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Body image interventions in cognitive-behavioural therapy of binge-eating disorder: a component analysis.

The present study sought to investigate effects of body exposure in the treatment of binge-eating disorder (BED). Cognitive-behavioural therapy with a body exposure component (CBT-E) was compared with CBT with a cognitive restructuring component focused on body image (CBT-C). Twenty-eight patients diagnosed with BED were randomly assigned to CBT-E or CBT-C, both delivered in a group format. Negative automatic thoughts about one's body, dysfunctional assumptions about shape and weight, and body dissatisfaction were assessed using experimental thought-sampling techniques, a clinical interview (Eating Disorder Examination), and self-report questionnaires. At posttreatment and at 4-month follow-up, CBT-E and CBT-C were equally effective in improving body image disturbance on all indicators assessed. Both CBT-E and CBT-C produced substantial and stable improvements in the specific and general eating disorder psychopathology. Results suggest that both treatment components are equally effective in the treatment of BED.

Adult↗

Eating and body image concerns among obese and average-weight children.

Research compared obese and average-weight children with regard to concerns about being or becoming overweight, history of dieting, concerns about the effects of eating food, and perceived discrepancy between real and ideal body image. Participants included 526 obese and average-weight elementary-age school children to whom questionnaires were administered. Gender (male/female), obesity status (obese/average-weight), and grade level (lower elementary/upper elementary) were considered. Obese children were significantly more likely to engage in dieting behaviors, to express concern about their weight, to restrain their eating, and to exhibit more dissatisfaction with their body image than average-weight children. Girls were more likely to exhibit these behaviors than were boys. These findings suggest the importance of studying the emergence of disordered eating habits in childhood.

Adolescent↗

Effects of a physical activity intervention on body image in university seniors: project GRAD.

Project GRAD (Graduate Ready for Activity Daily) was a randomized controlled study to teach university seniors behavioral skills necessary for increasing and/or maintaining physical activity habits in preparation for the transition to working adult roles after graduation. This study examines the secondary effects of this intervention on body image concerns among college-aged men and women. Three hundred thirty-eight undergraduates (54%female, Mage = 24years, SD = 1.95; MBody Mass Index = 24.26, SD = 4.0) were studied. The sample was 61/% Anglo, 16% Latino, 16% Asian/Pacific Islander, 4% African American, and 3% Native American/Other Body image concerns were assessed at pre- and posttreatment using 2 subscales of the Eating Disorder Inventory: Drive for Thinness and Body Dissatisfaction. Because the latter concentrates on body parts typically associated with female concerns (e.g., thighs, hips, buttocks), a parallel scale was developed to target body parts that may be of more concern to men (e.g., legs, shoulders, arms, stomach). Results indicated that compared to the control group, women in the intervention showed a significant increase in drive for thinness without any changes in body dissatisfaction. For men, there were no significant changes in drive for thinness or body dissatisfaction. These results suggest that physical activity interventions may have some negative consequences of increasing concerns about thinness in women. This negative effect occurred despite intervention content designed to prevent concern over eating, dieting, and the importance of weight. Health promotion studies should include assessments of potential negative side effects.

Adult↗

Changes in weight and body image over time in women with eating disorders.

BACKGROUND: This study examined the changes in body image and weight in young women with an adolescent eating disorder, relative to women without an eating disorder (noED). METHOD: Three diagnostic groups, anorexia nervosa (AN; n = 10), bulimia nervosa (BN; n = 27), and binge eating disorder (BED; n = 42) and three comparison groups (noED; n = 659 each) were compared on body mass index (BMI) and self-reported current body size, ideal body size, and weight dissatisfaction. Dependent variables were examined 2 and 1 year before the onset, the onset year, and 1 and 2 years after the onset of the eating disorder in a model that was adjusted for ethnicity and BMI. RESULTS: BMI was lower in the AN group at all time points except 2 years before onset. AN girls evidenced a significantly stronger relation between BMI and current self-ratings and weight dissatisfaction than noED girls. BMI did not differ between the BN group and the noED group. Girls with BN reported larger current body sizes and greater weight dissatisfaction across all time points. The BED group had higher BMI than the noED group across time. BED girls reported greater current body size ratings and weight dissatisfaction than the noED girls. Girls with AN, BN, or BED did not differ from the noED girls on body ideal ratings. DISCUSSION: Body weight seems to influence perception of body size more so for girls with AN than for noED girls. No support was found for an accelerated weight gain over time for BN. Weight may increase over time for the BED group relative to the noED group, but larger studies are needed. Across all three groups, ideal body size appears to be unrelated to diagnostic status. Rather, the risk for developing an eating disorder appears to arise from size overestimation and related weight dissatisfaction.

Adolescent↗

Weight concerns, body image, depression and anxiety in Swedish adolescents.

OBJECTIVES: To assess weight problems and correlates in respect of body image, depression, anxiety and demographic background factors. METHOD: 405 Swedish adolescents were assessed in respect of Body Mass Index (BMI), biographical data, the Body Esteem Scale for Adolescents and Adults (BESAA), the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI). RESULTS: Boys were in the positive and girls in the negative direction from ideal BMI for age and gender. Girls and boys differed in respect of CDI, MASC and of BESAA where girls generally were shifted in the "pathological" direction. DISCUSSION: The adolescents' own positive attitude to slimness, negative mood (girls), and anxiety symptoms that reflect social fears (boys) and physical aspects of anxiety (girls and boys) were important correlates of lower BMI than ideal. Adolescent cultural norms need to be addressed in preventive work. However, in girls' separation anxiety might be a protective factor against underweight. In girls, overweight seems to be associated with negative self-esteem.

Adolescent↗

Physical, behavioral, and body image characteristics in a tri-racial group of adolescent girls.

OBJECTIVES: The purpose of this study was to evaluate physical characteristics, nutrient intake, physical activity level, and body image in white (CC), African-American (AA), and Hispanic-American (HA) female adolescents. RESEARCH METHODS AND PROCEDURES: High school volunteers were solicited for this study. Self-reported information was used to determine subject characteristics, family income, physical activity, body image, and nutrient intake. Physical evaluations were used to determine body mass index, percent body fat, fat distribution, resting heart rate, and blood pressure (BP). RESULTS: Results showed that AA girls displayed significantly higher diastolic BP than HA girls (p = 0.029). CC adolescents showed greater physical activity (p = 0.010) and lower adiposity than HA adolescents (p = 0.048), as well as lower subscapular skinfold than AA adolescents (p = 0.018). AA adolescents selected a higher ideal body size than CC girls (p = 0.038). There was also a significant difference in percentage carbohydrates (p < 0.034) and cholesterol consumed (p < 0.016) among groups, with CC girls showing the highest values for carbohydrates and lowest values for cholesterol intake among groups. DISCUSSION: Given our findings of higher adiposity and lower physical activity levels in HA adolescents and greater diastolic BP levels and subscapular skinfold in AA adolescents, more interventions should be targeted toward improving health-related variables among minority populations.

Adipose Tissue↗

Body images of 4-8-year-old girls at the outset of their first artistic gymnastics class.

OBJECTIVE: The primary objective of this investigation was to compare body images of 54 girls (4-8 years old) who were beginning their first gymnastics class to 54 age-matched (+/-1 year) and % body fat-matched (+/-3%) girls not participating in gymnastics. METHOD: Ratings of actual and ideal body size and a computed measure of body dissatisfaction (actual minus ideal) were obtained. Body composition was measured with dual-energy x-ray absorptiometry. RESULTS: Girls beginning gymnastics did not differ significantly from controls on (mean +/- SD) actual (2.2 +/- 1.4 vs. 2.1 +/- 1.4), ideal (1.8 +/- 1.3 vs. 1.8 +/- 1.5), or body dissatisfaction (0.39 +/- 1.8 vs. 0.26 +/- 1.4) scores. DISCUSSION: Body images of 4-8-year-old girls beginning their first artistic gymnastics class do not differ from non-gymnast controls matched on age and % body fat. This observation casts doubt on the idea that young girls who are dissatisfied with their body and want to be smaller are more likely to enroll in gymnastics classes than girls without this type of body dissatisfaction.

Body Composition↗

Female college students and cosmetic surgery: an investigation of experiences, attitudes, and body image.

This large, multisite study investigated female college students' experiences with and attitudes about cosmetic surgery. The study also assessed the relationship between several aspects of body image, including appearance satisfaction and investment and symptoms of body dysmorphic disorder, and interest in cosmetic surgery. Thirty (5 percent) of the 559 women surveyed reported that they had undergone cosmetic surgery. Two thirds of respondents reported knowing someone who had received cosmetic surgery, and approximately one third indicated that a family member had undergone surgery. Overall, participants held relatively favorable attitudes about surgery. Regression analysis suggested that a greater psychological investment in physical appearance and greater internalization of mass media images of beauty predicted more favorable attitudes toward cosmetic surgery. Fourteen women (2.5 percent) screened positive for body dysmorphic disorder based on the nature and severity of their self-reported body-image concerns. Results of this study provide new information on young women's experiences and attitudes about cosmetic surgery and how these attitudes relate to body image.

Adolescent↗

The effects of pubertal changes on body image and relations with peers of the opposite sex in adolescence.

The purpose of this research was to study the impact of pubertal maturation on body image and on the perceived quality of relations with opposite sex peers in adolescence. A sample of 157 French adolescents aged from 11 to 16 years filled in self-report scales; physical development was measured by physicians using Tanner criteria (pubic hair, genitalia and breast growth). Results of ANOVAs confirmed that boys evaluate themselves on attractiveness more positively than girls, and showed no difference between the sexes on perceived physical condition. Multiple regression analyses revealed different effects--according to sex--of pubertal status on body image and relations with opposite sex peers. Correlational patterns suggested that the experience of the body and the experience of relations with opposite sex peers are not built in the same way in girls and boys during adolescence.

Adolescent↗

Dieting, body weight, body image and self-esteem in young women: doctors' dilemmas.

Many young women feel that body image and exercise are important for their self-esteem, want to lose weight, are afraid they might gain weight, and feel fat. Interventions that improve self-esteem, encourage communication and help adolescents to be supportive of each other may prevent some of these women from developing eating disorders. If an eating disorder is suspected, it may be useful for physicians to ask about fear of loss of control over the body, eating, weight and shape; and preoccupation with food, eating, nutrition, body weight and shape, as these issues may differentiate those at greater risk.

Adolescent↗

Peer influences, body-image dissatisfaction, eating dysfunction and self-esteem in adolescent girls.

A sample of 344 adolescent girls completed a variety of measures designed to index the associations among peer influences, body-image dissatisfaction, eating dysfunction and self-esteem. Results indicated that participants were significantly similar to their nominated friends on self-esteem, but not body image or eating disturbance. Peer measures were significantly associated with body dissatisfaction, eating problems and self-esteem. Peer suppression of feelings, internalization of the thin-ideal and appearance comparison were significant mediators in path analyses testing the direct and indirect role of peer influences on outcome variables. Implications for intervention and prevention programs are discussed.

Adolescent↗

A critical review of congenital phantom limb cases and a developmental theory for the basis of body image.

Reports of phantom limbs amongst aplasics (i.e., subjects who congenitally lack one or several limbs) have often been presented as evidence that body image is 'hard-wired' in the brain and that neither sensory input nor proprioceptive feedback are essential to its formation. Although attempts have been made to account for these phantoms by other means, these have been on a case by case basis and no satisfactory alternative framework has been proposed. This paper collates the accounts of aplasic phantoms and presents them as compatible with a four-part hypothesis, in which body image is learnt from experience during both pre- and post-natal development, and in which cross-cortical connections and mirror neurons play prominent roles. This model unites several previously disparate theories to offer a viable solution to several longstanding phantom limb mysteries and serves to highlight avenues worthy of further inquiry.

Body Image↗

Effects of a circuit weight training program on the body images of college students.

OBJECTIVE: The present investigation examined the extent to which participation in a 6-week circuit-weight training program produced changes in participants' body images relative to a matched control group. METHOD: The weight trainers consisted of 39 college students (27 women and 12 men). The control group of 39 individuals did not weight-train currently or within the past year. All participants were pre- and posttested on the Multidimensional Body Self-Relations Questionnaire, the Social Physique Anxiety Scale, and the Physical Self-Efficacy Scale. Weight trainers were also pre- and posttested on muscular strength and assessed on their motives for exercise. RESULTS: The program successfully increased upper- and lower-body strength. In contrast to the comparison group, weight trainers had a significantly improved evaluation of their appearance, greater body satisfaction, reduced social physique anxiety, and enhanced physical self-efficacy. Outcomes were unrelated to the extent of concurrent aerobic exercise and largely unrelated to exercise motives. DISCUSSION: Even a relatively brief weight training program can produce improvements in multiple aspects of body image. Further research should investigate weight training as an adjunct to psychosocial treatments of body dissatisfaction.

Adolescent↗

BRIDGE 2 (Building the Relationship Between Body Image and Disordered Eating Graph and Explanation): interventions and transitions.

BRIDGE 2 (Building the Relationship Between Body Image and Disordered Eating Graph and Explanation): Interventions and Transitions, builds upon the framework presented in the first publication of BRIDGE. BRIDGE 2 moves beyond increasing the understanding of the relationship between body image and eating disorders and encourages a movement into action. First, it suggests the appropriate point of intervention for both parents and teachers. Second, the continuum of health care from promotion to prevention, to early intervention, and to basic and specialized treatment services is positioned on the BRIDGE framework. This added dimension offers a new level of understanding specific to eating disorders by utilizing concepts from mental health promotion and mental illness prevention literature.

Journal Article↗

Normative and psychometric data on the body image assessment--revised.

After falling into disfavor in the early 1990s, the construct of body image, as measured by body-size estimation (BSE) techniques, has been the focus of increasing interest in the eating disorder literature because of recent theoretical, empirical, and methodological advances. However, no published BSE measure to date has been shown to be psychometrically sound, well normed, inexpensive, and straightforward. This article provides normative and psychometric data for an adapted silhouette BSE measure. Comprehensive normative data are presented on college women's cognitively and affectively based body-size estimates, as well as their desired body size and related discrepancy indexes (cognitive vs. desired, affective vs. desired, affective vs. cognitive). Preliminary data indicate that indexes from the new measure are moderately reliable over time, consistent with their theoretical link to fluctuations in body-related attitudes. Data also support the convergent validity of the measures. Affectively based BSE, alone or as part of a discrepancy measure with desired body size, was most strongly related to measures of eating pathology, body focus, body dissatisfaction, and depressed affect.

Adolescent↗

Depression and body image among women with polycystic ovary syndrome.

Common features of polycystic ovary syndrome (PCOS), including hyperandrogenism, ovarian dysfunction and obesity, can be highly distressing. We compared 40 women with PCOS to women with infertility but not PCOS, and to women with neither PCOS nor infertility, on measures of depression and body image. Women with PCOS reported higher depression scores and greater body dissatisfaction (p < .001) than comparison group women. Body image was strongly associated with depression overall, even after controlling body mass. Among women with PCOS, body dissatisfaction measures and education explained 66 percent of the variance in depression, suggesting explanations of the PCOS-depression link should consider the role of potentially mediating psychosocial variables.

Adult↗

Body image perception of children and adolescents with psychiatric disorders.

Interviews with 75 adolescents and children in a South Florida psychiatric hospital showed that patients expressed significantly less dissatisfaction with both height and weight than a group of 565 adolescents from the same geographical area. The dissatisfaction expressed by patients was more like that of a sub-group of the students with comparable ethnic characteristics. Patients reported that significant others concurred with their own judgements of body size. One half of patients who were judged by the researcher to be of normal weight wanted to be thinner. The recommendation is made that patients need help with body image perception and management because of the high percentage of dissatisfaction (85 per cent) even though hospitalization for psychiatric disorders does not appear to increase body-image problems.

Adolescent↗

Body image and eating attitudes among adolescent Chinese girls in Hong Kong.

The study investigated the relation between body image and eating attitudes among adolescent girls in Hong Kong. A sample of 358 senior secondary school girls completed the measures assessing body-part satisfaction and behaviors associated with eating. Analysis indicated that even though only 4.8% of the girls were overweight, 85.16% desired to weigh less. These Chinese teenage girls were concerned about their weight, and the desire for slimness was widespread. Correlations indicated that higher Body Mass Index was associated with lower satisfaction with weight. Lower scores on weight satisfaction were associated with higher scores on attitudes of dieting and food preoccupation.

Adolescent↗