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Self-perception of weight and physical fitness, body image perception, control weight behaviors and eating behaviors in adolescents

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Introduction: self-perception of weight and physical fitness, aesthetic reasons to diet, self-weighing as a way to feel better and body image perception have been related to a constellation of risks to develop both body image dissatisfaction and eating behavior disturbances, especially among adolescents. Objectives: to analyze weight self-perception and self-reported physical fitness, to explore the links between these variables and weight control behaviors, to explore possible relations among weight self-perception, self-reported physical fitness, dieting, self-weighing frequency and body mass index (BMI)/body image and to analyze the relation between all these variables and different eating behaviors. Methods: a total of 336 students (mean age of 12.46 ± 2.14; 47.62% females) took part in this study. Different scales were administered (weight self-perception and self-reported physical fitness, dieting, self-weighing frequency, body image perception, eating behaviors) and height and weight were measured in order to obtain the BMI. Results: mean BMI was 20.18 ± 3.58 and 41.14% of participants had overweight/obesity. Among those who perceived themselves as overweight, 76.92% were girls. More than 70% of participants reported average or good physical fitness and more boys reported good or excellent physical fitness. Almost 60% of participants who planned to diet for aesthetic reasons were girls, and girls more than boys self-weighed to feel better. BMI was significantly correlated with body image dissatisfaction/restrictive eating. Conclusions: there are clear links between weight self-perception, body image, dieting, self-weighing and eating behaviors at an age which might be considered as a starting point to eating behavior disturbances.
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Nutrición
Hospitalaria
Trabajo Original Valoración nutricional
ISSN (electrónico): 1699-5198 - ISSN (papel): 0212-1611 - CODEN NUHOEQ S.V.R. 318
Correspondence:
Ignacio Jáuregui-Lobera. Universidad Pablo de Olavide.
Ctra. de Utrera, 1. 41013 Sevilla, Spain
e-mail: ignacio-ja@telefonica.net
Jáuregui-Lobera I, Iglesias Conde A, Sánchez Rodríguez J, Arispon Cid J, Andrades Ramírez C, Herrero
Martín G, Bolaños-Ríos P. Self-perception of weight and physical fitness, body image perception, control
weight behaviors and eating behaviors in adolescents. Nutr Hosp 2018;35(5):1115-1123
DOI: http://dx.doi.org/10.20960/nh.1726
Self-perception of weight and physical fitness, body image perception, control weight
behaviors and eating behaviors in adolescents
Autopercepción del peso y forma física, percepción de la imagen corporal y conductas de control de
peso y alimentarias en adolescentes
Ignacio Jáuregui-Lobera1, Amalia Iglesias Conde2, Josefa Sánchez Rodríguez3, Juan Arispon Cid4, Cristina Andrades Ramírez5, Griselda Herrero Martín1
and Patricia Bolaños-Ríos3
1Universidad Pablo de Olavide. Sevilla, Spain. 2Nutritionist. Private Clinic. Sevilla, Spain. 3Instituto de Ciencias de la Conducta. Sevilla, Spain. 4Psychologist. Private Clinic.
Sevilla, Spain. 5Norte Salud Nutrición. Sevilla, Spain
Palabras clave:
Percepción del peso.
Percepción del estado
de forma física. Dieta.
Pesarse. Trastornos
alimentarios.
Adolescencia.
Resumen
Introducción: la autopercepción del peso y de la forma física, razones estéticas para hacer dieta, pesarse como método para sentirse mejor
y la percepción de la imagen corporal se han relacionado con una constelación de riesgos para desarrollar tanto insatisfacción corporal como
alteraciones alimentarias, especialmente en adolescentes.
Objetivos: analizar la autopercepción del peso y de la forma física, explorar los vínculos entre estas variable y conductas de control de peso,
explorar posibles relaciones entre la autopercepción del peso y de la forma física, realización de dietas, frecuencia con la que se pesan los
adolescentes e índice de masa corporal (IMC)/imagen corporal, así como la relación de todo ello con diferentes conductas alimentarias.
Resultados: el IMC medio fue de 20,18 ± 3,58 y el 41,14% de los participantes presentaba sobrepeso/obesidad. Entre quienes se percibían
con sobrepeso, el 76,92% eran chicas. Más del 70% de los participantes decían estar en una buena forma física o en la media y eran más los
chicos los que decían estar en buena o excelente forma física. Casi el 60% de los participantes que planeaban hacer dieta por razones estéticas
eran chicas y ellas más que los chicos se pesaban para sentirse mejor. El IMC correlacionó significativamente con la subescala imagen corporal/
ingesta restrictiva.
Conclusiones: existen claros vínculos entre autopercepción ponderal, imagen corporal, realización de dietas, pesarse y conductas alimentarias
en una edad que podría considerarse como un punto de partida para la presentación de alteraciones alimentarias.
Key words:
Weight
misperception.
Self-reported
physical fitness.
Diet. Self-weighing.
Eating disorders.
Adolescence.
Abstract
Introduction: self-perception of weight and physical fitness, aesthetic reasons to diet, self-weighing as a way to feel better and body image
perception have been related to a constellation of risks to develop both body image dissatisfaction and eating behavior disturbances, especially
among adolescents.
Objectives: to analyze weight self-perception and self-reported physical fitness, to explore the links between these variables and weight control
behaviors, to explore possible relations among weight self-perception, self-reported physical fitness, dieting, self-weighing frequency and body
mass index (BMI)/body image and to analyze the relation between all these variables and different eating behaviors.
Methods: a total of 336 students (mean age of 12.46 ± 2.14; 47.62% females) took part in this study. Different scales were administered
(weight self-perception and self-reported physical fitness, dieting, self-weighing frequency, body image perception, eating behaviors) and height
and weight were measured in order to obtain the BMI.
Results: mean BMI was 20.18 ± 3.58 and 41.14% of participants had overweight/obesity. Among those who perceived themselves as overweight,
76.92% were girls. More than 70% of participants reported average or good physical fitness and more boys reported good or excellent physical
fitness. Almost 60% of participants who planned to diet for aesthetic reasons were girls, and girls more than boys self-weighed to feel better.
BMI was significantly correlated with body image dissatisfaction/restrictive eating.
Conclusions: there are clear links between weight self-perception, body image, dieting, self-weighing and eating behaviors at an age which
might be considered as a starting point to eating behavior disturbances.
Received: 15/12/2017 • Accepted: 04/03/2018
©Copyright 2018 SENPE y ©Arán Ediciones S.L. Este es un artículo Open Access bajo la licencia CC BY-NC-SA (http://creativecommons.org/licenses/by-nc-sa/4.0/).
1116 I. Jáuregui-Lobera et al.
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INTRODUCTION
Misperception of weight is defined as the discordance between
an individual’s actual weight and the perception of his/her weight
status. Weight perception and misperception might influence the
healthy or unhealthy behaviors people engage in (1). In this regard,
misperception has repeatedly been documented among overweight
and obese adults, and it has been hypothesized that weight misper-
ception among overweight and obese individuals may preclude the
adoption of healthful attitudes and behaviors, perhaps as a result
of lower weight loss motivation. Overweight and obese individuals
who consider their weight healthy, for example, might not try to
lose weight and might be less inclined to eat healthfully and to be
physically active (2). On the other hand, some evidence indicates
that weight misperception among overweight and obese individuals
might be associated with healthful behaviors (e.g., better diet quality,
more physical activity, and less sedentary behavior) (2,3). Perceiv-
ing oneself as overweight-obese is relevant given the association
between that perception and unhealthy weight-control behaviors (1).
It seems that overweight misperception varies according to gender
(among other variables), females tending to perceive themselves as
overweight more than males do, even at the same measured body
mass index (BMI) (4-6). Misperception of overweight-obesity among
adolescents of normal weight might have negative consequences.
The combination of overweight-obesity misperception causing body
dissatisfaction predicts dieting, and dieting is a clear risk factor for
developing different eating disturbances (6). In addition, adolescents
who have been engaged in dieting and other unhealthy weight-control
behaviors have been found to be at risk of weight gain over time (7,8).
Besides the concept of weight misperception, one’s body shape
and/or one’s body image play a relevant role in different behaviors
(9). Both weight misperception and poor body image have nega-
tive psychological and psychosocial effects (e.g., low self-esteem,
anxiety, depression, isolation, discrimination, family conflicts, etc.).
It is well known that people engaged in a process of self-evaluation
(included body checking) comparing themselves to others who they
believe have more desirable sociocultural traits tend to be involved
in behaviors aimed to achieve those desired characteristics (10).
Self-reported physical fitness is another variable to consider as a
starting point to different healthy or unhealthy behaviors. Perceived
physical ability (i.e., the individual’s perception of physical abilities
developed over time as a result of cumulative interactions with the
environment) and perceived physical competence are two goal-ori-
ented self-perception constructs (11). Recently, it has been shown
that body dissatisfaction is a significant mediator of the effect of
BMI on perceived physical activity (12). A large body of research
has aimed to validate the idea that exercise improves body image
through changes in physical fitness (13). However, it has been
suggested that improvements in physical fitness play a minor role
in changing body image, because the effects of physical exercise
and activity on body satisfaction should be mediated by changes in
individuals’ perceptions of their physical fitness and competence.
As a result, it seems that perceptions (weight, physical fitness)
are core constructs to lead to healthy/unhealthy behaviors more
than actual weight or actual physical fitness do.
Healthy or unhealthy behaviors as consequence of different per-
ceptions and their corresponding psychological and psychosocial
effects lead to the concept of emotional eating among other eating
behaviors. Thus, it has been distinguished among restraint eating
(conscious restriction of food intake aimed to control body weight
and/or to promote weight loss), uncontrolled eating (inability to
resist emotional cues, eating as a response to different negative
emotions) and emotional eating (tendency to eat more than usual
due to a loss of control over intake with a subjective feeling of hun-
ger). Other authors have defined external eating as the tendency
to overeat in response to external food-related cues like the sight,
smell, and taste of palatable food, regardless of their physical
need for food (14-16). Moreover, some authors have noted that
different types of bingers and dieters may be found: bingers who
are engaged in restraint-induced binging, and bingers general-
ly disinhibited; dieters who eventually become disinhibited and
overeat, and dieters who maintain the restrictive attitude (17,18).
It has been reported that BMI and negative emotional eating
are highly related whereas positive emotional eating and external
eating loaded onto another factor. In this regard, it is plausible
that even though positive emotions may elicit eating, they do not
necessarily mirror disordered eating. Eating in response to positive
emotions might rather be related to hedonic or external eating
(19,20).
Some models conceptualize eating disturbances as disorders
of affect regulation, considering the impairment in the cognitive
capacity to process and regulate emotions as the primary regu-
latory disturbance (21). According to these models, some eating
behaviors, such as binge eating and compensatory behaviors, as
well as restricted food consumption, are interpreted as respons-
es to cope with intense or relatively undifferentiated emotional
states (22-24). These intense emotional states are usually linked
to self-perceptions (weight, physical fitness, body shape/body
image), especially among adolescents (25-28).
Based on the above-mentioned previous research, the objectives
of this study, focused on preadolescents and adolescents, were: a)
to analyze weight self-perception and self-reported physical fitness;
b) to explore the possible relationship between these variables and
some weight control behaviors (dieting, self-weighing frequency);
to explore possible relations among weight self-perception, self-re-
ported physical fitness, dieting, self-weighing frequency and BMI/
body image; and d) to analyze the relation between all these vari-
ables and different eating behaviors.
METHOD
PARTICIPANTS
The sample comprised 336 students, 160 females (47.62%)
and 176 males (52.38%), with a mean age of 12.46 ± 2.14;
they were all recruited from two public schools in Seville, repre-
senting a middle socio-economic status. The participants have
not any psychiatric history, which was assessed by means of a
brief questionnaire at the time of obtaining the parents’ informed
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SELF-PERCEPTION OF WEIGHT AND PHYSICAL FITNESS, BODY IMAGE PERCEPTION, CONTROL WEIGHT BEHAVIORS
AND EATING BEHAVIORS IN ADOLESCENTS
consent. None of the participants showed any comprehension
and/or language difficulties. A total of 400 students were invited to
take part in the study. Among them, 37 refused to participate and
there were 27 students whose parents did not return the signed
informed consent. Thus, the response rate was 84%.
INSTRUMENTS AND MEASURES
Weight self-perception and self-reported
physical fitness
Following several previous studies, these measures were
self-reported, so no infographics or any types of guidelines were
used. Participants were classified as “very overweight”, “slightly
overweight”, “about the right weight”, “slightly underweight” or
“very underweight” after responding to the question “How do you
think of yourself in terms of weight?” In addition, participants
were asked about their self-reported physical fitness and they
were classified as perceiving themselves as possessing a “poor”,
“fair”, “average”, “good” or “excellent” physical fitness (27,28).
Dieting
Participants were asked whether or not they were dieting at
the moment (yes/no), the reason or reasons for dieting (aesthetic
reasons, the specific objective of losing weight, other healthy
reasons, others), the origin of the diet (prescribed or self-im-
posed) and the intention to keep on dieting or being about to
do it (yes/no).
Self-weighing frequency
Participants indicated their self-weighing frequency, the possi-
ble responses being: “several times a day”, “once a day”, “several
times a week”, “once a week”, and “occasionally”. Then, partici-
pants were asked about “What is the reason for being weighed?”:
“controlling my weight”, “no fattening”, and “feel better”.
Body image perception
The body silhouettes method was used. This method is based
on self-reporting where participants must choose the silhouette that
most closely resembles the shape of their body. In this study, the nine
Stunkard’s silhouettes were applied (29). Silhouettes numbered 1
represent the thinnest figure and number 9 represents the heaviest.
Body mass index (BMI)
BMI was calculated as the relationship between weight (in kg)
and height squared (in m). Weight and height were taken in indi-
vidual sessions, with the participants in the standing position,
barefoot, and in light garments. A stadiometer Añó-Sayol Atlántida
S13 model was used. Overweight and obesity rates were deter-
mined using the value of BMI-specific percentiles for age and sex
in the reference population (30), considering the cut-off points of
85th and 97th for overweight and obesity, respectively.
Eating behaviors
Different eating behaviors were assessed by means of the
Spanish version of the Three-Factor Eating Questionnaire-R18
(TFEQ-Sp) (31). The questionnaire measures three differ-
ent aspects of eating behavior: a) restrained eating (defined
as conscious restriction of food intake aimed to control body
weight and/or to promote weight loss); b) uncontrolled eating
(the tendency to eat more than usual due to a loss of control
over intake with a subjective feeling of hunger); and c) emotional
eating (inability to resist emotional cues, eating as a response
to different negative emotions). The questionnaire comprises 18
items that are measured on a four-point response scale (defi-
nitely true: 1, mostly true: 2, mostly false: 3, definitely false: 4)
and items scores are summated into subscale scores: a, b and
c. Previous studies have reported that TFEQ-R18 has adequate
internal consistency reliability coefficients for the three sub-
scales, as well as for the whole questionnaire (ranging between
0.74 and 0.87) (14,31). In addition, the Spanish version of the
Eating Behaviors and Body Image Test for Preadolescent Girls
(EBBIT) was used. This instrument was designed to measure
behavioral indicators of dieting and binging and to be put in
practice with preadolescent population trying to avoid some of
the limitations of previous instruments. The content of this ques-
tionnaire permits to be applied in samples of preadolescents and
early years of adolescence. The internal consistency reliability
coefficients of the EBBIT are 0.92 for the BIDRE subscale (body
image dissatisfaction/restrictive eating), 0.82 for the BEB sub-
scale (binge eating behaviors) and 0.90 for the total scale (18).
PROCEDURE
The study was approved by the direction of the Behavioural Sci-
ences Institute (Seville, Spain). After having obtained the schools’
headmasters’ permission, the students’ approval and the parents’
informed consent, participants completed the aforementioned
instruments in group sessions without time limits. A psychologist,
a nutritionist and a teacher supervised the procedure, instructing
the students about how to complete the questionnaires until they
were completely sure about their full understanding of the instruc-
tions. Data collection was developed in a suitable setting so the
attainment of the task could be reached easily. All the participants
volunteered to take part in the study and none of them received
any kind of reward after fulfilling the task. The anthropometric
measures were taken by trained nutritionists with enough expe-
rience with working in these types of studies.
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STATISTICAL ANALYSES
Data are expressed as means ± standard deviations. To study
gender differences and others based on categorical variables, the
proportions (percentages) were considered, the analysis being
done by means of χ2. An analysis of variance (ANOVA) was con-
ducted to study differences with respect to the different variables
included in the study, after having applied the Kolmogorov-Smirn-
off test in order to analyze whether the data fitted a normal distri-
bution. The software used for the analyses was “R”, version 3.3.2
(2016-10-31), “Sincere Pumpkin Patch” (Copyright 2016, The R
Foundation for Statistical Computing Platform: x86_64-apple-dar-
win13.4.0 -64-bit-).
RESULTS
The sample comprised 336 students, 160 females (47.62%)
and 176 males (52.38%), with a mean age of 12.46 ± 2.14.
With respect to BMI, the mean was 20.18 ± 3.58. Considering
the value of BMI-specific percentiles for age and sex, 57.65%
of participants had normal weight, 14.41% had overweight and
26.73%, obesity. Thus, overweight + obesity (BMI ≥ 85th percen-
tile) was 41.14%.
Considering weight self-perception, 66.02% of participants
perceived themselves as normal weighted, 19.09% as overweight
and 4.21% as obese. This way the perceived total overweight was
23.30%. No significant gender differences with respect to weight
self-perception were found (χ2 = 8.04; p = 0.09). Overall weight
misperception was 44.77%. Among those participants who had
overweight, 69.23% misperceived their weight, mainly consid-
ering that they had normal weight (62.82%). In case of obese
participants, 88.63% misperceived their weight, 84.09% of them
perceiving themselves as normal weight or slightly overweight.
While 49.68% of boys misperceived their weight, in the case of
girls that percentage was 39.58%. Nevertheless, among those
who perceived themselves as very overweight, 76.92% were girls.
On the contrary, among those who perceived themselves as very
or slightly underweight, 62.5% and 60% respectively were boys.
Respecting self-reported physical fitness, most of participants
reported an average (34.57%) or good (38.27%) physical fit-
ness; poor (2.47%), fair (13.9%) and excellent (10.80%) were
the reported physical fitness of the rest. Considering gender differ-
ences, while 57.40% of men reported good and excellent physical
fitness, in case of women that percentage was 40.52%. On the
contrary, 28.40% of men reported average physical fitness while
this percentage was 41.83% for women (χ2 = 14.59; p < 0.01).
Most participants who considered to have average, good or
excellent physical fitness reported to be about the right weight
(66.79%). When the reported physical fitness was poor or fair,
there were more participants who perceived themselves as slightly
or very overweight (55.32%). Bearing in mind the actual weight,
we found similar results. Figure 1 represents the participants who
considered their physical fitness as average, good or excellent and
Figure 1.
Actual weight, weight self-perception and self-reported physical fitness (average, good, excellent).
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AND EATING BEHAVIORS IN ADOLESCENTS
the corresponding percentages related to weight self-perception
and actual weight (classified as normal, overweight or obesity).
Among boys, considering not weight perception but actual weight,
good and excellent physical fitness was reported by 72.27%,
42.10% and 25.92% of participants at normal weight, overweight
and obesity, respectively. In case of girls, these percentages were
45.34%, 38.63% and 16.66%.
With respect to dieting, 18.73% of participants were dieting at the
moment, and 29% planned to diet in the future. Among those who
planned to diet, 30.95% gave aesthetic reasons to do it, 57.14% of
them being girls. Considering self-weighing frequency, the following
percentages were obtained: several times a day (2.15%), once a
day (3.38%), several times a week (5.54%), once a week (20.31%),
and occasionally (66.77%). Only 1.85% of participants never self-
weighed. The main reason to self-weighing was “controlling my
weight” (67.71%), followed by “no fattening” (17.01%) and “feel
better” (12.15%). There were no significant gender differences
with respect to dieting and self-weighing frequency. Nevertheless,
57.14% of those who self-weighted to “feel better” were girls.
Body image perception was assessed by means of the body
silhouettes method. Table I shows the results by sex with mention
to the BMI linked (approximately) to each silhouette.
Bearing in mind the silhouettes which correspond to normal BMI
(2-4), more girls (60.51%) than boys (51.42%) chose silhouettes
3-4. Overall, no gender differences with respect to body image
perception were observed (Fig. 2).
Taking into account actual BMI and body perception, among
those who chose silhouettes 2, 3 and 4 (these silhouettes are
usually associated to normal BMI), 1.25% had moderate denu-
trition, 12.5% were overweight and 2.5% were obese in case
of silhouette 2; with respect to silhouette 3, 0.95% had severe
denutrition, 30.48% were overweight and 2.86% were obese;
finally, in the case of silhouette 4, 35.90% were overweight
and 20.51% were obese. As a result, when participants iden-
tify their body image with silhouette number 2, 16.25% was
misperceiving their weight; when participants chose silhouette
number 3, the percentage of misperception was 34.29; and,
finally, considering the silhouette number 4 the percentage of
misperception was 56.41.
With respect to physical fitness, among those who identified
themselves with silhouettes 2-4, self-reported physical fitness
was “average”, “good” or “excellent” in 89.01%. When partici-
pants chose silhouette number 1, that percentage was 85.71%.
Finally, the percentage was 56.86% when participants identified
themselves with silhouettes 5-9. It must be noted that poor phys-
Figure 2.
Silhouettes chosen by boys and girls.
Table I. Body image perception by sex
Silhouettes
123456789
Boys 5 42 53 37 24 10 3 0 1
Girls 10 39 52 43 10 2 1 0 0
BMI 17 19 19 23 25 27 29 31 33
χ2 = 13.50; p < 0.05.
1120 I. Jáuregui-Lobera et al.
[Nutr Hosp 2018;35(5):1115-1123]
ical fitness was considered by 0.78% when participants chose
silhouettes 2-4 and 11.76% in case of silhouettes 5-9. Nobody
referred poor physical fitness in case of silhouette number 1.
Due to the fact that silhouette number 8 has not been chosen
and number 9 only was chosen by one participant, these two
silhouettes have been removed from figure 3.
Means of eating behaviors as measured by means of TFEQ-Sp
and EBBIT are shown in table II. It must be noted that the original
purpose of the EBBIT was to test the hypothesis that young girls
at risk of eating disorders may exhibit problems in several areas.
Nevertheless, there are no psychometric reasons not to use this
instrument in boys so for this work it was applied.
Considering different nutritional states (severe denutrition [SD],
moderate denutrition [MD], normal weight [NW], overweight [OW],
obesity [OB]), there were no significant differences with respect
to restrained eating, emotional eating, uncontrolled eating and
binge eating behaviors. Significant differences were found in case
of body image dissatisfaction/restrictive eating (BIDRE) subscale
(p < 0.0001). Tukey mean-differences test revealed that scores
were higher in overweight/obesity than in normal weight (p <
0.0001) and scores were also higher in obesity than in overweight
(p < 0.0001) (Fig. 4).
Correlational analyses between scores on eating behaviors and
BMI revealed a unique significant correlation between BIDRE and
BMI (r = 0.47; p < 0.0001; 95% CI = 0.38-0.55), the rest being
not significant. With respect to different subscales of EBBIT and
TFEQ-Sp, BEB correlated negative a significantly with restrained
eating (r = -0.23; p < 0.0.1), uncontrolled eating (r = -0.18;
p < 0.01) and emotional eating (r = -0.32; p < 0.01). No signif-
icant correlations were found between BIDRE and uncontrolled
eating and restrained eating. BIDRE correlated positively with
emotional eating (r = 0.19; p < 0.05).
DISCUSSION
Weight misperception may be associated to healthful or
unhealthy behaviors (1-3). Misperception of overweight or obesi-
Figure 3.
Distribution of self-reported physical fitness by silhouettes.
Table II. Means of TFEQ-Sp and EBBIT
by sex
Boys Girls p
TFEQ-Sp
Restrained eating 14.31 15.51 < 0.05
Emotional eating 8.16 9.55 < 0.001
Uncontrolled eating 24.54 26.2 < 0.05
EBBIT
BIDRE 15.24 16.76 0.322
BEB 7.87 6.59 0.123
EBBIT: Eating Behaviors and Body Image Test; TFEQ-Sp: Three-Factor Eating
Questionnaire-R18, Spanish version; BIDRE: body image dissatisfaction/
restrictive eating; BEB: binge eating behaviors.
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AND EATING BEHAVIORS IN ADOLESCENTS
ty among adolescents at normal weight is a clear risk factor for
eating behavior disturbances. The sequence weight mispercep-
tion, body dissatisfaction and dieting is prone to develop negative
eating attitudes and finally high risk for different pathologies, eat-
ing disorders being the most relevant among adolescents (6-8).
It has been reported that females tend to perceive themselves
as overweight more than males do (4-6). In the current study,
despite no general differences were found considering the weight
self-perception scale, it must be noted that among the participants
who considered to be very overweight, 76.92% were girls. On
the contrary, among those who perceived themselves as very or
slightly underweight, 62.5% and 60% respectively were boys.
These results are similar to others previously found in a similar
study with a sample of adolescents with a mean age of 16.22,
so a bit older (28). Other studies have reported that females tend
to perceive themselves as overweight more than men usually do
(4-6). Generally, the identification with larger silhouettes (e.g.,
from 2 to 4) increases the percentage of weight misperception.
Body dissatisfaction has been considered as a mediator on the
effect of BMI on perceived physical activity (12), and body image
is improved by changes in physical fitness (13). Recently, it has
been shown that body dissatisfaction is a significant mediator of
the effect of BMI on perceived physical activity (12). A large body
of research has aimed to validate the idea that exercise improves
body image through changes in physical fitness (13). However,
Martin and Lichtenberger have suggested that improvements
in physical fitness play a minor role in changing body image,
because the effects of physical exercise and activity on body satis-
faction should be mediated by changes in individuals’ perceptions
of their physical fitness and competence (15). This study shows
that most participants reported an average or good physical fit-
ness (72.84%). Again, some gender differences appeared since
57.40% of boys reported good and excellent physical fitness, this
percentage being 40.52% in case of girls. This difference has
been reported previously (28). In view of our results, boys tend to
have a better perception of their physical fitness than girls, this
result appearing at normal weight, overweight and obesity.
A worse self-reported physical fitness (regardless of actual
weight) and a tendency to perceive themselves as overweight
could lead girls to higher risk of developing body dissatisfaction.
In addition, it must be noted that almost 31% of participants
who planned to diet in the future had aesthetic reasons to do
it, 57.14% of them being girls. The main reason for self-weigh-
ing was “controlling my weight”, but when the reason was “feel
better”, almost 58% of participants were girls. In this regard, a
worse self-reported physical fitness, a worse weight perception,
aesthetic reasons for planning to diet in the future and considering
self-weighing as a way to feel better could yield a constellation of
risks to develop both body image dissatisfaction and eating behav-
ior disturbances. In fact, a previous study has reported that dieting
for aesthetic reasons, weight misperception, worse self-reported
physical fitness and the fact of being female perform a high-risk
group of developing eating disorders (28).
Healthy or unhealthy behaviors as a consequence of different
perceptions and their corresponding psychological and psycho-
social effects lead to the concept of emotional eating, among
other eating behaviors. Thus, it has been distinguished among
restraint eating (conscious restriction of food intake aimed to
control body weight and/or to promote weight loss), uncontrolled
eating (inability to resist emotional cues, eating as a response
to different negative emotions) and emotional eating (tendency
to eat more than usual due to a loss of control over intake with
a subjective feeling of hunger) (14). Other authors have defined
external eating as the tendency to overeat in response to external
food-related cues like the sight, smell, and taste of palatable food,
regardless of their physical need for food (15,16). Moreover, some
authors have noted that different types of bingers and dieters may
be found: bingers who are engaged in restraint-induced binging,
and bingers generally disinhibited; dieters who eventually become
disinhibited and overeat, and dieters who maintain the restrictive
attitude (17,18). Also, in the field of eating behaviors, the concept
of dietary restraint is relevant, highlighting the regulation of food
intake in order to control weight and body shape (32). That control
based on restrictions may cause consequent overeating episodes
and eating disorders, and overweight and obesity at long-term
(14). Along with dietary restraint, other eating behaviors have been
described such as loss of control over intake and overeating as a
consequence of emotional distress (33).
It has been reported that BMI and negative emotional eating
are highly related whereas positive emotional eating and external
eating loaded onto another factor. In this regard, it is plausible
that even though positive emotions may elicit eating, they do not
necessarily mirror disordered eating. Eating in response to positive
emotions might rather be related to hedonic or external eating
(19,20).
Some models conceptualize eating disturbances as disorders
of affect regulation, considering the impairment in the cognitive
capacity to process and regulate emotions as the primary regulatory
disturbance (21). According to these models, some eating behav-
Figure 4.
Differences in BIDRE scores considering several nutritional states (SD: severe
denutrition; MD: moderate denutrition; NW: normal weight; OW: overweight; OB:
obesity).
1122 I. Jáuregui-Lobera et al.
[Nutr Hosp 2018;35(5):1115-1123]
iors, such as binge eating and compensatory behaviors, as well as
restricted food consumption, are interpreted as responses to cope
with intense or relatively undifferentiated emotional states (22-24).
These intense emotional states are usually linked to self-perceptions
(weight, physical fitness, body shape/body image), especially among
adolescents (25-28). Thereby, it has been reported that people with
higher weight and those who perceive themselves as overweight
usually show higher scores on cognitive restriction (31). In fact, the
link between higher BMI and higher scores on cognitive restriction
has been reported previously (34,35). In the current study we have
not found any significant differences with respect to restrained eat-
ing, emotional eating, uncontrolled eating and binge eating behav-
iors when the actual weight has been considered. In this regard, as
other studies have shown, cognitive dietary restraint is not consis-
tently linked to body weight-adiposity (29). Nevertheless, scores on
body image dissatisfaction/restrictive eating (BIDRE subscale) were
different with regards to actual weight (normal weight, overweight
and obesity). The fact that the difference is showed in this subscale
but not in the BEB subscale indicates that it is possible to maintain
a tendency to restrictive attitudes without binge eating behaviors in
both obese and overweight participants. With respect to the asso-
ciation, the correlation between BIDRE and BMI was 0.47. In fact,
BIDRE and BEB suggest that these two factors might be considered
as independent dimensions (18).
Another point to discuss refers to the instruments which aim to
assess eating behaviors. Thus, BEB correlated negative a signifi-
cantly with restrained eating, uncontrolled eating, and emotional
eating. This result seems to indicate that binge eating behavior,
restrained eating, uncontrolled eating and emotional eating are
different constructs despite having possible shared elements. In
addition, no significant correlations were found between BIDRE
and uncontrolled eating and restrained eating. It seems that when
there is a component linked to body image (e.g., BIDRE), correla-
tions with uncontrolled and restrained eating are not significant
but this changes with respect to emotional eating, in this case
existing a positive correlation. In this regard, body image dissatis-
faction could lead to eating disturbances through emotional more
than restrained eating.
This study adds some new results to others previously pub-
lished in the same field (25-28,32). Comparing to these others,
we have studied a sample with the lowest age range which per-
mits to study possible links between weight self-perception, body
image (and related variables such as dieting or self-weighing)
and eating behaviors in a stage of life which could be recognized,
to some extent, as a starting point to develop eating disorders.
Some conclusions emerge from the results. First, the majority of
participants who perceive themselves as obese are girls and the
majority of participants who perceive themselves as underweight
are boys. Second, boys tend to perceive themselves with a better
physical fitness than girls. Third, more girls than boys plan to
diet in the future for aesthetic reasons. Fourth, when the reason
to self-weighing is feel better, more girls than boys are involved.
Finally, BMI is significant and positively correlated to BIDRE. When
body image dissatisfaction is controlled for analysis, then BMI
correlates with emotional eating.
In view of these results, it would be interesting to study in depth
the reasons that lead girls to overestimate their weight and, on
the contrary, underestimate it in case of boys.
The current study has some limitations. Different variables are
self-reported at an age which could reflect doubts about reliabil-
ity. Nevertheless, previous studies have followed a similar way
to assess some information. Despite that EBBIT was designed
for young girls at risk for eating disorders, after analyzing the
content of the test no psychometric reasons have been found to
avoid that instrument in the current study. Body dissatisfaction has
not been assessed by means of a specific instrument apart from
the BIDRE subscale of the EBBIT. The body silhouettes method is
based on self-reporting where participants must choose the sil-
houette that most closely resembles the shape of their body. Then,
it is possible to analyze differences with respect to self-reported
weight or actual weight as well as others measures. In this study,
we emphasized some self-reported measures more than body
image dissatisfaction scores as usually are measured by several
questionnaires. Finally, precocious puberty is a risk factor clearly
related to the onset of that puberty. Secondary sexual character-
istics may lead to affective and psychosocial adaptive problems,
which also lead to behavior disorders and a negative body image.
Pubertal timing is a potentially significant factor when assessing
psychopathological symptoms. Pubertal timing refers to the timing
when pubertal development occurs in relation to peers, i.e., it
relates to whether an adolescent is ahead of peers in pubertal
development (early pubertal timing), in line with peers (on-time) or
behind peers in pubertal development (late pubertal timing). In this
regard, not having applied the pubertal stage categorization (e.g.,
by means of Tanner stages) is a limitation to take into account in
future similar studies (36).
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... Moreover, it is well recognized that obesity and overweight are closely linked to higher levels of body image dissatisfaction among adolescents [25][26][27]. Conversely, numerous studies have shown that regular physical activity is associated with improved body image, notably by fostering better self-esteem and a more positive perception of physical appearance [28][29][30]. ...
... In other words, fitness level may enhance body satisfaction even for adolescents who fall within a normal BMI range, highlighting the importance of fitness in fostering a positive body image. Indeed, the scientific literature extensively demonstrated a strong link between physical activity and a positive body image, defined by appreciation, acceptance, and self-respect [28][29][30]. This connection appears to be further reinforced by the physical benefits derived from regular exercise. ...
... Among these factors, body image plays a pivotal role, particularly in influencing the psychological well-being of adolescents [24,56]. As many studies report, a good level of physical fitness contributes significantly to the improvement of body image satisfaction [28][29][30]57]. This improvement in body image satisfaction has been linked to greater self-esteem, confidence, and social acceptance, all of which are critical for positive mental health. ...
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Background: The obesity epidemic among adolescents significantly impacts not only their physical health but also various psychological factors, including their perception of body image. Thus, this study pursued three main objectives: (1) to update the reference standard values for all the physical fitness tests performed; (2) to examine the impact of overweight and obesity on factors influencing physical fitness in adolescents; and (3) to determine the relationship between the physical fitness level and the body image dissatisfaction among a population of French-Canadian adolescents. Methods: A total of 1862 adolescents aged 12 to 17 (1008 boys and 854 girls) participated in this study. Data were collected from 12 French-language high-schools from different socioeconomic backgrounds and spread across four regions of the province of Québec, Canada. Anthropometric measures (body mass, body height, body mass index (BMI), waist circumference, waist-to-height ratio) and fitness tests (aerobic power, anaerobic power, muscle endurance, muscular power, flexibility) were conducted. To assess adolescents’ body perception, a silhouette scale was used. Results: Standardized normative values were established for each fitness test (Lambda Mu Sigma; LMS method). In boys, performance generally improved with age, except for the V-test and sit-ups, which remained stable, and VO2peak, which declined during adolescence in both genders (unpaired t-test and Cohen’s d effect size). In girls, only the vertical jump and 30 m sprint improved with age, while the other tests stabilized by age 13. Fitness level was significantly influenced by obesity status. Boys and girls with a normal BMI performed better than those who were overweight or obese (ANOVA = p < 0.001 and effect size F). Girls appeared to be less affected by obesity status, with differences between overweight and obese groups rarely being significant (p > 0.05). Fitness level was also linked to body satisfaction, with satisfied adolescents generally achieving better scores than dissatisfied ones, even among those with a typical BMI. Socioeconomic status did not impact body image perception in boys (p = 0.351). In contrast, girls from lower socioeconomic backgrounds exhibited significantly more negative perceptions (p = 0.002) than their peers from more affluent families. Conclusions: Obesity status is strongly associated with poorer performance on fitness tests. Conversely, higher levels of physical fitness are linked to improved body image satisfaction. This positive relationship between fitness and body image holds true even for individuals with a healthy body weight (typical BMI).
... Body weight misperception refers to the discrepancy between an individual's perceived weight and their actual weight [17]. Research has established a clear association between body weight misperception and eating behavior [18]. Perception of weight influences adolescents' lifestyle behaviors [19], including their eating habits and mental health outcomes [20]. ...
... A study of Iranian children also showed that in comparison with the accurateweight group, the overestimated-weight groups were less likely to have a daily consumption of sugar-sweetened beverages, sweets, and salty snacks [50]. Although snacking less may help to reduce the risk of obesity, the sequence of weight misperception, body dissatisfaction, and dieting (especially of healthy foods like vegetables, fruits, and milk) may lead to negative eating attitudes, which could increase the risk of various pathologies, including anxiety/depression, psychological distress symptoms, anorexia, and malnutrition [18,49,51]. Regarding underweight students, a previous study in Guangzhou, China, found that underweight children with accurate perception had a lower intake of fruits and vegetables than those who overestimated their weight [47]. ...
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Background Unhealthy snacking behaviors and body weight misperception are both significant concerns in adolescent health. Weight misperception are common among youth and may influence their motivation to engage in health-related behaviors, however, the effect on snacking patterns choice remains unclear. Our study aimed to examine the relationship between body weight misperception and snacking pattern choice among school adolescents. Methods A cross-sectional study was conducted using an online survey platform. Body weight misperception was defined based on perceived body weight and true weight. Snack intake was measured using a qualitative food-frequency questionnaire. Factor analysis was used to identify snacking patterns, and multiple linear regression was employed to examine the association between body weight misperception and snacking patterns. Results 190,296 students with the average age of 13.3 ± 1.0 years was included, and 44.5% of students misperceived their weight. Overestimation was more prevalent than underestimation. Two snacking patterns, namely a high-calorie snacking pattern and a healthy snacking pattern, were identified with eigenvalues > 1. Weight underestimation was positively linked to high-calorie snacking pattern scores for both normal weight students (β: 0.16, 95% CI: 0.11, 0.21) and students with overweight/obesity (β: 0.44, 95% CI: 0.35, 0.52), and to healthy snacking scores for students with overweight/obesity (β: 0.28, 95% CI: 0.22, 0.33), but negatively linked to healthy snacking pattern scores for normal weight students (β: -0.12, 95% CI: -0.15, -0.09). Conversely, weight overestimation was negatively linked to both high-calorie and healthy snacking pattern scores for normal weight students (β: -0.07, 95% CI: -0.11, -0.04 and β: -0.13, 95% CI: -0.15, -0.10), but positively linked to healthy snacking scores for underweight students (β: 0.15, 95% CI: 0.08, 0.21). Interactions were found between sex, grade, accommodation, only child, primary guardians, parental education level and weight misperception to snacking patterns. Conclusions Adolescents with normal weight and overweight/obesity who misperceived their weight exhibited less healthy snacking patterns, whereas underweight students who misperceived their weight displayed healthier snacking patterns. Comprehensive programs are crucial to educate and guide adolescents in understanding their weight status and making healthier snack choices, involving families, schools, and society.
... Additionally, Riahi et al. (2019) found that girls tend to overestimate and boys to underestimate their body weight [47]. However, other studies could not find a gender difference [2,3]. ...
... In contrast to previous research [3,47], we found that girls were more likely to underestimate their body size than boys. Methodological differences between the studies may also play a role, since they used specific questionnaires to assess over -and underestimation of a child's weight status, whereas we calculated the discrepancy. ...
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... An incorrect body weight perception can lead to various complications. Underestimation of body weight may lead to obesity and obesity-related morbidity while overestimation may lead to unhealthy eating habits which may lead to eating disorder such as anorexia nervosa and bulimia (3). Individuals with higher concerns on body image can have a negative body image which can subsequently lead to body shape dissatisfaction/concerns (2) and a disturbance of body image has long been recognized to be a diagnostic feature in the development of anorexia (4). ...
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... Some factors may be related to abdominal obesity and hypertriglyceridemia being more pronounced in male adolescents, such as excessive screen time [47], higher consumption of alcoholic beverages [48], and higher consumption of ultraprocessed foods (hot dogs, ham, hamburgers, and sugary drinks) [49], compared with females. Concerns regarding body weight are more frequent among female adolescents, largely because of the cult of thinness disseminated in the media [50]. A study of Brazilian adolescents from the São Paulo Health Survey (ISA-Capital) showed direct associations between low-quality diet and overweight, central adiposity, and CVD risk factors [51] as well as an increase in the consumption of commercial cookies, sweets, and juices between 2003 and 2015 [52]. ...
... La percepción errónea de la imagen corporal y la insatisfacción corporal pueden verse asociadas a comportamientos y conductas de riesgo, sobre todo en adolescentes (Jáuregui-Lobera et al., 2020;Díaz De León et al., 2022). De igual manera, la estigmatización juega un papel fundamental en el desarrollo de conductas negativas, incrementando el riesgo para desarrollar alteraciones de la conducta alimentaria (Madowitz et al., 2012, como se citó en Elizathe et al., 2017) y en la actitud hacia el sobrepeso y la obesidad (Catalán et al., 2020). ...
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Objective: To study the prevalence of obesity among children aged 5 to 14 years in the Republic of Tajikistan (RT) from 2017 to 2021. Methods: The clinical data used for research was obtained from the Republican Center of Medical Statistics and Information of the Ministry of Health and Social Protection of the Population of the RT. The data covered the period from 2017 to 2021 and included obese children between the ages of 5 and 14. Descriptive statistical methods were used to analyze the results, including data aggregation and trend line derivation. The range of values and their 95% confidence intervals were also calculated. For this purpose, absolute values were converted into rates per 10,000 children aged 5 to 14. Results: According to the study results, the prevalence of obesity among children aged between 5 and 14 years has increased between 2017 and 2021. In 2017, there were approximately 28 obese children per 10,000, while by the end of 2021, this number had risen to 102 per 10,000 children. The study also found a significant increase in the number of obese children in the capital city of Dushanbe and the Sughd region. The number of obese children was higher in urban than rural areas. However, there is also a noticeable increase in the number of children with obesity in rural areas; at the same time, in urban areas, obesity is more prevalent in girls than in boys. Conclusion: The study showed a rapid increase in childhood obesity rates, particularly in urban areas. To mitigate this issue, it is essential to utilize specialized programs. Keywords: Children, obesity, epidemiology, urban/rural healthcare, body mass index (BMI), morbidity, rising morbidity.
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Current literature is conflicting regarding whether accurate weight perception encourages healthy weight-related behaviors. This study examined the prevalence of weight misperception and explored associations between weight misperception and weight-related behaviors among 353 Black adolescents in Broward County, Florida. Overall, 44.8% of participants misperceived their weight, with boys more often misperceiving their weight than girls (52.2% vs 40.2%). Students who misperceived their weight were more likely to try to lose weight but less likely to be adequately physically active. Adolescents who underestimated their weight were less likely to be physically active and excessively play video or computer games or use a computer. There was no association between weight misperception and daily physical education attendance or excessive television watching. Weight misperception appears to be a risk factor for obesity in adolescents, as weight misperception was associated with lower engagement in physical activity.
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Background: Adolescence is a phase in life where one grows and learns about necessary skills and particular knowledge. One of the top barriers to seeking health-care in medical students is academic reprisal because they fear that whatever illness will affect them adversely. This study aimed to look at health-care-seeking behaviors in Indonesian medical students as compare to non-medical students. Methods: A cross-sectional study was done at the Universitas Pelita Harapan, Tangerang, Indonesia. Independent T-test analysis and chi-square performed using SPSS version 25. Results: There were 428 participants in this study with 261 (60.98%) female respondents. There were a significant mean difference (p = 0.0014) in the age at which they start working for the first time in the medical groups (17.96 years) and non-medical groups (18.75 years). In addition, a significant difference depicted (p = 0.044) on accessing of health-care facilities as medical students (59.26%) as compared to non-medical students (40.74%).Conclusion: There were a significant mean difference between medical students and non-medical students regarding their health-care-seeking behavior. Although often overlooked, adolescents also require health-care treatments, either medically or mentally. AbstrakLatar Belakang: Masa remaja merupakan fase dalam kehidupan dimana seseorang tumbuh dan belajar tentang keterampilan dan pengetahuan yang diperlukan di masa depan. Salah satu hambatan utama untuk mencari perawatan kesehatan pada mahasiswa kedokteran adalah dampak negatif secara akademis karena mereka takut bahwa penyakit yang diderita akan memberi dampak negatif bagi mereka. Penelitian ini bertujuan untuk melihat perilaku pencarian pelayanan kesehatan pada mahasiswa kedokteran di Indonesia dan membandingkannya dengan mahasiswa non kedokteran.Metode: Studi potong lintang dilakukan di Universitas Pelita Harapan, Tangerang, Indonesia. Analisis Independent T-test dan chi-square dilakukan dengan menggunakan SPSS versi 25.Hasil: Terdapat 428 peserta dalam penelitian ini dengan 261 (60,98%) responden perempuan. Terdapat perbedaan yang signifikan (p = 0,0014) pada usia pertama kali bekerja pada kelompok medis (17,96 tahun) dan non-medis (18,75 tahun). Perbedaan signifikan (p = 0,044) juga tampak pada akses layanan kesehatan dimana mahasiswa kedokteran (59,26%) lebih sering mengakses fasilitas kesehatan dibandingkan dengan mahasiswa non-medis (40,74%).Kesimpulan: Terdapat perbedaan rata-rata yang bermakna antara perilaku mahasiswa kedokteran dan mahasiswa non-medis dalam mencari pelayanan kesehatan. Meski sering diabaikan, remaja sesungguhnya membutuhkan perawatan kesehatan, baik secara medis maupun mental.
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Purpose of review: This review investigates how exposure to palatable food and its associated cues alters appetite regulation and feeding behaviour to drive overeating and weight gain. Recent findings: Both supraphysiological and physiological feeding systems are affected by exposure to palatable foods and its associated cues. Preclinical research, largely using rodents, has demonstrated that palatable food modulates feeding-related neural systems and food-seeking behaviour by recruiting the mesolimbic reward pathway. This is supported by studies in adolescents which have shown that mesolimbic activity in response to palatable food cues and consumption predicts future weight gain. Additionally, stress exposure, environmental factors and individual susceptibility have been shown to modulate the effects of highly palatable foods on behaviour. Further preclinical research using free-choice diets modelling the modern obesogenic environment is needed to identify how palatable foods drive overeating. Moreover, future clinical research would benefit from more appropriate quantification of palatability, making use of rating systems and surveys.
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Objectives: The aim of the study was to examine body-image dissatisfaction in adolescents aged 13-15 years reporting to be on a diet and to assess gender and age differences in weight-reduction behaviour in Slovak adolescents. Methods: Data on a representative sample of 2,765 adolescents (mean age 14.37 years) from the Slovak part of Health Behaviour in School Aged Children Study carried out in 2014 were analysed. Self-reported body-image dissatisfaction and engagement in weight-reduction behaviour of 13 to 15-year-old adolescents was assessed using multiple logistic regression models. Results: More that 20% of boys and 35% of girls perceived themselves to be too fat. Girls reported being on a diet more frequently than boys (28.8% vs. 14.9%). The most frequent weight-reduction behaviours were drinking more water (67.7%), eating more fruits and vegetables (67.1%), and consuming fewer sweets (60.5%) and soft drinks (51.7%). Girls prevailed above boys in the use of these dietary methods. Age differences were not apparent, except for smoking, believed to help in weight reduction and used upmost by 15-year-olds (8.9%) followed by 14 and 13-year-olds, 6.0% and 4.1%, respectively. Conclusions: Body-image dissatisfaction and weight-control behaviour are issues particularly in girls, however, they did not necessarily correspond with actual obesity. The most commonly used weight-reduction behaviours are in the same way important aspects of a healthy lifestyle. There is room to improve obesity control, particularly within primary health care.
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Background: Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of genes and the environment on food preferences in late adolescence are unknown. Objective: The aim of this study was to quantify the contribution of genetic and environmental influences on food preferences in older adolescents. Design: Participants were 2865 twins aged 18-19 y from the TEDS (Twins Early Development Study), a large population-based cohort of British twins born during 1994-1996. Food preferences were measured by using a self-report questionnaire of 62 individual foods. Food items were categorized into 6 food groups (fruit, vegetables, meat or fish, dairy, starch foods, and snacks) by using factor analysis. Maximum likelihood structural equation modeling established genetic and environmental contributions to variations in preferences for each food group. Results: Genetic factors influenced a significant and substantial proportion of the variation in preference scores of all 6 food groups: vegetables (0.54; 95% CI: 0.47, 0.59), fruit (0.49; 95% CI: 0.43, 0.55), starchy foods (0.32; 95% CI: 0.24, 0.39), meat or fish (0.44; 95% CI: 0.38, 0.51), dairy (0.44; 95% CI: 0.37, 0.50), and snacks (0.43; 95% CI: 0.36, 0.49). Aspects of the environment that are not shared by 2 twins in a family explained all of the remaining variance in food preferences. Conclusions: Food preferences had a moderate genetic basis in late adolescence, in keeping with findings in children. However, by this older age, the influence of the shared family environment had disappeared and only aspects of the environment unique to each individual twin influenced food preferences. This finding suggests that shared environmental experiences that influence food preferences in childhood may not have effects that persist into adulthood.
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Introduction: in the last years the rates of overweight and obesity in adolescents have been increasing simultaneously with a progressive abandon of the Mediterranean dietary patterns. In addition many adolescents misperceive their weight. Objectives: to analyse the prevalence of overweight/ obesity, to assess the self-perception of weight and to explore the eating habits in a child and adolescent sample. The relationship among these variables and the influence on the psychosocial wellbeing are also analysed. Method: a total of 87 secondary school students participated in this project. Weight and height were obtained, the self-perceived weight was assessed and a series of questionnaires were applied in order to explore the participants´ wellbeing. Results: 28.73% of the sample had overweight and 9.19% obesity, 27.48% of the students misperceived their weight and only a quarter of the sample had a proper Mediterranean dietary pattern. The frequency of weight control was related positively with a higher weight perception. Discussion and conclusions: many participants underestimated their weight and a possible association between overweight/obesity and skipping breakfast was observed. A progressive increase in the prevalence of overweight and obesity in adolescents is confirmed and the need to implement nutrition education programs after analyzing the eating habits is proposed.
Article
Objective: To examine prevalence of weight misperception (incongruence between one's perceived weight status and one's actual weight status) and disordered weight control behaviors (DWCBs; unhealthy behaviors aiming to control or modify weight), associations between weight misperception and DWCBs, and temporal trends in prevalence and associations among adolescents with overweight and obesity from 1999 to 2013. Methods: Self-reported data from eight biennial cycles (1999-2013) of the cross-sectional national Youth Risk Behavior Survey were used in analyses restricted to respondents with overweight/obesity. Data on weight status perception, use of fasting, purging, and diet pills to control weight, sex, race/ethnicity, and grade in school were used in multivariate logistic regression models. Results: Among U.S. high school students with overweight and obesity, no linear temporal trends were detected for prevalence of weight misperception, fasting, or purging between 1999 and 2013, while a significant linear decrease was observed for prevalence of diet pill use between 1999 and 2013 (b=-0.81, p<0.01). Using data pooled across 1999-2013, weight misperception predicted lower use of all DWCBs examined in this study among females and lower use of fasting to control weight among males. No significant changes over time in associations of weight misperception with fasting or purging were observed, though the association between weight misperception and diet pill use weakened somewhat across 1999-2013. Discussion: In the context of increasing prevalence of overweight and obesity, weight misperception appears to be a robust protective factor for DWCBs.
Article
Objective: To systematically review and quantify the effectiveness of Eating Disorder (ED) prevention interventions. Methods: Electronic databases (including the Cochrane Controlled Trial Register, MEDLINE, PsychInfo, EMBASE, and Scopus) were searched for published randomized controlled trials of ED prevention interventions from 2009 to 2015. Trials prior to 2009 were retrieved from prior reviews. Results: One hundred and twelve articles were included. Fifty-eight percent of trials had high risk of bias. Findings indicated small to moderate effect sizes on reduction of ED risk factors or symptoms which occurred up to three-year post-intervention. For universal prevention, media literacy (ML) interventions significantly reduced shape and weight concerns for both females (-0.69, confidence interval (CI): -1.17 to -0.22) and males (-0.32, 95% CI -0.57 to -0.07). For selective prevention, cognitive dissonance (CD) interventions were superior to control interventions in reducing ED symptoms (-0.32, 95% CI -0.52 to -0.13). Cognitive behavioural therapy (CBT) interventions had the largest effect size (-0.40, 95% CI -0.55 to -0.26) on dieting outcome at 9-month follow-up while the healthy weight intervention reduced ED risk factors and body mass index. No indicated prevention interventions were found to be effective in reducing ED risk factors. Conclusions: There are a number of promising preventive interventions for ED risk factors including CD, CBT and ML. Whether these actually lower ED incidence is, however, uncertain. Combined ED and obesity prevention interventions require further research.
Conference Paper
This article discusses potential areas for research in the prevention of eating disorders. Prevention research encompasses a large range of activities; reviews are available (Crisp 1988; Shisslak et al. 1987; USDHHS/McKnight 1996). This article focuses on school-based primary preventive interventions.
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The public health burden of eating disorders is well documented, and over the past several decades, researchers have made important advances in the prevention of eating disorders and related problems with body image. Despite these advances, however, several critical limitations to the approaches developed to date leave the field far from achieving the large-scale impact that is needed. This commentary provides a brief review of what achievements in prevention have been made and identifies the gaps that limit the potential for greater impact on population health. A plan is then offered with specific action steps to accelerate progress in high-impact prevention, most compellingly by promoting a shift in priorities to policy translation research and training for scholars through the adoption of a triggers-to-action framework. Finally, the commentary provides an example of the application of the triggers-to-action framework as practiced at the Strategic Training Initiative for the Prevention of Eating Disorders, a program based at the Harvard T. H. Chan School of Public Health and Boston Children's Hospital. Much has been achieved in the nearly 30 years of research carried out for the prevention of eating disorders and body image problems, but several critical limitations undermine the field's potential for meaningful impact. Through a shift in the field's priorities to policy translation research and training with an emphasis on macro-environmental influences, the pace of progress in prevention can be accelerated and the potential for large-scale impact substantially improved.