Secular trends in body image dissatisfaction and associated factors among adolescents (2007-2017/2018).

OBJECTIVE: To assess secular trends in body image dissatisfaction and associated factors among adolescents over a 10-year period (2007-2017/2018). METHODS: The sample included 1,479 (2007, n = 531; 2017/2018, n = 948) high school adolescents of both sexes, aged 14 to 18 years, of schools in a city in southern Brazil, in 2007 and 2017/2018. Data were collected on sex, age, physical activity (IPAQ, short form), anthropometric measurements (body weight, height, and triceps and subscapular skinfolds), and body image dissatisfaction (figure rating scale). The variables were compared with Independent samples t-test and Mann-Whitney U-test. The associations between sex and other variables were examined with chi-square test, and the factors associated with body image were identified with multinomial logistic regression. RESULTS: Most adolescents were dissatisfied with their body image in 2007 (65,2%) and 2017/2018 (71,1%). The prevalence of body dissatisfaction increased by 9.2% over the 10-year period, particularly dissatisfaction with thinness (21.3%). After stratification by sex, in 2017/2018 sample, dissatisfaction with overweight was 46.1% greater in boys, and dissatisfaction with thinness was 66.9% greater in girls. Factors found to be significantly associated with body image dissatisfaction were physical activity level, and body adiposity. CONCLUSIONS: There was a secular trend toward increased body image dissatisfaction in both sexes. Future efforts should go beyond scientific production, in public and private environments aimed at increasing awareness of health issues related to body care in the physical, psychological, and environmental domains.

Eating behaviours related to psychological stress are associated with functional hypothalamic amenorrhoea in exercising women.

Functional hypothalamic amenorrhoea (FHA) can occur due to the independent or combined effects of psychogenic and energetic stressors. In exercising women, research has primarily focused on energy deficiency as the cause of FHA while psychological stressors have been ignored. To assess both psychological and metabolic factors associated with FHA in exercising women, we performed across-sectional comparison of 61 exercising women (≥2 hours/week, age 18-35 years, BMI 16-25kg/m2), who were eumenorrheic or amenorrhoeic confirmed by daily urine samples assayed for reproductive hormone metabolites. Psychological factors and eating behaviours were assessed by self-report questionnaires. Exercising women with FHA had lower resting metabolic rate (p=0.023), T3 (p<0.001), T4 (p=0.013), leptin (p=0.002), higher peptide YY (p<0.001), greater drive for thinness (p=0.017), greater dietary cognitive restraint (p<0.001), and displayed dysfunctional attitudes, i.e., need for social approval (p=0.047) compared to eumenorrheic women. Amenorrhoeic women displayed asignificant positive correlation between the need for social approval and drive for thinness with indicators of stress, depression, and mood, which was not apparent in eumenorrheic women. In exercising women with FHA, eating behaviours are positively related to indicators of psychological stress and depression.

Comparison of body mass index range criteria and their association with cognition, functioning and depression: a cross-sectional study in Mexican older adults.

BACKGROUND: World population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures. METHODS: This cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60-98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel's Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale. RESULTS: WHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05). CONCLUSIONS: BMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.

[Association between dissatisfaction with body image and health-related physical fitness among adolescents]. / Associação entre insatisfação com a imagem corporal e aptidão física relacionada à saúde em adolescentes.

The scope of this study was to estimate the prevalence of dissatisfaction with body image and verify the association between dissatisfaction with thinness or with overweight and health-related physical fitness components among adolescents. Participants included 1058 adolescents (570 girls and 488 boys), with mean age of 16.3 (±1.0) years. The investigated variables were dissatisfaction with body image (Figure Rating Scale), and health-related physical fitness: body fat (skin folds), muscle strength (handgrip strength) and cardiorespiratory fitness (mCAFT test). The association of body image and the health-related physical fitness variables was tested by Multinomial Regression analysis. The prevalence of body dissatisfaction was 75.2% (girls = 79.5%; boys = 70.3%). Girls and boys with high body fat were less likely to be dissatisfied with thinness and more likely to be dissatisfied with overweight. Those who needed to improve muscle strength and cardiorespiratory fitness were more likely to be dissatisfied with thinness and with overweight, respectively. In conclusion, physical fitness was associated with body image, with the adolescents with less healthy conditions of the components being more dissatisfied.

O objetivo deste estudo foi estimar a prevalência de insatisfação com a imagem corporal e verificar a associação entre a insatisfação pela magreza e pelo excesso de peso e componentes da aptidão física relacionada à saúde em adolescentes. Participaram 1.058 adolescentes (570 moças e 488 rapazes), com média de idade de 16,3(± 1,0) anos. As variáveis investigadas foram a insatisfação com a imagem corporal (escala de silhuetas), e as relativas à aptidão física relacionada à saúde: adiposidade corporal (dobras cutâneas), força muscular (preensão manual) e aptidão cardiorrespiratória (teste mCAFT). A associação entre a imagem corporal e as variáveis de aptidão física foi testada por meio da Regressão Multinomial. A prevalência de insatisfação corporal foi de 75,2% (moças = 79,5%; rapazes = 70,3%). Moças e rapazes com adiposidade corporal elevada tiveram menor chance de insatisfação pela magreza e maior chance de insatisfação pelo excesso de peso. Os que necessitavam melhorar a força muscular e a aptidão cardiorrespiratória tiveram maior chance de insatisfação pela magreza e pelo excesso de peso, respectivamente. Conclui-se que a aptidão física relacionada à saúde esteve associada à imagem corporal, sendo que os adolescentes com níveis menos saudáveis dos diferentes componentes foram os mais insatisfeitos.

Prevention of eating disorders in argentine adolescents.

In the last few decades much effort has been devoted to developing prevention programs for eating disorders, as most individuals with these pathologies do not receive treatment and tend to become chronic. The purpose of this study was to evaluate a cognitive dissonance and media literacy intervention aimed at preventing eating disorders in female adolescents. Eighty-eight female students (aged 12-17) from Argentina, participated in a 3-session program. Adolescents completed a baseline, post-intervention and a 6-month follow-up survey. A significant decrease in thin-ideal internalization, body image concerns, influence of advertising, drive for thinness and bulimic attitudes was found at post-intervention. In addition, the number of participants with disturbed eating attitudes and behaviors decreased at post-intervention. Results for body image concerns and drive for thinness were maintained at follow-up.

Associação entre insatisfação com a imagem corporal e aptidão física relacionada à saúde em adolescentes / Association between dissatisfaction with body image and health-related physical fitness among adolescents

Resumo O objetivo deste estudo foi estimar a prevalência de insatisfação com a imagem corporal e verificar a associação entre a insatisfação pela magreza e pelo excesso de peso e componentes da aptidão física relacionada à saúde em adolescentes. Participaram 1.058 adolescentes (570 moças e 488 rapazes), com média de idade de 16,3(± 1,0) anos. As variáveis investigadas foram a insatisfação com a imagem corporal (escala de silhuetas), e as relativas à aptidão física relacionada à saúde: adiposidade corporal (dobras cutâneas), força muscular (preensão manual) e aptidão cardiorrespiratória (teste mCAFT). A associação entre a imagem corporal e as variáveis de aptidão física foi testada por meio da Regressão Multinomial. A prevalência de insatisfação corporal foi de 75,2% (moças = 79,5%; rapazes = 70,3%). Moças e rapazes com adiposidade corporal elevada tiveram menor chance de insatisfação pela magreza e maior chance de insatisfação pelo excesso de peso. Os que necessitavam melhorar a força muscular e a aptidão cardiorrespiratória tiveram maior chance de insatisfação pela magreza e pelo excesso de peso, respectivamente. Conclui-se que a aptidão física relacionada à saúde esteve associada à imagem corporal, sendo que os adolescentes com níveis menos saudáveis dos diferentes componentes foram os mais insatisfeitos.

Abstract The scope of this study was to estimate the prevalence of dissatisfaction with body image and verify the association between dissatisfaction with thinness or with overweight and health-related physical fitness components among adolescents. Participants included 1058 adolescents (570 girls and 488 boys), with mean age of 16.3 (±1.0) years. The investigated variables were dissatisfaction with body image (Figure Rating Scale), and health-related physical fitness: body fat (skin folds), muscle strength (handgrip strength) and cardiorespiratory fitness (mCAFT test). The association of body image and the health-related physical fitness variables was tested by Multinomial Regression analysis. The prevalence of body dissatisfaction was 75.2% (girls = 79.5%; boys = 70.3%). Girls and boys with high body fat were less likely to be dissatisfied with thinness and more likely to be dissatisfied with overweight. Those who needed to improve muscle strength and cardiorespiratory fitness were more likely to be dissatisfied with thinness and with overweight, respectively. In conclusion, physical fitness was associated with body image, with the adolescents with less healthy conditions of the components being more dissatisfied.

Reliability and validity of body weight and body image perception in children and adolescents from the South American Youth/Child Cardiovascular and Environmental (SAYCARE) Study.

OBJECTIVE: To assess the reliability and validity of body weight (BW) and body image (BI) perception reported by parents (in children) and by adolescents in a South American population. DESIGN: Cross-sectional study. BW perception was evaluated by the question, 'Do you think you/your child are/is: severely wasted, wasted, normal weight, overweight, obese?' BI perception was evaluated using the Gardner scale. To evaluate reliability, BW and BI perceptions were reported twice, two weeks apart. To evaluate validity, the BW and BI perceptions were compared with WHO BMI Z-scores. Kappa and Kendall's tau-c coefficients were obtained. SETTING: Public and private schools and high schools from six countries of South America (Argentina, Peru, Colombia, Uruguay, Chile, Brazil).ParticipantsChildren aged 3-10 years (n 635) and adolescents aged 11-17 years (n 400). RESULTS: Reliability of BW perception was fair in children's parents (κ=0·337) and substantial in adolescents (κ=0·709). Validity of BW perception was slight in children's parents (κ=0·176) and fair in adolescents (κ=0·268). When evaluating BI, most children were perceived by parents as having lower weight. Reliability of BI perception was slight in children's parents (κ=0·124) and moderate in adolescents (κ=0·599). Validity of BI perception was poor in children's parents (κ=-0·018) and slight in adolescents (κ=0·023). CONCLUSIONS: Reliability of BW and BI perceptions was higher in adolescents than in children's parents. Validity of BW perception was good among the parents of the children and adolescents with underweight and normal weight.

Exposure to intimate partner violence and malnutrition among young adult Bangladeshi women: cross-sectional study of a nationally representative sample.

This study explores the relationship between malnutrition and intimate partner violence (IPV) among 1,086 young adult Bangladeshi women aged 15-24 years using a cross-sectional data from the 2007 Bangladesh Demographic Health Survey (BDHS). About one-third (33.4%) young adult women experienced physical and/or sexual IPV, 14.5% experienced only sexual IPV and 29% experienced only physical IPV by husbands. About 32.6% young adult women were reported as being underweight (BMI < 18.5) and 6.2% were overweight (BMI ≥ 25). Underweight women experienced more physical IPV (OR = 1.39; 95%CI: 1.09-2.71) and physical and/or sexual IPV (OR = 1.48; 95%CI: 1.12-2.75) than normal range women. Results also indicate a positive association between being overweight/obese and all the forms of IPV. The study findings indicate that the IPV experience plays a significant role in underweight and overweight/obese young adult women and support that younger women's health and nutrition program and policies need to address IPV.

Body dissatisfaction among Iranian youth and adults.

Despite the importance of body satisfaction on one's self image and well-being, little has been written about body image or how it affects people in Iran. The aim of this study is to assess body dissatisfaction and its risk factors in the general Iranian population. The sample size for this cross-sectional study included approximately 1,200 participants (both male and female) and was conducted in 2011. Body dissatisfaction (based on the Figure Rating Scale), demographic characteristics, socioeconomic status, body mass index (BMI) and use of the media were recorded. Nearly two thirds of the participants were included in the middle age group and roughly half of them had a university education. Approximately two thirds of the participants were satisfied with their body. The mean score of body dissatisfaction in women was greater than men (p < 0.0001). Age, gender, marital status and BMI had a significant relationship with body dissatisfaction. The finding of this study demonstrates that in Iran, body dissatisfaction and it consequences must be addressed. While the prevalence and pattern of body dissatisfaction in Iran is as high as other Asian countries, considering cultural variation within Asian countries is also important.

Does body image perception relate to quality of life in middle-aged women?

OBJECTIVE: In Brazil, information about the influence of body image on the various life domains of women in menopausal transition is scarce. Thus, the objective of the study was to analyze the relationship between body image and quality of life in middle-aged Brazilian women. METHODS: This was a cross-sectional study of 250 women between 40 and 65 years old, living in Parnamirim/RN, Brazil, who were evaluated in relation to body image and quality of life. For body image, women were classified as: dissatisfied due to low weight, satisfied (with their body weight) and dissatisfied due to being overweight. Quality of life was assessed through a questionnaire in which higher values indicate higher quality of life. Multiple linear regression was performed to analyze the relationship between body image and quality of life, adjusted for covariates that presented p<0.20 in the bivariate analysis. RESULTS: The average age was 52.1 (± 5.6) years, 82% of the women reported being dissatisfied due to being overweight, and 4.4% were dissatisfied due to having low weight. After multiple linear regression analyzes, body image remained associated with health (p<0.001), emotional (p = 0.016), and sexual (p = 0.048) domains of quality of life, as well as total score of the questionnaire (p<0.001). CONCLUSION: Women who reported being dissatisfied with their body image due to having low weight or overweight had worse quality of life in comparison to those who were satisfied (with their body weight).

Body dissatisfaction among Iranian youth and adults / Dismorfofobia entre jovens e adultos iranianos / Dismorfofobia entre jóvenes y adultos iraníes

Abstract: Despite the importance of body satisfaction on one's self image and well-being, little has been written about body image or how it affects people in Iran. The aim of this study is to assess body dissatisfaction and its risk factors in the general Iranian population. The sample size for this cross-sectional study included approximately 1,200 participants (both male and female) and was conducted in 2011. Body dissatisfaction (based on the Figure Rating Scale), demographic characteristics, socioeconomic status, body mass index (BMI) and use of the media were recorded. Nearly two thirds of the participants were included in the middle age group and roughly half of them had a university education. Approximately two thirds of the participants were satisfied with their body. The mean score of body dissatisfaction in women was greater than men (p < 0.0001). Age, gender, marital status and BMI had a significant relationship with body dissatisfaction. The finding of this study demonstrates that in Iran, body dissatisfaction and it consequences must be addressed. While the prevalence and pattern of body dissatisfaction in Iran is as high as other Asian countries, considering cultural variation within Asian countries is also important.

Resumo: Apesar da importância da satisfação com o próprio corpo para a autoestima e o bem-estar, pouco tem sido publicado sobre auto-imagem e como afeta as pessoas no Irã. O objetivo do estudo é avaliar a dismorfofobia e fatores associados na população geral iraniana. A amostra nesse estudo transversal incluiu aproximadamente 1.200 participantes (homens e mulheres) em 2011. Foram registrados a dismorfofobia (baseada na Figure Rating Scale), características demográficas, nível socioeconômico, índice de massa corporal (IMC) e uso da mídia. Quase dois terços dos participantes foram classificados no grupo de meia idade, e cerca da metade tinha nível superior. Dois terços estavam satisfeitos com o próprio corpo. A média da dismorfofobia era mais alta em mulheres (p < 0,0001). Idade, gênero, estado civil e IMC mostraram relação significativa com a dismorfofobia. Os achados destacam a necessidade do enfrentamento da dismorfofobia e suas consequências no Irã. A prevalência da dismorfofobia é tão alta quanto em outros países asiáticos, mas é igualmente importante considerar as variações culturais dentro desses países.

Resumen: A pesar de la importancia de la satisfacción con el propio cuerpo para la autoestima y el bienestar, poco ha sido publicado sobre la auto-imagen y como afecta a las personas en Irán. El objetivo del estudio es evaluar la dismorfofobia y sus factores asociados en la población general iraní. La muestra en ese estudio transversal incluyó aproximadamente 1.200 participantes (hombres y mujeres) en 2011. Se registró la dismorfofobia (basada en la Figure Rating Scale), características demográficas, nivel socioeconómico, índice de masa corporal (IMC) y uso de los medios de comunicación. Casi dos tercios de los participantes se clasificaron en el grupo de mediana edad, y cerca de la mitad tenía nivel superior. Dos tercios estaban satisfechos con el propio cuerpo. La media de la dismorfofobia era más alta en mujeres (p < 0,0001). Edad, género, estado civil e IMC mostraron una relación significativa con a dismorfofobia. Los hallazgos destacan la necesidad del enfrentamiento de la dismorfofobia y sus consecuencias en Irán. La prevalencia de la dismorfofobia es tan alta como en otros países asiáticos, pero es igualmente importante considerar las variaciones culturales dentro de esos países.

Using Propensity Score Methods To Assess Causal Effects of Mothers' Dieting Behavior on Daughters' Early Dieting Behavior.

BACKGROUND: A high prevalence of dieting has been reported among preadolescent females. It is important to understand factors influencing the emergence of dieting because dieting is associated with increased likelihood of overeating, greater weight gain over time, and other chronic health problems. Previous studies suggest that mothers' own dieting behavior influences their daughters' dieting (i.e., modeling). Because it is not possible to randomly assign girls to a mother who is dieting versus not dieting, causal inference regarding the effects of mothers' modeling behaviors on daughters' dieting is not straightforward. METHODS: In an observational study, data were collected on four occasions of measurement across a 6-year period, with 2-year intervals between assessments on 181 girls and their parents. Propensity score methods were used to estimate the causal effects of mothers' dieting on the emergence of daughters' dieting between ages 7 and 11, examining the moderating effect of weight status. RESULTS: Girls whose mothers were currently dieting were significantly more likely to diet before age 11 than those whose mothers were not currently dieting, and this effect did not vary by girls' or mothers' weight status. CONCLUSIONS: We conclude by discussing the implications of the effects of mothers' dieting on daughters' early dieting as well as the potential of propensity score methods in the field of obesity compared with traditional methodology such as regression analysis.

Correlates of Body Dissatisfaction in Children.

OBJECTIVE: To assess body dissatisfaction among children between 9 and 14 years of age and to examine factors (age, sex, body mass index, perceived shape, and self-esteem) associated with wanting a thinner or a larger shape. STUDY DESIGN: Through at-school questionnaires, 1515 preadolescent children (51.2% girls) were asked to fill out the Culture Free Self-Esteem Inventory and the Contour Drawing Rating Scale (body dissatisfaction). Trained assessors then weighed and measured the students individually. RESULTS: Overall, 50.5% of girls wanted a thinner shape compared with 35.9% of boys. More boys wanted a larger shape compared with girls (21.1% vs 7.2%). Most of the preadolescents who were overweight or obese were unsatisfied whereas 58.0% of girls and 41.6% of boys who were underweight were satisfied with their body. Results of a multinomial logistic regression revealed that age, sex, body mass index, perceived shape, and self-esteem were significant correlates of the 4 body dissatisfaction contrasts (wanting a slightly thinner, much thinner, slightly larger, and much larger shape) and explained 50% of the variance. An interaction between sex and perceived shape was found, revealing that girls who perceived themselves as having a larger shape were more likely to desire a thinner shape than boys. CONCLUSIONS: The high prevalence rate of body dissatisfaction among children suggests that current approaches in our society to prevent problems related to body image must be improved. The different results between girls and boys highlight the need to take into account sex differences when designing prevention programs that aim to decrease body dissatisfaction.

Recovery in Young Children with Weight Faltering: Child and Household Risk Factors.

OBJECTIVE: To examine whether weight recovery among children with weight faltering varied by enrollment age and child and household risk factors. STUDY DESIGN: Observational, conducted in an interdisciplinary specialty practice with a skill-building mealtime behavior intervention, including coaching with video-recorded interactions. Eligibility included age 6-36 months with weight/age

[Weight control behaviors in dieting adolescent girls and their relation to body dissatisfaction and obsession with thinness]. / Conductas de control de peso en mujeres adolescentes dietantes y su relación con insatisfacción corporal y obsesión por la delgadez.

INTRODUCTION: Obsession with thinness and body dissatisfaction can lead adolescents to follow unsupervised diets, which could result in risky weight control behaviors such as fasting, vomiting, use of diuretics and laxatives. The aim of the current study is to examine weight control behaviors in dieting adolescents and relate them to body dissatisfaction (BD) and obsession with thinness (OT). METHODS: A cross-sectional study was conducted on 439 adolescents from Valparaiso public schools to investigate risky weight control behaviors due to BD and OT scales from the Eating Disorders Inventory-2 (EDI-2), comparing restrained eaters and non-restrained eaters. RESULTS: A total of 43% adolescents had followed a weight loss diet without medical supervision. The dieters had higher BD and OT values. Moderate to severe food restriction, based on expert judgment, was observed in 29.6%, and differences in the presence and severity of purging behaviors were found between the 2 groups. CONCLUSIONS: One third of the adolescents studied followed diets without professional supervision and had higher BD and OT values, as well as risky weight control behaviors. Overweight and obese adolescents followed more restrictive diets and developed riskier weight control behaviors.

[Stigma and discrimination: the experiences of HIV-positive women in poor neighborhoods of Maputo, Mozambique]. / Estigma e discriminação: experiências de mulheres HIV positivo nos bairros populares de Maputo, Moçambique.

The HIV/AIDS epidemic is a serious public health problem in Mozambique. The country has high prevalence rates, and the epidemic's impact is aggravated by the stigma affecting HIV-positive persons. This study takes a socio-anthropological perspective to analyze the experience of HIV-positive women in poor neighborhoods of Maputo and the ways they cope with stigma and discrimination. Semi-structured interviews were conducted with 10 HIV-positive women. The results show how gender inequalities increase women's vulnerability to HIV and contribute to their stigmatization and discrimination. In dealing with stigma, women try to keep their diagnosis confidential, seeking support in group meetings with others living with HIV. Public policies should focus on women's empowerment and the reduction of HIV/AIDS-related stigma.

Conductas de control de peso en mujeres adolescentes dietantes y su relación con insatisfacción corporal y obsesión por la delgadez / Weight control behaviors in dieting adolescent girls and their relation to body dissatisfaction and obsession with thinness

Introducción: La obsesión por la delgadez y la insatisfacción corporal pueden llevar a las adolescentes a seguir dietas sin supervisión, lo que podría asociarse además a conductas riesgosas de control de peso, tales como ayuno, vómitos, uso de diuréticos y laxantes. El objetivo fue explorar conductas de control de peso en adolescentes dietantes y relacionarlas con insatisfacción corporal (IC) y obsesión por la delgadez (DT). Pacientes y Método: Estudio transversal en 439 adolescentes de colegios públicos de Valparaíso diseñado para indagar conductas de control de peso riesgosas a través de escalas de IC y DT del Cuestionario de Trastornos Alimentarios (EDI-2), comparando dietantes y no dietantes. Resultados: El 43% había realizado dieta sin supervisión médica. Las dietantes presentan valores superiores en DT e IC. El 29,6% de ellas presenta restricción alimentaria de riesgo moderado a alto, tomando como base el criterio de expertos, y se encuentran diferencias en la presencia y severidad de las conductas purgativas de control de peso entre los dos grupos estudiados. Conclusiones: Un tercio de las adolescentes estudiadas hacen dietas sin supervisión profesional, presentan mayor IC y DT y conductas riesgosas de control de peso. Aquellas con sobrepeso y obesidad realizan dietas más restrictivas y conductas de control de peso más riesgosas.

Introduction: Obsession with thinness and body dissatisfaction can lead adolescents to follow unsupervised diets, which could result in risky weight control behaviors such as fasting, vomiting, use of diuretics and laxatives. The aim of the current study is to examine weight control behaviors in dieting adolescents and relate them to body dissatisfaction (BD) and obsession with thinness (OT). Methods: A cross-sectional study was conducted on 439 adolescents from Valparaiso public schools to investigate risky weight control behaviors due to BD and OT scales from the Eating Disorders Inventory-2 (EDI-2), comparing restrained eaters and non-restrained eaters. Results: A total of 43% adolescents had followed a weight loss diet without medical supervision. The dieters had higher BD and OT values. Moderate to severe food restriction, based on expert judgment, was observed in 29.6%, and differences in the presence and severity of purging behaviors were found between the 2 groups. Conclusions: One third of the adolescents studied followed diets without professional supervision and had higher BD and OT values, as well as risky weight control behaviors. Overweight and obese adolescents followed more restrictive diets and developed riskier weight control behaviors.

Body image dissatisfaction and anthropometric indicators in male children and adolescents.

BACKGROUND/OBJECTIVES: The aim of this study was to investigate the association between body image dissatisfaction and body mass index (BMI) and body fat percentage (BF%) and to identify which of these anthropometric indicators are more strongly associated, and finally to estimate the prevalence of overweight and high body adiposity in male children and adolescents, according to maturational stages. SUBJECTS/METHODS: Overall, 1499 students aged from 7 to 17 years from Cascavel, PR, Brazil, were evaluated. Body image was self-rated through the body silhouette scale. Body weight, height and triceps and subscapular skinfolds were measured and BMI and BF% were calculated. Sexual maturity was self-assessed by the development of pubic hair. Data analysis used the Fisher exact test, the χ(2)-test and multinomial logistic regression. RESULTS: Body image dissatisfaction because of excess weight was associated with BMI and BF%, whereas in prepubertal students, this association did not remain in the adjusted analysis. In pubescent students, both BMI (odds ratio (OR)=5.25, confidence interval (CI) 95%=3.06-9.01) and BF% (OR=2.42, CI 95%=1.60-3.66), and in post-pubescent students for BMI (OR=3.77, CI 95%=1.33-10.70), the association remained. Body image dissatisfaction because of thinness was associated only with BF% in pubescent (OR=0.50, CI 95%= 0.33-0.75) and post-pubescent students (OR=0.38, CI 95%= 0.16-0.94). CONCLUSIONS: Body image dissatisfaction was associated with BMI and BF%, especially in pubescent and post-pubescent students.

Neurobehavioral functioning in adolescents with and without obesity and obstructive sleep apnea.

STUDY OBJECTIVES: Children and adults with obstructive sleep apnea syndrome (OSAS) exhibit neurobehavioral abnormalities, but few studies have evaluated the transitional stage of adolescence. Obesity is also associated with neurobehavioral abnormalities, and many patients with OSAS are obese. However, the confounding effect of obesity on neurobehavioral abnormalities in adolescents with OSAS has not been evaluated. We hypothesized that obese adolescents with OSAS would exhibit more neurobehavioral abnormalities than obese and lean adolescents without OSAS. DESIGN: Cross-sectional, case control. SETTING: Sleep Center and community. PARTICIPANTS: Obese adolescents with OSAS compared to (1) nonsnoring, obese controls without OSAS, and (2) nonobese, nonsnoring controls. INTERVENTIONS: Neurobehavioral evaluation. MEASUREMENTS AND RESULTS: Obese adolescents with OSAS had significantly worse executive function and attention compared to both obese (P < 0.001) and lean (P < 0.001) controls, and more depression (P = 0.004) and externalizing symptoms than lean controls (P = 0.008). A higher percentage of participants in the OSAS group scored in the clinically abnormal range on executive functioning, attention, sleepiness, and behavioral functioning than lean controls. Mediation analyses indicated that level of sleep apnea significantly mediated the effect of body mass on executive functioning, attention, and behavior. CONCLUSIONS: Obese adolescents with OSAS show impaired executive and behavioral function compared to obese and lean controls, and are more likely to score in the clinically abnormal range on measures of neurobehavioral functioning. These results are especially concerning given that the frontal lobe is still developing during this critical age period. We speculate that untreated OSAS during adolescence may lead to significant neurobehavioral deficits in adulthood.

Body size dissatisfaction among young adults from the 1982 Pelotas birth cohort.

BACKGROUND/OBJECTIVES: To identify the prevalence and factors associated with body dissatisfaction. SUBJECTS/METHODS: Birth cohort study investigating 4100 subjects (2187 men and 1913 women) aged between 22 and 23 years who answered questionnaires, including the body satisfaction Stunkard Scale were included in the study; they were weighed and measured. Multinomial logistic regression was used in the crude and adjusted analyses. RESULTS: The prevalence of body dissatisfaction was 64% (95% CI, 62.7-65.6); 42% (95% CI, 40.6-43.6) of the subjects reported feeling larger than the desired body size, and 22% (95% CI, 20.7-23.3) reported feeling smaller than desired. Underweight subjects, subjects with less schooling, poor and sedentary male subjects with low psychological well-being and female subjects who were already mothers were more likely to express body dissatisfaction, perceiving their body as smaller than the desirable body size. The prevalence of body dissatisfaction was also high among overweight subjects, subjects with a high socioeconomic status and married female subjects, who perceived their body size as too large. Minor psychiatric disorders were associated with body dissatisfaction in all subjects, regardless of perceiving themselves as larger or smaller than the desired body size. Most women perceived themselves as larger, but similar proportions of men perceived themselves as too small or too large. CONCLUSIONS: Body dissatisfaction was observed among men and women with normal weight, but it was more evident in the obese individuals. Regardless of the nutritional status, both men and women should be appropriately counseled because body size perception can lead to unhealthy behaviors in relation to diet and physical activity.