: the accuracy of self-reporting].

OBJECTIVE: To evaluate the accuracy of the self-reported body mass index and body image perception in a population of Mexican adults. MATERIAL AND METHODS: In 1998, in the state of Morelos, Mexico, participants in the longitudinal study of Mexican Social Security Institute workers "IMSS Cohort Study" responded to a baseline, self-administered questionnaire designed to collect a large variety of lifestyle risk factors for chronic diseases. Participants self-reported their body image by selecting the silhouette that best portrayed them, from a set of silhouettes ranked from 1 to 9. Participants also self-reported their current weight and height, unaware that direct measurements of weight and height were to follow. Four to eight months later participants were weighed and their heights were measured using standardized procedures. Spearman correlations were computed to analyze the correlation between self-reported and measured data. The Kruskal-Wallis test was used to evaluate the magnitude of difference between measured and self-reported height, weight and body mass index (BMI) (measured minus self-reported), by educational level and categories of age. Robust regression was used to evaluate the potential effect of specific individual characteristics on differences between measured and self-reported weight and height. Logistic regression analysis was used to evaluate the sensitivity, specificity, and predictive values for BMI. RESULTS: The study included 934 subjects, of which 62.6% were female. Females had a mean measured height of 1.55 m (SD 0.06) and weight of 65.4 kg (SD 10.9), while males had a mean height of 1.67 m (SD 0.06) and weight of 77.7 kg (SD 12.5). The mean BMI was 27.4 kg/m2 (SD 4.3) (females: 27.2 kg/m2 +/- 4.45; males: 27.8+/-3.87). The median of body image perception (BIP) was 5 (25th percentile=4; 75th percentile=6). Correlations between measured and self-reported height, weight, and BMI for all subjects were 0.94, 0.96, and 0.90, respectively. The correlation between BMI and BIP was 0.64 (0.67 for females and 0.59 for males). Self-reported mean varied no more than 1.3 cm from measured height and no more than 3.17 kg from measured weight. Error estimations of height, weight, and BMI decreased with educational level. Sensitivity and specificity before adjusting self-reported BMI with overweight and obesity categories that were collapsed into one were 94.8 and 83.0%, respectively; for BIP, those values were 87.6 and 48.9%. CONCLUSIONS: The results suggest that self-reported BMI and BIP can be useful indicators of an overweight condition in Mexican adults. The sensitivities and specificities associated with corrected self-reported BMI categories could be used to adjust odds ratios and relative risks, calculated from BMI levels derived from the self-reported BMI. Body image perception made it possible to correctly classify individuals with BMI > or = 25, showing that it may be a valid estimate for use in epidemiological surveys.

Adolescent↗

Physical growth, sexual maturation, body image and sickle cell disease.

PURPOSE: This study assessed delays in physical growth and sexual maturation, self-esteem and body image in youth with homozygous sickle hemoglobin disease (HgbSS). METHOD: A consecutive sample of 30 subjects age 8 through 19 with homozygous sickle cell disease (hemoglobin SS) and a similar number of control subjects matched for age, race, gender and socioeconomic status and free of chronic illness were examined for height, weight and Tanner staging of sexual development. Subjects also completed the Body Cathexis Scale and Piers-Harris Self-Concept Scale. Assessments were with paired samples t-tests. RESULTS: The subjects with sickle cell disease had significantly lower weights and were shorter than matched control subjects. Sexual development (physical) was also delayed in the sickle cell subjects. The study failed to find significant differences for either body image or self-esteem. CONCLUSIONS: The latency age and adolescent subjects with sickle cell disease had significant delays in physical (height, weight, secondary sexual characteristics) maturation. The study failed to find significant differences in either self-esteem or body image between the two groups. Theoretical constructs from the literature were presented which questioned the belief that these expected delays in physical growth and sexual maturation have an adverse effect upon self-esteem and body image.

Adolescent↗

Aspects of body image perception in obese and normal-weight youngsters.

Perceptual and projective aspects of body image in obese youngsters (not in psychological treatment) and normal-weight youngsters 8-9 years of age and 12-13 years of age were investigated. The results indicate that perceptual distortions in estimating various body dimensions of oneself are primarily a function of age rather than weight status. The accuracy of estimating the weight of peers and an adult showed an association with the sex of the subject. No group differences were found in terms of projective aspects of body image as measured by barrier and penetration responses. This study suggests that obese youngsters in the middle childhood and entering puberty periods in comparison to normal-weight youngsters of the same age do not manifest differences in perceptual factors of body image.

Adolescent↗