Media Exposure, Current and Future Body Ideals, and Disordered Eating Among Preadolescent Girls: A Longitudinal Panel Study

Internalization of the thin body ideal is considered by many to account for the relationship between media exposure and disordered eating among girls and young women, but almost all supporting research has employed adolescent and adult samples. Using longitudinal panel survey data collected from 257 preadolescent girls at 2 points in time 1 year apart, we tested relationships between self-reported television and magazine exposure at wave 1 and current (prepubescent) and future (postpubescent) body ideals and disordered eating at wave 2. Controlling age, race, perceived body size, and body ideals and disordered eating measured at wave 1, television viewing at wave 1 predicted increased disordered eating and a thinner postpubescent body ideal at wave 2. In contrast, none of the media variables predicted a thinner prepubescent body ideal at wave 2. These findings suggest that the thin-ideal internalization construct needs refinement to enhance its developmental sensitivity.

Gender-related Risk and Protective Factors for Depressive Symptoms and Disordered Eating in Adolescence: A 4-year Longitudinal Study

The interplay between intrapersonal risk (low self-esteem, perfectionism and body dissatisfaction) and interpersonal protection (social support) appears relevant for delineating gender-specific pathways that lead to both depressive and eating psychopathology. The aims of this longitudinal study were to examine gender differences in the levels of depressive symptoms, disordered eating and the co-occurrence of both problems from preadolescence to mid-adolescence and to identify gender-specific risk and protective factors of depressive symptoms and disordered eating. A Spanish community-based sample initially comprising 942 early adolescents (49% females) was assessed at baseline (T1; X _age = 10.8 years) and at 2 and 4-year follow-up (T2 and T3). Gender differences emerged at T2 for disordered eating and at T3 for depressive symptoms and for co-occurring depressive symptoms and disordered eating. Predictors of depressive symptoms were body dissatisfaction, low self-esteem and fear of getting fat, for girls, and body dissatisfaction and low self-esteem, for boys. Predictors of disordered eating were body dissatisfaction, depressive symptoms, BMI and perfectionism, for girls, and low social support and BMI, for boys. In addition, for boys only, social support moderated the effect of body dissatisfaction on depressive symptoms and the effect of depressive symptoms on disordered eating. The hypotheses of the study were partially supported. Clinical implications are derived regarding the components that should be included in programs for preventing depression and eating disorders in both girls and boys.     

The Body Perfect Ideal and Eating Regulation Goals: Investigating the Role of Adolescents’ Identity Styles

Adolescents are exposed to images depicting the thin or muscular ideal almost on a daily basis. When the body perfect ideal is adopted, adolescents are at increased risk for developing unhealthy and disordered eating behaviors. The aim of the current 3-wave longitudinal study among adolescents (N = 418; 54 % girls) was to investigate whether different styles of identity exploration (i.e., information-oriented, normative, and diffuse-avoidant) are associated differentially with changes in adoption of the body perfect ideal, which, in turn, would relate to changes in appearance-focused and health-focused eating regulation. Results indicated that the information-oriented style predicted decreases and the normative style predicted increases in adoption of the body perfect ideal. In turn, adoption of the body perfect ideal predicted significant increases in appearance-focused eating regulation but not in health-focused eating regulation. A diffuse-avoidant style was unrelated to changes in adoption of the body perfect, yet directly predicted decreases in health-focused eating regulation. Theoretical and clinical implications of these findings are discussed.     

A Biopsychosocial Model of Body Image Concerns and Disordered Eating in Early Adolescent Girls

Body image and eating concerns are prevalent among early adolescent girls, and associated with biological, psychological and sociocultural risk factors. To date, explorations of biopsychosocial models of body image concerns and disordered eating in early adolescent girls are lacking. A sample of 488 early adolescent girls, mean age = 12.35 years (SD = 0.53), completed a questionnaire assessing depressive symptoms, self-esteem, body mass index (BMI), sociocultural appearance pressures, thin-ideal internalization, appearance comparison, body image concerns and disordered eating. Structural equation modelling was conducted to test a hypothetical model in which internalization and comparison were mediators of the effect of both negative affect and sociocultural influences on body image concerns and disordered eating. In addition, the model proposed that BMI would impact body image concerns. Although the initial model was a poor fit to the data, the fit was improved after the addition of a direct pathway between negative affect and bulimic symptoms. The final model explained a large to moderate proportion of the variance in body image and eating concerns. This study supports the role of negative affect in biopsychosocial models of the development of body image concerns and disordered eating in early adolescent girls. Interventions including strategies to address negative affect as well as sociocultural appearance pressures may help decrease the risk for body image concerns and disordered eating among this age group.     

Gender Differences Among Adolescents in Family,and Peer Influences on Body Dissatisfaction,Weight Loss,and Binge Eating Behaviors

The present study examined perceived family and peer influences on body dissatisfaction, weight loss, and binge eating behaviors in adolescents. Three hundred and six girls aged 11 to 17 years (M = 13.66, SD = 1.12) and 297 boys aged 11 to 18 years (M = 13.89, SD = 1.13) completed a questionnaire that examined the direct influence and quality of family and peer relationships on body dissatisfaction and disordered eating. Direct influences of family and peers, rather than the quality of these relationships, predicted body dissatisfaction and disordered eating in adolescent boys and girls. Interesting differences were found between girls and boys in the nature of the influences and in the way they were expressed. In particular, parental and peer discussion and encouragement of weight loss predicted disordered eating behaviors in girls, while maternal and peer encouragement predicted binge eating and weight loss behaviors in boys. Fathers played a salient role in the expression of more severe forms of eating problems, while siblings played a small yet significant role in cognitive restraint among girls. The findings highlight gender differences in the importance of significant others in the expression of body dissatisfaction and disordered eating in adolescence.     

Weight Perception, Substance Use, and Disordered Eating Behaviors: Comparing Normal Weight and Overweight High-School Students

Disordered eating behaviors and substance use are two risk factors for the development of serious psychopathology and health concerns in adulthood. Despite the negative outcomes associated with these risky behaviors, few studies have examined potential associations between these risk factors as they occur during adolescence. The importance of accurate or inaccurate weight perception among adolescents has received increased interest given documented associations with nutritional beliefs and weight management strategies. This study examined the associations among the perceptions of weight and substance use with disordered eating behaviors among a diverse sample of normal weight and overweight adolescent males and females. Data came from the 2007 National Youth Risk Behavior Survey (YRBS). The sample consisted of 11,103 adolescents (53.4% female; 44% Caucasian, 21% African American; 13% Hispanic; age responses ranged from 12 and under to 18 and over), with 31.5% meeting criteria for being either at-risk for obesity or already obese (i.e., overweight). As hypothesized, overestimation of weight among normal weight adolescents and accurate perceptions of weight among overweight adolescents were associated with higher rates of disordered eating behaviors. In normal weight adolescents, use of all three substances (tobacco, binge drinking, and cocaine) was associated with each disordered eating behavior. In contrast, findings revealed differences for overweight adolescents between the type of substance use and disordered eating behavior. Post hoc analyses revealed that gender moderated some of these relationships among overweight individuals. Implications for the development and implementation of secondary prevention programs aimed at reducing disordered eating behaviors, substance use, and obesity risk among normal and overweight adolescents are considered.     

Disordered Eating Precursors in Pre- and Early Adolescent Girls and Boys

First- and second-year findings from a study of the development of disordered eating in pre- and early adolescents are presented. Fifth- and sixth-grade girls (n = 80) and boys (n = 85) were assessed on depression, body image, self-esteem, and eating behaviors and attitudes in Year 1 and again one year later. Weight, height, and pubertal development were also evaluated in Year 1 and Year 2. Gender differences existed on all measures in Year 2 and indicated consistently poorer scores for girls compared to boys. For girls, Year 1 Body Mass Index and pubertal development predicted Year 2 disordered eating. For boys, poor body image in Year 1 predicted Year 2 disordered eating. The importance of identifying early risk factors for eating disorders is discussed.     

Gender Differences in Peer and Parental Influences: Body Image Disturbance,Self-Worth,and Psychological Functioning in Preadolescent Children

The connections between body image disturbance and psychological functioning have been well established in samples of older adolescent girls and young women. Little is known, however, about body image in younger children. In particular, little is known about possible gender differences in preadolescent children. The current study explored self-reported body image disturbance and psychological functioning in relation to peer and parental influences in 141 elementary school-aged girls and boys aged 8–11. Results suggest that girls are more concerned about dieting and are more preoccupied with their weight than are boys. Girls also reported a greater drive for thinness and a higher level of family history of eating concerns than did boys. Correlations suggested that girls' experiences of body image concerns (body dissatisfaction, bulimia, and drive for thinness) were related to a number of factors (such as family history of eating concerns, peer influences, teasing, depression, and global self-worth) whereas boys' experiences of body image concerns were related to fewer factors. On the basis of these findings, the assessment and treatment of body image concerns in preadolescent children (especially girls) are of great importance. Implications for intervention and prevention programs are discussed.     

The Contribution of Emotion Regulation to Body Dissatisfaction and Disordered Eating in Early Adolescent Girls

To understand whether difficulties in emotional functioning distinguish between body dissatisfaction and disordered eating, a set of emotion regulation (i.e., negative emotion, emotional awareness, coping), demographic (i.e., age), and physical (i.e., BMI (Body Mass Index)) factors were assessed in 234 early adolescent girls, grades six to eight. Compared to younger girls, older girls had higher BMI and reported increased body dissatisfaction. Age, BMI, and negative affect predicted body dissatisfaction, whereas BMI, body dissatisfaction, and lack of emotional awareness predicted disordered eating. Further, girls who reported high levels of disordered eating reported experiencing increased levels of negative affect, greater difficulties with emotional awareness, and more difficulty coping constructively with negative emotion than girls who reported low levels of disordered eating. Results support the contention that body dissatisfaction, combined with difficulties in emotional awareness are related to disordered eating.Leslie Sim is an assistant professor at the Mayo Medical School, a Senior Associate at the Mayo Clinic, and Clinical Director of the Mayo Inpatient Eating Disorders Program. She received her Ph.D. from University of Maine in Developmental and Clinical Psychology. Her research interests include eating disorders, self-injurious behavior, and emotion regulation skills in children and adolescents.Janice Zeman is an associate professor at the College of William and Mary. She received her Ph.D. from Vanderbilt University in Developmental and Clinical Psychology. Her research interests include children's and adolescents' emotion regulation skills particularly as they relate to maladaptive functioning with other research interests in parental and peer socialization of emotion.     

Psychosocial Correlates of Shape and Weight Concerns in Overweight Pre-Adolescents

Shape and weight concerns among overweight pre-adolescents heighten risk for eating disorders and weight gain. Treatment and prevention efforts require consideration of psychosocial factors that co-occur with these concerns. This study involved 200 overweight pre-adolescents, aged 7–12 years (M age = 9.8; SD = 1.4), presenting for family-based weight control treatment. Hierarchical regression was used to examine the influence of pre-adolescents’ individual characteristics and social experiences, and their parents’ psychological symptoms, on shape and weight concerns as assessed by the Child Eating Disorder Examination. Findings revealed that higher levels of dietary restraint, greater feelings of loneliness, elevated experiences with weight-related teasing, and higher levels of parents’ eating disorder symptoms predicted higher shape and weight concerns among overweight pre-adolescents. Interventions addressing overweight pre-adolescents’ disordered eating behaviors and social functioning, as well as their parents’ disordered eating behaviors and attitudes, may be indicated for those endorsing shape and weight concerns.     

Weight-Based Victimization Among Adolescents in the School Setting: Emotional Reactions and Coping Behaviors

Weight-based victimization is a frequent experience for adolescents, but little is known about their emotional reactions and coping strategies in response to weight-based teasing and bullying. The present study examined the ways that adolescents cope with experiences of weight-based victimization at school. An initial sample of 1,555 students from two high schools in central Connecticut completed a comprehensive battery of self-report measures to assess their experiences of weight-based teasing and bullying at school, affective responses to these experiences, and coping strategies used to deal with incidents of weight-based victimization. Only those students who reported experiencing weight-based victimization (N = 394) were included for the purposes of the present study. Of this sub-sample, 56% were females, 84% were Caucasian, and the mean age was 16.4 years. Weight-based victimization resulted in 40–50% of adolescents feeling sad and depressed, worse about themselves, bad about their body, angry, and some feeling afraid. Gender differences emerged with respect to how boys and girls react to experiences of weight-based victimization. However, structural equation model estimates demonstrated that both boys and girls who reported negative affect in response to weight-based victimization were more likely to use coping strategies of avoidance (e.g., avoiding gym class), increased food consumption, and binge eating. Binary logistic regressions showed that the odds of students skipping school or reporting that their grades were harmed because of weight-based teasing increased by 5% per teasing incident, even after controlling for gender, age, race, grades, and weight status. To our knowledge, this study is the first systematic examination of affective reactions and coping strategies among overweight adolescents in response to weight-based victimization. These findings can inform efforts to assist overweight youth to cope adaptively with weight-based victimization.     

Body image ideals of low-income African American mothers and their preadolescent daughters

Given the high incidence of obesity and obesity-related health problems among low-income African American women, it is both timely and significant to study factors that contribute to obesity in this population. The perception of current body size (body image) and desired body size (body image ideal) has been associated with the development of anorexia and bulimia in white adolescent girls. Body images and ideals may also be related to the development of obesity among African Americans adolescent girls. This study examined the body images and ideals of 27 low-income African American mothers and their 29 preadolescent daughters. Results suggest that there is a relationship between mothers' perceptions of their daughters bodies and their daughters' body images. Preadolescent, low-income, African American girls have normal weight ideals rather than the ultrathin ideals typically found among white girls. Normal weight girls have ideals that are heavier than their body images. This population may be less motivated than those with thinner ideals to engage in behaviors that would prevent the development of obesity during adolescence. Health promotion programs for this population should acknowledge cultural body weight standards.This study was funded by the American Heart Association of Metropolitan Chicago.Received B.A from the University of Pennsylvania. Research interests include cross-cultural studies of body image, eating disorders, health risk perceptions, and health promotion programs.Received Ph.D. from in Clinical Psychology from Long Island University. Research interests include obesity prevention, binge eating, and cultural differences in eating behavior.     

Sociocultural Variations in the Body Image Perceptions of Urban Adolescent Females

This study investigated the influences of ethnicity, socioeconomic status, and ethnic peer group composition on awareness and internalization of socially sanctioned standards of appearance using the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ). The researchers surveyed a convenience sample of 208 adolescent females at an ethnically diverse urban high school. Statistical analyses found that ethnicity influenced awareness of socially sanctioned standards of appearance but the effects of ethnicity varied by level of caregiver educational attainment. Ethnicity and caregiver educational attainment together accounted for variance in the internalization of these standards. Moreover, African American girls with ethnically heterogeneous peer groups had significantly higher awareness and internalization scores than those without mixed friends. These findings highlight the importance of multiple ecological factors in assessing risk for disturbed body image and eating disorders. Ethnicity remains an important predictor of disturbed body image but should be treated as a dynamic, rather than a fixed risk factor.     

The Peer Appearance Culture During Adolescence: Gender and Body Mass Variations

The purpose of this research was to examine gender and body mass, as factors linked to perceived experiences within the peer appearance culture. The sample included 215 girls and 200 boys who were either in 7th grade or 10th grade. Students provided self-reports on experiences in three domains: appearance culture among friends (appearance conversations and diet/muscle talk), peer evaluations (peer appearance pressure, appearance teasing, and vicarious peer teasing), and peer acceptance concerns (appearance-based acceptance, peer appearance comparison). The results indicated that although girls reported more appearance conversations, boys perceived more appearance pressure and teasing. Boys also admitted that they talked with friends about muscle building at a rate greater than girls talked about dieting. BMI showed distinct gender patterns. BMI was a key attribute that unified the experiences within the appearance culture for overweight girls. Among the boys, BMI was associated with differentiated experiences for underweight and overweight participants.Associate Professor in Educational Psychology at the University of Washington. She is a developmental psychologist specializing in the contributions of peers to body image and social-emotional well-being during adolescence. Research interests include body image during adolescence and gender differences.Doctoral student at the University of Washington in Human Development and Cognition. Her research focuses on the social-emotional development of adolescents, academic and appearance social comparisons, and issues related to gender and science. Research interests include body image during adolescence, gender differences, social comparison, and academic competence.     

Eating Problems and Their Risk Factors: A 7-Year Longitudinal Study of a Population Sample of Norwegian Adolescent Girls

The longitudinal stability of eating problems and their relationships to risk factors were investigated in a representative population sample of 623 Norwegian girls aged 13–14 followed over 7 years (3 time points). Three eating problem symptoms were measured: Restriction, Bulimia-food preoccupation, and Diet, all taken from the12-item Eating Attitudes Test. The aim of the study was to investigate the stability of these eating problem symptoms both as separate components (as opposed to total symptom load) as well as from a syndrome perspective. Over 7 years, dieting behavior showed the highest correlational stability (0.32). Regarding stable eating problem syndromes, at all 3 time points, 1 group of girls with generalized eating problems was found, characterized by simultaneously pronounced bulimic tendencies and dieting. However, we did not establish individual stability across 7 years for this syndrome group. Through development, eating problem symptoms were associated with characteristic risk factors. Similarities and differences between findings regarding eating problems and eating disorders are discussed.     

Weight-Related Teasing in the School Environment: Associations with Psychosocial Health and Weight Control Practices Among Adolescent Boys and Girls

Weight-related teasing has been found to be associated with low self-esteem, depressive symptoms, body dissatisfaction, and weight control behaviors in adolescents. While research has typically examined weight-related teasing directed towards the individual, little is known about weight-related teasing at the school level. This study aimed to determine the association between the school-level prevalence of weight-related teasing and psychosocial factors, body dissatisfaction and weight control behaviors in adolescents. Adolescents (N = 2,793; 53.2 % female) attending 20 US public middle and high schools were surveyed as part of the Eating and Activity in Teens (EAT) 2010 study. Generalized estimating equations were used to estimate the association between school-level weight-related teasing and health variables, controlling for individual-level weight-related teasing, clustering of individuals within schools, and relevant covariates. A greater school-level prevalence of weight-related teasing was associated with lower self-esteem and greater body fat dissatisfaction in girls, and greater depressive symptoms in boys, over and above individual-level weight-related teasing. Dieting was associated with the school-level prevalence of weight-related teasing in analysis adjusted for covariates in girls, but not following adjustment for individual-level weight-related teasing. Unhealthy weight control behaviors, extreme weight control behaviors, and muscle-enhancing behaviors were not associated with the school-level prevalence of weight-related teasing in girls or boys. Findings from the current study, in conjunction with previous findings showing associations between weight-related teasing, psychological concerns, and weight control behaviors, highlight the importance of implementing strategies to decrease weight-related teasing in schools.     

Longitudinal Predictors of Restrictive Eating and Bulimic Tendencies in Three Different Age Groups of Adolescent Girls

This study examined longitudinal predictors of future eating problems in 435 female adolescents in Grades 7, 8, and 10, who were tested at two time points 8 months apart. Restrictive eating and bulimic tendencies were found to be relatively stable from Time 1 to Time 2, particularly in older grade levels. Partial correlations predicting Time 2 restrictive eating and bulimic tendencies indicated a role of body dissatisfaction, depression, and weight-related teasing, with findings being most clear in Grade 7. Path analyses indicated that the relationships among predictors were more complex and that some of the relationships were mediated by other variables.     

Mental Health Literacy and Eating-Disordered Behavior: Beliefs of Adolescent Girls Concerning the Treatment of and Treatment-Seeking for Bulimia Nervosa

This research examined the “mental health literacy” of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking for the problem described. Results indicated that primary care practitioners, mothers and close female friends were most highly regarded as potential sources of help. Self-help interventions, including the use of vitamins and minerals, were also highly regarded, whereas participants were less positive about the benefits of mental health specialists and ambivalent about the use of anti-depressant medication. Most participants believed that the problem described would be difficult to treat, and that relapse was likely even given appropriate treatment. An additional finding of note was that among participants with a high level of eating disorder symptoms (n=36, 6.9%), recognition of an eating problem was poor. We conclude that beliefs likely to be conducive to low and/or inappropriate treatment-seeking for eating problems may be common among adolescent girls. In addition, the findings suggest that prevention programs for the eating disorders need to target not only at-risk individuals, but also individuals in their immediate social environment.     

Body Dissatisfaction Among Adolescent Boys and Girls: The Effects of Body Mass,Peer Appearance Culture and Internalization of Appearance Ideals

Body image dissatisfaction is a significant risk factor in the onset of eating pathology and depression. Therefore, understanding predictors of negative body image is an important focus of investigation. This research sought to examine the contributions of body mass, appearance conversations with friends, peer appearance criticism and internalization of appearance ideals to body dissatisfaction among adolescents. The sample was comprised of 239 (54% female) adolescents, with a mean age of 16 years. Self-report questionnaires were completed on body dissatisfaction, peer appearance conversations and criticism, internalization of appearance ideals, height and weight. For girls and boys, body mass, appearance conversations with friends, peer appearance criticism and internalized appearance ideals emerged as significant predictors of body dissatisfaction. Gender moderated the effect of body mass on body dissatisfaction. Internalization mediated the relationship between peer appearance conversations and criticism, and body dissatisfaction. These findings suggest that while body mass exerts a differential risk for body dissatisfaction among boys and girls, internalisation may represent a key psychological process that underpins body dissatisfaction among both boys and girls.     

Parental and Peer Factors Associated with Body Image Discrepancy among Fifth-Grade Boys and Girls

Many young adolescents are dissatisfied with their body due to a discrepancy between their ideal and actual body size, which can lead to weight cycling, eating disorders, depression, and obesity. The current study examined the associations of parental and peer factors with fifth-graders’ body image discrepancy, physical self-worth as a mediator between parental and peer factors and body image discrepancy, and how these associations vary by child’s sex. Body image discrepancy was defined as the difference between young adolescents’ self-perceived body size and the size they believe a person their age should be. Data for this study came from Healthy Passages, which surveyed 5,147 fifth graders (51 % females; 34 % African American, 35 % Latino, 24 % White, and 6 % other) and their primary caregivers from the United States. Path analyses were conducted separately for boys and girls. The findings for boys suggest father nurturance and getting along with peers are related negatively to body image discrepancy; however, for girls, fear of negative evaluation by peers is related positively to body image discrepancy. For both boys and girls, getting along with peers and fear of negative evaluation by peers are related directly to physical self-worth. In addition, mother nurturance is related positively to physical self-worth for girls, and father nurturance is related positively to physical self-worth for boys. In turn, physical self-worth, for both boys and girls, is related negatively to body image discrepancy. The findings highlight the potential of parental and peer factors to reduce fifth graders’ body image discrepancy.