The Impact of Exposure to the Thin-Ideal Media Image on Women

The purpose of this study was to experimentally examine the effects of exposure to the thin-ideal body image on women's affect, self-esteem, body satisfaction, eating disorder symptoms, and level of internalization of the thin-ideal. College women (N = 145) were randomly exposed to photographs from popular magazines containing either thin-ideal images or neutral images. Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, although it did not cause more internalization of the thin-ideal. Exposure to thin-ideal media images may contribute to the development of eating disorders by causing body dissatisfaction, negative moods, low self-esteem, and eating disorders symptoms among women.     

Efficacy of body exposure as treatment component for patients with eating disorders

Background and objectives

Body exposure and cognitive restructuring are well known interventions in cognitive-behavioral therapies for patients with eating disorders. Though promising, little is known about the impact of body exposure on body dissatisfaction, overvaluation of weight and shape and other aspects of eating disorder psychopathology. Thus, the aim of the two studies presented here is to evaluate the efficacy of mirror exposure and video exposure on body dissatisfaction, weight and shape concerns and other aspects of eating disorder psychopathology.

Method study 1

Fourteen women diagnosed with Eating Disorders Not Otherwise Specified (EDNOS; DSM-IV-TR) were treated in repeated mirror exposure sessions. Assessments were carried out before (baseline) and after body exposure.

Results study 1

Measures of body dissatisfaction, shape concerns and eating disorder psychopathology were significantly improved at the post treatment assessment.

Method study 2

Thirteen women with Bulimia Nervosa (BN; DSM-IV-TR) received repeated mirror and video exposure sessions. Measures were assessed before (baseline) and after body exposure.

Results study 2

Body image dissatisfaction was significantly improved at post treatment assessment.

Limitations

These preliminary results are based on subjective data from two small clinical samples. Comparisons between the studies are limited by design variations.

Conclusions

The studies provide evidence that body exposure is a promising technique for treatment of body dissatisfaction in EDNOS and BN. Moreover, in EDNOS shape concern and aspects of eating disorder psychopathology were improved after body exposure. Reasons for the lack of change in shape and weight concern as well as in eating disorder psychopathology in BN are discussed.     

The impact of exposure to the thin-ideal media image on women

The purpose of this study was to experimentally examine the effects of exposure to the thin-ideal body image on women's affect, self-esteem, body satisfaction, eating disorder symptoms, and level of internalization of the thin-ideal. College women (N = 145) were randomly exposed to photographs from popular magazines containing either thin-ideal images or neutral images. Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, although it did not cause more internalization of the thin-ideal. Exposure to thin-ideal media images may contribute to the development of eating disorders by causing body dissatisfaction, negative moods, low self-esteem, and eating disorders symptoms among women.     

Brief report: Direct and indirect relations of risk factors with eating behavior problems in late adolescent females

This study explored correlations between risk factors and eating behavior problems in late adolescent, non-clinical females (N = 301). Participants completed questionnaires for assessing eating problems, the closely associated factors of Body Mass Index (BMI) and body dissatisfaction, and a number of other risk variables that are thought to be involved in psychopathology in general, namely insecure attachment, low self-esteem, and negative affect (i.e., social anxiety and depression). Results indicated that high levels of eating problems were associated with high levels of insecure attachment, social anxiety, and depression, and with low levels of self-esteem. Further, regression analyses suggested that depression and self-esteem had a unique, direct relationship with eating problems, whereas insecure attachment and social anxiety only seemed to have indirect relations. The links between these general risk variables and eating behavior problems were independent from the specific eating problem correlates of BMI and body dissatisfaction.     

What happens in the course of body exposure? Emotional, cognitive, and physiological reactions to mirror confrontation in eating disorders

OBJECTIVE: Though body exposure seems to enhance outcome in cognitive-behavioural therapy of anorexia and bulimia nervosa, the underlying mechanisms are still unknown. METHODS: Participants with eating disorders (ED; n = 21) and normal controls (NC; n = 28) were exposed to their own bodies in front of a mirror for 40 minutes under standardized conditions. Emotions, cognitions, and saliva cortisol were assessed every 10 minutes during body exposure. Heart rate and skin conductance were recorded continuously. RESULTS: ED showed higher negative emotional and cognitive responses to body exposure compared to NC, whereas no group differences were found for physiological reactions. In the course of body exposure, the extent of negative emotions and cognitions decreased significantly with medium effects for emotions and low effects for cognitions. Physiological parameters remained stable during the task. CONCLUSION: Body exposure is a promising technique to overcome negative body-related emotions, but additional cognitive techniques are necessary.     

Effects of emotional acceptance and rumination on media-induced body dissatisfaction in anorexia and bulimia nervosa

IntroductionBody dissatisfaction is an important risk and maintaining factor for eating disorders. The aim of the present study was to experimentally test the effects of two emotion regulation strategies - acceptance and rumination - on media-induced body dissatisfaction in eating disorders.MethodAfter watching pictures of thin models, women with anorexia nervosa (AN; n = 39) and bulimia nervosa (BN; n = 39) were encouraged to either use emotional acceptance or rumination to cope with their feelings. Body dissatisfaction and mood were repeatedly assessed.ResultsAcceptance significantly improved body dissatisfaction in women with BN. Rumination led to a significant increase of body dissatisfaction in both eating disorder groups. Results were independent from mood changes.DiscussionFindings highlight the importance ruminative thinking may have in the aggravation of dissatisfaction with the own body in AN and BN. Results suggest that emotional acceptance is a useful strategy to regulate body dissatisfaction after exposure to thin-ideal media in BN.     

Does habitual body avoidance and checking behavior influence the decrease of negative emotions during body exposure in eating disorders?

Abstract

The aim of the present study was to assess whether habitual body avoidance and body-checking behavior influences the decrease of negative emotions during body exposure. Twenty-one eating-disordered female participants completed the Body Image Avoidance Questionnaire and the Body Checking Questionnaire. On another day, a 40-min body exposure session was conducted under standardized conditions. Every 10 min, negative emotions were assessed. It was shown that the extent of decrease in negative emotions during the body exposure session could be predicted by a lower degree of body checking. Results indicate that habitual checking behavior seems to negatively influence the effect of body exposure. Therefore, an adaptation of body exposure to patients with a higher degree of body-checking behavior might be promising.     

Non-suicidal self-injury in patients with eating disorders: prevalence,forms, functions,and body image correlates

IntroductionMore than one third of patients with eating disorders report NSSI. Moreover, negative attitudes and feelings toward the body, body dissatisfaction, and body image disturbances have been linked to NSSI in community and clinical samples. However, there is a lack of studies exploring NSSI frequency and functions and the specific relationship between multidimensional body image dimensions and NSSI in eating disorder patients.ObjectivesFirst, we explored the frequency, types, and functions of NSSI in a sample of 226 Spanish female participants with eating disorders (ED). Second, we explored differences in NSSI and body image depending on the ED restrictive-purgative subtype; and third, we explored differences in body dissatisfaction, body image orientation, and body investment in eating disorder patients without NSSI (n = 144), with NSSI in their lifetime (n = 19), and (b) with NSSI in the previous year (n = 63).ResultsOf the overall sample, 37.1% (n = 89) had a history of self-injury during their lifetime, and 27.1% (n = 65) had self-injured in the previous year. Among the types of ongoing NSSI, the most frequent were banging (64.6%) and cutting (56.9%). Restrictive vs purgative patients differed on NSSI lifetime, Appearance Evaluation, Body Areas Satisfaction, Body Protection and Feelings and Attitudes toward the Body. Moreover, significant differences were found on Appearance Evaluation, Body Areas Satisfaction, Positive Feelings and Attitudes towards the Body, Body Protection, and Comfort with physical contact, between participants without a history of self-injury and both NSSI groups.DiscussionBody dissatisfaction and body investment have been found to be variables related to NSSI. Thus, the present study highlights the importance of working on body image in ED patients to reduce the frequency of NSSI.     

Troubles alimentaires,désirabilité sociale,insatisfaction corporelle et estime de soi physique chez des étudiantes de première année

Objectives

The relation between the subject and its own body seems to be problematic in Eating Disorders. This study aims to better understand eating disorders in non-clinical population, by focusing on social desirability, body dissatisfaction and physical self-esteem. The students represent a high-risk population for eating disorders. These latters usually begin during this period, especially in the first years of study. Weight control as observed in eating disorders could report for the tendency of the individual to seek peers’ approval and could reflect a need to respond to a “social desirability”. It seems important to grasp the concerns of body image by focusing on the individual's perception of his body and the value it assigns. This research deals with eating behaviours disturbances and focuses, on the one hand, on body dissatisfaction, on the other hand, on the analysis of the role of different physical self-esteem dimensions on these behaviours. In addition we explore the relationship between social desirability, body dissatisfaction and eating disorders. We wish to bring light on individuals’ body perception within the framework of eating behaviours disturbance.

Childhood beauty pageant contestants: associations with adult disordered eating and mental health

This study evaluated the association between childhood beauty pageants and adult disordered eating, body dissatisfaction, depression, and self-esteem. Eleven women who participated in childhood beauty pageants were matched on age and BMI with 11 non-participating women. Childhood pageant participants scored higher on body dissatisfaction, interpersonal distrust, and impulse dysregulation than non-participants, and showed a trend toward greater ineffectiveness. There were no significant differences between groups on measures of bulimia, body perception, depression, and self-esteem. These findings suggest childhood beauty pageant participation may influence adult body dissatisfaction, interpersonal distrust, and impulse dysregulation, but not bulimic behaviors, body perception, depression, and self-esteem.     

Childhood Beauty Pageant Contestants: Associations with Adult Disordered Eating and Mental Health

This study evaluated the association between childhood beauty pageants and adult disordered eating, body dissatisfaction, depression, and self-esteem. Eleven women who participated in childhood beauty pageants were matched on age and BMI with 11 non-participating women. Childhood pageant participants scored higher on body dissatisfaction, interpersonal distrust, and impulse dysregulation than non-participants, and showed a trend toward greater ineffectiveness. There were no significant differences between groups on measures of bulimia, body perception, depression, and self-esteem. These findings suggest childhood beauty pageant participation may influence adult body dissatisfaction, interpersonal distrust, and impulse dysregulation, but not bulimic behaviors, body perception, depression, and self-esteem.     

Breast and Chest Size Satisfaction: Relation to Overall Body Image and Self-Esteem

Abstract

Multiple ratings of breast and chest size preferences were assessed in 68 male and 120 female undergraduates and related to overall levels of appearance satisfaction, body image anxiety, and general self-esteem. Discrepancies between personal ideals, perceived ideals of the opposite sex, and current size ratings were differentially related, by gender, to other disturbance measures. For all analyses, the direction of associations was clear, indicating that among men chest discrepancies (indicative of dissatisfaction) were positively associated with body image disturbance and low self-esteem: among women, breast discrepancies were not related to these measures. The findings strongly support emerging research suggesting that the chest area is a site of dissatisfaction for men. The results are discussed in relation to possible cultural reasons for the gender differences found in this investigation as well as potential links between dissatisfaction with upper torso and unhealthy eating behaviors.     

Body image, emotions and thought control strategies in body dysmorphic disorder compared to eating disorders and healthy controls

ObjectiveA disordered body image, emotions such as shame and disgust, and intrusive thoughts are described as important and interdependent features of body dysmorphic disorder (BDD). However, research in this field is scarce and knowledge is often based on clinical observation.MethodsThe present study examined body image dimensions, emotions, and thought control strategies in individuals with: BDD (n = 31), anorexia nervosa (n = 32), bulimia nervosa (n = 34), and healthy controls (n = 33). Assessment was based on structured diagnostic interviews and self-report questionnaires.ResultsIndividuals with BDD scored higher on psychosocial and appearance manipulation dimensions of body image compared to healthy controls. Furthermore, they reported higher psychosocial impairment due to appearance than both eating disorder groups. In terms of emotions, BDD subjects reported a higher degree of negative emotions compared to healthy controls, whereas no differences were found in comparison to eating-disordered patients. Individuals with BDD reported using maladaptive strategies such as worrying and confrontation more often than healthy controls, when encountering intrusive and unwanted thoughts.ConclusionThe results indicate that individuals with BDD experience substantial psychosocial impairment due to appearance, high levels of various negative emotions and frequently use maladaptive thought control strategies.     

Body dissatisfaction and disordered eating in trans people: A systematic review of the literature

Abstract

Body dissatisfaction plays a prominent role in gender dysphoria. In some individuals body dissatisfaction appears to manifest disordered eating in order to suppress bodily features of natal gender and accentuate features of gender identity. To date, there has been no systematic review of the literature pertaining to body dissatisfaction and disordered eating in trans individuals. Such a review may highlight important implications for clinicians working with trans people. Therefore, the aim was to critically and systematically review the available literature examining body dissatisfaction or disordered eating in a trans population, and also the literature pertaining to how body dissatisfaction and disordered eating are related in trans people. This review found three studies that explored disordered eating in trans people, five studies that explored body image and disordered eating in trans people, and 18 studies that explored body image in trans people. The findings from this review suggest that body dissatisfaction is core to the distress trans people experience and that this dissatisfaction may also put some individuals at risk of developing disordered eating. Additionally, the findings appear to suggest that gender dysphoria treatment is successful at increasing body satisfaction and improving body image. The clinical implications are discussed.     

Implicit cognitive processes in binge-eating disorder and obesity

ObjectivesBinge-eating disorder (BED) is characterized by recurrent binge eating episodes, associated eating disorder and general psychopathology, and commonly occurs in obese individuals. Explicit self-esteem and explicit weight bias have been linked to BED, while little is known about implicit cognitive processes such as implicit self-esteem and implicit weight bias.MethodsObese participants with BED and an individually matched obese only group (OB) and normal weight control group (CG; each N = 26) were recruited from the community to examine group differences and associations in explicit and implicit self-esteem and weight bias, as well as the impact of implicit cognitive processes on global eating disorder psychopathology. Implicit cognitive processes were assessed using the Implicit Association Test.ResultsSignificantly lower explicit self-esteem, as well as higher exposure to explicit weight bias, compared to CG and OB was found in the BED group. All groups showed positive implicit self-esteem, however, it was significantly lower in BED when compared to CG. BED and CG demonstrated equally high implicit weight bias whereas OB did not. Explicit and implicit measures were not significantly correlated. Global eating disorder psychopathology was predicted by explicit and implicit self-esteem.ConclusionsThe results of the present study add to the importance of implicit self-esteem and implicit weight bias beyond explicit measures in BED, while both were previously shown to be associated with onset and maintenance of BED. In conclusion, implicit cognitive processes should be focused on in interventions for BED to investigate their impact on psychological treatments.     

Body dissatisfaction and disordered eating among Portuguese and Spanish adolescents: The role of individual characteristics and internalisation of sociocultural ideals

The aim of this study was to explore the differences in patterns of risk factors for body dissatisfaction and disordered eating attitudes in both female and male adolescents from Portugal and Spain. The sample included 455 adolescents aged 12–16 years (M = 13.28, SD = 0.65) from two urban areas of each country. Body mass index, self-reported self-esteem, perfectionism, internalisation of sociocultural ideals, body dissatisfaction and disordered eating attitudes were assessed. Path analyses provided partial support for a cross-cultural model of body dissatisfaction and disordered eating in Western countries due to the presence of certain differences in the patterns of relationships across sex and country. The findings suggest the importance not only of identifying cultural specificities, even in “neighbouring” countries, but also of developing a global and comprehensive preventive approach that focuses on the influence of the ideal of beauty transmitted by Western societies.     

Effect of Ethnic Identity on Attitudes,Feelings, and Behaviors Toward Food

Abstract

A nationwide study examined differences in attitudes, feelings, and behaviors of African-American and White female college students toward food. The study also explored the relationship between eating disorder symptoms and ethnic identity among the two groups. All subjects completed the Eating Disorder Inventory-2 (EDI-2), a demographic questionnaire, and the Multi-Group Ethnic Identity Scale (MGEI). Analyses of variance and unpaired t-test revealed that White women exhibited significantly greater disordered eating behaviors and attitudes than African-American women. After controlling for degree of overweight, differences in disordered eating symptomology between the two groups became even greater. In contrast to White women, African-American women's dissatisfaction with body weight and shape was related to actual weight problems. Furthermore, degree of ethnic identity was greater among African-American women. Nonetheless, regression analysis revealed that ethnic identity was a predictor of drive for thinness, bulimia, and body dissatisfaction for White but not African-American women.     

Low perception of control as a cognitive factor of eating disorders. Its independent effects on measures of eating disorders and its interactive effects with perfectionism and self-esteem

Objective

There is a large body of research about perfectionism and low self-esteem in eating disorders (ED). However, little is known about the influence in ED of a distorted cognition in the domain of control: the perception of low control. The present study examined the main and interactive effects of concern over mistakes (an important dimension of perfectionism), self-esteem, and perception of control on drive for thinness, bulimia, and body dissatisfaction.

Method

Forty individuals with ED and 55 controls completed the Multidimensional Perfectionism Scale, the Anxiety Control Questionnaire, the Rosenberg self-esteem scale, and the three symptomatic scales of the Eating Disorder Inventory, which are drive for thinness, bulimia and body dissatisfaction. Multiple linear regression was used to test the hypothesis that perception of low control has a significant effect on the symptomatic scales of the EDI.

Results

The ED group had significantly lower perception of control and self-esteem and higher concern over mistakes, drive for thinness, bulimia, and body dissatisfaction than the control group. Analysis of interactive effects suggested that a combination of a low perception of control and a low self-esteem seems to moderate the effects of concern over mistakes on drive for thinness, bulimia, and body dissatisfaction.

Discussion

ED are associated with a tendency to worry about mistakes, a low sense of self-esteem, and a low perception of control over internal feelings and external events. Perception of control and self-esteem seems to moderate the predictive power of concern mistakes on symptoms of ED. The results suggest that a low perception of control is an important cognitive factor in ED.     

The Body Attitude Test for Patients with an Eating Disorder: Psychometric Characteristics of a New Questionnaire

Abstract

The Body Attitude Test (BAT) is a new self-report questionnaire developed for female patients suffering from eating disorders. Its psychometric characteristics have been tested in a large number of patients and control subjects (eating disorders, Weight Watchers, and normal subjects). Repeated analyses yielded a stable four factor structure: negative appreciation of body size, lack of familiarity with one's own body, general body dissatisfaction, and a rest factor. Repeated tests in different subgroups have shown the BAT to be reliable and valid, as well as easy and practical (only 20 items).