Self-weighing among adolescents: associations with body mass index, body satisfaction, weight control behaviors, and binge eating

Among adolescent girls, the health effects of frequent self-weighing are unclear. This study examines cross-sectional and longitudinal associations between frequency of self-weighing and body mass index (BMI), body satisfaction, weight control behaviors, and binge eating among a diverse population of adolescent girls. The study was conducted in the Minneapolis/St Paul, MN, metropolitan area between 2007 and 2009. The study population included 356 adolescent girls (mean age 15.7 years); 46.2% of the girls were overweight or obese and >75% were from a racial/ethnic minority group. Anthropometric and survey data were collected at baseline and at follow-up 9 months later. Hierarchical linear regression models were developed to test associations. Cross-sectionally, frequent self-weighing was associated with lower body satisfaction (P=0.034) and higher rates of healthy (P=0.002), unhealthy (P=0.016), and extreme (P=0.038) weight control behaviors. A quadratic association was found between frequency of self-weighing and binge eating, with girls who weighed themselves least and most frequently reporting the highest prevalences of binge eating (P=0.014). No association was observed between frequency of self-weighing and girls' BMI (P=0.111). Short-term longitudinal associations between baseline frequency of self-weighing and changes in body satisfaction, weight control behaviors, binge eating, or BMI were not observed. Findings suggest that among adolescent girls, frequent self-weighing is cross-sectionally associated with both healthy and potentially harmful unhealthy weight control behaviors, and does not contribute to weight loss over time. Adolescents should not be encouraged to engage in frequent self-weighing.     

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.     

Eating and weight control behaviors among middle school girls in relationship to body weight and ethnicity

This study examined the links among body mass index (BMI), weight control practices, binge eating, and eating disorders in 1164 middle school girls. Both the prevalence and frequency of weight control behaviors increased as BMI increased, but binge eating was reported approximately equally by girls across the BMI spectrum.     

Suicidal behavior in adolescents: relationship to weight status, weight control behaviors, and body dissatisfaction

OBJECTIVE: Suicide is associated with full syndromal eating disorders, but it is unclear whether subsyndromal eating disorders carry the same risk. This study examined associations between suicidal behaviors and extreme and less extreme weight control behaviors (EWCB and LWCB, such as fasting, vomiting, meal skipping, etc.), body dissatisfaction, and weight status in adolescents. METHOD: Data on body dissatisfaction, depressive symptoms, suicidal ideation and attempts, and body mass index (BMI) were drawn from Project EAT, a survey of 4,746 7th-12th grade students. Multivariate logistic regression examined associations between eating- and weight-related variables and suicidality. RESULTS: Suicidal ideation and suicide attempts were more commonly observed in adolescents with EWCB (boys: ideation OR = 2.12, attempts OR = 4.10; girls: ideation OR = 1.66, attempts OR = 2.29), LWCB (boys: ideation OR = 1.33, attempts OR = 1.76; girls: ideation OR = 1.77, attempts OR = 1.80), as well as body dissatisfaction (boys: ideation OR = 1.75, attempts OR = 2.23; girls: ideation OR = 1.77, attempts OR = 1.81), even after controlling for depressive symptoms. No association was observed between BMI and suicidal attempts or ideation. CONCLUSION: Thus, it appears that suicidal behavior in adolescents is associated even with low-level eating disorder symptoms.     

Psychosocial predictors of weight loss behaviors and binge eating in adolescent girls and boys

This study examined the predictors of dieting, extreme weight loss behaviors, and binge eating in adolescents (606 females and 315 males). High school classes were administered measures of weight loss behaviors, binge eating, perceived current and ideal body size, body dissatisfaction, advantages of being thinner and physically fitter, satisfaction with fitness, depression, self-esteem, parental overprotection, parental caring, and family adaptability and cohesion. Principal component analyses grouped predictor (body image, psychosocial) and criterion (weight loss behaviors, binge eating) variables. The primary predictor of weight loss behaviors in both sexes and binge eating in girls was the desire to be thinner which included a larger current body size. Psychological and family variables played lesser roles but were significantly predictive in a number of cases. Sex differences in factor structures and important predictors emerged. © 1992 John Wiley & Sons, Inc.     

Comparison of the child and parent forms of the Questionnaire on Eating and Weight Patterns in the assessment of children's eating-disordered behaviors

OBJECTIVE: The assessment of eating-disordered behaviors in middle childhood is challenging. Frequently, both child and parents are queried about the child's eating behavior. However, no direct comparisons between parent and child reports of child eating disturbance have been published. We compared results from the adolescent and parent versions of the Questionnaire on Eating and Weight Patterns (QEWP-A and QEWP-P, respectively) in a nontreatment sample of overweight and normal weight children. METHOD: The QEWP-A and QEWP-P were administered to 142 overweight (body mass index [BMI] > or = 85th percentile) and 121 normal weight (BMI 15th-84th percentile) children, age 9.7 +/- 1.9 years, recruited from the community. RESULTS: The QEWP-A and QEWP-P showed good agreement for the absence of eating-disordered behavior but were not concordant in terms of the number or type of binge eating, overeating episodes, or compensatory weight control behaviors in the past 6 months. Children categorized by their own reports (QEWP-A) as engaging in no overeating, simple overeating, or binge eating behaviors did not differ significantly in body composition or in eating and general psychopathology. Children categorized according to their parents' reports (QEWP-P) as engaging in binge eating had significantly greater body adiposity, eating-disordered cognitions, body dissatisfaction, and parent-reported problems (all ps <.001) than children engaging in no overeating or simple overeating according to the QEWP-P. DISCUSSION: Child and parent reports of eating behaviors are not concordant regarding the presence of binge eating or compensatory behaviors. Further investigation of the utility of these questionnaires is needed before either can serve as a surrogate for a clinical interview.     

Body dissatisfaction and dietary restraint influence binge eating behavior

As binge eating is a common behavior throughout the general population, we hypothesized that body dissatisfaction would produce binge eating via its prediction of dieting. Six hundred eight individuals were nonrandomly recruited from the community. The mean age and body mass index of participants were 34.76 years (SD, 14.41) and 27.82 kg/m² (SD, 9.54), respectively. Participants were asked to complete several self-report questionnaires, which included measures of dieting status, binge eating behavior, body dissatisfaction, overvaluation of weight and shape, and self-esteem. The results showed that dieting was a common behavior; 38.1% of participants reported dieting during the past year. Binge eating during the previous 6 months was reported by 9.9% of the sample and was associated with a higher body mass index as well as more frequent dieting. A model including dieting status, overvaluation of weight and shape, shape satisfaction, and self-esteem showed the best fit for the prediction of binge eating behavior. Moreover, those who dieted and overvalued their weight and shape were 2.01 and 2.31 times more likely, respectively, to binge eat. Structural equation modeling revealed that body dissatisfaction caused dietary restraint, thus triggering binge eating. Both dieting and overvaluation of weight and shape are important risk factors for the development of binge eating disorders. Dieting and binge eating are common behaviors that represent a risk for the development of both excess weight and eating disorders. The structural model proposed in this study could be beneficial in understanding this causal relationship.     

Disordered eating among preadolescent boys and girls: the relationship with child and maternal variables

Objective: (i) To analyze the eating behaviors and body satisfaction of boys and girls and to examine their mothers’ perceptions of these two domains; and (ii) to evaluate eating problem predictors using child body mass index (BMI), self-esteem, and body satisfaction as well as maternal BMI, eating problems, and satisfaction with their child’s body. The participants included 111 children (54.1% girls aged between 9 and 12 years old) and their mothers. Assessment measures included the Child Eating Attitude Test, the Self-Perception Profile for Children, the Eating Disorders Questionnaire, and the Child Eating Behavior Questionnaire. Child and maternal measures also included BMI and Collins Figure Drawings. Results: (i) No association between child and maternal BMI for either sex was found; (ii) no difference was found between boys and girls with regard to eating behavior; (iii) most children revealed a preference for an ideal body image over their actual body image; (iv) most mothers preferred thinner bodies for their children; (v) greater BMI was related to higher body dissatisfaction; and (vi) child BMI and dissatisfaction with body image predicted eating disturbances in boys, whereas self-esteem, maternal BMI, and eating behavior predicted them in girls. Discussion: Maternal eating problems and BMI were related to female eating problems only.     

Differentiating the effects of maternal and peer encouragement to diet on child weight control attitudes and behaviors

Obese and overweight youth are more at risk for engaging in frequent dieting, unhealthy weight control behaviors and report more body dissatisfaction than their normal weight peers. Previous research has indicated that peer and maternal encouragement to diet is predictive of unhealthy weight related behaviors and attitudes. The current study aims to examine if maternal and peer encouragement to diet equally mediate the relationship between youth BMI z-score and (a) unhealthy weight control behaviors, (b) diet frequency and (c) body dissatisfaction in a sample of racially diverse boys and girls. Participants were 94 children/adolescents between the ages of 8-17. Results were stratified by gender. Three bootstrapped multiple mediation models were conducted to examine each outcome variable. Results indicated that maternal encouragement to diet mediated the relationships predicting unhealthy weight control and diet frequency for girls, but not for boys. Peer encouragement to diet significantly mediated the relationship predicting unhealthy weight control behaviors, with increased peer encouragement associated with fewer unhealthy weight control behaviors for girls. Peer encouragement to diet was not a significant mediator for any of the outcomes for boys. Results suggest that maternal encouragement to diet may play a larger role than peer encouragement to diet in predicting unhealthy weight attitudes and behaviors for girls.     

Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later?

OBJECTIVE: To determine if adolescents who report dieting and different weight-control behaviors are at increased or decreased risk for gains in body mass index, overweight status, binge eating, extreme weight-control behaviors, and eating disorders 5 years later. DESIGN: Population-based 5-year longitudinal study. PARTICIPANTS: Adolescents (N=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2). MAIN OUTCOME MEASURES: Weight status, binge eating, extreme weight control, and self-reported eating disorder. STATISTICAL ANALYSIS: Multiple linear and logistic regressions. RESULTS: Adolescents using unhealthful weight-control behaviors at Time 1 increased their body mass index by about 1 unit more than adolescents not using any weight-control behaviors and were at approximately three times greater risk for being overweight at Time 2 (odds ratio [OR]=2.7 for girls; OR=3.2 for boys). Adolescents using unhealthful weight-control behaviors were also at increased risk for binge eating with loss of control (OR=6.4 for girls; OR=5.9 for boys) and for extreme weight-control behaviors such as self-induced vomiting and use of diet pills, laxatives, and diuretics (OR=2.5 for girls; OR=4.8 for boys) 5 years later, compared with adolescents not using any weight-control behaviors. CONCLUSIONS: Dieting and unhealthful weight-control behaviors predict outcomes related to obesity and eating disorders 5 years later. A shift away from dieting and drastic weight-control measures toward the long-term implementation of healthful eating and physical activity behaviors is needed to prevent obesity and eating disorders in adolescents.     

Prevalence and magnitude of body weight and shape dissatisfaction among university students

Although prevalence of overweight and obesity is increasing, prevailing sociocultural influences lead females to desire a thin body and males a muscular body, often resulting in body dissatisfaction (BD) because many cannot achieve the cultural ideal. This study examined the magnitude of BD in university undergraduates (n=310). Body weight dissatisfaction (BWD) was measured as the difference between current and idealized body weight; body shape dissatisfaction (BSD) as the difference between and current and idealized body shape. Overall, females expressed greater BD than males. Overweight individuals expressed the greatest BWD and BSD, yet half desired a weight that would maintain their overweight body mass index (BMI) classification. Normal weight females desired a slightly thinner, lighter body, while desires among normal weight males were mixed. Underweight females and normal weight males expressed little BWD and BSD, commonly idealizing a body weight maintaining their BMI classification. However, results may suggest a shift in body size ideals in an era of prevalent obesity, with overweight males and females expressing less BD and few normal weight individuals, particularly females, idealizing a very thin body.     

Why do slim women consider themselves too heavy? A characterization of adult women considering their body weight as too heavy

OBJECTIVE: The purpose of this study was to characterize women who, in spite of a low body mass index (BMI), considered themselves too heavy. METHOD: Of 11,905 women (27-38 years of age), we focused on 2,443 nonpregnant women with a low BMI (18.5-21.0 kg/m(2)), who considered their weight acceptable or too heavy. Participants completed a comprehensive questionnaire. By multiple logistic regression we examined associations between lifestyle and health variables and the risk of considering own body weight too heavy. RESULTS: Approximately 10 % considered their body weight too heavy. Risk factors included early severe life events, young age at start of risky lifestyle behaviors, weight fluctuation, self-reported lifetime history of eating disorders, perception of too heavy workload, and poor physical form and self-rated health. Body dissatisfaction decreased with increasing age. DISCUSSION: Our results indicate that body dissatisfaction is established in childhood and adolescence. It is unknown if this body dissatisfaction influences the life of the women, but it might influence the values they pass on to their children.     

Factors associated with body dissatisfaction in non-clinical adolescents at risk of eating disorders

Aim To examine factors (individual, familiar and socio-cultural) associated with body dissatisfaction (BD) by gender in non-clinical adolescents at risk of eating disorders (rED) and in a control group (CG). Subjects and methods A total of 2,967 adolescent students was screened using the Eating Attitudes Test-40 and the Youth’s Inventory-4. Of these, 217 students (161 girls and 56 boys) identified as being at rED were chosen for the study, and 208 students (168 girls and 40 boys) were chosen as the CG. The subjects were given the Body Areas Satisfaction Test, the Youth’s Inventory-4, a questionnaire to evaluate social influences on the “model of thinness” (SI-MT), the Family Environment Scale, and their body mass index (BMI) was determined. Results BD frequency in at-risk girls (44.6%) was significantly higher than in boys (27.3%). Girls at rED were most dissatisfied with their weight. BMIs were significantly higher and energy intake was significantly lower in dissatisfied girls than in satisfied girls at rED. In girls at rED, multiple linear regression analyses showed that SI-MT factors and dysthymia were associated with BD. In the CG, higher BMI were associated with BD. These relationships were not found in adolescent boys. Conclusion Within the at-risk group, adolescents with BD had higher BMIs, consumed fewer calories, were more influenced by socio-cultural factors and had more emotional issues than those who were satisfied. We suggest that although high BMIs are associated with BD, the interaction with other social and psychopathological characteristics increases the risk of the development of eating disorders.     

Predictors of body image dissatisfaction and disturbed eating attitudes and behaviors in African American and Hispanic girls

Disturbed eating attitudes and behaviors are widespread among girls in the United States. Because obesity is one of the leading risk factors for eating disorder development, African American and Hispanic girls may be at heightened risk due to their greater prevalence and degree of overweight. The present study examined the associations among disturbed eating attitudes and behaviors, body image dissatisfaction, weight classification, fears of negative evaluation, and coping skills among 139 African American and Hispanic girls in Grades 4 and 5 from a low-income urban area. African American girls had significantly lower body image dissatisfaction than Hispanic girls. Significant predictors of body image dissatisfaction included fear of negative evaluation and weight classification. Fear of negative evaluation was also a significant predictor of disturbed eating attitudes and behaviors. Overall, 10.1% of the African American girls and 12.7% of the Hispanic girls qualified for a diagnosis of a probable eating disorder. Girls with eating disorders had greater fears of negative evaluation and engaged in more cognitive avoidance. Both groups are at risk of eating disorder development.     

The sociocultural model of eating disorder development: application to a Guatemalan sample

Exposure to Western ideals of appearance along with rapid societal change appears to be salient risk factors for eating disorder development. According to the sociocultural model, internalization of the thin ideal leads to body dissatisfaction and subsequent negative affect and dieting behaviors which increase the risk for eating disorder development. An expanded version of the sociocultural model was examined among an economically stratified sample of 347 girls in grades 5 and 6 from Guatemala City. Questionnaires used to measure disturbed eating attitudes and behaviors, body dissatisfaction, social sensitivity, and internalization of the thin ideal were administered and BMI was calculated following measurement of height and weight. Path analyses showed that the expanded sociocultural model was an excellent fit to the data. Both elevated adiposity and social sensitivity led to increased body dissatisfaction and thin ideal internalization. Thin ideal internalization led to body dissatisfaction and to disturbed eating attitudes and behaviors. Results suggest that developing countries are not immune to the influence of sociocultural risk factors for eating disorders.     

Chocolate craving among children: implications for disordered eating patterns

The aim was to test the validity of a multidimensional model of chocolate craving among children, and to examine if the dimensions underlying the model predict consumption and eating disordered symptoms. Participants were 602 children (53% female) aged 11, 12, and 13 from 11 schools in Western Australia. Measures included the Orientation to Chocolate Questionnaire (OCQ) designed to assess three components of chocolate craving (approach, avoidance, and guilt), questions assessing body image dissatisfaction and dieting, and body mass index (BMI). Using structural equation modeling, results confirmed that chocolate craving among children is best conceptualized as a three-factor model (approach, avoidance, guilt). The underlying dimensions were differentially associated with self-reported chocolate consumption and indicators of disordered eating patterns. After controlling for BMI and gender, chocolate-related guilt was strongly associated with greater body dissatisfaction and dieting, and avoidance inclinations were also associated with dieting. Chocolate-related guilt was higher in girls than in boys. Results suggest that children experience chocolate craving as a multidimensional phenomenon reflecting some ambivalence. A gender difference in chocolate-related guilt appears to emerge in childhood, potentially contributing to a greater risk for girls to develop exaggerated concerns about body shape and weight.     

Development of body image,eating disturbance,and general psychological functioning in adolescent females: a replication using covariance structure modeling in an Australian sample

OBJECTIVE: The current study is a follow up to a covariance structure modeling (CSM) investigation of predictors of body image, eating dysfunction, and general psychological functioning in U.S. adolescent females. METHOD: Four hundred and seventy Australian girls (13-17 years old) completed measures of teasing history, body dissatisfaction, global psychological functioning, dietary restraint, and bulimic behaviors. They were also measured in order to compute body mass index (BMI). CSM techniques were used to analyze the relationships between these latent variables. Two a priori models were tested, one was selected, and post-hoc model-fitting was undertaken. RESULTS: The final model indicated that BMI directly influenced teasing, which directly influenced body dissatisfaction. Body dissatisfaction influenced both global psychological functioning and restriction, whereas restriction had a direct influence on bulimia. Global psychological functioning also had a direct influence on bulimia. DISCUSSION: The results support previous research indicating that teasing and body dissatisfaction are risk factors for the development of eating disturbances.     

Binge eating and weight-related quality of life in obese adolescents

Limited data exist regarding the association between binge eating and quality of life (QOL) in obese adolescent girls and boys. We, therefore, studied binge eating and QOL in 158 obese (BMI ≥ 95th percentile) adolescents (14.5 ± 1.4 years, 68.0% female, 59% African-American) prior to weight-loss treatment. Youth completed an interview to assess binge eating and a questionnaire measure of QOL. Controlling for body composition, binge eating youth (n = 35), overall, reported poorer QOL in domains of health, mobility, and self-esteem compared to those without binge eating (ps < 0.05). Also, girls, overall, reported poorer QOL than boys in activities of daily-living, mobility, self-esteem, and social/interpersonal functioning (ps < 0.05). Girls with binge eating reported the greatest impairments in activities of daily living, mobility, self-esteem, social/interpersonal functioning, and work/school QOL (ps < 0.05). Among treatment-seeking obese adolescents, binge eating appears to be a marker of QOL impairment, especially among girls. Prospective and treatment designs are needed to explore the directional relationship between binge eating and QOL and their impact on weight outcomes.     

Why does dieting predict weight gain in adolescents? Findings from project EAT-II: a 5-year longitudinal study

OBJECTIVE: Dieting has been found to predict weight gain in adolescents, but reasons for this association remain unclear. This study aimed to explore potential mechanisms by which dieting predicts weight gain over time in adolescents. DESIGN: Population-based, 5-year longitudinal study. PARTICIPANTS: Adolescents (n=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2). MAIN OUTCOME MEASURE: Body mass index (BMI) change over 5 years. STATISTICAL ANALYSIS: Multiple regressions were used to examine associations between Time 1 dieting and Time 2 binge eating, breakfast consumption, fruit and vegetable intake, and physical activity. Associations were then examined between these behaviors and BMI change. Finally, to test for mediating effects, associations between dieting and BMI change were examined with and without the inclusion of these behaviors, and regression coefficients were compared. RESULTS: In female adolescents, dieting predicted increased binge eating (P<0.001) and decreased breakfast consumption (P=0.030). In male adolescents, dieting predicted increased binge eating (P<0.001), decreased physical activity (P=0.006), and a trend toward decreased breakfast consumption (P=0.064). These behaviors were also associated with increases in BMI. The association between dieting and BMI increase was weakened, but still remained significant, after binge eating, breakfast consumption, fruit/vegetable intake, and physical activity were included in the model being tested. Thus, the longitudinal association between dieting and BMI increase was partially mediated by these behaviors. CONCLUSIONS: In part, dieting may lead to weight gain via the long-term adoption of behavioral patterns that are counterproductive to weight management.     

Relative validity of self-assessment of silhouette and BMI (body mass index)

Overweight and obesity in childhood and adolescence is unquestionable risk factor for pathogenic obesity in adulthood, high mortality and morbidity for cardiovascular diseases and other health disorders, and also may cause the worse social and economical adaptation. Nevertheless, little is yet known about subjective perception of own body, the pathway leading to dissatisfaction of the body, development of chronic stress and behavioural disorders (anorexia, binge eating, bulimia) as a consequence. In Health Promotion Department of the National Institute of Hygiene the multidimensional investigations of adolescents' health and life style were undertaken, and analysis of association between subjective image of body and real body mass was a part of these investigations. Data were obtained from 672 randomly selected schoolchildren aged 14-15 years attending seventeen public and private schools in Warsaw. Respondents informed about their weight and high for calculation BMI. Simultaneously, they were asked, whether they assess themselves as leaner than their peers, the same or thicker. The study showed that girls in comparison with boys more accurately assessed their silhouette. The boys were more likely than girls to perceive themselves as the same as their peers, despite they had real underweight or overweight. Our findings suggest that real mass of body itself account for variance of subjective perceived body in moderate degree, and there are other factors influencing body image at least as real mass of body.