Changes in Prevalence of Overweight and in Body Image among Fijian Women between 1989 and 1998**

Objective: To investigate changes in prevalence of overweight and obesity and in body image among ethnic Fijian women in Fiji during a period of rapid social change and the relationship between changes in body image and BMI. Research Methods and Procedures: The study design was a multiwave cohort study of BMI in a traditional Fijian village over a 9.5‐year period from 1989 to 1998. Cohorts were identified in 1989 (n = 53) and in 1998 (n = 50). Selection criteria included Fijian ethnicity, female gender, age of at least 18 years, and residence in a specific coastal Fijian village in 1989 and 1998, respectively. Assessments consisted of measurement of height and weight, collection of demographic data by written survey, and administration of the Nadroga Language Body Image Questionnaire. Results: The prevalence of overweight and obesity was significantly different between the cohorts, increasing from 60% in 1989 to 84% in 1998 (p = 0.014). In addition, the age‐adjusted mean BMI was significantly higher in 1998 compared with 1989 (p = 0.011). Finally, there were significant between‐cohort differences in multiple measures of body image, which were mostly independent of BMI. Discussion: At 84%, the prevalence of overweight and obesity in this community sample of Fijian women is among the highest in the world. The dramatically increased prevalence over the 9.5‐year period studied corresponds with rapid social change in Fiji and significant shifts in prevailing traditional attitudes toward body shape.     

Body Dissatisfaction and Binge Eating in Obese Women: The Role of Restraint and Depression

Objective: This study examined the association between body dissatisfaction and binge eating, and the mediating role of restraint and depression among obese women. Research Methods and Procedures: Participants were obese women taking part in a cognitive-behavioral treatment program who completed self-report measures at baseline (n = 89) and post-treatment follow-up (n = 69). Results: At baseline, body dissatisfaction was strongly correlated with binge eating score. This was partly a direct effect and partly mediated by depression. No mediating effect of restraint was observed. Over the treatment period, a reduction in body dissatisfaction was associated with a reduction in binge-eating score. As in the cross-sectional data, there was evidence for mediation by change in depression with the greatest improvement in binge eating among those who became more restrained and less depressed. Discussion: These results suggest that it would be valuable to address psychological well-being, and especially body image, as part of the management of binge-eating behavior in obesity.     

Differences in Body Image and Depression Among Obese Women With and Without Binge Eating Disorder

Obese individuals with binge eating disorder (BED) differ from obese non-binge eating (NBE) individuals in a number of clinically relevant ways. This study examined attitudinal responses to various measures of body image in women seeking obesity treatment, by comparing NBE participants (n=80) to those with BED (n=48). It was hypothesized that women with BED would demonstrate greater attitudinal disturbance of body image compared to NBE individuals. It was further hypothesized that significant differences between groups would remain after statistically controlling for degree of depression. Consistent with the primary hypothesis, BED participants reported significantly increased attitudinal disturbance in body dissatisfaction and size perception compared to NBE participants. Although shared variance was observed between measures of depression and body image on some items, several aspects of increased body image disturbance remained after statistically controlling for depression. Treatment implications and recommendations for future research are discussed.     

Disordered Eating: Can Women Accurately Recall Their Ringing and Purging Behaviors 10 Years Later?

Objective: To test women's ability to recall their past binging and purging behaviors. Design: Ten-year follow-up study of women who had participated in a cross-sectional survey during college. Subjects: In 1982, a sample of freshman and senior women at a large university in the Boston area were questioned about their weight, dieting history, bulimic symptoms, and eating patterns, attitudes, and concerns. In 1992, all subjects who responded to the 1982 survey were followed up to assess changes in bulimic symptoms and ability to recall past behaviors. Results: Among the 476 women who responded to both surveys, the percentage in 1992 who reported having ever binged and/or purged was less than the percentage in 1982, indicating that the recall of past behaviors was less than perfect. Denial in 1992 of ever having engaged in the behaviors ranged from 22% among the women who were self-inducing vomiting in 1982 to 64% among the women who had reported current fasting or strict dieting in 1982. Recall of past behaviors in 1992 was better among the women who had been current bingers or purgers in 1982. Conclusion: Our results demonstrate that ability to recall past binging and purging is only modest. Therefore to better understand the mental and physical health consequences of these behaviors this information should be collected prospectively.     

The Social Self,Body Dissatisfaction,and Binge Eating in Obese Females

We examined the relationship of the social self to body dissatisfaction and to binge eating in two clinical samples of obese females. In the first study, with 32 nonbingeing obese females, social self measures of Public Self-Consciousness and Social Anxiety were positively correlated with body dissatisfaction. Self-esteem was negatively correlated with body dissatisfaction. In the second study, 11 obese binge eaters were compared with 11 matched nonbingeing obese females. Binge eaters were characterized by significantly higher levels of social anxiety and body dissatisfaction than the obese nonbingeing controls. These findings support the hypothesized links of social self concerns to body dissatisfaction and to binge eating in obese females .     

Emotional Eating,Alexithymia, and Binge‐Eating Disorder in Obese Women

Objective: To investigate the relationships between alexithymia and emotional eating in obese women with or without Binge Eating Disorder (BED). Research Methods and Procedures: One hundred sixty‐nine obese women completed self‐report questionnaires, including the Beck Depression Inventory, the State Trait Anxiety Inventory, the Stress Perceived Scale, the Dutch Eating Behaviour Questionnaire, and the Toronto Alexithymia Scale. The presence of BED, screened using the Questionnaire of Eating and Weight Patterns, was confirmed by interview. Results: Forty obese women were identified as having BED. BED subjects and non‐BED subjects were comparable in age, body mass index, educational level, and socioeconomic class. According to the Dutch Eating Behaviour Questionnaire, BED subjects exhibited higher depression, anxiety, perceived stress, alexithymia scores, and emotional and external eating scores than non‐BED subjects. Emotional eating and perceived stress emerged as significant predictors of BED. The relationships between alexithymia and emotional eating in obese subjects differed between the two groups according to the presence of BED. Alexithymia was the predictor of emotional eating in BED subjects, whereas perceived stress and depression were the predictors in non‐BED subjects. Discussion: This study pointed out different relationships among mood, alexithymia, and emotional eating in obese subjects with or without BED. Alexithymia was linked to emotional eating in BED. These data suggest the involvement of alexithymia in eating disorders among obese women.     

Many Mirrors: Body Image and Social Relations and Body, Self, and Society: The View from Fiji

Many Mirrors: Body Image and Social Relations. Nicole Sault. ed. New Brunswick, NJ: Rutgers University Press,1994(cloth and paper), xvi. 346 pp.
Body, Self, and Society: The View from Fiji. Anne E. Becker. Philadelphia: University of Pennsylvania Press, 1995(cloth and paper), xvi. 206 pp.     

Ritual, Risk, and Danger: Chain Prayers in Fiji

Rituals that defuse immediate senses of danger can perpetuate senses of powerlessness. Ambiguous language used in defensive rituals can heighten people's senses of the risks they are confronting and also compel people to perform those rituals again in the future. In this article, I illustrate this argument by examining Fijian Methodist masu sema (chain prayers), which are conducted to defuse the dangers that beset society, including curses from demonic ancestors. I argue that Fijian cultural themes of present-day human powerlessness are generated largely by competition between Methodist and chiefly authorities. "Chain prayers" are attempts to negate the power of dangerous ancestors, but in requesting God's help, ritual participants cast themselves as powerless. Verbal ambiguity in chain prayers gives "demons" lives of their own, compelling their future circulation.     

Nature,Natives, and Nations: Glorification and Asymmetries in Museum Representation,Fiji and Hawaii

The Fiji Museum and Hawaii's Bishop Museum research and represent local indigenes differently, and more extensively, than they do the culture and history of descendants of plantation laborers. While these museums connect Japanese-Hawaiians and Indo-Fijians to themes of economic struggle and multiculturalism, the erstwhile 'natives'are strongly, if implicitly, connected to 'nature.'Against Foucaultian approaches depicting museums as 'modern' institutions of classification, this argument locates museums with a liberal focus on nature, natives and nations (three conceptions, from the same Latin root, for self-constituting objects) as descendants of imperial museum projects, and finds not classification but glorification originally organizing museum representations. The politics of museum representation concern dilemmas in glorification, not classification. The asymmetries traced here follow local will as well as institutional design.     

Intergenerational Perceptions of Body Image in Hispanics: Role of BMI,Gender, and Acculturation

Objective: To assess role of BMI, gender, and acculturation on maternal and children's perception of body size, body ideal, and attractiveness. Research Methods and Procedures: Eighty mothers and their 6‐ to‐ 12‐year‐old children (41 boys, 39 girls) participated. Maternal and children's perceptions of body size (actual and ideal) and attractiveness were assessed through a pictorial instrument. Mother and child height and weight, demographic, and acculturation characteristics were also assessed. Results: Seventy‐nine percent of the mothers were overweight, and 32% of the boys and 34% of the girls were overweight or at‐risk for overweight. BMI influenced the children's selection of perceived ideal size. Overweight or at‐risk for overweight children were more likely to select thinner figures as the ideal size than non‐overweight children. Gender and acculturation differences concerning children's perceptions of body size and attractiveness were also found. Girls perceived the obese figure as being less attractive than did the boys. More acculturated children were likely to select thinner figures as more attractive than their less acculturated counterparts. Maternal acculturation was associated positively with the girls’ choice of thinner figures as an ideal body size, but not with the boys. Mothers viewed their daughters’ actual body size and BMI as ideal, although 34% of the girls were at‐risk for overweight. Mothers perceived average body size figures as more attractive for their sons. Discussion: Findings from this study provide empirical data about the role of BMI, gender, acculturation, and familial influences on children's perceptions of actual and ideal body sizes and attractiveness.     

Teasing History,Onset of Obesity,Current Eating Disorder Psychopathology,Body Dissatisfaction,and Psychological Functioning in Binge Eating Disorder

Objective: The primary goal of this study was to examine associations among teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in women with Binge Eating Disorder (BED). Research Methods and Procedures: Subjects were 115 female adults who met DSM‐IV criteria for BED. Measurements assessing teasing history (general appearance [GAT] and weight and size [WST] teasing), current eating disorder psychopathology (binge frequency, eating restraint, and concerns regarding eating, shape, and weight), body dissatisfaction, and psychological functioning (depression and self‐esteem) were obtained. Results: History of GAT, but not WST, was associated with current weight concerns and body dissatisfaction, whereas both GAT and WST were significantly associated with current psychological functioning. Patients with earlier onset of obesity reported more WST than patients with later onset of obesity, but the groups did not differ significantly in GAT, current eating disorder psychopathology, body dissatisfaction, or psychological functioning. Obese women reported more WST than non‐obese women, but no differences in GAT or the other outcome variables were observed. Higher frequency of GAT was associated with greater binge frequency in obese women, and with greater eating restraint in non‐obese women. Discussion: Although physical appearance teasing history is not associated with variability in most eating disorder psychopathology, it is associated with related functioning, most notably body dissatisfaction, depression, and self‐esteem. Our findings also suggest that the age of onset of obesity and current body mass index status in isolation are not associated with eating psychopathology or associated psychological functioning in adult patients with BED.     

Weight Loss Attempts and Attitudes toward Body Size,Eating, and Physical Activity in American Indian Children: Relationship to Weight Status and Gender

Objective: This study examined dieting, weight perceptions, and self‐efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. Research Methods and Procedures: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second‐ through third‐grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. Results: Forty‐two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self‐efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. Discussion: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family‐based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.     

Dietary Intake in Relation to Restrained Eating,Disinhibition, and Hunger in Obese and Nonobese Swedish Women

The aims of this study were to: describe dietary intakes of obese and nonobese middle-aged women using a validated food frequency questionnaire; to assess dietary restraint, disinhibition, and hunger by the three factor eating questionnaire (TFEQ) in obese and nonobese samples and determine which of the factors are independently associated with obesity; and to examine correlations between selected nutritional variables and the TFEQ factors. Subjects studied included 179 obese Swedish women (BMI>32) and 147 nonobese population-based controls (BMI<28). Age-adjusted mean energy intake was significantly higher in obese women (2730 ± 78 vs. 2025 ± 85 kcal, p<0.0001). In absolute and relative terms, fat intake was higher and alcohol intake was lower in the obese subjects. Disinhibition was the strongest TFEQ factor independently differentiating the obese and nonobese states, i.e., after adjustment for restraint and hunger. Within the obese sample, strong associations were seen between energy intake and disinhibition (p=0.0005) and hunger (p=0.0004). The association between energy intake and restrained eating was negative and weaker (p=0.04). No such associations were seen in nonobese women. Thus, using a dietary instrument that is valid and unbiased with respect to obesity, strong psychological correlates, possibly causal, of variability in energy intake were detected in middle-aged women with obesity. Disinhibition is associated with both obesity and high-energy intakes and is therefore an important factor to consider in the treatment of women with obesity.     

Childhood Psychological,Physical, and Sexual Maltreatment in Outpatients with Binge Eating Disorder: Frequency and Associations with Gender,Obesity, and Eating‐Related Psychopathology

Objective: To examine rates of reported childhood maltreatment in binge eating disorder (BED), and to explore associations with obesity, gender, eating disorder features, and associated functioning. Research Methods and Procedures: Subjects were 145 consecutive outpatients with BED as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition. Subjects were interviewed and they completed questionnaires to assess eating disorder features and functioning. The Childhood Trauma Questionnaire was given to assess childhood maltreatment in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). Results: A total of 83% of BED patients reported some form of childhood maltreatment. A total of 59% of BED patients reported emotional abuse, 36% reported physical abuse, 30% reported sexual abuse, 69% reported emotional neglect, and 49% reported physical neglect. There were no differences in the distribution of any form of childhood maltreatment by gender or by obesity status. The different forms of maltreatment were not associated with variability in current body mass index, binge eating, or in the attitudinal features of eating disorders. Only one of the five forms of maltreatment (physical neglect) was associated with dietary restraint in women. Emotional abuse was significantly associated with greater body dissatisfaction, higher depression, and lower self‐esteem in men and women and sexual abuse was associated with greater body dissatisfaction in men. The different forms of maltreatment were unrelated to the age at onset of overweight, dieting, or binge eating. Discussion: BED outpatients reported a wide range of childhood experiences of maltreatment that do not differ by gender or obesity status. Different forms of maltreatment were not associated with the onset of overweight, dieting, or binge eating, or with variability in current body mass index or eating disorder features (except for one association between physical neglect and dietary restraint). Reports of emotional abuse were associated with greater body dissatisfaction and depression and lower self‐esteem in men and women and sexual abuse with greater body dissatisfaction in men.     

Binge Eating,Body Image,Depression, and Self-Efficacy in an Obese Clinical Population

CARGILL, BRIAN R., MATTHEW M. CLARK, VINCENT PERA, RAYMOND S. NIAURA, AND DAVID B. ABRAMS. Binge eating, body image, depression, and self-efficacy in an obese clinical population. Obes Res. Objective: Binge eating disorder appears to be an important factor in obesity treatment. Researchers have proposed that specialized treatment programs be developed to address chronic binge eating behavior. This study was conducted to examine the relationships between binge eating, depression, body image, and self-efficacy. Based on related research, it was hypothesized that depression and negative body image would be greater for binge eaters whereas weight self-efficacy would be lower. Research Methods and Procedures: Subjects were 159 clinic patients participating in a multidisciplinary weight management program. Baseline measurements of binge eating status, body image and related eating behaviors, depression, and self-efficacy were obtained, whereas follow-up measures consisted of weight loss and attendance. Exploratory factor analyses were performed to obtain factors for items contained in the Eating Habits Questionnaire. Chi-square, t-tests, and logistic regression analyses determined relationships between binge eating, body image, depression, and self-efficacy. Results: Univariate comparisons indicated that increased perceptions of poor body image were significantly related to binge eating. Higher levels of depression and lower weight self-efficacy were related to binge eating, but the results were qualified after applying corrective statistics for multiple comparisons. A stepwise regression analysis indicated that body image, particularly characterized by a sense of shame and concern with public appearance, had the strongest relationship to binge eating among all the factors examined in this study. Discussion: These findings extend current understanding of the relationships between binge eating, body image, depression, and self-efficacy. The significance of body image, especially in relation to negative social consciousness, was determined when comparing several psychological and behavioral factors thought to influence binge eating. Further research is needed to determine the causal relationships between binge eating and the other factors examined in this study.     

Eating Behaviors and Indexes of Body Composition in Men and Women from the Québec Family Study

Objective: To put into relationship the dietary and anthropometric profile of men and women with their eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) and to assess whether gender and obesity status influence these associations. Research Methods and Procedures: Anthropometric measurements (including visceral adipose tissue accumulation), dietary profile (3‐day food record), and eating behaviors (Three‐Factor Eating Questionnaire) were determined in a sample of 244 men and 352 women. Results: Women had significantly higher cognitive dietary restraint and disinhibition scores than men (p < 0.0001). In both genders, scores for disinhibition and susceptibility to hunger, but not for cognitive dietary restraint, were higher in obese subjects than in overweight and nonobese subjects (p < 0.05). Positive correlations were observed between rigid restraint and most of the anthropometric variables studied (0.12 ≤ r ≤ 0.16). Moreover, in women, flexible restraint was negatively associated with body fat and waist circumference (r = ?0.11). Cognitive dietary restraint and rigid restraint were positively related to BMI among nonobese women (0.19 ≤ r ≤ 0.20), whereas in obese men, cognitive dietary restraint and flexible restraint tended to be negatively correlated with BMI (?0.20 ≤ r ≤ ?0.22; p = 0.10). Discussion: Gender could mediate associations observed between eating behaviors and anthropometric profile. It was also found that disinhibition and susceptibility to hunger are positively associated with the level of obesity. On the other hand, cognitive dietary restraint is not consistently related to body weight and adiposity, whereas rigid and flexible restraint are oppositely associated to obesity status, which suggests that it is important to differentiate the subscales of cognitive dietary restraint. Finally, counseling aimed at coping with disinhibition and susceptibility to hunger could be of benefit for the long‐term treatment of obesity.     

Weight Loss Expectations in Obese Patients and Treatment Attrition: An Observational Multicenter Study

Objective: To investigate the influence of weight loss expectations (expected 1‐year BMI loss, dream and maximum acceptable BMI) on attrition in obese patients seeking treatment. Research Methods and Procedures: Obese subjects (1785; 1393 women; median age, 46 years; median BMI, 36.7 kg/m²) seeking treatment in 23 medical Italian centers were evaluated. Baseline diet and weight history, weight loss expectations, and primary motivation for seeking treatment (health or improving appearance) were systematically recorded. Psychiatric distress, binge eating, and body image dissatisfaction were tested at baseline by self‐administered questionnaires (Symptom Check List‐90, Binge Eating Scale, and Body Uneasiness Test). Attrition and BMI change at 12 months were prospectively recorded. Results: At 12 months, 923 of 1785 patients (51.7%) had discontinued treatment. Compared with continuers, drop‐outs had a significantly lower age, a lower age at first dieting, lower dream BMI, a higher expected 1‐year BMI loss, and a higher weight phobia. At logistic regression analysis, the strongest predictors of attrition at 12 months were lower age and higher expected 1‐year BMI loss. The risk of drop‐out increased systematically for unit increase in expected BMI loss at 12 months (hazard ratio, 1.12; 95% confidence interval, 1.04 to 1.20; p = 0.0018). The risk was particularly elevated in the first 6 months. Discussion: Baseline weight loss expectations are independent cognitive predictors of attrition in obese patients entering a weight‐losing program; the higher the expectations, the higher attrition at 12 months. Unrealistic weight goals should be tackled at the very beginning of treatment.     

Body area dissatisfaction in white,black and Latina female college students in the USA: an examination of racially salient appearance areas and ethnic identity

Abstract

Dissatisfaction with one's physical appearance is rampant among women living in western cultures. However, little research has examined dissatisfaction with body areas that may be more salient to racial-minority groups (e.g., hair, eyes, skin colour). This study examined dissatisfaction with racially salient appearance areas and ethnic identity in self-identified black (n=76), white (n=104) and Latina (n=106) female college students in the southern USA. Results revealed that Latina women reported significantly more dissatisfaction with their eyes and nose than white and black women. Additionally, white and Latina women reported significantly more dissatisfaction with their facial features, lips, lower body and overall body than black women. Stronger ethnic identity predicted lower levels of body dissatisfaction on most appearance areas for all women. These results suggest that social scientists should consider racially salient appearance areas in the measurement and conceptualization of body dissatisfaction in ethnically diverse women.     

Olfactory Discrimination and Transient Mood Change in Young Men and Women: Variation by Season,Mood State,and Time of Day

Odor performance varies by clinical state and gender, though little is known about its variation by season or time of day. Many odors, including lavender, induce transient mood changes. This study explored discrimination differences between various lavender oil blends and their effects on transient mood in the morning and evening in depressed and nondepressed adults. We also determined seasonal influences on these measures. A total of 169 subjects, 98 women and 71 men (mean age ± SD, 19.3 ± 1.6 y) participated, with different subjects studied at different times of the year. The Beck Depression Inventory (BDI) classified subjects as depressed (score ≥10; N = 57) or nondepressed (score <10; N = 112). In the discrimination test, subjects compared pairs of two different lavender oil blends or a control. Transient change in mood was assessed by the Profile of Mood States (POMS) after each trial of five lavender blends interspersed by three control odors. Tests were conducted in the morning (08:00–10:00 h) and evening (18:00–20:00 h). In all subjects, discrimination was significantly better for some odor pairs than for others, thus demonstrating test specificity. Discrimination was better overall in the fall than winter/spring and better in depressed than nondepressed subjects for specific odor pairs. No significant gender or time-of-day differences in discriminability were detected. There were, however, significant group differences in transient mood profiles. Current depressed state affected mood response, with lavender increasing anger in depressed subjects only. In addition, depressed subjects and men, whether or not depressed, exhibited diurnal mood variation, with better mood in the evening; the former group also showed more evening energy. All subjects were more confused in the morning than evening. Season also affected transient mood; winter/spring-tested subjects reported more vigor than fall-tested subjects. In addition, summer-tested subjects showed more tension in the morning, whereas fall-tested subjects showed the opposite pattern in the evening. In all subjects, lavender increased fatigue, tension, confusion, and total mood disturbance, and it decreased vigor. The study showed that both chronobiological (seasonal and time-of-day) and clinical factors modify discrimination and mood response to odors. Brief lavender odor presentation may serve as a nonphotic method for altering mood in young depressed and nondepressed adults particularly during the fall, a time of heightened discriminability.