Article

Evidence for a Self-Esteem Approach in the Prevention of Body Image and Eating Problems among Children and Adolescents

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Abstract

Early suggestions from the 1980s for a self-esteem approach in the prevention of eating problems have been adopted by researchers, and the results of several interventions show support for the efficacy, safety, and suitability of a predominantly self-esteem and self-acceptance approach. Several recent studies utilizing strong self-esteem components as part of their controlled prevention interventions have produced improvements in body dissatisfaction, dietary restraint, internalization of the thin ideal, and attitudes associated with the eating disorders. This article discusses self-esteem as one of the important risk and protective factors in the development of body image concerns and eating disorders and describes the subsequent use of a self-esteem approach for prevention of eating disorders. Interventions containing strong self-esteem components from around the world are discussed in relation to their impact on the body image and eating behaviors of adolescents. Applications of the self-esteem approach for the prevention of child obesity also are discussed.

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... Findings from this study provide support for future investigations on the feasibility and potential efficacy of pairing children and their caregivers with horses to accomplish health-related goals. multidisciplinary team [4,10,11]. Successful weight loss is also more likely to occur when individuals actively engage in the behaviors known to reduce weight [12]. For example, youth report a preference for exercising to improve their health and value peer support formats that could be fun, as well as educational [13]. ...
... It has been recommended that obesity treatments for youth should focus on environmental factors such as dietary and physical activity behaviors that are modifiable [9], rather than focusing primarily on overweight and weight control. The latter focus could be demoralizing to young people and lead to poor body image, fear of food, self-consciousness around peers, negative beliefs about physical abilities, and low self-worth [10]. Consequently, research indicates that treatment should consist of multicomponent models that are grounded in positive health education and delivered by a ...
... Three children met the initial screening criteria and were enrolled in the study. Table 1 shows an outline of the Equine-Assisted Positively Fit (EAPF) program, which is an adaptation of the Positively Fit curriculum [29], an evidenced-based, 10 week, manualized intervention that covers topics related to eating habits/dietary choices, increasing exercise, and helping parents navigate the challenges of making changes in their family to support their children's lifestyle efforts. A team of clinical psychology graduate students supervised by a Ph.D.-level clinical supervisor, and a counselor certified as a Professional Association for Therapeutic Horsemanship, International (PATH, Intl.) ...
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In this article, we present an exploratory case study that describes the initial outcomes of the Equine-Assisted Positively Fit (EAPF) program. Children with obesity and their caregivers were recruited to participate in the eight-session program. Results indicated that treatment completers (n = 2) had a decrease in fat mass and fat mass percentage and an increase in fat-free mass and fat-free mass percentage. Moreover, results from accelerometer measurements of physical activity indicated that participants increased their moderate to vigorous physical activity, as well as reported increased self-efficacy for physical activity. Qualitative data from the post-intervention focus group suggested children perceived the treatment acceptable and enjoyable. Findings from this study provide support for future investigations on the feasibility and potential efficacy of pairing children and their caregivers with horses to accomplish health-related goals.
... Based on principles of positive psychology, Gouig (2006) hypothesizes that the onset of eating pathology among young adolescents can be prevented by focusing on nurturing their own signature strengths (such as perseverance, kindness, honesty and creativity; Peterson & Seligman, 2000) in order to increase their overall self-esteem. Furthermore, in a review of existing preventive programs which focus on increasing self-esteem, O'Dea (2004) concluded that programs incorporating components that strengthen self-esteem have resulted in significant improvements regarding eating behaviors, as well as weight and shape concerns among children and adolescents. Additionally, Fairburn (2008) posits that enhancing self-esteem might lead to better therapeutic outcomes in the treatment of eating disorders. ...
... We hypothesized that gender differences would be present, with women displaying higher levels of disordered eating than men. Furthermore, based on previous research (e.g., O'Dea, 2004;Stein et al., 2013), we hypothesized that self-esteem, identity coherence, positive body connection and comfort, and agency and functionality would be associated with lower degrees of disordered eating, and predict lower degrees of disordered eating among both women and men. ...
Article
Applying a positive psychology perspective, this study aimed to identify potential intra-individual factors that might protect against the development of disordered eating in a community sample of young women and men (N = 510; 56 % women; Mage = 24.3). Based on existing literature, the study included the general resilience factors of self-esteem and identity coherence as well as two dimensions of positive embodiment (positive body connection and comfort, and agency and functionality). All factors were negatively correlated with disordered eating among women and men. Hierarchical regression analyses indicated that positive embodiment, specifically positive body connection, was a significant predictor of lower degrees of disordered eating symptoms in both women and men, followed by self-esteem. The overall prediction model accounted for 42.6 % in the variation of disordered eating symptoms for women and 23.9 % for men. Prevention and treatment interventions promoting health factors that protect against the development of eating disorders are much needed. The present study informs such efforts by emphasizing the promotion of positive embodiment.
... Furthermore, although self-esteem has been established as an efficacious, safe, and suitable approach to reduce body image concerns in young women, few studies have compared a pure self-esteem approach with a self-compassionate alternative (Fuller-Tyszkiewicz et al., 2018). Specifically, many self-esteem interventions have included activities designed to promote self-acceptance and emphasise that body dissatisfaction is a common and shared experience, both core components of the self-compassion construct (O'Dea, 2010). Thus, it is important to ascertain whether observed treatment effects for self-esteem interventions could have been confounded by the inclusion of elements representing a self-compassionate approach. ...
... In addition, we have demonstrated the superiority of self-compassion through being one of the first studies to directly compare a pure self-compassion approach with a pure self-esteem approach (Fuller-Tyszkiewicz et al., 2018). This comparison is important when evaluating intervention efficacy as self-esteem programs have had the strongest evidence base for managing body image concerns in young women, yet many of these programs have included elements of selfcompassion in intervention protocols (O'Dea, 2010;Seekis et al., 2017). These findings can also speak to the efficacy of a brief selfcompassion writing intervention immediately following exposure to a body image threat. ...
Article
This study explored the efficacy of reflective writing tasks for reducing state body dissatisfaction and improving self-improvement motivation. Participants (N = 153) were exposed to a threatening body image scenario, after which they reported their state body dissatisfaction. Following randomisation to one of three interventions (self-esteem, self-compassion, or positive distraction control), participants completed the state body dissatisfaction measures again along with a measure of self-improvement motivation. At post-intervention, state weight dissatisfaction and appearance dissatisfaction were significantly lower and self-improvement motivation was significantly higher in the self-compassion group than in both the self-esteem and control groups. Trait body dissatisfaction moderated the efficacy of the intervention whereby the benefit of the self-compassion intervention became evident at moderate levels of trait body dissatisfaction, and was most apparent at high levels of body dissatisfaction. Self-compassion was a robust and efficacious method through which to promote immediate improvements to bodily feelings and desire to self-improve.
... νική απόρριψη, κοινωνικό στίγμα, ταπείνωση (Frost & Hoggett, 2008. Petterson, 2012. Ridge, 2009, καθώς και σημαντικά καταθλιπτικά ή αγχώδη συμπτώματα (Ridge, 2009 (Kling et al., 1999. Tamini & Valibeygi, 2011, η ανεργία (Batty & Flint, 2010. Dolan, 2007. Orton, 2009. Pahl et al., 2007. Ridge, 2009) και η παρουσία κάποιας ασθένειας (Δημοπούλου, 2006. O'Dea, 2004. Sowislo & Orth, 2013 (Breakwell, Harrison & Proper, 1984. Fielden & Davidson, 1999. Giuntoli, South & White, 2011. Kapuvari, 2011, ενώ καθίστανται ιδιαίτερα επιρρεπή να εμφανίσουν σοβαρή μορφή ψυχοπαθολογίας (Holland, 2012. Ozamiz, Gumplmaier & Lehtinen, 2001. Paul & Moser, 2009. Φατούρου, 2010. ...
... ο.Βρέθηκε, δηλαδή, ότι οι πάσχοντες από κάποια νόσο εμφανίζουν στατιστικώς σημαντικά χαμηλότερη ποιότητα ζωής και αυτοεκτίμηση. Τα αποτελέσματα αυτά επιβεβαιώνονται από τη διεθνή βιβλιογραφία, καθώς έρευνες έχουν δείξει ότι η αυτοεκτίμηση των ατόμων που έρχονται αντιμέτωποι με διάφορες σωματικές και ψυχικές νόσους μειώνεται αισθητά(Δημοπούλου, 2006. O'Dea, 2004. Sowislo & Orth, 2013. Το ίδιο ισχύει και για την ποιότητα ζωής των ατόμων, η οποία παρουσιάζει σημαντική μείωση, ιδιαίτερα όταν το άτομο έρχεται αντιμέτωπο με πολύ σοβαρές ψυχικές ή σωματικές ασθένειες, όπως το AIDS(Skevington et al., 2010), η σχιζοφρένεια (Jasovic-Gasic et al., 2010) και η κατάθλιψη(Daly et al., 2010).Ακόμη, βρέθηκαν ...
Thesis
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This research is an original study that explored the relationship between quality of life, psychological resilience, self-esteem and demographic data of young Greeks in the context of the contemporary socio-economic crisis. The participants in the survey were 469 young people aged between 16 and 34 years old, who completed a questionnaire on the Internet, examining quality of life, psychological resilience and self-esteem. The reliability of the questionnaires for the Greek sample was high. The avalanche method was followed during sampling. The results showed that young people affected by unemployment show a decline in their quality of life, self-esteem and psychological resilience. In addition, university students and women, who have a significantly lower self-esteem, seemed to be more affected by unemployment. Specifically, those of the latter work, occupy in most cases an illegal part-time job. It has also been found that the self-esteem, the quality of life and the psychological resilience of young people are positively correlated and predict one another. Simple and complex prediction models were identified to explain each of these three variables to a significant extent. Overall, the above data is of great importance for the implementation of programs to promote mental health and prevent mental disorders in young people affected by unemployment and job insecurity.
... If (sub-)clinical conditions are already present at the baseline time, longitudinal findings rather reveal how personality contributes to the course and outcome of EDs. In adolescence, findings from this perspective show that depression, self-critical perfectionism, self-esteem, urgency, and ineffectiveness are significant temporal antecedents of later dysfunctional eating conditions (Boone, Soenens, & Luyten, 2014;O'Dea, 2004;Pearson, Combs, Zapolski, & Smith, 2012). ...
... Research has also showed sex differences in EDs. The onset of eating disordered symptoms comes later for adolescent boys than for girls, ED males report more vomiting, but less laxative abuse episodes, are less dissatisfied with their bodies, and show lower levels of drive for thinness than girls (Leon, Fulkerson, Perry, & Early-Zald, 1995;Nùnez-Navarro et al., 2012;O'Dea, 2004). Sex differences have emerged in the associations between ED-relevant conditions and personality as well, although not consistently across studies. ...
Article
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Eating disorders are mosy likely to occur for the first time in adolescence. Delineating vulnerable personality profiles of unhealthy conditions helps prevent their onset and development. This study investigated a non-clinical sample of 142 adolescents and how some theoretically salient individual differences in personality contribute to predict changes in behaviors, attitudes, and psychological characteristics that are clinically significant in eating disorders (EDs). The results from cross-lagged pattern analyses supported the influence of depression, obsessiveness, and self-esteem in the trajectories favoring the development of psychological characteristics, such as ineffectiveness and interoceptive awareness, which are salient in the ED risk process. Results also confirmed that body mass index, perfectionism, and body dissatisfaction predict increases in dysfunctional concerns with weight control and food consumption. Empirical support for the impact of ED-relevant variables on personality self-views emerged as well. Trajectories linking EDs and personality in relation to sex differences and permeability to transitory psychological conditions in adolescence were also confirmed.
... [18][19][20][21][22][23] Prevention programs designed to improve selfesteem and body satisfaction typically target risk factors for eating pathology in order to increase resilience and reduce future disordered eating symptoms. 15,24,25 Evaluations of such programs have revealed mixed results, 19,21,20,[26][27][28][29] and few studies have employed randomized trial evaluation methodologies. [30][31][32][33][34] Primary prevention programs have been delivered to groups of children without specifically identified risk factors or conditions. ...
... Self-esteem approaches emphasise the importance of focusing on overall health and wellbeing without promoting weight loss diets and thus shift the focus to weight-neutral outcomes. 18,26,[54][55][56][57][58][59][60] This school of thought continues to suggest that this should flow on to improved body satisfaction, an aspect that was not confirmed in our study. It is possible that the impact of our intervention was not strong enough to be detected given our sample size. ...
Article
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Purpose: To test the effectiveness of an intervention delivered by health professionals outside the school environment to girls identified with issues such as poor body image, low self-esteem, low self-confidence, nonparticipation in sports, or being overweight or underweight. Design: The study's design was a stepped-wedge randomized controlled trial to test the efficacy of an intervention on self-esteem, impairment induced by eating disorders, self-efficacy, body satisfaction, and dieting behaviors. Setting: The study took place at the community health center located in a culturally diverse area of Melbourne, Victoria, Australia. Subjects: Participants were 122 primary and secondary school girls between 10 and 16 years of age. Intervention: Girls on the Go! is a 10-week program designed to improve self-esteem, body image, and confidence, using an empowerment model that involved interactive and experiential learning approaches. Weekly themes included body image and self-esteem, safety and assertiveness, a healthy mind, physical activity, healthy eating, trust and confidence, and connections. Measures: Measurements were made using Rosenberg Self-Esteem Scale, clinical interview assessment, health self-efficacy (included mental health and physical health self-efficacy scales), body esteem scale, and the Dutch Eating Behavior Questionnaire for Children. Analysis: A linear mixed model was used. Results: The intervention led to a significant increase (p < .05) in self-esteem and self-efficacy (mental and physical health self-efficacy subscales), for both primary and secondary school-aged participants and reduced dieting behaviors (secondary school participants). These gains were retained after 6 months of follow-up. Conclusion: This group-based, low-dose intervention, which, although targeting girls with a range of psychological issues and including both overweight and underweight participants, is a successful means of improving self-esteem among girls from diverse cultural backgrounds.
... The current findings point to the role of two intense emotional experiences in the predisposition of childhood trauma for later-life eating problems. It is reasonable to suggest that prevention strategies focusing on self-esteem (O'Dea, 2004), self-compassion (Breines et al., 2014, adaptive coping strategies (Bloks et al., 2004), and emotion regulation skills (Holmqvist Larsson et al., 2020) which are all highlighted as important protective factors in problematic eating patterns, can also be effective in alleviating self-directed disgust and body shame. Furthermore, treatment plans covering the assessment of a patient's early trauma experiences and related symptoms, problems, and emotions rather than targeting only symptoms are assumed to be more effective (Brewerton, 2007). ...
Article
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Bozulmuş yeme tutumları, uyumsuz yeme davranışlarını tetikleyebilmekte ve yeme bozuklukları için bir yatkınlık oluşturabilmektedir. Beliren yetişkinlik döneminde yaygın olarak gözlenen yeme ile ilgili sorunlarda, çocukluk dönemindeki örseleyici yaşantıların rolü ortaya koyulmuş olmakta birlikte, bu ilişkide açıklayıcı duygusal mekanizmalara dair bilgi ihtiyacı devam etmektedir. Bu çalışmada, çocukluk travmaları ile bozuk yeme tutumu arasındaki ilişkide öz tiksinme ve beden utancının aracılık rolünün incelenmesi amaçlanmıştır. Araştırma, yaşları 18 ile 25 (Ort. = 21.89, SS = 2.11) arasında değişen 397 gönüllü kadın katılımcı ile yürütülmüştür. Çalışmanın verisi Çocukluk Çağı Ruhsal Travma Ölçeği, Öz Tiksinme-Revize Formu, Nesneleştirilmiş Beden Bilinci Ölçeği ve Yeme Tutum Testi kullanılarak çevrimiçi toplanmıştır. Korelasyon analizi sonuçları çocukluk travmaları, benliğe yönelik tiksinme, beden utancı ve yeme tutumunda bozulmanın birbirleri ile pozitif yönde ilişkili olduğunu göstermiştir. Seri aracılık modeli de öz tiksinme ve beden utancının hem bağımsız olarak hem de bir arada çocukluk travması ile yeme tutumu arasında tam aracı rolünün olduğunu ortaya koymuştur. Bu bulgular, yeme ile ilgili sorunların kavramsallaştırılmasına katkı sunmakta; önleyici ve sağaltıma yönelik uygulamaların etkililiği için çocukluk dönemindeki travmatik deneyimlerin ve sürdürücü duygusal mekanizmaların değerlendirilmesinin önemine işaret etmektedir.
... At the individual-level, BID may be managed effectively to prevent the development of adverse outcomes across an individual's lifetime. This may be achieved using cognitive-behavioural therapy [15,16] or self-esteem enhancement [17]. In addition, BID also holds promise as a potentially modifiable risk factor for population-based interventions. ...
Article
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Disordered eating and self-harm commonly co-occur in young people suggesting potential for shared underlying causes. Body image dissatisfaction (BID) has been recognised as a psychological correlate of body size, associated with both disordered eating and self-harm. However, the investigation into etiological pathways early in the lifecourse to provide detail on how body size and BID may foster disordered eating and self-harm remains largely unexplored. Employing data from two large population-based cohorts, the UK Biobank and the Avon Longitudinal Study of Parents And Children (ALSPAC), we conducted bidirectional Mendelian randomization (MR) to determine the causal direction of effect between genetically predicted prepubertal body size and two measures of BID indicating (i) desire to be smaller, and (ii) desire to be larger. We then used multivariable regression followed by counterfactual mediation analyses. Bidirectional MR indicated robust evidence that increased genetically predicted prepubertal body size increased desire to be smaller and decreased desire to be larger. Evidence for the reverse causal direction was negligible. These findings remained very similar across sensitivity analyses. In females and males, multivariable regression analyses demonstrated that being overweight increased the risk of disordered eating (risk ratio (RR), 95% confidence interval (CI): 1.19, 1.01 to 1.40 and 1.98, 1.28 to 3.05, respectively) and self-harm (RR, 95% CI: 1.35, 1.04 to 1.77 and 1.55, 0.86 to 2.81, respectively), while being underweight was protective against disordered eating (RR, 95% CI: 0.57, 0.40 to 0.81 and 0.81, 0.38 to 1.73, respectively). There was weak evidence of an increase in the risk of self-harm among underweight individuals. Mediation analyses indicated that the relationship between being overweight and subsequent disordered eating was largely mediated by the desire to be smaller. Our research carries important public health implications, suggesting distinct risk profiles for self-harm and disordered eating in relation to weight and body image. In addition, a better understanding of genetically predicted prepubertal BID may be valuable in the prevention and treatment of disordered eating and self-harm in adolescence.
... Based on these premises, a few studies have been conducted to investigate the protective role of self-esteem on EDs and related symptoms, demonstrating that self-esteem might protect against developing ED symptoms in both women and men (Brechan & Kvalem, 2015;Croll, Neumark-Sztainer, Story, & Ireland, 2002;Voica et al., 2021). Finally, in a review of existing preventive interventions that aimed to enhance self-esteem, O'Dea (2004) determined that programs incorporating elements to bolster self-esteem have led to improvements in maladaptive eating. ...
... An effective approach in preventing and treating eating problems is considered the one based on promoting self-esteem and self-acceptance (O'Dea, 2004). The author indicates that several studies that had used them as part of prevention activities had achieved many positive results on reducing body image dissatisfaction, food restriction, thin ideal internalization and attitudes associated with eating disorders. ...
Article
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The aim of this study was to investigate the preventive potential of self-acceptance and mindfulness against sociocultural pressures to be thin and the internalization of this ideal. A moderated mediation model was conducted to test whether there is a mediating effect of perceived sociocultural pressure to be thin in the relationship between unconditional self-acceptance and thin ideal internalization, and whether this effect is moderated by the level of mindfulness. The sample analyzed included 146 female adolescents, aged between 16-18 years old. The study contributes to the understanding why some individuals are more prone to internalize the thin ideal, and offers relevant insight that can be used to improve prevention programs for dysfunctional eating. The results indicate the importance of promoting self-acceptance and training healthy habits like mindfulness practicing in addressing eating disorders.
... Therefore, there may be no difference in whether a person has ever dieted, unless the eating disorder is severe, the person has morbid anxiety, or a body complex. Indeed, higher self-esteem has been associated with fewer worries and anxieties about body image and with the promotion of positive evaluations of one's weight and shape (19). This study's results indicate that the average score for both underweight and normalweight groups was around 29, which suggests that the respondents did not have an overly negative evaluation of their body shape and did not have an overly slim ideal. ...
Article
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Introduction This study examines the background of underweight young women in Japan from multiple perspectives, focusing on whether they have ever dieted. Methods A screening survey was administered to 5,905 underweight (BMI < 18.5 kg/m2) women aged 18–29 years, who could report their birth weight recorded in their mother-child handbook. Valid responses were obtained from 400 underweight and 189 normal-weight women. The survey collected data regarding height, weight (BMI), body image and perception of weight, dieting experience, exercise habits from elementary school age onwards, and current eating habits. Additionally, five standardized questionnaires were used (EAT-26, eHEALTH, SATAQ-3 JS, TIPI-J, and RSES). The primary analysis was a comparative analysis (t-test/χ2)—with the presence or absence of underweight and diet experience as independent variables, and each questionnaire as a dependent variable. Results The screening survey revealed that approximately 24% of the total population was underweight, with a low mean BMI. Of the respondents, more than half reported their body image as skinny and a small percentage as obese. Compared with the non-diet-experienced group (NDG), the diet-experienced group (DG) had a significantly higher proportion of past to current exercise habits. There was a significantly higher percentage of disagreement responses from the DG for weight and food gain than for the NDG. The NDG weighed significantly less than the DG in terms of birth weight, and lost weight easier than the DG. Additionally, the NDG was significantly more likely to agree with increasing weight and food intake. The NDG’s exercise habits were below 40% from elementary school age to the present, predominantly owing to a dislike for exercise and a lack of opportunity to implement it. In the standardized questionnaire, the DG was significantly higher for EAT-26, eHEALTH, SATAQ-3 JS, and Conscientiousness (TIPI-J), whereas the NDG was only significantly higher for Openness (TIPI-J). Discussion The results suggest the need for different health education programs for underweight women who desire to lose weight and experience dieting and for those who do not. This study’s results are reflected in the development of sports opportunities optimized for each individual, and in the development of measures to ensure adequate nutritional intake.
... Self-esteem is an optimistic view of self without considering physical appearance (Neff & Vonk, 2009). Previous researchers have conducted several interventions to increase self-esteem (O'Dea, 2004). Further impact of this community service is expected to contribute to others that adolescents' self-esteem increases after education. ...
Article
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Adolescent girls aged 15-24 are at risk of contracting sexually transmitted diseases such as HIV/AIDS. The existence of adolescent promiscuity, inadequate knowledge of adolescents about HIV/AIDS, and lack of communication with parents on adolescent reproductive health are some related factors to the increased number of adolescents infected with sexually transmitted diseases and HIV/AIDS. Based on these situations, providing health education to adolescents is an alternative solution. The activities were carried out by implementing health education for teenage girls, conducted in four sessions. All sessions were held online, with interactive discussion methods, role play and demonstrations. A total of 18 adolescent girls participated in this activity. The final results showed that there is an increasing mean score of post-test on HIV knowledge (0.5), adolescent reproductive health (0.44), and self-esteem (0.39). There are no significant different between pre and post-test for the level of knowledge on HIV, adolescent reproductive health, adolescent risk behavior and self-esteem. Only risky behavior does not demonstrate an increase in the mean score. Providing health education to teenage girls has improved their knowledge and understanding of HIV/AIDS and adolescent reproductive health and increased adolescent self-esteem. However, these activities did not affect the score of teens’ behavior change. It was due to the duration of health education was not sufficient to change their behavior.
... Objectification means that someone views less powerful people as a means to meet their own goals or needs. People lacking self-determination and agency are considered more likely to become targets of objectification (Nussbaum, 1999). As power is positively associated with self-determination, agency (Anderson et al., 2012), and self-esteem, it is possible that power may also buffer people against becoming the target of objectification. ...
Article
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We expected power – the perceived capacity to influence others – to be an antecedent of positive body image because power is closely linked to self-esteem, which in turn is linked to body image. In a cross-sectional study ( N = 318), sense of power was positively related to body appreciation and satisfaction with one’s appearance. Self-esteem partially mediated this effect. In an experimental study ( N = 114), participants assigned to a high-power group indicated more body appreciation, reported more body satisfaction, and estimated themselves to be taller than participants assigned to a low-power group. Self-esteem mediated all the effects. Altogether, power affected body image directly but also indirectly through elevated self-esteem. Implications refer to clinical prevention and intervention programs.
... 10 BID may contribute to depression, low self-esteem, obesity and eating disorders such as anorexia or bulimia. [11][12][13][14][15][16][17] According to limited studies conducted in Turkey, BID has been seen as an important problem in adolescence. For example, Arslan et al. 18 found, among high school students in Istanbul, the percentage of BID was 46.8% overall. ...
Article
Background: This study aimed to validate the Turkish version of Collins` Body Figure Perceptions and Preferences (BFPP) scale. The second aim of this study was to investigate the relationship between body image dissatisfaction (BID) and body esteem (BE), and between body mass index (BMI) and BID, among Turkish children. Methods: A descriptive cross-sectional study was conducted among 2066 4th grade children (mean age was 10.06 ± 0.37 years) in Ankara, Turkey. The Feel-Ideal Difference (FID) index from Collins` BFPP was used to assess the degree of BID. FID ranges from -6 to +6, with scores below or above 0 indicating BID. Collins` BFPP`s test-retest reliability was evaluated in a subset of 641 children. The Turkish version of the BE Scale for Adolescents and Adults was used to evaluate the children` BE. Results: More than half of the children were dissatisfied with their own body images (57.8% of girls vs. 42.2% of boys, p < .05). The lowest BE score in both genders was among adolescents who desired to be thinner (p < .01). The criterion-related validity of Collins` BFPP, in relation to BMI and weight, was at an acceptable level in girls (BMI rho= 0.69, weight rho= 0.66) and boys (BMI rho= 0.58, weight rho= 0.57), and was statistically significant in all cases (p < .01). The test-retest reliability coefficients of Collins` BFPP were found to be moderately high for both girls (rho=0.72) and boys (rho=0.70). Conclusions: Collins` BFPP scale is a reliable and valid tool for Turkish children aged 9-11 years. This study demonstrates that more Turkish girls than boys were dissatisfied with their bodies. Children who were affected by overweight/obesity and underweight had a higher BID than those with a normal weight. It is important to evaluate adolescents` BE and BID in addition to their anthropometric measurements during their regular clinical follow-up.
... The cognitive model of BDD posits that appearance importance plays a maintaining role in disorder phenomenology and should be explicitly targeted in treatment (Veale, 2004). Additionally, appearance importance has been found to predict BDD-related anxiety, dietary restriction, body dissatisfaction, suicidal behavior, nonsuicidal self-injury, and self-esteem (Aparicio-Martinez et al., 2019;Nelson & Muehlenkamp, 2012;O'dea, 2004). ...
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Background Appearance importance is a core transdiagnostic construct that has been identified in the maintenance of body-image pathology that has primarily been measured through self-report questionnaires.Methods The Appearance Preference Task (APT) is a 33-item computerized forced-choice task designed to measure appearance importance. In Study 1, the latent factor structure of the original 34 items was evaluated in a sample of undergraduate women (N = 300) through the use of principal axis factoring. In Study 2, this factor structure was replicated in another sample of women (N = 367) utilizing confirmatory factor analysis, and the validity of the APT was assessed by observing its relationship with measures of appearance importance and clinically relevant symptoms.ResultsThe 33-item APT was found to be an internally consistent three-dimensional measure. The APT demonstrated appropriate convergent and divergent validity and was also associated with symptoms of eating pathology, body dysmorphic disorder, and appearance anxiety.Conclusion The present investigation provides preliminary support for the APT’s potential utility as a novel assessment of appearance importance.
... 19,20 There is also a negative association between alcohol use and the mindfulness facets of AA, D, 14,21 NR, 21 and NJ 22 such that higher levels of alcohol consumption relate to lower levels of mindfulness practice. Moreover, interventions suggest that increasing mindfulness effectively reduces disordered eating 23 and alcohol consumption and alcohol consequences among college students. 24 However, there is no research that explores the relation between mindfulness and the combined behavior of alcohol use and disordered eating -drunkorexia. ...
Article
Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.
... Leavy and Hastings (2010) examined body image across lesbian, bisexual, and heterosexual women in the context of their sexual identity, and the lesbian and bisexual women in their study reported believing that coming out was the primary reason they were not as affected by heteronormative beauty standards. As a woman transitions through the stages of developing a lesbian sexual identity, her self-acceptance increases (Cass, 1979a(Cass, , 1979b; an increase in self-acceptance has been associated with an increase in positive body image (O'Dea, 2004). The experiences of the women in this study support the growing body of literature that suggests coming out can positively affect body image (Krakauer & Rose, 2002). ...
Article
Research on body image commonly focuses on the negative aspects of the construct, and the majority of findings related to body image in general arise from quantitative methods of investigation. Furthermore, little is known about the experiences lesbian women go through as they come out, and what consequence this has on their body image. In this study we examined the experiences of 12 lesbian women and explored how coming out affected their body image. Data were collected via face-to-face interviews and analyzed using thematic analysis. Participants’ ages ranged from 20 to 33 (M = 25). The analysis revealed that all participants reported experiencing improved body image after coming out. Other changes related to the presentation of sexual identity in terms of how they dressed, i.e., presenting as either more masculine or feminine. Most participants reported feeling that the sexual and gender minority community was more accepting of different body shapes and sizes compared to the heteronormative society in which they resided. Negative feelings and experiences related to family situations, and occasionally from within themselves. The results are important in understanding how gender and sexual orientation are intertwined to create a distinct experience of body image in lesbian women, and also to illustrate the heterogeneity of body image within subgroups of women.
... Body image dimensions had a causal relationship with self-esteem. A study by O'Dea (2004) explained that self-esteem is an important factor in the development of body image issues and use of self-esteem approach can prevent the development of such issues. ...
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Body image is a multidimensional concept that entails a person's perceptions, thoughts, and feelings about his or her body. This concept is widely documented among adolescence as it's a stage marked by intense self-consciousness and a strong desire to look the most perfect version of one self. Hence, to study the body image concerns of adolescents suffering from the genetic blood disorder of beta thalassemia major which entails various physical deformities and other clinical manifestations becomes important. It is also vital to understand whether having certain personality traits play a role in body self-image issues. The aim of the present study is to explore the relationship of body self-image with personality traits and self-esteem of beta thalassemia major patients. An empirical study was done with total sample 96 beta thalassemia major patients of the age range 14-22 years. Data was collected using Body Self Image Questionnaire (BSIQ), Neo Five Factor Inventory-3 and Rosenberg Self Esteem Scale. The results indicated that personality traits had significant relationship with body self-image especially in domains appearance evaluation, attention to grooming, height dissatisfaction, health/fitness evaluation and social dependence along with self-esteem. Body self-image also had a causal relationship with self-esteem.
... While recognising that child agency is powerful in the family context this health promotion role is also one that may burden the child (Backett-Milburn et al. 2006;Backett-Milburn et al. 2010a, 2010bBurrows 2017;Leahy and Wright 2016;Wills et al. 2011). In Australia, there is some indicative research about the potential for stigma and distress in messages about obesity (Campos et al. 2006;Heuer 2009, 2010) and negative impacts for children when they are encouraged to focus on their body weight, exercise and healthy eating practices (Gunson et al. 2016(Gunson et al. , 2017O'Dea 2004;Purcell 2008;Welch, McMahon, and Wright 2012;Wright, Burrows, and Rich 2012). A number of studies both in Australia and elsewhere indicate that the emphasis on educating children about obesity has created unintended consequences of negative and disturbing ideas for children about their bodies and food (Burrows and Wright 2007;Fullagar 2009;Leahy 2009Leahy , 2014Leahy and Wright 2016;Rich and Evans 2005). ...
Article
This paper draws on a multi-method study with 50 families in Victoria, Australia. Primary school children were asked about food knowledge from school and whether they felt motivated to bring knowledge home. Generally, children and parents felt school food messages are unclear, contradictory and not relevant to them and this reduced the likelihood of messages coming home from school. We identify a critical difference in how families thought about healthy eating and food practices at home and the framework of school messages. Families focused on children's eating in a pragmatic way, infused with nurturance as well as concern. We argue their practices can be viewed as a form of relational consumption (Lindsay and Maher 2013. Consuming Families: Buying, Making, Producing Family Life in the Twenty-First Century. New York: Routledge.) where food is part of the everyday exchange of love and care. A disjunction exists between familial relational approaches and the regulatory framework of school food messages that impacts how messages move between these spaces. Attention to relational aspects of food consumption at school might allow for a more valuable exchange between family and schools that supports family endeavours to feed children well. ARTICLE HISTORY
... Self-esteem refers to the overall judgement one makes of oneself. Having high self-esteem means being able to accurately appraise one's negative and positive attributes and live comfortably with that knowledge (O'Dea, 2004). Self-esteem and body image are positively correlated as higher self-esteem in children is linked to more positive body image and can shield them from developing eating disorders to a larger extent (Mitchell et al., 2012). ...
Article
Background: Increasingly, children are at risk of developing eating disorders. A systematic review and a meta-analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self-esteem among children aged 5-17 years old. Methods: Nine electronic databases were systematically searched from each database's point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study's risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta-analysis was conducted using the random-effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I2 statistic and Cochran's Q chi-squared test. Publication bias was assessed using funnel plots. Results: A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children's body esteem, self-esteem, and internalization of appearance ideals at postintervention and at follow-up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective. Conclusions: The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.
... Although past family interactions cannot be altered, PWB itself can be a point of intervention and prevention against body dissatisfaction and maladaptive eating behaviors. Findings of the present study reinforce the utility of intervention and prevention programs focused on improving self-esteem, building skills to form supportive and warm social relationships, and improving stress management skills to reduce psychological distress (O'Dea, 2004). ...
Article
Objective To examine whether parental communication is associated with body dissatisfaction and disordered eating among college‐age daughters and whether these associations are mediated by psychological well‐being. Background Appearance‐related parental comments such as weight criticism have been shown to contribute to daughters' body dissatisfaction and disordered eating. Yet less is known about how the general quality of parental communication that is not directly related to appearance is associated with these problems. Method Structural equation modeling was used with a convenience sample of 306 undergraduate women who completed an online survey that included perceptions of mothers' and fathers' acceptance (i.e., warmth and care) and challenge (i.e., pushing children so that they can achieve greater success). Results Parental confirmation was associated with greater psychological well‐being, which, in turn, was negatively related to body dissatisfaction and disordered eating behaviors. The associations of acceptance and challenge with body dissatisfaction differed by parental sex. Conclusion The findings suggest that body‐satisfied daughters who are less likely to engage in disordered eating have (a) a combination of accepting and challenging communication from mothers and (b) accepting (not challenging) communication from fathers. Implications Family practitioners are encouraged to educate parents about the link between their communication and daughters' issues surrounding body image and eating behaviors.
... Self-esteem refers to the overall judgement one makes of oneself. Having high self-esteem means being able to accurately appraise one's negative and positive attributes and live comfortably with that knowledge (O'Dea, 2004). Self-esteem and body image are positively correlated as higher self-esteem in children is linked to more positive body image and can shield them from developing eating disorders to a larger extent (Mitchell et al., 2012). ...
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Aims: To evaluate the effectiveness of psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities. Design: A systematic review and a meta-analysis. Data sources: Seven electronic databases (CINAHL, CENTRAL, EMBASE, ProQuest Dissertation and Theses, PsycINFO, PubMed and Scopus) were searched from each database's point of inception to December 2018. Review methods: Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Data were analysed using Review Manager 5.3. The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. Results: A total of 18 studies were included in this review. Eleven studies were involved in a meta-analysis and the remaining seven studies were summarized narratively. The meta-analysis found that psychological interventions significantly reduced parental stress at postintervention but not at 3-6 months' postintervention. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety. Conclusion: Psychological interventions appeared to reduce parental stress temporarily. Healthcare professionals can offer varied psychological interventions for parents to choose from. Policymakers can ease accessibility and affordability for parents to attend interventions. Impact: Psychological interventions were found to have short-term effects in reducing parental stress. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety. Healthcare professionals should ensure that knowledge is transmitted to parents when delivering their interventions. Policymakers worldwide should ensure that parents of children and adolescents with developmental disabilities can attend interventions by making them accessible and affordable.
... For example, New Moves, a school-based program, designed to promote positive weight-related health, which was implemented within physical education classes in high schools, significantly improved body satisfaction and self-worth among adolescent girls . Similarly, a self-esteem enhancement program called Everybody's Different has been shown to reduce body dissatisfaction among adolescents (O'Dea, 2004;O'Dea & Abraham, 1999). Internet-based intervention programs, such as Student Bodies, have also shown efficacy in reducing body dissatisfaction among college women at high risk for eating disorders (Taylor et al., 2006). ...
Article
Body dissatisfaction is common in adolescence and associated with negative outcomes (e.g., eating disorders). We identified common individual trajectories of body dissatisfaction from midadolescence to adulthood and predictors of divergent patterns. Participants were 1,455 individuals from four waves of Project EAT (Eating and Activity in Teens and Young Adults), a population-based, 15-year longitudinal study. Aggregate body dissatisfaction increased over 15 years, which was largely attributable to increases in weight. Growth mixture modeling identified four common patterns of body dissatisfaction, revealing nearly 95% of individuals experienced relatively stable body dissatisfaction from adolescence through adulthood. Baseline depression, self-esteem, parental communication/caring, peer dieting, and weight-based teasing predicted differing trajectories. Body dissatisfaction appears largely stable from midadolescence onward. There may be a critical period for body image development during childhood/early adolescence. Clinicians should intervene with clients experiencing body dissatisfaction before it becomes chronic and target depression, self-esteem, parent/child connectedness, and responses to teasing and peer dieting.
... This phenomenon did not appear in relation to male adult participants. Individuals with body dissatisfaction experience possible negative effects including low self-esteem, social anxiety, depressive mood, impaired sexual functioning, and possible development of eating disorders (Cash & Fleming, 2002;O'Dea, 2004O'Dea, , 2012Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006;Wiederman, 2002). Regarding college students, the association of body dissatisfaction with dieting, disordered eating, and exercise behaviors is well documented in the West (Drewnowski, Yee, Kurth, & Krahn, 1994;Kenardy, Brown, & Vogt, 2001;O'Dear & Abraham, 2000). ...
Article
Body image is considered to be positively correlated with self-esteem and self-efficacy. “Beauty in the midst of moving: My healthy body image” program based upon a creative dance/movement therapy approach was proposed to improve body dissatisfaction in female college students. A quasi-experiment design with three groups: the experiment group of 16 female college students, the comparison group (mat Pilates course) of 17 female college students, and the control group of 24 female college students. These three groups were examined at three different time-points: pre-intervention, post-intervention, and three-month follow-up. The experimental group was designed with eight 90 min sessions, once a week for eight weeks. The results showed that after the program, the scores of body-image, mindfulness, and self-esteem were improved in the experimental group compared to the comparison and control groups, and the scores of body image and mindfulness were maintained in the three month follow-up.
... Theoretically, programs that address the self-related constructs described in this review could help buffer against the development of eating disorders. For example, data show that incorporating self-esteem in prevention may be a promising way to curb body image and eating concerns, particularly for females (Le, Barendregt, Hay, & Mihalaopoulos, 2017;O'Dea, 2004). Further, Corning and Heibel (2016) theorize that including global self-esteem into prevention programs is an important future direction for the field, via relaying the value of one's self-esteem being derived from a variety of domains instead of using the body as one's primary source of esteem. ...
Article
In our review, we focus on self‐related constructs in the context of eating disorders with four aims. First, we examine a variety of self‐related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well‐researched constructs of self‐esteem and self‐efficacy, we also report on findings related to selflessness, contingent self‐worth, self‐objectification, ego‐syntonicity, self‐concept clarity, self‐compassion, social comparison, self‐oriented perfectionism/self‐criticism, and narcissism. Second, we discuss self‐related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self‐related constructs play a prominent role. Lastly, we share future research directions regarding self‐related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders. This article is protected by copyright. All rights reserved.
... Dangerous practices include laxative abuse, vomiting, starvation, smoking and using slimming pills. 4 Promoting high self-esteem is important because it relates to academic and life success, but before investing significant time, money, and effort on packaged programs, principals should understand why such endeavours have failed and what schools can do to effectively foster students' selfesteem and self-concept. 5 The cognitive, physical, social, and lifestyle changes during adolescence can create profound changes in their eating patterns. ...
... As DE is much more prevalent than diagnosed EDs and can be considered as a pre-stage for an even more pathological development, intervention should start as early as possible. As the association between CM and DE is at least partially mediated via self-esteem, consistent strengthening of self-esteem among maltreated children might possibly prevent some of the abuse's dysfunctional long-term consequences (O'Dea 2004). ...
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The current study investigated relationships between different experiences of child maltreatment (CM) and disordered eating (DE) in a large population-based sample of Danish young adults. Participants completed a structured interview comprising socio-demographic, psychological and physical domains. Questions regarding CM, DE, PTSD symptoms and self-esteem were analyzed using chi-square-tests, ANOVAs, hierarchical regression, and multiple mediation analyses. Participants with a history of CM experienced higher levels of DE than non-abused individuals. PTSD symptoms and self-esteem appeared to differentially mediate the relationship between three classes of CM and DE. Whereas the relation between emotional and sexual abuse with DE was partially mediated via participants’ level of PTSD symptoms and self-esteem with emotional abuse having a stronger impact on self-esteem and sexual abuse more strongly influencing PTSD symptoms, the relation between polyvictimization and DE was fully mediated by PTSD and self-esteem, mainly due to the indirect effect via PTSD.
... According to the life-skills-approach (Botvin et al. 1980), we further aimed to enhance resources. Therefore, we included problem-solving techniques and coping strategies (see lessons 5, 6, and 8) which are potential protective factors not only in relation to eating disorders but also other diseases (Beato-Fernandez et al. 2004;O'Dea 2004;Shisslak and Crago 2001;Steck et al. 2004;Uzunian and Vitalle 2015). The didactic approach is interactive, and the program focuses on both, reducing major risk factors and promoting health (Neumark-Sztainer et al. 2006). ...
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Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development. Effective prevention programs are needed to prevent unhealthy developmental trajectories. This study evaluated the efficacy of the POPS-program (POtsdam Prevention at Schools), a universal school-based eating disorder prevention program for adolescents. In a cluster-randomized design, we compared the intervention group receiving the prevention program to a waiting control group. Outcomes included indicators of disordered eating and relevant risk factors for eating disorders (body dissatisfaction, internalization of the thin ideal, perceived media pressure, perfectionism, emotional element of exercise, social comparison, and perceived teasing). Questionnaires were administered at the start of the intervention, 3 and 12 months post intervention. At baseline, 1112 adolescents aged 10 to 16 years participated (49% girls; 51% intervention group). Intention-to-treat analyses with the complete data set and per-protocol analyses as a completer analysis were performed. The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing. Effect sizes were small but comparable to other primary prevention programs. At 1-year follow-up, a small but significant effect on disordered eating was observed. Results of the per-protocol analyses were mostly confirmed by the intention-to-treat analyses. Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal. Further studies are warranted examining successful program elements and whether gender-specific programs are needed.
... In terms of the different dimensions of self-concept, particular attention should be paid to physical self-concept and body image, which have been closely linked to eating attitudes and eating disturbances (Ricciardelli & McCabe, 2001). Accordingly, it has been argued that interventions for preventing eating disorders in children and adolescents should include strong self-esteem/self-concept components (O'Dea, 2004). The affect dimension of self-concept is also important as emotions and feelings about food are closely related with food rejection (Macht, 2008). ...
Article
Food problems in children and adolescents often have a detrimental effect on the emotional and psychological wellbeing of their parents. However, the impact of such problems on the psychological wellbeing of children and adolescents themselves has been less widely studied. The purpose of this study was to determine whether children and adolescents with food neophobia differed in trait anxiety and dimensions of self-concept from their neophilic and their average peers. A community sample of 831 participants (368 males and 463 females) between the ages of 8 and 16 were classified into six groups based on scores obtained on the Spanish Child Food Neophobia Scale (i.e., neophobic, average, and neophilic) and their age (i.e., children vs. adolescents). Compared with their neophilic peers, children with food neophobia showed higher levels of trait anxiety and a poorer social, physical, and academic self-concept. Among adolescents similar results were observed for trait anxiety and physical self-concept, but instead of social and academic self-concept it was family self-concept which distinguished between neophobic and neophilic participants. These results suggest that food neophobia is associated with trait anxiety and with some dimensions of self-concept. This highlights the need to ascertain the threshold between ‘normal’ and ‘problematic’ eating behaviors, since the fact that a behavior is to some extent usual does not imply that it is harmless.
... The second strategy currently under investigation sought to promote participants' self-esteem or overall evaluation of self-worth (Harter, 2000). Although the direction of any causal associations between self-esteem and body image has yet to be established (Wichstrøm & Von Soest, 2016), the existence of a robust link between these variables has provided the basis for the development of self-esteem based interventions for the prevention of body image concerns (O'Dea, 2004). For example, in O'Dea's (1995) Everybody's Different program, students focus on developing their sense of selfworth by embracing multiple aspects of the self to help decrease the importance of appearance. ...
Article
This study investigated whether single-session self-compassion and self-esteem writing tasks ameliorate the body image concerns evoked by a negative body image induction. Ninety-six female university students aged 17–25 years (Mage = 19.45, SD = 1.84) were randomly assigned to one of three writing treatment groups: self-compassion, self-esteem, or control. After reading a negative body image scenario, participants completed scales measuring state body appreciation, body satisfaction, and appearance anxiety. They then undertook the assigned writing task, and completed the three measures again, both immediately post-treatment and at 2-week follow-up. The self-compassion writing group showed higher post-treatment body appreciation than the self-esteem and control groups, and higher body appreciation than the control group at follow-up. At post-treatment and follow-up, self-compassion and self-esteem writing showed higher body satisfaction than the control. The groups did not differ on appearance anxiety. Writing-based interventions, especially those that enhance self-compassion, may help alleviate certain body image concerns.
... Body dissatisfaction is of concern for both genders [27]. School-based interventions have achieved modest improvements in body satisfaction in both girls and boys [28][29][30]. A program reported significant improvements in body image at post-test that were sustained until 6-months follow-up in boys [21]. ...
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Purpose: The aim of this study was to assess the adaptability and acceptability of a prevention program. Methods: A total of 169 Korean students (83 boys and 86 girls) with a mean age of 12.3 years from a 6th grade class at an elementary school participated in the study. Mental health social workers delivered Me, You and Us, a school-based body image intervention program originally developed in the UK, through a set of six sessions. The participants were assessed in terms of their body satisfaction and self-esteem before the program, after the program, and at 1-month follow-up. They were also surveyed about their satisfaction and acceptability levels after the program. Results: At baseline, girls had lower body satisfaction and self-esteem than boys, and their body satisfaction and self-esteem improved after the program. The improved body satisfaction was maintained at the 1-month follow-up. The efficacy of the program on body satisfaction was positively correlated with the frequency of their baseline level of "fat talk." The program was more effective in girls with possible symptoms of an eating disorder at baseline. 93.7% of boys and 77.4% of girls responded that they enjoyed the program. Conclusions: The program Me, You and Us was well-accepted by early adolescents in Korea and it can play a role in increasing body satisfaction and self-esteem by reducing "fat talk" in 6th grade students. Level of evidence: Level III, cohort study with intervention.
... Studies have indicated that the prevalence of eating disorders was 2.17% in female students in China in 2015 [5] and 5.10% in female students in Japan in 2016 [7]. In another study similar in design to the present study, Ghaderi and Scott found the lifetime prevalence of eating disorders to be 7.8% in females aged between 18 and 30 [22]. In a study on 731 male students aged 15-18 years from United Arab Emirates, the proportion of disordered eating attitudes was found to be relatively high compared to many developing and developed countries, and ranged from 33.1 to 49.1% [23]. ...
Article
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Purpose: It was aimed to determine the prevalence of high disordered eating tendencies and its relationship with food addiction, emotional eating and self esteem in participants at 18 and 33 years age group. Methods: This study was planned as a cross-sectional study and conducted with 1359 young adult volunteers (M = 386, F = 973) with an average age of 22.4 ± 2.84 years. Eating Attitudes Test-26 (EAT-26), Yale Food Addiction Scale (YFAS), Emotional Appetite Questionnaire (EMAQ) and Rosenberg Self-Esteem Scale (RSES) were used. EAT-26 score above 20 was considered as eating disorders risk cutoff. Results: Participants with disordered eating tendencies have higher rates (22.4%) of food addiction compared to participants without high disordered eating tendencies (7.2%). There is no difference for EMAQ and YFAS scores; however, there is a significant difference for RSES and EAT-26 scores according to gender. A positive association of EAT-26 with YFAS and EMAQ-negative scores and a negative association of EAT-26 with RSES and EMAQ-positive were found. Discussion: There is association among EAT-26, YFAS, and Rosenberg Self-Esteem Scale, and Emotional Appetite Questionnaire scores. This study provides information for future studies about high disordered eating tendencies, food addiction and mood that are thought to be important in young adults. Level of evidence: Level V (cross-sectional descriptive study).
... However, this does not directly tackle the issue of body size overestimation. Other interventions include the following: fitness training to improve physical capacity and shift attention from appearance to functionality (Farrell, Shafran, & Lee, 2006;Jarry & Cash, 2011), media literacy to challenge the impact of images of thin bodies (Ginis & Bassett, 2011;Martin & Lichtenberger, 2002), self-esteem enhancement to improve self-worth (Grabe, Ward, & Hyde, 2008;Irving & Berel, 2001), and psychoeducation (O'Dea, 2004;. O'Dea & Yager, 2011). ...
Article
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Objectives: Anorexia nervosa (AN) is a life-threatening mental health condition. A core feature is a disturbance of body image, such that sufferers see themselves as fatter than they actually are. Design: We tested the effectiveness of a novel training programme to recalibrate our participants' perception of body size. Methods: In a novel adaptation of a cognitive bias training programme, participants judged the body size of a series of female bodies and were given feedback to improve their accuracy over four daily training sessions. In Study 1, we recruited young women with high concerns about their body size for a randomized controlled study. In Study 2, we then applied the training programme to a case series of women with atypical AN. Results: In Study 1, the training programme significantly improved the body size judgements of women with high body concerns compared to controls. We also found evidence of improved body image and reduced eating concerns in this group. In Study 2, the programme again recalibrated the body size judgements of women with atypical AN. We also saw evidence of a clinically meaningful reduction in their body size and eating-disordered concerns. Conclusions: This training has the potential to be a valuable treatment used together with more traditional talking therapies. Statement of contribution What is already known on this subject? A core feature of anorexia nervosa (AN) is an overestimation of body size; sufferers believe themselves to be larger than they are in reality. This study shows that an individual's perceptual boundary between what they classify as a fat versus a thin body is not immutable; it can be changed through a cognitive bias training programme. What does this study add? This means that body size overestimation may now be treatable. Critically, as well as improving the accuracy of body size judgements, we also found a clinically significant improvement in participants' eating-disordered concerns. This demonstrates that a targeted behavioural training regime can change body perception, and the central role that body overestimation has in eating-disordered beliefs.
... According to the life-skills-approach (Botvin et al. 1980), we further aimed to enhance resources. Therefore, we included problem-solving techniques and coping strategies (see lessons 5, 6, and 8) which are potential protective factors not only in relation to eating disorders but also other diseases (Beato-Fernandez et al. 2004;O'Dea 2004;Shisslak and Crago 2001;Steck et al. 2004;Uzunian and Vitalle 2015). The didactic approach is interactive, and the program focuses on both, reducing major risk factors and promoting health (Neumark-Sztainer et al. 2006). ...
Article
Zusammenfassung Gestörtes Essverhalten ist unter Jugendlichen weit verbreitet und birgt u.a. die Gefahr der Entwicklung einer manifesten Essstörung. Wirksame Präventionsansätze sind daher dringend erforderlich. Vorgestellt wird das universelle, schulbasierte und koedukative POPS-Programm („Potsdamer Prävention an Schulen“), das in neun interaktiven Sitzungseinheiten zentrale Risikofaktoren wie Körperbild oder Mediendruck thematisiert. Der Ein-Jahres-Follow-up konnte positive Effekte zeigen.
... Psychologists suggest that the level of self-esteem within an individual effects every aspect of their life, including personal success, happiness, achievements, creativity and relationships (Healey, 2002). Those with self-esteem levels are fundamentally content with themselves, whilst still able to identify their weaker characteristics (Healey, 2002;O'Dea, 2004). These individuals usually have confidence in themselves and are able to confront and solve problems with little concern (Healey, 2002). ...
Article
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BACKGROUND: Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups. AIM: 1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology. METHODS: The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used. RESULTS: Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating. CONCLUSION: There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.
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Due to the public health concerns associated with eating disorders and obesity, increasingly more attention is being paid to body image and body image difficulties. Body dissatisfaction, which is ubiquitous among girls and women, can be characterized as the difference between one’s perceived body size and one’s vision of the ideal body, particularly with regard to the desire to be thin. Body dissatisfaction has become so commonplace that it has been described as “normative discontent.” It is also considered one of the most robust risk and maintenance factors for clinical eating disorders. A wide range of risk factors contribute to the development of body dissatisfaction, including biological and physical factors, individual characteristics, and sociocultural influences. In addition, females who place a strong emphasis on thinness and physical appearance and routinely engage in body comparison are particularly vulnerable to experiencing body dissatisfaction. Body image problems and disordered eating behaviors know no boundaries; they impact females across age groups, ethnicities, cultures, socioeconomic levels, and social identities. Therefore, it is essential for health professionals to understand body image and risk factors for the development of body dissatisfaction. They should also be knowledgeable about body image assessment techniques and evidence-based interventions aimed at promoting positive body image. Armed with this insight, health professionals will be in position to foster positive body image and enhance wellness and quality of life among females throughout the lifespan.
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W tej monografii Czytelnik znajdzie 12 prac z trzech obszarów zdrowia kobiet. Pierwszym obszarem będzie problematyka zdrowia w kontekście biomedycznym. Autorzy prezentują wybrane choroby i zagrożenia dla zdrowia kobiet w ujęciu epidemiologicznym i klinicznym, wskazując na specyfikę diagnozy i leczenia chorób kobiecych. Drugi nurt naukowych rozważań odbywa się w odniesieniu do społecznych ról kobiet. Przyjmowane przez kobiety role opiekuńcze: matki, córki, pielęgniarki oznaczają duży wysiłek i generują lęki, napięcie i poczucie odpowiedzialności za zdrowie innych. Ten stres społeczny odciska piętno na zdrowiu subiektywnym i obiektywnym. Trzecim obszarem jest budowanie zdrowia w kontekście kultury współczesnej, kształtowanie wizerunku ciała kobiet, influencerów i followersów, uwypuklając przy tym możliwości „naprawcze” nowoczesnych mediów.
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Background Eating disorders are prevalent, often have chronic courses and relapses are frequent even after effective treatment approaches. Therefore, prevention is decisive; however, many of the current prevention programs are resource intensive. Internet-based interventions can represent cost-effective and low threshold alternatives but only few approaches have so far been investigated.Objective The aim of this study was to evaluate the efficacy of an internet-based unaccompanied preventive intervention.Material and methodsThe intervention was newly developed based on behavior therapeutic techniques and piloted in a group of 200 students using a randomized waiting list control group design. Data on eating disorder-specific pathology (eating disorder examination questionnaire, EDE-Q), self-esteem (Rosenberg self-esteem scale, RSES), and well-being (World Health Organization-five well-being index, WHO-5) were collected before and after the intervention or the waiting period. Data were evaluated based on variance analysis.ResultsA total of 43% of participants completed the intervention. Self-esteem increases were stronger in the intervention group in comparison to the waiting control group with large effect sizes (ηp2\eta _{p}^{2} = 0.33). There were no significant differences between the groups for the other variables.Conclusion Unaccompanied online self-help appears to provide a promising approach for improving self-esteem thus contributing to the prevention of eating disorders. Investigations in larger and more heterogeneous groups are necessary in the future to identify possibly present smaller preventive effects .
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Objective The present study tested a hypothesized mediation model in which the seven contingencies of self‐worth proposed by Crocker and Wolfe mediate the association between global self‐esteem and eating disturbances in college women. Method This study utilized a sample of 408 college women. Path analysis was used to produce a model in which the association between global self‐esteem and eating disturbances was accounted for through contingencies of self‐worth. Results The finalized model indicated that self‐worth based on appearance and competition mediated the link between global self‐esteem and both drive for thinness and bulimic symptoms. Self‐worth based on virtue mediated the link between global self‐esteem and bulimic symptoms. Conclusion The present findings clarify facets of self‐worth accounting for the association between global self‐esteem and eating disturbances in college women, and point to how self‐worth based on one's appearance, or the ability to outdo others, is centrally implicated in this relationship.
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Body dissatisfaction is widely recognized as an important public health concern mainly for women because of its increasing incidence worldwide. The aim of this exploratory study was to test the predictive role of family influence on body satisfaction (BS) among young Italian women, during a decade conceptualized as ‘emerging adulthood’. Instruments designed to assess BS, appearance-focused parental comments, maternal and paternal criticism were administered to 688 women aged between 18 and 28 years (M age = 23.40; SD = 2.33). Two regression analyses were used with life satisfaction levels, parental comments, and maternal/paternal criticism as independent variables to explain variance in BS for younger (18–23 years) and older (24–28 years) women. The data reveal an interesting difference in the influence of parental criticism on BS depending on the age cohort: maternal criticism negatively predicts BS in younger women, while paternal criticism is a risk factor for BS in older women.
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Through a lens of confirmation theory, this study examined how parental confirmation acceptance and challenge was related to emerging adults’ body image, and how these associations were mediated by social competence and self-concept. This study also examined whether the hypothesized links differed by parental and child sex. Male and female college students (N = 447) completed an online questionnaire. A multiple-group analysis generally supported the proposed mediation model, providing a somewhat complex picture of associations among key concepts in terms of which component of confirmation was associated with certain components of body image and through which mediator varied as a function of parental sex. Unlike parental sex, child sex played a minimal role in the current study. This research underscores the utility of employing a confirmation perspective in understanding the mechanisms of how family interactions are related to body image.
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Research finds that children who have experienced parental neglect and abuse in their childhood are more likely to engage in unhealthy behaviors or experience obesity. The relationship between child maltreatment and obesity is supported in previous studies, but the mechanism of how child maltreatment leads to obesity has not yet been adequately examined. We aim to investigate the mediating roles of children's self-esteem and depressive symptoms in the longitudinal influences of child maltreatment on child obesity. We employ national longitudinal data from the Korean Children and Youth Panel Study collected annually in South Korea. The sample consists of 1796 elementary school students. Child maltreatment was measured by the child's report of parental neglect and physical abuse in wave 2 when the sample was the second grade. Child obesity was assessed using Body Mass Index (BMI) in wave 5. Self-esteem was measured in wave 3, and depressive symptoms in wave 4. The Structural Equation Modeling analysis shows that children's self-esteem significantly mediates the association between parental neglect and child obesity as well as that between physical abuse and child obesity. However, children's depressive symptoms do not demonstrate statistically significant mediating effects. This study discusses implications for research and practice to advance current knowledge and intervention efforts.
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This chapter provides a resource for school counselors to assist in identifying, assessing, and intervening with students who have eating-related concerns. School counselors are often the first line of defense when it comes to identifying eating-related problems among children and adolescents. The chapter provides school counselors with a resource for assessing and managing eating issues in the schools, with an emphasis on the process of identification, consultation, and intervention with students who are struggling with eating-related problems. It is divided into sections covering eating-related issues on a continuum of severity, beginning with body image concerns, continuing to disordered eating, and concluding with eating disorders (EDs). Using the American School Counselor Association (ASCA) National Model as a guide, the chapter provides and discusses suggestions for interventions at each level of assessment. It then presents a flexible framework that should be interpreted and applied depending on the individual needs of each student.
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Slimness is generally seen as a desirable attribute for girls and young women in prosperous western cultures. Being slender is associated with self-control, elegance, social attractiveness and youth, and girls as young as five aspire to a slender ideal (Grogan 2008). The adult ideal is epitomised in the slim but full-breasted figure of actors and models such as Angelina Jolie and Elle MacPherson — the body type that Marchessault (2000: 204) describes as ‘the physically impossible, tall, thin and busty Barbie-doll stereotype’. Muscle tone is also important, and the feminine ideal in the 2000s is a firm-looking, toned body (Bordo 2003). Researchers from psychology, sociology and gender studies have shown that body image is socially constructed and that maintaining a positive body image in cultures that specify a narrow range of acceptable body types can be a challenge. This chapter aims to investigate what we know about body image in western cultures, where a slender body type is idealised, and proposes ways of promoting positive body image in girls and young women. As such it will provide a complementary, primarily psychological, approach to other perspectives on contested bodies of children and youth presented in this text.
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This meta-analytic review of prospective and experimental studies reveals that several accepted risk factors for eating pathology have not received empirical support (e.g., sexual abuse) or have received contradictory support (e.g., dieting). There was consistent support for less-accepted risk factors(e.g., thin-ideal internalization) as well as emerging evidence for variables that potentiate and mitigate the effects of risk factors(e.g., social support) and factors that predict eating pathology maintenance(e.g., negative affect). In addition, certain multivariate etiologic and maintenance models received preliminary support. However, the predictive power of individual risk and maintenance factors was limited, suggesting it will be important to search for additional risk and maintenance factors, develop more comprehensive multivariate models, and address methodological limitations that attenuate effects.
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Objective: To assess by self-reported participation in vigorous physical activity, the quantity and quality of school physical education, team sports, and television watching among 11 631 American high school students. Results: Of all students in grades 9 through 12, 37% reported engaging in 20 minutes of vigorous physical activity three or more times per week. Participation in vigorous physical activity was higher among boys than girls (P<.01) and higher among white students than among those of other races and ethnic groups (P<.01). Overall, 43.7% of boys and 52% of girls reported that they were not enrolled in physical education classes. Of the students who reported attending physical education class during the past 2 weeks, 33.2% reported exercising 20 minutes or more in physical education class three to five times per week. In contrast, rates of participation in varsity and junior varsity sports remained constant across grade levels, but participation in recreational physical activity programs showed a lesser magnitude and also decreased with advancing grade. More than 70% of students reported spending at least 1 hour watching television each school day, and more than 35% reported watching television 3 hours or more each school day. Conclusions: Participation in vigorous physical activity and physical education class time devoted to physical activity are substantially below the goals set in Healthy People 2000. As students move toward graduation, we observed disturbing declines in participation in community recreation programs and overall vigorous activity. Students appear to spend considerably more time watching television than participating in physical activity. Public health efforts should focus on increasing the physical activity levels of our youth to enhance their current well-being and to reduce the risks of future chronic disease.(Arch Pediatr Adolesc Med. 1994;148:1131-1136)
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The apparent increasing incidence of anorexia nervosa (AN) and of bulimia nervosa (BN) has resulted in a surge of interest in effective treatment methods among a wide range of health professionals. The aim of this chapter is to provide a practical overview of treatment principles that have been identified as useful in the management of these eating disorders. Emphasis will be given to cognitive-behavioral (CB) methods that may be justified for BN by the growing body of empirical literature indicating that these methods are effective for many patients (Fairburn, Kirk, O’Connor, & Cooper, 1986; Freeman, Barry, Dunkeld-Turnbull, & Henderson, 1988; Giles, R. R. Young, & D. E. Young, 1985; Hsu & Holder, 1986; Kirkley, Schneider, Agras, & Bachman, 1985; Lee & Rush, 1986; Leitenberg, Rosen, Gross, Nudelman, & Vera, (1989); Ordman & Kirschenbaum, 1985; Schneider & Agras, 1985; Wilson, Rossiter, Kleifeld, & Lindholm, 1986; cf. Garner, 1987; Garner, Fairburn, & Davis, 1987). The rationale for the application of CB interventions to AN is based almost entirely on clinical experience since comparative treatment trials have not been reported.
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Risk and protective factors associated with disordered eating were examined among 363 girls (X age =12.9 years) in middle-level school. The variables included self-report rat-ings of competence and of the importance of physical appearance and social acceptance by peers, self-oriented and socially prescribed perfectionism, negative events, and paren-tal support. In a multivariate regression analysis, low competence in physical appearance, high importance of social acceptance, high self-oriented perfectionism, and low pater-nal support were correlated significantly with reports of high levels of disordered eating. The negative influence of low physical appearance competence on disordered eating was attenuated for those girls who placed low, as compared with high, levels of importance on physical appearance. Paternal support was found to have a protective function in regard to disordered eating for those girls who experienced high, as compared with low, levels of school-related negative events. Implications for school-based prevention strate-gies are discussed. In an attempt to improve on existing eating disorder prevention programs, researchers have highlighted the need to identify risk and protective factors 75 This research was funded partially by a Social Sciences and Humanities Research Council Pre-Doctoral Fel-lowship (#753-91-0287) and was based on findings from the first author's doctoral dissertation from York Uni-versity. Special thanks to Dr. Peggy Ng and Ms. Savie Jodhan for technical support.
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The authors seek to clarify, from both an epidemiologic and genetic perspective, the major risk factors for bulimia nervosa and to understand the relationship between narrowly defined bulimia and bulimia-like syndromes. Personal structured psychiatric interviews were conducted with 2,163 female twins from a population-based register. Psychiatric disorders were assessed using DSM-III-R criteria. Lifetime prevalence and risk for narrowly defined bulimia were 2.8% and 4.2%, respectively. Including bulimia-like syndromes increased these estimates to 5.7% and 8.0%, respectively. Risk factors for bulimia included 1) birth after 1960, 2) low paternal care, 3) a history of wide weight fluctuation, dieting, or frequent exercise, 4) a slim ideal body image, 5) low self-esteem, 6) an external locus of control, and 7) high levels of neuroticism. Significant comorbidity was found between bulimia and anorexia nervosa, alcoholism, panic disorder, generalized anxiety disorder, phobia, and major depression. Proband-wise concordance for narrowly defined bulimia was 22.9% in monozygotic and 8.7% in dizygotic twins. The best-fitting model indicated that familial aggregation was due solely to genetic factors with a heritability of liability of 55%. A multiple threshold model indicated that narrowly defined bulimia nervosa and bulimia-like syndromes represented different levels of severity on the same continuum of liability. The liability to fully syndromal bulimia nervosa, which affects around one in 25 women at some point in their lives, is substantially influenced by both epidemiologic and genetic risk factors. The same factors that influence the risk for narrowly defined bulimia also influence the risk for less severe bulimia-like syndromes.
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To assess by self-reported participation in vigorous physical activity, the quantity and quality of school physical education, team sports, and television watching among 11,631 American high school students. Of all students in grades 9 through 12, 37% reported engaging in 20 minutes of vigorous physical activity three or more times per week. Participation in vigorous physical activity was higher among boys than girls (P < .01) and higher among white students than among those of other races and ethnic groups (P < .01). Overall, 43.7% of boys and 52% of girls reported that they were not enrolled in physical education classes. Of the students who reported attending physical education class during the past 2 weeks, 33.2% reported exercising 20 minutes or more in physical education class three to five times per week. In contrast, rates of participation in varsity and junior varsity sports remained constant across grade levels, but participation in recreational physical activity programs showed a lesser magnitude and also decreased with advancing grade. More than 70% of students reported spending at least 1 hour watching television each school day, and more than 35% reported watching television 3 hours or more each school day. Participation in vigorous physical activity and physical education class time devoted to physical activity are substantially below the goals set in Healthy People 2000. As students move toward graduation, we observed disturbing declines in participation in community recreation programs and overall vigorous activity. Students appear to spend considerably more time watching television than participating in physical activity. Public health efforts should focus on increasing the physical activity levels of our youth to enhance their current well-being and to reduce the risks of future chronic disease.
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This study examined the effects and interactions of gender, pubertal status, and body weight on the self-concept of 462 young adolescent Australian students from two different schools. All students enrolled in Years 7 and 8 completed the Self-Perception Profile for Adolescents, which includes several self-concept subscales and ratings of the importance of each subscale. The self-concept subscales ranked as most important by male and female students were Close Friendship, Scholastic Competence, and Job Competence. Females rated their ability to form close friendships significantly higher and of greater importance than did males. Standard body weight was related to students' Physical Appearance subscale scores, with higher weight students having lower self-concept, and postmenarcheal females having the poorest opinion of their physical appearance. Higher body weight males had lower scores on Athletic Competence, Job Competence, and Behavioral Conduct than did other males. Overweight females and normal weight males considered athletic competence to be more important than did other students. Pubertal status was related to students' scores on Athletic Competence, with postpubertal males who were not overweight scoring highest, and on Physical Appearance, with postmenarcheal females having the lowest opinion of their appearance. The mean self-concept score was significantly related to students' standard body weight, and there was an interaction between gender and puberty, with postpubertal males having the highest and postmenarcheal females the lowest self-concept score. The discrepancy score suggested that females felt they had failed to meet their ideal self-concept significantly more than did males. The results suggest that school programs should be implemented to provide exercise and job skill training suitable for all students, especially those who are overweight. These programs, while taking into account students' pubertal status, should aim to improve self-image without resulting in feelings of failure.
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This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.
Article
Objective: To examine prevalence of overweight and trends in overweight for children and adolescents in the US population.Design: Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight.Participants: Between 3000 and 14000 youths aged 6 through 17 years examined in each of five separate national surveys during 1963 to 1965, 1966 to 1970, 1971 to 1974, 1976 to 1980, and 1988 to 1991 (Cycles II and III of the National Health Examination Survey, and the first, second, and third National Health and Nutrition Examination Surveys, respectively).Main Outcome Measures: Prevalence of overweight based on body mass index and 85th or 95th percentile cutoff points from Cycles II and III of the National Health Examination Survey.Results: From 1988 to 1991, the prevalence of over-weight was 10.9% based on the 95th percentile and 22% based on the 85th percentile. Overweight prevalence increased during the period examined among all sex and age groups. The increase was greatest since 1976 to 1980, similar to findings previously reported for adults in the United States.Conclusions: Increasing overweight among youths implies a need to focus on primary prevention. Attempts to increase physical activity may provide a means to address this important public health problem.(Arch Pediatr Adolesc Med. 1995;149:1085-1091)
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The effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls was evaluated over a 1-year period. A total of 263 girls in Grade 6, one-half of whom were in the control group, completed questionnaires that assessed body image satisfaction and eating problems before and 1 week after the prevention program, and 6 and 12 months later. The six-session prevention program was developed around two principal components: (a) media literacy about the dangers associated with the idealization of thinness and (b) the promotion of life skills, including self-esteem enhancement strategies, stress management techniques, and peer relations skills. There was no program effect. Instead, the findings revealed significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and control groups.
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This article begins by reviewing the literature linking self esteem to eating disorders (EDs) in girls. Prevention strategies used to enhance self-esteem and some of the limitations of these approaches are then discussed. The article concludes with a presentation of a model that addresses these shortcomings and that will help guide the design, implementation, and evaluation of future, prevention programs targeting EDs.
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The task of this paper is to examine the interplay between socio-cultural forces and personality, specifically psychopathology, as a way of explaining the increase in contemporary women suffering from eating disorders. Several questions are raised regarding the cultural preoccupation with thinness, the apparent increase in anorexia nervosa and related eating disorders, and whether the current theories of etiology of eating disorders are adequate in explaining the increase in this phenomena. Finally, an integrative psychosocial model is proposed.
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Objective: To evaluate a community-based intervention aimed at the primary prevention of disordered eating among preadolescent girls. Design: Girl Scout troop members were randomized into control and intervention groups. Program feasibility and effect at postintervention and 3-month follow-up were evaluated. Subjects/setting: 226 girls (mean age = 10.6 years, standard deviation = 0.7) from 24 Girl Scout troops. Intervention: Six 90-minute sessions focusing on media literacy and advocacy skills. Main outcome measures: Evaluation focused on program satisfaction and short-term effect on dieting behaviors, body image attitudes, and media knowledge, attitudes, and habits. Statistical analyses: Performed t tests, chi 2 tests, and analyses of covariance including troop as a random source of variation. Results: At baseline, 29% of the girls were trying to lose weight. The program had a notable positive influence on media-related attitudes and behaviors including internalization of sociocultural ideals, self-efficacy to impact weight-related social norms, and print media habits. A modest program effect on body-related knowledge and attitudes was apparent at post-intervention (i.e., on body size acceptance, puberty knowledge, and perceived weight status) but not at follow-up. Significant changes were not noted for dieting behaviors, but they were in the hypothesized direction. Satisfaction with the program was high among girls, parents, and leaders. Applications/conclusions: It is feasible to use community youth settings, such as the Girl Scouts, to implement interventions to prevent disordered eating behaviors. The program led to positive trends in outcome variables; however, longer and more intensive interventions are needed for lasting changes in body image and dieting behaviors.
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Examines research indicating that children are affected by U.S. society's preoccupation with thinness, discusses self-esteem and healthy body image, and offers suggestions for incorporating strategies into existing comprehensive school health programs to deter disordered eating and inappropriate dieting habits among children. (SM)
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Prevention programs in the area of eating disorders, designed for schoolchildren, have tended to cover overlapping content areas and follow didactic paradigms of intervention with limited documented success. A critical analysis of the domains of knowledge development, paradigms of intervention, social prejudice, and fund allocation lead to several suggested revisions in school programs for eating disorders. School programs will be enriched by relying on children's and adolescents' authority regarding their lived experience and by attending to relational and contextual factors. It is hoped that broadening the scope of prevention programs will lead to enhanced efficacy.
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In this chapter the authors discuss the feminine perspective on primary prevention. They define the key terms (primary prevention, eating disorders, and feminism) used in the chapter and propose 3 ways in which the field can move forward constructively on the question of whether prevention should be an important goal. The authors argue that there are definite limitations inherent in adopting a "specific disease" model for eating disorder problems that are caused, at least in part, by social and cultural factors. To be effective, primary prevention must reduce risk, either by removing the cause or by rendering invulnerable the individual at risk. The conceptualization of primary prevention as opposite to or in conflict with treatment is conceptually flawed in that it invokes an artificial dichotomy. The authors argue that prevention and treatment interventions lie on one continuum of interventions and that theory and research in both areas benefit from mutual influence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
39 women chose not to participate in a survey on eating disorders. Their medical records revealed a high rate of eating problems. Four Ss met diagnostic criteria for anorexia nervosa, 5 Ss had significant problems with eating, 6 Ss were overweight, and 24 Ss had no recorded problems with eating or weight. This finding, together with those of 2 related studies, suggests that such problems are overrepresented among those who elect not to take part in surveys of this type. As a result, estimates of the prevalence of eating disorders are likely to be underestimates: Indeed, it may never be possible to get accurate figures for the prevalence of eating disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Presents an update and extension of the authors' (1996) review of the literature on mass media, developmental psychology, and eating disorders. The chapter explores the literature connecting mass media to the developmental psychology of eating disorders and to classroom-based primary prevention efforts. This review suggests a great need for further etiological research based on an integration of social comparison theory, developmental social learning theory, and vulnerability-stressor models of disordered eating. There is also a need for primary prevention research based on the multidimensional, community-oriented theories which have emerged from fairly successful efforts to equip young adolescents with the skills to resist initiation of cigarette smoking. The authors also argue that people committed to primary prevention should learn how to use mass media for health promotion, political activism, and development of protective factors such as "media literacy skills." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Describes a participatory action project aimed at addressing body weight and shape preoccupation in a school. Specifically, the processes of inquiry and knowledge development undertaken by the girls and adolescent women of that school in their quest to understand and change their own body dissatisfaction are examined. This chapter is divided into 3 parts: the background and initial phase of the project, the process of knowledge construction, and the development of action. Each part begins with a brief methodological and theoretical section and continues with a description of the project itself. The chapter ends with a discussion of the implications of this study for the role of qualitative research in the development of knowledge in psychology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A six-session eating disorder prevention program was completed with three samples: middle school, high school, and college females. The program was intended to promote resiliency factors while mitigating risk factors that had been identified earlier by hierarchical multiple regression analyses and subsequent path analyses from a large epidemiological sample (Phelps, Johnston, & Augustyniak, 1999). Utilizing this etiological model, the program was successful in: (a) facilitating an acknowledgement of the ubiquitous pressures for attainment of the model skeletal look; (b) changing attitudes about standards of beauty; (c) altering the participants' current and future intentional use of pharmaceutical aids or disordered eating behaviors (e.g., fasting, strenuous dieting, purging, excessive exercise) as methods of weight control; (d) building physical self-esteem and personal competence; and (e) reducing body dissatisfaction. To facilitate replication, the article includes a description of the objectives and activities for each of the six sessions. It is recommended that future research efforts focus on testing the long-term efficacy of this program. © 2000 John Wiley & Sons, Inc.
Article
Objective The aim of this study was to evaluate the effectiveness of a school-based eating disorder prevention program designed to reduce dietary restraint and concern about shape and weight among adolescent girls.MethodA total of 474 girls aged 13–14 years received the program as part of their normal school curriculum. An assessment-only control group included 386 pupils. Measures of eating disorder features, self-esteem, and knowledge were administered before and after the intervention and at 6-month follow-up.ResultsImmediately following the intervention, there was a small reduction in dietary restraint and attitudes to shape and weight in the index group, whereas there was no change in the control group. This reduction was not maintained at 6-month follow-up although the dietary restraint scores of the index group remained lower than those of the control group.DiscussionThis prevention program achieved change in eating attitudes and behavior, although the change was modest in size and not sustained. Focusing on a high-risk subgroup of dieters might be a more fruitful primary prevention strategy. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 107-118, 2001.
Article
Abstract Since eating disorders frequently begin during adolescence, high school students represent a high risk population for the development of these disorders. For this reason, a pilot project for the prevention of eating disorders was instituted at the high school level. The primary goal of this pilot project was to educate students, faculty, and staff at the school about the incidence, symptoms, and consequences of eating disorders. Consultation and referral services were also provided. An evaluation component of the project assessed the informational impact of the prevention program on the students. On a questionnaire designed for the project, a significantly greater number of questions about eating disorders were answered correctly by students who were recipients of the prevention program than by those who were not. The results of this project demonstrate the feasibility of using the high school setting to promote increased awareness of eating disorders and their consequences among high school students.
Article
Although childhood obesity may have detrimental consequences for childhood self-esteem, the prevalence and magnitude of this problem is controversial. In addition, the social and emotional effects of decreased self-esteem in obese children are unknown. A total of 1520 children, 9 to 10 years of age, born to mothers in the National Longitudinal Survey of Youth were studied. Comprehensive demographic data including race and family income were available in 97% of the cohort. Self-esteem was measured using Self-Perception Profile for Children. The 4-year follow-up Self-Perception Profile for Children scores were available in 79% of the children. Obesity was defined as a body mass index greater than the 95th percentile for age and gender. Additional data include a self-administered questionnaire at 13 to 14 years of age concerning emotional well being, smoking, and alcohol consumption. Data were stratified by race and gender. The data were weighted to reflect a nationally representative sample of children born to mothers 17 to 28 years of age. Scholastic and global self-esteem scores were not significantly different among 9- to 10-year-old obese and nonobese children. However, over the 4-year period, obese Hispanic females and obese white females showed significantly decreased levels of global self-esteem compared with nonobese Hispanic females and nonobese white females, respectively. Mild decreases in self-esteem also were observed in obese boys compared with nonobese boys. As a result, by 13 to 14 years of age, significantly lower levels of self-esteem were observed in obese boys, obese Hispanic girls, and obese white girls compared with their nonobese counterparts. Decreasing levels of self-esteem in obese children were associated with significantly increased rates of sadness, loneliness, and nervousness compared with obese children whose self-esteem increased or remained unchanged. In addition, obese children with decreasing levels of self-esteem over the 4-year period were more likely to smoke and drink alcohol compared with obese children whose self-esteem increased or remained unchanged. Obese Hispanic and white females demonstrate significantly lower levels of self-esteem by early adolescence. In addition, obese children with decreasing levels of self-esteem demonstrate significantly higher rates of sadness, loneliness, and nervousness and are more likely to engage in high-risk behaviors such as smoking or consuming alcohol.
Article
The diagnostic spectrum of eating disorders according to DSM-III-R was examined in a sample of 86 consecutive cases from a defined urban catchment area of Stockholm, Sweden. Presenting diagnoses were: bulimia nervosa 65%; atypical eating disorders, 20%; anorexia nervosa, restricting subtype, 9%; and, anorexia nervosa, bulimic subtype, 6%. All groups showed an extreme fear of weight gain. Restricting anorexics were older, had the latest age of onset of eating disorder, and had the shortest duration of illness. Bulimic anorexics had the longest duration of illness, earliest age of onset, and greater eating disorder psychopathology than restricting anorexics and atypicals. Bulimics exhibited significantly greater eating disorder psychopathology compared with atypicals. Both bulimics and bulimic anorexics presented with significantly greater general psychopathology compared with restricting anorexics and atypicals. Atypicals appeared to be the least disturbed group, whereas bulimic anorexics were the most disturbed. Results are discussed in terms of the relative merits of DSM-III and DSM-III-R, the characteristics of particular disorders, and the possibility of an underlying sequential course of illness in the eating disorders.
Article
SYNOPSIS Three hundred and forty-three eating disorder patients (50% anorexia nervosa, 37% bulimia and 13 % atypical eating disorder) were seen by the eating disorder service in the Wellington (New Zealand) region between 1977 and 1986. Ninety-six per cent were female. Annual rate of referral for anorexia nervosa remained stable at 5 per 100000 population (34 per 100000 females aged 15–29 years). Annual referral rate for bulimia increased from 6 to 44 per 100000 females aged 15–29 years.
Article
The paper reports on the first stage of a planned prospective study of self-esteem and risk for eating disorders in 594 schoolgirls aged 11-12. Subjects completed a short questionnaire which incorporated the Rosenberg Self-Esteem Scale and a few "problem" questions, including one on fatness concern. Low self-esteem was associated with increased fatness concern, but also with problems in general. The girls will be followed up in detail at age 15-16, with a view to clarifying whether low self-esteem is predictive of clinically significant eating disorders.
Article
Research on the epidemiology of bulimia nervosa has focused largely on the prevalence of the disorder. As methods have improved, consensus has increased regarding the prevalence rate among adolescent and young adult women--about 1%. However, the accuracy of this figure and its clinical significance must be questioned. In this synthesis of the epidemiological work to date, the authors review the literature from a clinical and research perspective. They recommend a shift in emphasis away from studies of the distribution of the disorder toward studies of the determinants of the whole spectrum of the disturbance that exists in the community.
Article
Synopsis The occurrence and course of eating disorder in a large representative population of 15-year-old London schoolgirls has been assessed using a two-stage survey methodology. Attempts to control weight were common and often transient. Dieting was in the great majority of girls found to be a benign practice without progression to more extreme concerns about food and weight. However, a small proportion of dieters did become cases and formed the majority of new cases found at follow-up. The relative risk of dieters becoming cases was eight times that of non-dieters. Many factors conventionally associated with eating disorder were associated more with attempting weight control than caseness. These included pre-morbid personality, pre-morbid obesity and family weight pathology. Other factors, including social class, career choice and psychosexual development, had no association either with attempting weight control or caseness.
Article
The widely used DSM-III criteria for the diagnosis of bulimia essentially define bulimia as a syndrome of guilty, secretive and subjectively hard to control binge over-eating. A self-report questionnaire for bulimic behavior was administered to three community and two hospital populations in South Australia. 13% of females in the community samples could be categorized as bulimic according to the DSM-III criteria. Those criteria did not adequately define the behaviour of patients in treatment for bulimia in a Weight Disorders Unit, 85% of whom not only binged, but induced vomiting afterwards. When diagnostic criteria were more closely aligned to clinical experience, the prevalence of bulimia in the community appeared closer to 1-2%. New DSM criteria (DSM-III-R) have been proposed and prevalence rates using them fell within the 1-2% range.
Article
Eating disorders have increased dramatically over the past two decades, but the primary prevention of these disorders has received little attention. This article summarizes our current understanding of anorexia nervosa and bulimia and offers some suggestions for the primary prevention of these disorders at the individual, family, and community levels. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
To examine prevalence of overweight and trends in overweight for children and adolescents in the US population. Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight. Between 3000 and 14,000 youths aged 6 through 17 years examined in each of five separate national surveys during 1963 to 1965, 1966 to 1970, 1971 to 1974, 1976 to 1980, and 1988 to 1991 (Cycles II and III of the National Health Examination Survey, and the first, second, and third National Health and Nutrition Examination Surveys, respectively). Prevalence of overweight based on body mass index and 85th or 95th percentile cutoff points from Cycles II and III of the National Health Examination Survey. From 1988 to 1991, the prevalence of overweight was 10.9% based on the 95th percentile and 22% based on the 85th percentile. Overweight prevalence increased during the period examined among all sex and age groups. The increase was greatest since 1976 to 1980, similar to findings previously reported for adults in the United States. Increasing overweight among youths implies a need to focus on primary prevention. Attempts to increase physical activity may provide a means to address this important public health problem.
Article
Three factors of a body-esteem scale, Appearance, Weight, and Attribution, were inversely related to relative weight in youngster between 8 and 16 years old (243 girls and 168 boys). Global self-esteem, however, was generally not related to relative weight. Nonetheless, self-esteem covaried with Appearance and Attribution.
Article
A number of authors have emphasized the importance of self-esteem in the aetiology of the eating disorders anorexia nervosa and bulimia nervosa. Evidence for such theorizing, however, mainly derives from clinical observations on people being treated for eating disorders. This study is the first prospective study to investigate the role of self-esteem in aetiology prior to the onset of an eating disorder. Self-esteem was measured in 594 schoolgirls aged 11-12 using the Rosenberg Self-Esteem Scale (Rosenberg, 1965). Almost 400 of these girls were successfully followed up at age 15-16 and they completed a questionnaire examining eating and other psychological problems. Results showed that girls with low self-esteem at age 11-12 were at significantly greater risk of developing the more severe signs of eating disorders, as well as other psychological problems, by the age of 15-16. It is argued that more research is needed to replicate and extend these findings. The results also give weight to the case for examining the potential role of self-esteem enhancement in the prevention of eating disorders.
Article
This study aimed to investigate the extent of eating problems and their association with self-esteem in girls aged 15-16. Six hundred and nine schoolgirls aged 15-16 completed a questionnaire examining eating behavior, self-esteem, and general psychological well-being. A subsample of 31 girls was subsequently interviewed in terms of eating behavior and self-esteem. The questionnaire findings revealed that 56% of girls felt too fat and had used some form of weight control strategy. In addition, 32% scored above the Hospital Anxiety and Depression Scale (HADS) threshold for anxiety and 43% reached the Rosenberg Self-Esteem Scale criterion for low self-esteem. Interviews confirmed that those showing abnormal eating behavior in the questionnaires did indeed show greater eating pathology as well as lower self-esteem. Interviews also revealed that those with high levels of eating concern showed greater levels of global self-dissatisfaction and higher dissatisfaction with their physical appearance and family relationships. The results suggest that preventative interventions targeted at girls with low self-esteem may be appropriate.
Article
To examine the cross-sectional relationships between weight concerns, weight control behaviors, and initiation of tobacco use among youths. Smoking status, weight concerns, and weight control behaviors were assessed in a cross-sectional sample of 16 862 children, 9 to 14 years of age, in 1996. Logistic regression was used to examine the relationship between weight concerns, weight control behaviors, and early stages of smoking initiation (precontemplation, contemplation, and experimentation). All analyses were adjusted for age, body mass index, and known predictors of initiation. Approximately 9% of participants had experimented with cigarettes, and 6% were contemplating cigarette smoking. Contemplation of tobacco use was associated with misperception of being overweight (boys: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.10-2.48), unhappiness with appearance (girls: OR, 2.05; 95% CI, 1.48-2.84; boys: OR, 1.60; 95% CI, 1.05-2. 42), and a tendency to change eating patterns around peers (girls: OR, 2.87; 95% CI, 2.28-3.62; boys: OR, 1.83; 95% CI, 1.25-2.66). Experimentation with cigarettes was associated with daily exercise to control weight among boys (OR, 1.92; 95% CI, 1.07-3.43) and with monthly purging (OR, 2.54; 95% CI, 1.27-5.07) and daily dieting among girls (OR, 1.79; 95% CI, 1.09-2.96). Our findings suggest that, among both girls and boys, contemplation of smoking is positively related to weight concerns. Experimentation seems to be positively related to weight control behaviors. It is important for both pediatricians and comprehensive school health programs to address healthy methods of weight maintenance and to dispel the notion of tobacco use as a method of weight control.
Article
This paper outlines the Health Promoting Schools Framework and how it may be implemented in schools for preventing eating and body image problems. Discussion focuses on the efficacy of preventive school-based strategies, and on the safest and most successful interventions. The Framework encompasses three major areas of intervention in the school and community: 1) School curriculum, teaching, and learning; 2) School ethos, environment, and organization; and 3) School-community partnerships and services. Suggested strategies for implementing the Framework are outlined. A case study of how a girls high school adapted the new approach for dealing with the problem of eating and body image problems is presented.
Article
This study examines the effect of an interactive, school-based, self-esteem education program on the body image and eating attitudes and behaviors of young male and female adolescents following the program and after 12 months. All 470 eligible students (63% female) aged 11-14 years volunteered to participate. The intervention group students participated in the program, whereas the control group students received their scheduled personal development and health class. The program significantly improved the body satisfaction of the intervention students and significantly changed aspects of their self-esteem; social acceptance, physical appearance, and athletic ability became less important for the intervention students and more important for control students. Female intervention students rated their physical appearance as perceived by others significantly higher than control students and allowed their body weight to increase appropriately by preventing the age increase in weight-losing behaviors of the control students. One year after the intervention, body image and attitude changes were still present. These findings also held for the 116 students (63% females) with low self-esteem and higher anxiety, who were considered at risk for the development of eating disorders. These students also had significantly lower drive for thinness and greater body satisfaction following the intervention and the decreased importance of physical appearance to their self-esteem was present at 12 months. Control at-risk students significantly decreased their body weight, whereas the weight of the intervention at-risk students significantly increased. The intervention program was effective, safe, having no effect on measures of students' anxiety or depression, and was rated highly by students. This is the first controlled educational intervention to successfully improve body image and to produce long-term changes in the attitudes and self-image of young adolescents. This new approach to prevent the development of eating disorders by improving self-esteem may be effective, particularly if reinforced by teachers and family.