The Role of Body Dissatisfaction and Bingeing in the Self-Esteem of Women with Type II Diabetes

This study investigated the impact of body dissatisfaction and binge eating on self-esteem in women with Type II diabetes. The relationship of body dissatisfaction and bingeing to perceived blood glucose control was also assessed. Questionnaires were completed by a total of 215 women: 125 women with Type II diabetes and 90 comparison women, who were roughly matched for age, education, and ethnicity. When actual weight (BMI) was statistically controlled, there was no difference between the groups in body dissatisfaction or bingeing behavior. The women with diabetes, however, had significantly lower self-esteem. Further, bingeing made a significant contribution to their self-esteem, in contrast to the women without diabetes. For the women with diabetes, body dissatisfaction and bingeing were also related to perceived blood glucose control, although only bingeing remained significant when both variables were entered into the regression equation. It was concluded that diabetes broadens the domains of body dissatisfaction which are related to self-esteem.     

Body Image and Affective Experiences of Subjectively Underweight Females: Implications for Exercise Behavior

The purpose of the present study was to determine whether subjectively underweight females reported similar psychosocial experiences as women who perceived themselves as being overweight. Twenty-eight college-aged females were assessed via a questionnaire consisting of measures of social physique anxiety, body dissatisfaction, depression proneness, and self-esteem. Similar to previous research completed on college-aged women who perceived themselves as being overweight, females in the present study reported low to moderate degrees of social physique anxiety, body dissatisfaction, depression proneness, and self-esteem. Additionally, higher feelings of physique anxiety were modestly associated with lower levels of self-esteem and higher levels of body dissatisfaction and depression. It was concluded that women who perceived themselves as being too thin experienced similar psychosocial issues as women who perceived themselves as being overweight in previous studies.     

Trend in the prevalence of overweight and obesity among urban African American hospital employees and public housing residents

INTRODUCTION: To help understand the impact of socioeconomic status, we examined the current prevalence and age-specific trend in overweight and obesity among two socioeconomically diverse groups of African Americans in the Washington, DC, area. MATERIALS AND METHODS: Data on height and weight were collected between March 1995 and December 1996 as a part of nutrition survey to develop a food frequency questionnaire. Gender-stratified multiple logistic regression analyses were used to examine factors related to the current prevalence of overweight and obesity. RESULTS: Three hundred nine African American public housing residents and 293 African American hospital employees participated in this survey. Overall, hospital workers and public housing residents differed significantly in the distribution of BMI (p = 0.003). Among men, the prevalence of overweight and obesity were 34.9% and 29.4% for hospital workers and 27.0% and 18.2% for public housing residents, respectively. For females these rates were 31.3% and 46.3% for hospital employees and 26.1% and 42.9% for public housing residents, respectively. CONCLUSION: Overweight and obesity were highly prevalent among all age and socioeconomic groups. Future research should focus on a more in-depth study of the relationship between socioeconomic status and the correlates of obesity among African-Americans, particularly women.     

Body image satisfaction and depression in midlife women: the Study of Women’s Health Across the Nation (SWAN)

With aging, women’s bodies undergo changes that can affect body image perception, yet little is known about body image in midlife. The purpose of this study was to examine associations between body image and depressive symptoms in Caucasian and African–American midlife women from the Study of Women’s Health Across the Nation (SWAN) Chicago site. Body image was measured using the Stunkard Adult Female Figure Rating Scale, and a clinically significant level of depressive symptoms was defined as Center for Epidemiologic Studies Depression Scale (CES-D) score of ≥16 (N?=?405; N?=?63 (15.6 %) with clinically significant levels of depressive symptoms). Differences between perceived actual, perceived ideal, and actual body size and responses to questions concerning weight satisfaction and attractiveness were examined using logistic regression for associations with a CES-D score of ≥16. Women with body image dissatisfaction (odds ratio (OR)?=?1.91; p?=?0.04) or who perceived themselves as “unattractive” (OR?=?7.74; p?<?0.01) had higher odds of CES-D of ≥16. We found no significant difference by race. Our results were not confounded by BMI. These results suggest that midlife women with poor body image may be more likely to have clinically significant levels of depressive symptoms. Larger prospective studies are needed to better understand this association.     

Racial/ethnic differences in body mass index, morbidity and attitudes toward obesity among U.S. adults

OBJECTIVE: To describe racial/ethnic differences by gender in body mass index (BMI), to examine the relationship between existence of current morbidity and BMI, and to assess racial/ethnic disparities in attitudes and perceptions toward obesity. DESIGN AND SETTING: Cross-sectional random-digit telephone survey of a representative sample of noninstitutionalized U.S. adults aged > or =18 years in 2005 (N = 1,000, 62% response rate and 82% cooperation rate). RESULTS: The prevalence of overweight or obesity in 2005 among U.S. adults was 63%. Racial disparities in obesity were observed among women, not among men. The mean BMI of non-Hispanic black women was 29.8, significantly (P < 0.01) higher than that of non-Hispanic white women (26.7). Eighteen percent of the respondents reported having serious morbidities, with 8.5% reporting diabetes. A dose-response relationship was observed between BMI groups and existence of morbid conditions. Twenty-seven percent of obese respondents (BMI > or = 30) and 55% of extremely obese respondents (BMI > or = 40) reported such conditions. Race (blacks versus whites) was not a significant predictor for any of the six different attitudes and perceptions toward obesity in fully adjusted logistic models. CONCLUSIONS: There is no evidence of plateau or decrease in the prevalence of overweight or obesity and diabetes among U.S. adults. Racial disparities between blacks and whites persist among women. A modification of attitudes and perceptions might not have significant effects on people's behavior that can influence the prevalence of overweight and obesity.     

妊娠前体质指数和胎次对妊娠糖尿病发病的影响

目的：探讨妊娠前体质指数(body mass index,BMI)、胎次与妊娠糖尿病(gestational diabetes mellitus,GDM)发病的关系,并探讨其对妊娠糖尿病(GDM)发病的影响。方法：本研究选择我院2014年2月至2014年12月接受孕产期检查、临床资料完整的且患有妊娠糖尿病的孕妇262名,对其采取葡萄糖耐量实验(OGTT实验),按照WTO标准,对262例足月妊娠初产妇女在孕24~28周常规进行75 g口服糖耐量试验,并完整记录年龄、孕周、文化程度、妊娠前体质指数及胎次等临床资料。根据妊娠前体质指数(BMI)将孕妇分为BMI分为4组,BMI<18.5 kg/m2者为偏瘦组,BMI 18.5~23.0 kg/m2者为正常体质量组,BMI 23.1~25.0 kg/m2者为超重组,BMI>25.0 kg/m2为肥胖组,采用SPSS l8.0统计软件对资料进行描述性分析、两样本t检验、非条件Logistic回归分析两组孕妇妊娠前体质指数(BMI)、胎次与妊娠糖尿病的关系。结果：4组OGTT结果显示妊娠前超重或肥胖的孕妇发生妊娠糖尿病的风险高于正常和偏瘦体质量组;非条件logistic回归分析结果表明,影响GDM的因素依次为：胎次、体质指数、年龄、文化程度,各影响因素回归系数分别为：2.372、     

Brief report: weight dissatisfaction, weight status, and weight loss in Mexican-American children

OBJECTIVE: To assess the association between weight dissatisfaction, weight status, and weight loss in Mexican-American children participating in a weight management program. METHODS: Participants included 265 Mexican American children recruited for a school-based weight management program. All children completed baseline assessments and changes in standardized body mass index (zBMI) were monitored in at-risk for overweight and overweight children (i.e., > 85th BMI percentile) who had been randomized to receive the weight loss intervention (n = 101). RESULTS: Participants classified as at-risk for overweight or overweight reported greater weight dissatisfaction than normal weight children. Lower weight dissatisfaction at baseline was associated with greater changes in zBMI at 6 months. Weight dissatisfaction did not change across the course of treatment. CONCLUSIONS: Mexican-American children whose weight status is greater than normal have greater weight dissatisfaction. Children with greater weight dissatisfaction are less likely to lose weight in a weight management program and weight dissatisfaction remains stable over the course of treatment.     

Racial differences in sleep architecture: the role of ethnic discrimination

African Americans have been consistently shown to have less deep (slow wave sleep; SWS) and more light (Stages 1 and 2) sleep than Caucasian Americans. This paper explored whether discrimination, a stressor that uniquely impacts certain ethnic groups, contributes to differences in sleep architecture. The sleep of 164 African and Caucasian Americans was examined with laboratory based polysomnography (PSG). Experiences of perceived discrimination (The Scale of Ethnic Experience) and sociodemographic factors were also assessed. After adjusting for age, body mass index (BMI), socioeconomic status (SES) and smoking status, African Americans slept approximately 4.5% more total sleep time (TST) in Stage 2 sleep and 4.7% less TST in SWS than Caucasian Americans (ps < .05). Perceived discrimination was a partial mediator of ethnic differences in sleep architecture. Individuals who reported experiencing more discrimination slept more time in Stage 2 and less time in SWS (ps < .05). Results suggest that the impact of stress related to ethnic group membership plays a part in explaining differences in sleep architecture.     

Perceived size of friends and weight evaluation among low-income adolescents

Drawing from social comparison theory, we examine how perceptions of friends’ body sizes may influence adolescents’ subjective evaluations of their own body (e.g., how accurate they are in judging their weight, how much body dissatisfaction they feel), particularly for adolescent females. Participants were low-income, minority adolescents (Study 1: N = 194 females, Mean age = 15.4; Study 2: N = 409 males and females; Mean age = 14.9). Adolescents used figure rating scales to indicate their perceived size and that of four of their closest friends and completed several measures of subjective weight evaluation (e.g., weight classification, body dissatisfaction, internalized weight bias). In both studies, how adolescents perceived their body size and the body sizes of their thinnest and heaviest friends were positively correlated. In Study 1, overweight females based on measured BMI were less likely to accurately judge themselves as overweight if they had a close friend they perceived as heavy. In addition, females who viewed themselves as having a larger figure reported more internalized weight bias when they had friends they viewed as relatively thin. Findings from Study 2 suggest that how friends’ bodies are perceived is predictive of subjective weight evaluation measures only for adolescent females. Programs that address negative aspects of social comparison may be important in preventing both obesity and eating disorder symptoms in adolescent females.     

体质指数对女性胫骨超声传导速度的影响

目的研究体质指数(BMI)对骨峰值期和绝经后女性的胫骨超声传导速度(SOS)的影响。方法采用骨定量超声仪测量399例骨峰值期和589例绝经后女性的胫骨SOS值,并按BMI不同各分为低体重组、正常体重组和肥胖组进行分析。结果骨峰值期,女性BMI与胫骨SOS无相关性(r=0.054,P=0.287),低体重组、正常体重组和肥胖组的胫骨SOS差异无显著性(F=0.2,P=0.801);绝经后,女性BMI与胫骨SOS呈正相关(r=0.115,P=0.006),肥胖组的胫骨SOS高于低体重组和正常体重组(F=4.2,P=0.016),且肥胖组和正常体重组骨质疏松症的患病率均低于低体重组(P<0.001)。结论女性骨峰值期,BMI对胫骨的强度影响小;绝经后,BMI大者能延缓胫骨的强度下降。     

Correlates of obesity among patients attending an urban family medical center

Urban populations face unique health challenges. We used data from a cross-sectional comprehensive health risk assessment survey conducted at an urban family medicine center to explore demographic and clinical correlates of obesity among 923 adults ages 20-64 years. Based on univariate analyses, there were no significant differences for body mass index (BMI) categories or health status ratings by racial group. A logistic model revealed that obese respondents (BMI >30.0) were significantly less likely to be female, white and to report a body image of overweight. Overall, just 25% of persons with a BMI of >30 classified themselves as being overweight. A second logistic model revealed that respondents reporting a body image of overweight were significantly more likely to be age 50-64 years, female, white and to report their health as good or fair/poor, which may reflect differing cultural and social beliefs of how individuals perceive their weight. This misperception between calculated BMI and reported body image in this urban population may serve to moderate attempts to address weight control as a health issue.     

Screening for diabetes in an African American community: identifying characteristics associated with abnormal blood glucose readings

ObjectiveTo identify characteristics associated with abnormal blood glucose readings among African Americans and to determine the potential value of a more targeted approach to community-based screenings for type 2 diabetes.MethodsData were collected from 7113 participants with no previous diagnosis of diabetes at mobile screening events in Detroit, Michigan. Data collected included gender, race, age, self-reported height and weight, total diabetes risk score, blood pressure, and random capillary blood glucose.ResultsNearly 9% of participants had abnormal random plasma glucose readings (RPG > 160 mg/dL). Results indicated that higher age, elevated blood pressure, and body mass index (BMI) were significantly associated with abnormal glucose readings.ConclusionThese findings suggest that community-based screenings for diabetes that are targeted to adults aged more than 50 years who have high blood pressure or a BMI of at least 25 may enhance detection of abnormal glucose levels among African Americans.     

Relations among multiple peer influences, body dissatisfaction, eating disturbance, and self-esteem: a comparison of average weight, at risk of overweight, and overweight adolescent girls

OBJECTIVE: The goal of this study was to evaluate peer-related influences on appearance, body dissatisfaction, eating disturbance, and self-esteem in average weight, at risk of overweight, and overweight adolescent girls. METHODS: Three hundred twenty-five adolescent girls from high schools in Florida were assessed. Ninety met criteria for being at risk of overweight or overweight. Logistic and multiple regression analyses were used to evaluate group differences on all variables and to assess the amount of variance accounted for by peer-influence variables in the prediction of body dissatisfaction, eating disturbance, and self-esteem. RESULTS: Overweight and at risk of overweight girls scored higher than average weight girls on body dissatisfaction, dieting, and a peer measure that assessed negative comments and attributions about appearance. They also scored lower than average weight girls on self-report measures that assessed conversations about appearance and anti-dieting advice. How influential friends were in determining one's body image was a unique predictor of body dissatisfaction but only for the overweight and at risk of overweight group. CONCLUSIONS: Possible implications for clinical intervention programs are discussed along with directions for future research.     

Reach-out: a family-based diabetes prevention program for African American youth

Objective: To pilot test and assess the feasibility of a culturally grounded approach to adolescent overweight and diabetes prevention.Study Design: Reach-Out, a family-based nutrition and exercise program for overweight African American youth aged 9 to 12 years and their families, is led by lay health leaders and conducted in a community setting on Chicago's south side (Illinois). Age-appropriate interactive sessions focus on skills building, problem solving, and setting goals during 14 weekly sessions, with monthly meetings thereafter. Pre-post comparisons were made for 29 families (62 subjects) using physical (body mass index [BMI], blood pressure, waist circumference), biochemical (glucose, insulin, lipid levels) and behavioral data. Statistical analyses included mixed-effects linear models and logistic regression.ResultsChildren's mean BMI z score fell from 2.46 at baseline to 2.38 at 14 weeks and 2.39 at 1 year (p =.02), while parents' BMI remained stable. Children reported increased walking (p = 0.07) and exhibited a corresponding rise in mean serum high-density lipoprotein cholesterol from 49.4 to 54.2 (p <.001). Qualitative assessment showed that participants enjoyed the program but felt the program could be improved by making the sessions even more interactive.Conclusion: A community-based program for overweight minority youth and families can successfully address overweight, with the potential to decrease diabetes risk in youth.     

Gender differences in body image and health perceptions among graduating seniors from a historically black college

This study's purpose was to identify gender differences in body size awareness and perceived impact of weight on social interactions and risk for disease among young African-American adults. A cross-sectional survey of 318 African-American graduating seniors from a historically black college or university (HBCU) was conducted. Data were collected on anthropometrics, body image, ideal weight, perceived risk for disease due to weight, and impact of weight on social interactions. Only 39% of males who were overweight perceived themselves as overweight compared with 68% of overweight females. Eighty percent of females and 63% of males expressed some body size dissatisfaction. Fewer obese males (38%) perceived a risk for disease due to their weight compared with obese females (64%), p<0.01. Males perceived greater impact than females of their weight on social interactions, with extremely obese males perceiving the greatest impact. Perceived risk for disease due to weight was related to body mass index, family weight history, body awareness and income, but not body size satisfaction. Findings suggest gender differences in the self-perception of body size, accuracy of body size perception, and understanding of acceptable weight ranges. Awareness of acceptable weight ranges and consequences of overweight needs to be raised.     

Association between measured BMI and self-perceived body size in Mexican adults

AIM: The study examined the association between perceived body size (through self-selection of Stunkard's body shape silhouettes) and measured body mass index (BMI) in Mexican Mestiso adult men and women, and determined the BMI values that corresponded to each silhouette. SUBJECTS: A sample of 1092 men and 1247 women, apparently healthy, aged 20-69, was studied. METHODS: Participants were asked to identify the silhouette that most accurately represented his/her body size. Weight and height were measured in duplicate to calculate BMI. A simple linear regression analysis was used to adjust BMI values to silhouette categories by gender. Areas under the receiver operating characteristic curves (AUC) were calculated to assess accuracy. RESULTS: Gender-specific BMI values for each silhouette were obtained. Correlation coefficients between silhouette ratings and BMI were 0.702 in males and 0.766 in females. Overweight ranged from silhouette 4 to 6 and obesity from silhouette 6 to 9, in both men and women. In the regression models, 49.3% of BMI variance in males and 58.7% in females were explained statistically by silhouette self-selection. AUC were higher than 0.8 for overweight and obesity in males and females. CONCLUSIONS: Both male and female models had a good fit, indicating that BMI can be associated with body shape silhouettes. Silhouettes can be useful for defining overweight and obesity in settings such as schools or worksites, or where scales and stadiometers might not be available. They can also be used to provide health advice to the public.     

Exploring differences in trust in doctors among African American men and women

ObjectivesLow trust in doctors may partially account for African Americans' adverse health outcomes. Understanding the drivers of low trust can guide health care policy to improve trust and delivery of health care for African Americans. This study examines gender differences in trust in doctors among African Americans and explores factors differentially associated with low level trust for men vs women.Methodsand Measures: Cross-sectional analysis of 3649 African Americans using data from the 2003-2004 Community Tracking Study Household Survey, including 4 items measuring trust in doctors (range, 1 = lowest trust and 5 = highest trust). Items were assessed separately and as an index measure. Linear regression analyses adjusted for multiple con-founders and accounted for complex data sampling.ResultsOverall, men were less trusting of doctors than women. However, men differed from women only on 2 trust measures: "doctor influenced by insurance rules" (adjusted mean scores = 2.48 for men and 2.79 for women, p = .001) and "doctor performs unnecessary tests" (adjusted mean score = 4.00 for men and 4.28 for women, p = .010). Common correlates of low trust in men and women included less than high school education, age of at least 65 years, and having no usual source of care. Unique correlates of lower trust for men included rural living and no doctor visit in the preceding year. Unique correlates for women included low income and poorer health status.ConclusionsThere are differential predictors of low trust among African American men vs women, underscoring the need for gender-based and health care system-level approaches to improve African Americans' trust and health outcomes.     

A tale of 2 epidemics: the intersection between obesity and HIV infection in Philadelphia

BACKGROUND: Obesity and HIV infection are ongoing epidemics in the United States. Obesity predisposes to diabetes and cardiovascular disease, which are complications also associated with HIV and/or its treatment. OBJECTIVE: To determine the prevalence and risk factors for overweight and obesity in HIV-infected individuals. DESIGN AND SETTING: Retrospective cross-sectional study in which 1689 patients enrolled in the University of Pennsylvania Center for AIDS Research Adult/Adolescent Database at 1 university hospital clinic, 2 affiliated practices, and 1 Veterans Administration clinic in Philadelphia had demographic, social, and medical data collected prospectively since 1999. PARTICIPANTS: Body mass index (BMI) data were available for 1669 HIV-infected subjects: 78% were men, and 60% were African American. The median CD4 count was 381 cells/microL, 47% of subjects had a viral load <400 copies/mL, and 9% of subjects were treatment naive. MAIN OUTCOME MEASURES: The prevalence and risk factors for overweight (BMI: 25-29.9 kg/m) and obesity (BMI>or=30 kg/m) in HIV-infected subjects. RESULTS: Obesity and overweight were more prevalent than wasting (14%, 31%, and 9%, respectively; P<0.0005), but they were not more common than in the general population. Although women and men were equally overweight (30% vs. 31%), women were more obese than men (28% vs. 11%; P<0.001). Among women, African American race (odds ratio [OR]=1.8, 95% confidence interval [CI]: 1.1-2.9) and a CD4 count>or=200 cells/microL (OR=2.8, 95% CI: 1.6-4.9) were associated with overweight and obesity. Among men, only a CD4 count>or=200 cells/microL (OR=1.6, 95% CI: 1.04-2.4) was associated with increased BMI. In men and women, smoking was associated with decreased obesity and overweight (OR=0.59, 95% CI: 0.47-0.74 and OR=0.65, 95% CI: 0.43-0.98, respectively). Age, income, employment, education, past or current intravenous drugs, being on HIV treatment, and viral load were not associated with obesity in the multivariate model. There was a positive correlation between BMI and total cholesterol, triglycerides, and glucose. CONCLUSION: Obesity is more common than wasting in this therapeutic era. Women, particularly those of African American race, are at high risk. Obesity might add to metabolic abnormalities associated with HIV or its treatment and contribute to morbidity, as patients with HIV live longer.     

Correlates of high serum C-reactive protein levels in a socioeconomically disadvantaged population

Individuals from low socioeconomic backgrounds are disproportionately affected by the burden of cardiovascular disease (CVD), yet data regarding risk factors in this population are lacking, particularly regarding emerging biomarkers of CVD such as C-reactive protein (CRP). We measured high-sensitivity CRP and examined its association with demographic and lifestyle factors in a sample of 792 participants aged 40-79 years from the Southern Community Cohort Study, which has an over-representation of socioeconomically disadvantaged individuals (over 60% with a total annual household income < USD15,000). We found that within this population the prevalence of elevated CRP (>3 mg/L) varied significantly by sex, race, smoking status, and body mass index (BMI). The multivariable-adjusted prevalence odds ratios (ORs) (95% CIs) for having elevated CRP were 1.6 (1.1-2.3) for women vs. men, 1.4 (0.9-2.0) for African Americans vs. whites, 2.3 (1.4-3.8) for African American women vs. white men, 1.8 (1.2-2.7) for current smokers vs. non-smokers, and 4.2 (2.7-6.6) for obese (BMI 30.0-44.9 kg/m;{2}) vs. healthy-weight (BMI 18.3-24.9 kg/m;{2}) participants. Further stratified analyses revealed that the association between BMI and elevated CRP was stronger among African Americans than whites and women than men, with prevalence ORs (95% CI) comparing obese vs. healthy-weight categories reaching 22.8 (7.1-73.8) for African American women. In conclusion, in this socioeconomically disadvantaged population, sex, race, smoking, and BMI were associated with elevated CRP. Moreover, inflammatory response to obesity differed by race and sex, which may contribute to CVD disparities.     

Racial and socioeconomic disparities in body mass index among college students: understanding the role of early life adversity

The role of early life adversity (ELA) in the development of health disparities has not received adequate attention. The current study examined differential exposure and differential vulnerability to ELA as explanations for socioeconomic and racial disparities in body mass index (BMI). Data were derived from a sample of 150 college students (M _age  = 18.8, SD = 1.0; 45 % African American; 55 % European American) who reported on parents’ education and income as well as on exposure to 21 early adverse experiences. Body measurements were directly assessed to determine BMI. In adjusted models, African American students had higher BMI than European Americans. Similarly, background socioeconomic status was inversely associated with BMI. Significant mediation of group disparities through the pathway of ELA was detected, attenuating disparities by approximately 40 %. Furthermore, ELA was more strongly associated with BMI for African Americans than for European Americans. Efforts to achieve health equity may need to more fully consider early adversity.