The nature of body image disturbance in patients with binge eating disorder

OBJECTIVE: This study examined the distinction between body dissatisfaction and self-evaluation unduly influenced by body shape and weight, and their longitudinal relationships to depressive symptomatology and self-esteem in patients with binge eating disorder (BED). METHOD: Ninety-seven patients with BED completed measures tapping these constructs at baseline and again 4 weeks later. RESULTS: Change in body dissatisfaction was significantly correlated with both change in depressive symptomatology and change in self-esteem over time, whereas change in self-evaluation was significantly correlated only with change in self-esteem. In addition, change in shape concern, but not change in weight concern, was significantly correlated with change in self-esteem only. DISCUSSION: These findings suggest that self-evaluation unduly influenced by body shape is a more useful indicator for BED than body dissatisfaction or self-evaluation unduly influenced by weight.     

Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance

OBJECTIVE: The current study examined comorbidity and clinical correlates of eating disorders in a large sample of individuals with body dysmorphic disorder (BDD). METHOD: Two hundred individuals with DSM-IV (4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994) BDD completed reliable interviewer-administered and self-report measures, including diagnostic assessments and measures of body image, symptom severity, delusionality, psychosocial functioning, quality of life (QOL), and history of psychiatric treatment. RESULTS: A total of 32.5% of BDD subjects had a comorbid lifetime eating disorder: 9.0% had anorexia nervosa, 6.5% had bulimia nervosa, and 17.5% had an eating disorder not otherwise specified. Comparisons of subjects with a comorbid lifetime eating disorder (n = 65) and subjects without an eating disorder (n = 135) indicated that the comorbid group was more likely to be female, less likely to be African American, had more comorbidity, and had significantly greater body image disturbance and dissatisfaction. There were no significant group differences in BDD symptom severity, degree of delusionality, or suicidal ideation or attempts. Functioning and QOL were notably poor in both groups, with no significant between-group differences. However, a higher proportion of the comorbid eating disorder group had been hospitalized for psychiatric problems. This group had also received a greater number of psychotherapy sessions and psychotropic medications. CONCLUSION: Eating disorders appear relatively common in individuals with BDD. BDD subjects with a comorbid eating disorder differed on several demographic variables, had greater comorbidity and body image disturbance, and had received more mental health treatment than subjects without a comorbid eating disorder. These findings have important implications for the assessment and treatment of these comorbid body image disorders.     

Body image dissatisfaction and disordered eating in black and white women

OBJECTIVE: This study predicted and found that body image dissatisfaction and bulimic symptoms have a curvilinear relationship among undergraduate women. RESULTS: For the women in this sample, regardless of race, body image dissatisfaction correlated with bulimic symptoms, such that women who perceived themselves as bigger or smaller than the ideal body size for their ethnic group endorsed bulimic symptoms. Black and white women differed regarding their ethnic group's ideal body image and their self-perceptions of how they compared with the ideal image. Black women tended to report being underweight, whereas white women tended to report being overweight. DISCUSSION: The findings in this study suggest that some black women are not buffered against eating disorders as suggested in previous research.     

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.     

长春市大学生人际宽恕与人际关系困扰关系

目的了解吉林省长春市大学生人际宽恕情况及其与人际关系困扰的关系。方法采用中国-Mullet宽恕问卷和人际关系诊断量表,对整群抽取的吉林省长春市2所高校492名在校大学生进行问卷调查。结果 492名在校大学生中有56.1%的学生人际宽恕得分高于平均人际宽恕得分(195.24±35.98)分;不同性别、不同年级间大学生人际宽恕得分差异均有统计学意义(P<0.01);大学生人际关系困扰平均得分为(9.45±4.97)分;有人际关系困扰者占57.90%,其中70.53%为轻度人际关系困扰,29.47%为重度人际关系困扰;有人际交谈困扰者占76.10%,有人际交友困扰者占84.20%,有待人接物困扰者占40.00%,有异性交往困扰者占61.80%;不同性别、不同生源地间大学生人际关系困扰差异均有统计学意义(P<0.05);大学生人际关系困扰人际交谈困扰、人际交友困扰、待人接物困扰、异性交往困扰4个维度得分差异有统计学意义(F=103.15,P<0.001);大学生人际宽恕与人际关系困扰及其4个维度均呈负相关关系(P<0.01)。结论大学生人际宽恕对人际关系困扰有一定影响。     

Viewership of pro-eating disorder websites: association with body image and eating disturbances

OBJECTIVE: To evaluate the association between pro-eating disorder website viewership and concurrent levels of body dissatisfaction and eating disturbance. METHOD: A sample of 1575 women were surveyed for viewership of a variety of websites, including those promoting disordered eating (pro-eating disorder) and those providing information about eating disorders (professional). RESULTS: Individuals who frequented pro-eating disorder sites had higher levels of body dissatisfaction and eating disturbance than a control group. The group who frequented only professional information websites, but not pro-eating disorder websites, differed from controls on only one of the four measures of disturbance. The pro-eating disorder group did not differ from the professional group on any measure. CONCLUSION: The findings offer moderate evidence indicating that viewers of pro-eating disorder sites have higher levels of disturbance than a control sample of nonviewers, but limited evidence that those who view pro-eating disorder sites differ from individuals who view professional sites offering information regarding eating disorders. The findings are discussed in light of the difficulty determining causality in this area of inquiry and a cautionary note regarding the potential iatrogenic effects of this type of research is offered.     

Exercise status and sexual orientation as moderators of body image disturbance and eating disorders in males

OBJECTIVE: This study evaluated the moderating effects of sexual orientation and exercise status on measures of body image and eating disturbance in a sample of men. METHOD: One hundred and thirty-four men completed measures designed to index a range of body image facets (ideals, actual, partner's preference, overall dissatisfaction), eating disturbance (restrictive and bulimic levels), and overall self-esteem. RESULTS: There were few significant effects as a function of exercise status or sexual orientation. Bodybuilders were more satisfied on a global measure of body image and had a higher ideal and actual upper torso size rating. Gay men had a smaller actual upper torso rating than heterosexual men, but ideal size upper torso did not differ as a function of sexual orientation. DISCUSSION: Findings are discussed in terms of methodological limits of previous work and future examinations of moderating factors for body image and eating disturbance in men.     

The tripartite influence model of body image and eating disturbance: a replication with a Japanese sample

OBJECTIVE: To examine the tripartite influence model of body image and eating disturbance as a viable sociocultural explanation for the development of eating and body image problems with young Japanese females. METHOD: A sample of 289 Japanese female undergraduates completed a variety of measures designed to index family, peer, and media influences, as well as levels of body dissatisfaction, eating disturbances, and self-esteem. RESULTS: The data were evaluated with structural equation modeling to test the tripartite model. Fit indices indicated a moderate fit to the overall tripartite model, replicating previous findings. CONCLUSION: This study suggests that the sociocultural variables found to influence body image and eating disturbances in Japan are similar to those observed with US samples. The implications for prevention and intervention programs are discussed.     

Body image and personality predictors of eating disorder symptoms during the college years.

OBJECTIVE: Women entering college (N = 118) were longitudinally followed for 3 years with assessments of eating pathology (Restraint and Bulimia). METHOD: Measures taken at Time 1 included timing of onset of puberty, Figure Dissatisfaction, Ineffectiveness, Public Self-Consciousness, and mood states (Profile of Mood States). Measures were evaluated as predictors of changes in Restraint and Bulimia scores across the three-year period. RESULTS: Both Restraint (r = .69) and Bulimia (r = .50) were quite stable across the 3 years. Mean weight gain of 5.4 pounds (p < .001) was paralleled by an increase in "ideal weight" of 4.7 pounds. Hierarchical regressions controlling for Time 1 levels of eating disorder symptoms revealed that changes in Bulimia (R(2) = .38, p < .0001) were related to the psychological measures and to Figure Dissatisfaction. Changes in Restraint (R(2) = .61, p < .0001) were significantly related to Figure Dissatisfaction. DISCUSSION: Findings are discussed in the context of the value of longitudinal designs in identifying risk factors. Dissatisfaction with one's figure seems to be consistently related to worsening eating pathology.     

Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity

OBJECTIVE: To assess body image disturbance as a composite of three aspects (distortion, discrepancy, and dissatisfaction) in obese subjects before and after weight loss. Disturbance was then related to race, gender, binge eating behavior, and age of onset of obesity. METHODS: Eighty-two obese outpatients (24 males, 58 females) completed the Stunkard Figure Rating Scale (FRS). A Disturbance score was derived from the weighted sum of distortion, discrepancy, and dissatisfaction. The measures were repeated 4 weeks after starting a medically supervised liquid formula diet. RESULTS: Prior to weight loss, race (r =.28, p =.01) and gender (r =.25, p =.02) were each predictive of disturbance, with Caucasians and men having the most disturbance. Binge eaters exhibited more discrepancy (p =.03) and dissatisfaction (p =.005) than non-binge eaters. Early-onset subjects demonstrated more discrepancy than adult-onset subjects (p =.02). Following weight loss, disturbance scores decreased for all groups (p =.009). However, early-onset subjects still showed more discrepancy (p =.002) and more dissatisfaction (p =.005) than adult-onset subjects. DISCUSSION: Body image disturbance was viewed as a composite of three aspects. Prior to weight loss, the high disturbance score in Caucasians may be due to them experiencing greater cultural pressure to be thin. The men may have exaggerated their degree of obesity because of less denial of being overweight than women. Following weight loss, disturbance decreased for all groups but remained elevated for those with early onset, possibly because of a persistent self-image from adolescence.     

Body checking and avoidance in overweight patients with binge eating disorder

OBJECTIVE: Repetitive body checking and avoidance are viewed as behavioral manifestations of the core psychopathology of eating disorders (EDs). We examined select body checking and avoidance behaviors in overweight patients with binge eating disorder (BED). METHOD: Three hundred seventy-seven overweight (body mass index [BMI] > or = 25) treatment-seeking BED patients (80 men and 297 women) were administered measures to assess body checking and avoidance, other key behavioral features of EDs (binge eating, dietary restraint, and disinhibition), and the core psychopathology of EDs (overevaluation of weight and shape). RESULTS: The majority of participants reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations emerged between checking and restraint, and conversely, between avoidance and binge eating. Both checking and avoidance were positively and significantly associated with overevaluation of weight and shape, even after controlling for their unique effects. DISCUSSION: These findings offer support to the potential role of checking and avoidance behaviors in the maintenance of BED.     

Body image evaluations in obese females with binge eating disorder

Dimensions of body image in a sample of obese women diagnosed with binge eating disorder (BED; N=42) were compared with a sample of obese women without BED (non-BED; N=42), matched on age and BMI. Additionally, the relationship between BED, body image and several dimensions of treatment response was examined. Results indicated BED women were more likely to negatively evaluate their global physical appearance and have less satisfaction with specific areas of the body than were non-BED women, even after controlling for depression scores. While BED women were significantly more likely to endorse depressive symptoms, depression scores were negatively correlated with body satisfaction in non-BED women only. BED women did not fare worse in formal weight-loss treatment, as measured by length of time in treatment, group-therapy attendance, or BMI at posttreatment. The role of body image in women with BED seeking weight-loss treatment is discussed relevant to the context of potential impact of BED and negative body image on active weight-loss treatment and maintenance.     

Disordered eating attitudes in relation to body image and emotional intelligence in young women

Background:  A number of different psychological factors have been implicated in the multifactorial aetiology of disordered eating (DE) attitudes and behaviours; however, the possible role of emotional intelligence in DE symptomatology has not been thoroughly investigated in the past. The present study aimed to explore the possible differences in emotional intelligence, body image and anxiety levels in young females with DE attitudes and healthy controls. Methods:  A total of 92 Greek female university students, 18–30 years old, were recruited. Subjects completed the following questionnaires: the Eating Attitudes Test (EAT‐26), the Multidimensional Body‐Self Questionnaire (MBRSQ), the State‐Trait Anxiety Inventory (STAI) and the BarOn Emotional Intelligence Questionnaire (BarOn EQ‐I). Results:  The EAT‐26 revealed that 23% of the subjects presented DE attitudes. Women in the DE atttitudes group had lower levels of Emotional Intelligence (EI) in comparison to the control group, particularly in factors such as emotional self‐awareness (P < 0.05), empathy (P < 0.05), interpersonal relationships (P < 0.001), stress management (P < 0.05) and happiness (P < 0.05). The MBRSQ has revealed significant differences between the two groups in terms of overweight preoccupation (P < 0.001) and illlness orientation (P < 0.01). The DE atttitudes group had higher anxiety scores (STAI), although the differences were not significant. Finally, anxiety levels (STAI) were significantly correlated with levels of EI (BarOn EQ‐I) (P < 0.001). Conclusions:  The young women enrolled in the present study with DE attitudes, a potential precursor to eating disorders, appear to have significant differences in many psychometrical parameters of emotional intelligence, such as emotional self‐awareness and interpersonal relationships, which is an important finding in terms of the prevention and management of DE, and warrants further investigation.