A cultural models approach to understanding body fatness perceptions and disordered eating in young South Korean men.

OBJECTIVE: The eating disorders field has been limited by a predominant focus on White, Western women, and there is growing recognition of the need to understand cross-cultural variation in key constructs (i.e., ideal body types). A transdisciplinary, cultural models approach systematizes the incorporation of an "emic" perspective (a culture's own understandings of phenomena) into assessments of relationships between body shapes and eating disorders. METHOD: Eighty-one young South Korean men aged 19-34 years living in Seoul participated in this research. A cultural model of body fatness was identified using cultural consensus analysis during 18 months of ethnographic, mixed-methods fieldwork. Participants also completed questionnaires assessing age, height, weight, sexual identity, university prestige, body dissatisfaction, eating disorder symptoms, and cultural consonance with the Korean cultural model of the ideal male body. Variation in these factors was analyzed using a series of chi-squares and analyses of variance with the culturally defined categories of body fatness as the independent variables. RESULTS: Cultural consensus analysis found that young South Korean men are consistent in identifying categories of "too thin," "balanced," and "too fat." The "balanced" category contained the lowest proportion of high-prestige university attendees and the highest average cultural consonance. The "too fat" category was characterized by the highest levels of body dissatisfaction and dieting, as well as proportion of probable eating disorders. DISCUSSION: A cultural models approach identified culturally important factors and patterns in disordered eating among young South Korean men and may be effective for understanding eating disorders in other populations not typically studied. PUBLIC SIGNIFICANCE: This study applies a systematic, "emic" perspective to young South Korean men's body ideals. Young Korean men share a cultural model of body fatness, and this model frames how they experience risk for eating disorders. This study demonstrates a method for incorporating culture into research on eating disorder risk.

Using Social Influence Strategies to Improve Rates of Online Mental Health Survey Participation: Results from Two Experiments.

Online surveys are routinely used in mental health screening and treatment follow-up assessment, though they can yield low response rates. We tested the effects of social psychology-informed influence strategies for increasing rates of participation in an online mental health screening survey (Experiment 1) and a treatment follow-up survey (Experiment 2). In Experiment 1 (N = 45,569), embedding one or any combination of three motivational appeals (personal gain, community gain, and inclusivity) in screening survey invitation and reminder emails unexpectedly led to lower rates of survey participation compared to when the appeals were not included (overall participation rate = 12.02%, ORs = 0.75 to 0.97, ps < .001). In Experiment 2 (N = 873), a video of a TikTok influencer encouraging survey participation embedded in treatment follow-up survey invitation and reminder emails did not significantly affect survey completion compared to a humorous gif unrelated to survey participation (overall participation rate = 47.88%, OR = 1.18, p = .200). Moderator analyses revealed that the video led to higher rates of participation than the gif among White participants (OR = 1.39, p = .031) and non-Hispanic participants (OR = 1.35, p = .029) only, whereas the video led to lower rates of participation than the gif among students who did not disclose their race (OR = 0.31, p = .010). Results suggested that efforts to improve online survey participation should be balanced with possible downsides (e.g., added email length) and should be evaluated for differential performance among population subgroups prior to widespread implementation.

Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents.

OBJECTIVE: This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD: Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. RESULTS: Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). CONCLUSIONS: Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.

Cultural consonance, body image, and disordered eating among young South Korean men.

Eating disorders are serious mental illnesses, but little research explores non-Western men's cultural experiences of body image and what affects their risks of disordered eating. Drawing on data collected over 17 months (August 2019 to January 2021) of fieldwork in Seoul, South Korea, the lens of intersectionality is employed alongside multiple regression and moderation analysis to understand how two axes of identity which emerged as important from the ethnography-sexual identity and university prestige-shape the ways in which young Korean men's cultural consonance with their local model of the ideal male body, influenced heavily by the kkonminam (flower boy), relates to risk for developing an eating disorder. Among young Korean men, intersections of university prestige and sexual identity frame embodiment of cultural models of male body image as a strategy for the making and maintenance of social relations and the advancement of social status in a precarious neoliberal economy.

Flower boys and muscled men: comparing South Korean and American male body ideals using cultural domain analysis.

Body image disturbance and eating disorders are rising all over the world. However, little is known about experiences of body image in men across cultural groups, and measurement tools often fail to account for the profound ways in which culture and gender can affect these data. An American cultural model of the ideal male body was compared with that of South Koreans using cultural domain analysis and residual agreement analysis. Cultural domain analysis gives researchers the ability to systematically study cultural models based on informants' emic understanding of phenomena; residual agreement analysis evaluates the patterns of agreement in disagreement with a larger cultural model. This study shows that Americans and South Koreans often overlap in their assessments of the desirability of male bodily features; however, they also strongly endorse many differing features, as well as similar features for different cultural reasons. For example, Americans endorse muscularity because it indexes physical prowess and health; South Koreans only sometimes endorse muscularity, mainly as an aesthetic choice. As a result, psychometric tools for measuring body dissatisfaction that are uncritically adopted for use in cross-cultural research may miss important information affecting the validity of findings and the efficacy of prevention campaigns and treatment plans.

Alternative hematological and vascular adaptive responses to high-altitude hypoxia in East African highlanders.

Elevation of hemoglobin concentration, a common adaptive response to high-altitude hypoxia, occurs among Oromo but is dampened among Amhara highlanders of East Africa. We hypothesized that Amhara highlanders offset their smaller hemoglobin response with a vascular response. We tested this by comparing Amhara and Oromo highlanders at 3,700 and 4,000 m to their lowland counterparts at 1,200 and 1,700 m. To evaluate vascular responses, we assessed urinary levels of nitrate (NO3-) as a readout of production of the vasodilator nitric oxide and its downstream signal transducer cyclic guanosine monophosphate (cGMP), along with diastolic blood pressure as an indicator of vasomotor tone. To evaluate hematological responses, we measured hemoglobin and percent oxygen saturation of hemoglobin. Amhara highlanders, but not Oromo, had higher NO3- and cGMP compared with their lowland counterparts. NO3- directly correlated with cGMP (Amhara R2 = 0.25, P < 0.0001; Oromo R2 = 0.30, P < 0.0001). Consistent with higher levels of NO3- and cGMP, diastolic blood pressure was lower in Amhara highlanders. Both highland samples had apparent left shift in oxyhemoglobin saturation characteristics and maintained total oxyhemoglobin content similar to their lowland counterparts. However, deoxyhemoglobin levels were significantly higher, much more so among Oromo than Amhara. In conclusion, the Amhara balance minimally elevated hemoglobin with vasodilatory response to environmental hypoxia, whereas Oromo rely mainly on elevated hemoglobin response. These results point to different combinations of adaptive responses in genetically similar East African highlanders.