Differences in body dissatisfaction between individuals with and without stigma toward obesity: A study of preadolescents and adolescents.

INTRODUCTION: Previous studies have focused on understanding the biopsychosocial implications of obesity stigma and have made proposals to minimize its negative consequences, as well as recommendations to eliminate or reduce this stigma; however, knowing which individuals stigmatize obesity and why will allow us to have a broader picture of stigmatization and thus help in planning interventions with greater impact. OBJECTIVE: The aims were to describe the stigmatization toward obesity in preadolescents and adolescents and to determine whether there are differences in body dissatisfaction, abnormal eating behaviors and self-esteem among those with and without stigma toward obesity. METHODS: A total of 307 preadolescents and 349 adolescents answered a set of questionnaires that evaluated abnormal eating behaviors, body dissatisfaction, self-esteem and stigma. RESULTS: Fifty-nine percent of the participants stigmatized individuals with obesity, with preadolescents having the greatest stigma levels. Differences were observed only in body dissatisfaction, where the group of preadolescents who stigmatized individuals with obesity and the group of adolescents who did not stigmatize individuals with obesity reported higher levels of body dissatisfaction. CONCLUSION: Obesity is stigmatized at early ages, regardless of sex; however, preadolescents with stigma toward obesity and adolescents without stigma toward obesity have greater body dissatisfaction, indicating that body dissatisfaction plays a crucial role in the stigmatization of obesity. LEVEL OF EVIDENCE: Level V, cross-sectional analytical study.

Exploratory study of the prevalence of food addiction and its relationship with executive functioning, depression, and reinforcement sensitivity in a sample of Mexican adults.

Introduction: The study of food addiction (FA) has become relevant due to its high prevalence, the negative impact on quality of life, and its association with neuropsychological and psychiatric symptoms. Several studies have provided scientific support for these associations, however, the results are contradictory. Additionally, studies have unsuccessfully elucidated the true nature of the failures in executive functioning in people with FA symptomatology, particularly when it comes to executive deficits. Therefore, the purpose of this research was to establish whether the presence of executive dysfunction, depressive symptoms and binge eating problems, as well as high reward sensitivity entails a greater severity in FA traits and high body mass index (BMI) in a sample of Mexican adults. Methods: The sample consisted of Mexican men and women between 21-59 years (n = 36); who completed self-report questionnaires and performance tests to measure the study variables. Additionally, BMI was estimated with self-reported height and weight. Results: Our results showed that a high number of FA symptoms were associated with higher executive dysfunction scores, greater reward sensitivity, and more severe depressive and binge eating problems. Furthermore, factors that are more strongly associated with higher scores of FA include severe executive deficits, greater activation of the punishment avoidance system, and persistence in the search for reward when the depressive symptoms increased. The factors that best explained changes in the estimated BMI of women were a decreased crystallized intellectual capacity and the inability to control food intake as the number of FA symptoms increased. Discussion: In summary, the cognitive functioning profile characterized by general failure of the executive functioning, as well as a greater activation of the Punishment Avoidance System and persistence in the search for reward, were associated with greater severity of FA symptoms, especially when the depressive symptomatology was severe. In parallel, the psychopathology in participants associated with FA confirms the contribution of anxious and depressive symptomatology and borderline personality traits which could facilitate the expression of clinically relevant FA symptoms in women. Finally, we found that decreased crystallized intellectual capacity and inability to control food intake were linked to higher BMI when the number of FA symptoms increased.

Composición corporal, presencia de anorexia nerviosa y sintomatología asociada en bailarines de danza folclórica / Body composition, presence of anorexia nervosa and associated symptoms in folkloric dancers

Resumen Dada la exigencia en la disciplina dancística sobre los requerimientos corporales del bailarín, se han llevado a cabo diversos estudios sobre trastornos alimentarios (TA), sin embargo, son escasos los datos en bailarines de danza folklórica. Por tal motivo, el objetivo del presente trabajo fue conocer la composición corporal, imagen corporal, sintomatología y presencia de anorexia nerviosa en bailarines de danza folklórica profesionales (n = 37), recreativos (n = 37) y en muestra comunitaria (n = 37). El estudio se llevó a cabo en dos fases, en la primera se aplicaron los instrumentos EAT-26 y BSQ, además, se calculó el porcentaje de grasa corporal (PGC), el índice de masa corporal (IMC) y la masa muscular esquelética (MME). En la segunda fase se entrevistaron a aquellos que rebasaron punto de corte del EAT-26 y/o BSQ así como a un grupo control de la misma muestra que no haya rebasado ningún punto de corte para descartar falsos negativos. Solo se encontraron diferencias entre grupos en IMC y en PGC. De acuerdo con las entrevistas, ningún participante fue diagnosticado con anorexia nerviosa pero sí con sintomatología de TA. Se concluye que los estándares corporales exigidos en danza folklórica, son lo suficientemente altos como para que los bailarines realicen conductas de riesgo que podrían comprometer su salud física y psicológica.

Abstract Given the strict discipline in dancing activities and on the body requirements, wide research has been performed on eating disorders (ED) in this field, however, data on folk dancers are scarce. For this reason, the aim of this study was to know the body composition, body image, symptomatology and presence of anorexia nervosa in professional folkloric dancers (n = 37), recreational dancers (n = 37) and in a community sample (n = 37). The study was carried out in two phases, in the first one, the EAT-26 and BSQ instruments were administered, in addition, the body fat percentage (BFP), the body mass index (BMI) and the skeletal muscle mass (SMM) were obtained. In the second phase, those who exceeded the cut-off point of EAT-26 and/or BSQ were interviewed, as well as a control group of the same sample that did not scored above the cut-off point of any instrument to detect false negatives. Differences were only found between groups in BMI and BFP. According to the interviews, no participant was diagnosed with anorexia nervosa, but they were diagnosed with ED symptoms. It is concluded that the body standards required in folk dance are high enough for dancers to perform risky behaviors that could compromise their physical and psychological health.

Velocidad al comer en personas con normopeso y sobrepeso-obesidad: un análisis experimental / Eating speed in people with normal-weight and overweight-obese: An experimental analysis

Resumen La obesidad se ha posicionado como uno de los principales problemas de salud pública en México. Su estudio involucra el análisis de la conducta alimentaria (CA) y de algunos de sus parámetros, como la velocidad al comer (VC). El objetivo de este trabajo fue comparar la VC, tamaño y número de mordiscos, número y patrón de masticaciones que realizan personas con normopeso (n = 5) y sobrepeso-obesidad (n = 4). Mediante un diseño cuasiexperimental de una sola evaluación, los participantes fueron video-grabados mientras comían una rebana de pizza (90 gramos). Se encontraron diferencias significativas en el tamaño del mordisco (Z = 2.357, p = 0.016) y el número de mordiscos (Z = -2.357, p = 0.016), con un tamaño del efecto pequeño en ambos parámetros (r = 0.29), lo que indica que las personas con sobrepeso-obesidad tienen un mordisco de mayor tamaño y realizan un menor número de mordiscos. México posee un ambiente obesogénico y una prevalencia alta en enfermedades crónico-degenerativas, que comparten a la CA como una de las principales causas de su génesis, continuar con el estudio de la VC y parámetros asociados permitirá sentar las bases para el diseño de intervenciones para la prevención de sobrepeso-obesidad.

Abstract Obesity has become one of the main public health problems in Mexico. Its study involves the analysis of eating behavior (EB) and some of its parameters, such as eating speed (ES). The objective of this study was to compare the ES, size and number of bites, number and pattern of chewing performed by normal-weight (n = 5) and overweight-obese (n = 4) individuals. Using a single-assessment quasi-experimental design, participants were videotaped while eating a slice of pizza (90 grams). Significant differences were found in bite size (Z = 2.357, p = 0.016) and number of bites (Z = -2.357, p = 0.016), with a small effect size in both parameters (r = 0.29), indicating that overweight-obese individuals have a larger bite size and take a smaller number of bites. Mexico has an obesogenic environment and a high prevalence of chronic degenerative diseases, which share EB as one of the main causes of their genesis; continuing with the study of ES and associated parameters will allow us to lay the foundations for the design of interventions for the prevention of overweight-obesity.

Terapia Cognitivo-Conductual sobre la adherencia terapéutica y conducta alimentaria en personas adultas mayores: una revisión sistemática / Cognitive-Behavioral Therapy on therapeutic adherence and eating behavior in elderly: a systematic review

Resumen La diabetes mellitus (DM) es uno de los principales padecimientos en población adulta. Se dice que en México el 47.7% de personas adultas mayores (PAM) viven con este padecimiento, razón por la cual resulta indispensable conocer las investigaciones psicológicas centradas en mejorar el estado de salud y la adherencia al tratamiento médico en este grupo etario que va en aumento debido a la transición demográfica. El objetivo de esta revisión sistemática fue reunir los estudios que den cuenta de la eficacia de la Terapia Cognitivo-Conductual sobre la adherencia terapéutica y la conducta alimentaria en PAM con DM tipo 2. La búsqueda se realizó por medio de la estrategia PIO en siete bases de datos (Pubmed, PsycINFO, Scopus, PsycArticles, SciELO, Dialnet y Redalyc). Se encontraron 4,088 estudios, de los cuales sólo 11 cumplieron los criterios de inclusión. Los resultados revelan que este tipo de intervenciones son eficaces para favorecer conductas de adherencia al tratamiento, produciendo cambios significativos en la dieta, HbA1C y colesterol HDL, a pesar de que originalmente no fueron diseñadas para PAM y aun cuando las muestras de participantes fueron heterogéneas. Resulta evidente la carencia de tratamientos diseñados exclusivamente para PAM con DM, además de no considerar en el tratamiento variables como años con el diagnóstico, conducta alimentaria, funcionalidad, comorbilidades, escolaridad, apoyo social y nivel socioeconómico.

Abstract Diabetes mellitus (DM) is one of the primary diseases in the adult population. It is said that in Mexico 47.7% of older adults (OA) live with this condition, which is why it is essential to know psychological research focused on improving health status and adherence to medical treatment in this age group that is increasing due to the demographic transition. The aim of this systematic review was to gather the studies that account for the efficacy of Cognitive-Behavioral Therapy on therapeutic adherence and eating behavior in PAM with type 2 DM. The search was carried out using the PIO strategy in seven databases. data (Pubmed, PsycINFO, Scopus, PsycArticles, SciELO, Dialnet and Redalyc). 4,088 studies were found, of which only 11 met the inclusion criteria. The results reveal that this type of intervention is effective in favoring treatment adherence behaviors, producing significant changes in diet, HbA1C and HDL cholesterol, even though they were not initially designed for PAM and even when the participant samples were heterogeneous. The lack of treatments created exclusively for PAM with DM is evident, in addition to not considering treatment variables such as years since diagnosis, eating behavior, functionality, comorbidities, education, social support and socioeconomic level.

Bulimia nerviosa: instrumentos de evaluación para población de habla hispana / Bulimia nervosa: Assessment instruments for Spanish-speaking population

Resumen De la población mundial 7.8% es hispanohablante, esto representa 567 millones de personas y se calcula que para 2050 esta cifra se elevará, además, el español es el segundo idioma de comunicación a nivel internacional; con este contexto y a casi cuatro décadas de la aparición formal de la Bulimia Nerviosa (BN), es necesario conocer cuáles y cómo son los instrumentos para evaluar los síntomas de la BN en este tipo de población. Por tanto, el objetivo de la presente investigación fue describir los cuestionarios para evaluar en población de habla hispana los síntomas de BN. Se encontró que México, cuenta con seis instrumentos; España con cinco; Colombia tiene tres instrumentos; Puerto Rico y Cuba cuentan con dos; Argentina, Costa Rica, Bolivia, El Salvador, Venezuela y República Dominicana, cuentan con uno. Estos pueden ser para el tamizaje de síntomas de la BN; o para evaluar los síntomas de la BN como parte de la evaluación de diversas dimensiones; o para evaluar a los familiares/cuidadores en el proceso de tratamiento de la BN. Se concluye que, es alentador que la población de habla hispana cuente con diversos cuestionarios adaptados y validados en su lengua para evaluar los síntomas de la BN.

Abstract Of the world population 7.8% is Spanish-speaking, this represents 567 million people and it is estimated that by 2050 this figure will rise, in addition, Spanish is the second language of communication at the international level; With this context and almost four decades after the formal publication of Bulimia Nervosa (BN), it is necessary to know which and how are the instruments to evaluate the symptoms of BN in this type of population. Therefore, the objective of the present investigation was to describe the questionnaires to evaluate the symptoms of BN in the Spanish-speaking population. It was found that Mexico has six instruments; Spain has five; Colombia has three instruments; Puerto Rico and Cuba have two; Argentina, Costa Rica, Bolivia, El Salvador, Venezuela and the Dominican Republic have just one. These can be for the screening of BN symptoms; or to evaluate the symptoms of BN as part of the evaluation of some dimensions; or to evaluate family members /caregivers in the BN treatment process. It is concluded that it is encouraging that the Spanish-speaking population has several questionnaires adapted and validated in their language to evaluate the symptoms of BN.

Body dissatisfaction and quality of life: contribution to the occurrence of anomalous eating behaviors in administrative personnel in hospitals / Insatisfacción corporal y calidad de vida: contribución a la ocurrencia de conductas alimentarias anómalas en administrativos hospitalarios

Abstract The purpose of this study involved assessing the predictive capacity of the body mass index (BMI), body image, positive and negative affect, attitudes toward obese individuals and quality of life (QL) related to the anomalous eating behaviors of administrative personnel of Mexico City's health sector; aside from knowing gender differences and BMI in study variables. A total of 181 administrative employees took part in the study, divided according to their BMI (normal weight, overweight, obese) who filled out a personal data sheet and self-report questionnaires. Findings of this study indicate that body dissatisfaction, along with the perception of vitality and physical well-being may partially explain the presence of the anomalous eating behaviors that promotes excessive weight gain. Additionally, significant differences in positive affect were observed between sexes, aside from differences between the obese and normal weight groups regarding body dissatisfaction, negative affect, physical performance, physical role and social performance.

Resumen El objetivo del presente estudio consistió en evaluar la capacidad predictiva de variables como el índice de masa corporal (IMC), la imagen corporal, el afecto positivo y negativo, las actitudes hacia la gente obesa y la calidad de vida (CV) sobre las conductas alimentarias anómalas del personal administrativo del sector salud en la Ciudad de México, además de conocer las diferencias entre los sexos y del IMC en las variables de estudio. En total, participaron 181 trabajadores administrativos, divididos según su IMC (normopeso, sobrepeso, obesidad), que completaron una hoja de datos generales y cuestionarios de autorreporte. En general, se encontró que la insatisfacción de la imagen corporal, aunada a la percepción de vitalidad y bienestar físico, podría explicar en parte la presencia del comportamiento alimentario anómalo, el cual favorece a la ganancia excesiva de peso corporal. Adicionalmente, se observaron diferencias significativas entre los sexos en el afecto positivo, además de diferencias entre el grupo con obesidad y el grupo normopeso en insatisfacción corporal, afecto negativo, funcionamiento físico, rol físico y funcionamiento social.

Children with obesity: peer influence as a predictor of body dissatisfaction.

PURPOSE: To analyze self-esteem, as well as the different peer influence components (messages, interactions and likability) as predictors of body dissatisfaction in children with obesity. METHOD: A total of 123 children aged between 10 and 12 years were divided into two groups according to their body mass index. The group with obesity was comprised of 36 boys and 21 girls and the group with normal weight of 32 boys and 34 girls. All of the participants answered the Body Shape Questionnaire-16, the Inventory of Peer Influence on Eating Concerns, and the Rosenberg Self-Esteem Scale. RESULTS: The hierarchical multiple regression analysis for each group showed that likability and peer messages explain 67% of the body dissatisfaction variance in children with obesity and 54% in children with normal weight. CONCLUSION: Peer influence predicted body dissatisfaction in children; however, children with obesity assimilate messages from their peers differently compared with children with normal weight.

Influencia de pares en preadolescentes y adolescentes: Un predictor de la insatisfacción corporal y las conductas alimentarias anómalas / Peer influence in preadolescents and adolescents: A predictor of body dissatisfaction and disordered eating behaviors

Los pares contribuyen a la presencia de insatisfacción corporal y conductas alimentarias anómalas, mismas que tienen su pico de ocurrencia durante la adolescencia; sin embargo, se ha sugerido que los pares pueden incidir desde edades más tempranas. Por ello, los propósitos de este estudio fueron: evaluar la influencia de pares, la interiorización del ideal corporal, la insatisfacción corporal y las conductas alimentarias anómalas en preadolescentes vs. adolescentes; y analizar la influencia de pares en la predicción de la insatisfacción corporal y las conductas alimentarias anómalas. Participaron 273 preadolescentes y 175 adolescentes, hombres y mujeres, quienes completaron cuatro cuestionarios, además de recabar su peso y estatura. La prueba t de Student solo reveló diferencias entre los grupos en índice de masa corporal, interacción con pares, interiorización del ideal corporal y conductas alimentarias anómalas, siendo los adolescentes quienes obtuvieron mayores puntuaciones en las primeras tres variables. Los análisis de senderos mostraron que en ambos grupos los pares tuvieron efecto directo sobre la insatisfacción corporal, misma que actuó como mediadora del efecto sobre el comportamiento alimentario. Se concluye que la insatisfacción corporal no difiere entre preadolescentes y adolescentes, y que en ambos la influencia de pares mostró ser un importante factor predictor.

Peers contribute to the development of body dissatisfaction and disordered eating behaviors, conditions that show their peak occurrence during the adolescence; however, literature has suggested that peers may influence since earlier ages. Therefore, the objective of this study was to evaluate peer influence, internalization of the body ideal, body dissatisfaction and disordered eating behaviors, in preadolescents vs. adolescents; and to analyze the peer influence in the development of disordered eating behaviors and body dissatisfaction. A total of 273 preadolescents and 175 adolescents' men and women answered four questionnaires, additionally weight and height was measured. The t Student test showed differences between groups only in body mass index, interaction with peers, internalization of body ideal and eating behaviors, being adolescents who obtained higher scores in the first three variables. Path analysis showed that in both groups peers influenced body dissatisfaction, which act as a mediator of disordered eating behavior. It is concluded that body dissatisfaction is not different between preadolescents and adolescents and in both groups peer influence was an important predictive factor.

Systematic review of disordered eating behaviors: Methodological considerations for epidemiological research / Revisión sistemática de las conductas alimentarias de riesgo: consideraciones metodológicas para la investigación epidemiológica

Disordered eating behaviors (DEB) such as dieting, fasting, laxatives or diuretics abuse, self-induced vomiting and binge eating may lead serious physiological and psychological consequences in individuals. Epidemiological data helps to the understanding of the magnitude of this problem within population; however point prevalence rates and the trend of DEB are still a subject of constant debate. Therefore the aim of this study is to systematically review empirical studies that have estimated the prevalence of DEB in women and provide some methodological considerations for future epidemiological studies. The search of articles was made through MEDLINE and SCIENCE DIRECT databases from 2000 to 2013. According to inclusion and exclusion criteria 20 studies were reviewed. Results yielded that the point prevalence range of dieting (0.6-51.7%), fasting (2.1-18.5%) and binge eating (1.2-17.3%) are higher than purgative behaviors (0-11%). However finding a trend in DEB over time was difficult since methodologies were significantly different. Methodological considerations for future research in DEB are proposed.

Las conductas alimentarias de riesgo (CAR) de los trastornos alimentarios, tales como dieta, ayuno, abuso de laxantes o diuréticos, vómito autoinducido y atracón, pueden causar graves consecuencias fisiológicas y psicológicas en el individuo. Los datos epidemiológicos ayudan a la comprensión de la magnitud de este problema en la población, sin embargo las tasas de prevalencia puntual y la tendencia de las CAR aún son tema de constante debate. Por lo tanto, el objetivo del presente estudio es revisar sistemáticamente estudios empíricos que estimen la prevalencia de las CAR en mujeres y proveer consideraciones metodológicas para futura investigación epidemiológica. La búsqueda de artículos fue a través de las bases de datos de MEDLINE y SCIENCEDIRECT de 2000 a 2013. Con base en los criterios de inclusión y exclusión 20 estudios fueron analizados. Los resultados arrojaron que el rango de la prevalencia puntual para dieta (0,6-51,7%), ayuno (2,1-18,5%) y atracón (1,2-17,3%) son mayores que el de las conductas purgativas (0-11%). Sin embargo, fue difícil encontrar una tendencia en las CAR a través del tiempo debido a que las metodologías utilizadas fueron significativamente diferentes. Se proponen consideraciones metodológicas para futuras investigaciones en CAR.

Edad, Consciencia e Interiorización del Ideal Corporal como Predictores de Insatisfacción y Conductas Alimentarias Anómalas / Idade, Consciência e Interiorização do Ideal Corporal como Preditores de Insatisfação e Condutas Alimentares Anômalas / Age, Awareness and Internalization of Body Ideal as Predictors of Body Dissatisfaction and Disordered Eating Behaviors

Este estudio indaga si la edad, la consciencia y la interiorización del ideal corporal predicen la insatisfacción corporal y las conductas alimentarias anómalas, en una muestra de 144 mujeres y 138 hombres, en dos grupos de diferentes edades (9-12 y 13-15 años). Para tal fin se aplicaron tres cuestionarios: Cuestionario de Imagen Corporal, Test Infantil de Actitudes Alimentarias y Cuestionario de Actitudes Socioculturales hacia la Apariencia. Mediante un modelo hipotético, que se probó a través de un path análisis, se concluye que la edad es un predictor directo de la insatisfacción corporal y las conductas alimentarias anómalas en los hombres, mientras que la interiorización del ideal corporal es el principal predictor de la insatisfacción corporal en ambos sexos.

The aim of this study was to examine whether age, awareness, and internalization of body ideal predict body dissatisfaction and abnormal eating behaviors in men and women. An intentional, non-probabilistic sample of 144 women and 138 men was divided into two different age groups (9-12 and 13-15) that had to respond to the following questionnaires: Body Shape Questionnaire, Children's Eating Attitudes Test and Sociocultural Attitudes Towards Appearance Questionnaire - Revised. A hypothetical model tested through path analysis made it possible to conclude that age is a direct predictor of body dissatisfaction and abnormal eating behaviors in men, while the internalization of the body ideal is the main predictor of body dissatisfaction in both genders.

Este estudo indaga se a idade, a consciência e a interiorização do ideal corporal predizem a insatisfação corporal e as condutas alimentares anômalas, em uma amostra de 144 mulheres e 138 homens, em dois grupos de diferentes idades (9-12 e 13-15 anos). Para tal fim, aplicaram-se três questionários: Questionário de Imagem Corporal, Teste Infantil de Atitudes Alimentares e Questionário de Atitudes Socioculturais direcionadas à Aparência. Mediante um modelo hipotético, que se provou por meio de um path análise, conclui-se que a idade é um preditor direto da insatisfação corporal e as condutas alimentares anômalas nos homens, enquanto a interiorização do ideal corporal é o principal preditor da insatisfação corporal em ambos os sexos.

Propiedades psicométricas del Inventario de Influencia de Pares sobre la Preocupación Alimentaria / Psychometric properties of the Inventory of Peer Influence on Eating Concerns

El propósito del presente estudio fue conocer las propiedades psicométricas del Inventario de Influencia de Pares sobre la Preocupación Alimentaria en mujeres y hombres mexicanos de entre 10 y 19 años de edad. La muestra fue no probabilística de tipo intencional, conformada por 917 participantes (498 mujeres y 419 hombres). Se realizaron tres piloteos, a partir de estos se consideró necesario derivar dos versiones, una para cada sexo. Se obtuvo un alpha de Cronbach de .94 y .92 para la versión femenina y masculina, respectivamente. El análisis factorial exploratorio arrojó tres factores, los cuales son: mensajes, popularidad con el sexo opuesto e interacción con pares del mismo sexo, es preciso señalar que a pesar de ello ambas versiones no son equiparables. Finalmente, se realizó un análisis factorial confirmatorio para cada versión, femenina y masculina, que corroboró el modelo factorial propuesto en el análisis exploratorio. A partir de los resultados obtenidos es posible concluir que ambas versiones del inventario constituyen una herramienta útil para evaluar la influencia de pares sobre la preocupación alimentaria.

The aim of this research was to know the psychometric properties of the Inventory of Peer Influence on Eating Concerns in Mexican female and male population among 10 and 19 years old. The sample was non-probabilistic, composed by 917 participants (females 498 and males 419). After three testing pilots it was necessary to carried out two versions, one for each gender. Cronbach's alpha of .94 was obtained for female and .92 for male version. The exploratory factor analysis yielded three factors, which are: messages, likability with peers of the opposite sex and interaction with peers of the same sex, however it is worthy to note that these two versions are not comparable. Finally, a confirmatory factor analysis was conducted for each version, female and male, which confirmed the factorial model proposed in the exploratory analysis. Based on these results it is possible to conclude that both versions of this inventory are a useful tool to evaluate peer influence on eating concerns.