A dyadic analysis of anti-fat attitudes and partners' diet-related influence among gay married men.

OBJECTIVES: The focus on physical appearance among gay men has potential implications for anti-fat attitudes, including those directed toward romantic partners. Partners often influence each other's behaviors including those linked to weight, but most research has examined the consequences of these influence strategies versus their antecedents. To address this research gap, we examined how men's own and their partners' anti-fat attitudes were related to both health-promoting (control) and health-compromising (undermining) types of diet-related influence and whether these associations differed by weight status. METHODS AND RESULTS: Analyzing data from a cross-sectional online survey of 450 U.S. adult gay married men (225 couples), Actor-Partner Interdependence Models revealed that individuals' own anti-fat attitudes (all types) were positively associated with more frequent receipt of spousal control and undermining. Additionally, partner's fears about gaining weight were positively associated with more frequent receipt of spousal control and dislike of higher weight people and fear of gaining weight (among those of higher weight status) were positively associated with more frequent receipt of spousal undermining. CONCLUSION: Our findings add to the literature on diet-related interactions among gay married men, highlight the value of examining these processes dyadically, and suggest the importance of including both members of couples in health promotion and intervention efforts.

Additive and interactive associations among body appreciation, self-compassion, and gender in understanding college students' health behaviors.

Body appreciation and self-compassion are associated with each other and individually associated with important health behaviors. Less is known about their combined associations with health behaviors, although previous work has examined self-compassion as a moderator of negative body image experiences. Self-compassion may likewise amplify the positive association between body appreciation and engagement in healthy behaviors. In this study, we examined the additive and interactive associations of body appreciation and self-compassion with three health behaviors (physical activity, sleep, stress management activities) among 302 college students from a northeastern university in the United States. We further examined gender differences in key variables and in associations among body appreciation, self-compassion, and health behaviors. We found that body appreciation was independently associated with physical activity and stress management activities, with the association stronger for men than women. We also found that self-compassion was independently associated with sleep and stress management activities. Body appreciation and self-compassion did not interact in predicting any health behaviors. Findings from this study highlight the unique associations of body appreciation and self-compassion with different health behaviors and underscore the need to increase body appreciation and self-compassion among college students to promote overall health and well-being.

Understanding eating disorder symptoms in same-gender couples: social environmental factors.

BACKGROUND: Sexual minority individuals are at disproportionately greater risk for eating disorders, yet little is known about the ways in which factors in the social environment relate to eating disorder symptoms in this population. Utilizing an ecological systems theory framework, we investigated the relative relationships of macro level (i.e., internalization of sociocultural attitudes about appearance) and micro level (i.e., quality of romantic relationship) social environment influences. METHODS: Men (n = 144) and women (n = 144) in committed same-gender relationships were recruited as a dyad and completed study questionnaires, including multiple measures of eating disorder symptoms. Multilevel models controlling for key variables (e.g., body mass index) were used to examine gender differences, main effects, and interactions. RESULTS: Men reported greater internalization of sociocultural attitudes and uncontrolled eating. Greater internalization of sociocultural attitudes was related to greater eating pathology across all measures. For men, greater relationship quality was related to less uncontrolled eating. CONCLUSIONS: Individuals in same-gender relationships experience macro (e.g., sociocultural) level vulnerability factors in relation to disordered eating; however, internalization of sociocultural attitudes may be greater for men. Support at the microsystem level in the form of a high quality committed romantic relationship appears to be helpful protection against uncontrolled eating for men.

Sexual minority individuals are at disproportionately greater risk for eating disorders, yet little is known about the ways in which factors in the social environment relate to eating disorder symptoms in this population. This research investigates sociocultural attitudes and romantic relationship quality as factors in the social environment in relation to eating disorder symptoms for men and women in same-gender relationships. We found differences in the occurrence of eating disorder symptoms, such that sexual minority men had more uncontrolled eating compared to sexual minority women. Across all participants, internalization of sociocultural attitudes was linked to greater disordered eating symptoms. We also investigated a potential buffering role of a romantic partner on eating disorder symptoms, and found that high quality, committed, romantic relationships were beneficially associated with less uncontrolled eating for sexual minority men.

A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates.

INTRODUCTION: Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD: Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS: Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION: Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Examining health experiences and body dissatisfaction in two unique samples of patients with type 2 diabetes.

Using cross-sectional data from two samples of adult patients with type 2 diabetes (n = 123 and n = 111), we used an embodiment perspective to examine whether health experiences were related to the extent of individuals' dissatisfaction with their bodies. The nature and strength of associations differed across the two unique samples examined, but weight status had the strongest and most robust association with body dissatisfaction in both samples. None of the associations differed as a function of gender or age. These findings contribute to an understanding of the complex relationship between physical and mental health in the context of diabetes.

Perceptions of Weight Change Among Romantic Partners: Considering Body Image, Relationship Experiences, Gender, and Sexual Orientation.

Romantic relationship experiences have been found to be relevant to body image and weight in adulthood. In this study, we investigated predictors of heterosexual, lesbian, and gay romantic partners' (N = 500, M age = 29.3) perceptions of their own and their partners' weight at the beginning of their relationship and 4.8 years later, on average. Perceived changes in participants' own weight status was associated with greater body dissastisfaction and longer relationship length. Perceived changes in partners' weight status was associated with their partners' BMI, as well as relationship quality. We also found that gender was important in understanding some of these associations. Implications of weight perceptions for individuals' and their partners' health and well-being and the critical role of relationship quality are discussed in the context of the health regulation model.

An examination of preadolescent girls' social media use and body image: Type of engagement may matter most.

Research continues to accumulate suggesting that social media use presents a risk to youths' body image, yet the majority of this research has examined late adolescents and emerging adults. This study examined 151 preadolescent girls' (M age = 12.06, SD = 1.22) social media use and associations with both positive and negative body image at two time points separated by approximately five months. Girls completed an online survey that included several body image measures and items that queried girls about the social media platforms they used and the activities they engaged in on these platforms. Findings suggest that girls who use social media do not differ significantly from girls who do not use social media in terms of their body image. However, among girls who use social media, their type of engagement (appearance-focused versus communication-focused use) is important; only girls who engage in appearance-focused social media use seem to experience negative body image concerns.

Testing of a model for risk factors for eating disorders and higher weight among emerging adults: Baseline evaluation.

Although a range of risk factors have been identified for disordered eating and weight status, the breadth of risk factors have been rarely considered within a single, comprehensive model. The robustness of these findings across countries also remains an open question. The present study sampled 6272 participants aged 18-30 years from eight countries in an attempt to evaluate combined and unique predictors for these two conditions, and to explore possible cross-country differences in these models. Participants completed a range of demographic, biological, behavioral, psychological, and sociocultural measures to test a comprehensive model of the contributions of these predictors for disordered eating and weight-related constructs (binge eating, body mass index, compensatory behaviors, dietary restraint, drive for muscularity, and drive for leanness). Structural invariance testing within a multigroup path analysis framework revealed that a single model across the eight countries provided poor model fit. Freeing of 22% of parameters across countries provided excellent fit and a satisfactory compromise for country-invariant and country-variant parameters in the model. Overall, predictors accounted for between 15% and 60% of variance in the outcome measures, with lowest explained variance for the disordered eating outcomes. Significant unique contributions to prediction were observed for each of the five risk factor variable types and across the eight countries. Thus, the findings show strong support for this model as an explanatory framework of both disordered eating and weight status.

The importance of sleep and parity in understanding changes in weight and breastfeeding behavior among postpartum women.

BACKGROUND: Breastfeeding duration has been linked with the health of both women and their children, but research that considers women's weight change postpartum and practical factors that may impact their quality of life (i.e., sleep quantity, number of children) is limited. METHOD: A survey was administered to 568 women (M age = 31.32 years; SD = 4.21) who had given birth within the past year. The survey included assessments of pre- and post-pregnancy weight and height, breastfeeding practices, current sleep quantity, presence of breastfeeding-specific support, and other demographics including their total number of children. RESULTS: Greater pre-pregnancy to postpartum weight increase was related to shorter duration of breastfeeding. Mothers who exclusively breastfed for the first six months had less postpartum weight increase (i.e., the discrepancy between their pre-pregnancy and post-pregnancy weight was smaller) than those who did not. Fewer children and greater hours of sleep were significantly associated with longer duration of breastfeeding. Sleep partially accounted for the relationship between body mass index change and breastfeeding duration. Breastfeeding-specific support did not impact the effect of low sleep on shorter breastfeeding duration. CONCLUSIONS: Duration of breastfeeding may suffer due to fatigue. Sleep plays a key role in understanding the ways in which weight change impact breastfeeding behavior. Greater holistic support for mothers in the postpartum period is needed to foster an environment that encourages breastfeeding.

Breastfeeding, body image, and weight control behavior among postpartum women.

The goal of this study was to examine breastfeeding behavior and attitudes as predictors of women's body image and weight control behavior. This study extends past research by focusing on positive body image variables including body appreciation and perceived body functionality. Women (N = 597) from the United States who had recently birthed biological babies ages 0-12 months participated in an online study. Current breastfeeding rates were high (86 %), and average breastfeeding duration was approximately 3 months. Women who were currently breastfeeding indicated more positive body images and less likelihood of engaging in maladaptive weight control behaviors than women who were no longer breastfeeding or had never breastfed their baby. Women's positive attitudes toward breastfeeding were associated with awareness and appreciation of body functionality and fewer maladaptive weight control behaviors. These findings extend research on the health benefits of positive body image and suggest that breastfeeding may occur within a constellation of beliefs and behaviors indicative of positive body image.

Main and interactive effects of diabetes distress and stress from life events on overall psychological distress.

This study sought to extend previous research by examining rates of three different types of diabetes distress and whether stress from life events amplified the association between diabetes distress and overall psychological distress in a community-based sample of 119 middle-aged and older adults with type 2 diabetes. Consistent with past research, individuals experienced a moderate level of diabetes distress. However, only some types of diabetes distress were associated with depressive symptoms, independent of stressful life events, whereas all types of diabetes distress were only related to anxious symptoms when stress from life events was also high.

Body image, weight management behavior, and women's interest in cosmetic surgery.

In the current study, we examined body image and weight management behavior as potential factors associated with young women's interest in obtaining cosmetic surgery. Research focusing on objectification theory, problem behavior syndrome, and positive body image provide support for considering these factors as predictors of interest in cosmetic surgery. Female undergraduates (N = 170; M = 20.27 years old) at a college in the northeastern United States completed assessments of interest in cosmetic surgery, body image, and weight management behavior. Regression analyses indicated that women who had higher BMIs, higher body surveillance, higher body shame, and who engaged in more unhealthy weight management behaviors were more interested in obtaining cosmetic surgery. Body appreciation was significantly negatively correlated with interest in cosmetic surgery but did not significantly predict it when other factors were considered in a regression model. Results suggest that self-objectification and engaging in a constellation of appearance-related risk behaviors may place women at risk for pursuing cosmetic surgery.

Cross-Country Measurement Invariance and Effects of Sociodemographic Factors on Body Weight and Shape Concern-Related Constructs in Eight Countries.

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; Mage = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image.

Predictors of disordered weight loss behaviors among same-sex and opposite-sex romantic partners.

Although the majority of adults will attempt to lose weight at some point in their lives, most weight loss behaviors are ineffective and potentially harmful. Further, weight loss behaviors often closely resemble disordered eating, and include behaviors such as fasting and purging. The current study examined potential predictors of disordered approaches to weight loss in the context of same-sex and opposite-sex romantic partnerships by investigating participants' (n = 500, Mage = 29.62 years) BMI, body image, self-esteem, relationship quality and disordered weight loss behaviors. We conducted analyses using Actor Partner Interdependence Models, which revealed that the greatest predictors of participating in disordered weight loss behavior were body dissatisfaction and having a male partner. These findings suggest that it is not sexuality, per se, that places individuals at risk for disordered weight loss behavior, but perhaps the value placed on thinness as defined by particular gender and cultural groups.

Assessing positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults: A cross-validation study across eight countries.

Positive body image refers to individuals' ability to conceptualize their bodies with love, respect, and appreciation. The study of positive body image is relatively new, and instruments used to investigate this multi-faceted construct have received limited use in non-English speaking countries. Thus, the aim of this investigation is to consider four measures that are associated with positive body image across eight different countries. Participants (n = 6272) completed the Body Appreciation Scale-2, the Body Areas Satisfaction Scale, the Physical Appearance Comparison Scale, and the Weight Bias Internalization Scale. Multi-group confirmatory factor analyses (MG-CFAs) and item-response theory (IRT) models were used to examine the measurement invariance of these surveys. Our results generally suggest that positive body image, weight bias, and appearance comparison can be assessed using brief assessments and that these four instruments can be used in different countries, but care should be taken to consider individuals' gender, BMI, and socio-economic position.

Feeling let down: An investigation of breastfeeding expectations, appreciation of body functionality, self-compassion, and depression symptoms.

BACKGROUND: Public health efforts to promote breastfeeding have resulted in many women expecting to exclusively breastfeed their infants. Women who plan to exclusively breastfeed but are not able to do so may experience psychological distress, including poor body image and symptoms of depression. AIM: We sought to investigate discrepancies between desired and actual breastfeeding behaviors, appreciation of the functionality of one's body, and self-compassion, in relation to symptoms of depression. METHODS: A convenience sample of women (N = 536) who had recently given birth and expected to feed their infants exclusively with breastmilk provided information on an online survey. RESULTS: There was an indirect effect of feeding discrepancies on depressive symptoms via lower appreciation of body functionality; women who expected to exclusively feed their infant breastmilk but were not able to do so had lower appreciation of body functionality. The effect of appreciation of body functionality was moderated by self-compassion such that those with the lowest self-compassion had the lowest appreciation of body functionality and the highest depressive symptoms; there was no difference in depressive symptoms for those with the highest levels of self-compassion. CONCLUSIONS: Implications of this work include the potential for interventions to bolster body image and self-compassion, which may reduce the likelihood of depressive symptoms in this population. Recommendations are provided regarding balancing the importance of increasing breastfeeding rates while also normalizing the challenges of breastfeeding and promoting body positivity and self-compassion.

Assessment of Personality and Psychopathology in Healthcare Settings: Introduction to the Special Section.

Healthcare in the United States has increasingly benefited from the adoption of multidisciplinary providers. Many multidisciplinary teams include psychologists who often conduct psychological and personality assessments in their practice. This special section highlights areas of personality and psychological assessment in applied healthcare contexts. Nghiem and colleagues review the psychometric performance of various personality and psychopathology instruments and provide recommendations for the assessment of solid organ transplant evaluations. Gottschling and colleagues present a culturally adapted screener for anxiety-related symptoms in geriatric adults that can easily be administered in various healthcare settings. Perry and colleagues provide a rationale and method for including a brief personality assessment for patients with cancer. McCord presents a broadband screener, the Multidimensional Behavioral Health Screen (MBHS), that assesses 9 components of psychopathology. Mitchell and colleagues provide evidence for using the MBHS in primary care clinics as an alternative to the Patient Health Questionnaire-9. This special section provides evidence-based information regarding personality and psychological assessments that will likely be useful in varied healthcare contexts.

Body image experiences in the context of chronic pain: An examination of associations among perceptions of pain, body dissatisfaction, and positive body image.

Although body image research has recently begun to examine positive body image and ways to improve body image, it remains unclear the extent to which these findings generalize to individuals who experience chronic pain. With this in mind, this study examined individuals with chronic pain conditions (N = 278, Mage = 36.75, SD = 11.56), including their reports of their ability to control, manage, and accept their pain. Participants also completed assessments of four facets of body image: perceptions of body functionality, body appreciation, appearance evaluation, and body satisfaction. Results indicated that pain acceptance was the most consistent, unique predictor of these body image constructs, after controlling for the other pain facets, as well as body mass index, gender, and age. These findings have implications for improving body image among people with chronic pain; it appears that controlling or altering pain may be less relevant to body image than is how individuals cope with pain.

Understanding body image among adults in mid-late life: Considering romantic partners and depressive symptoms in the context of diabetes.

Although our bodies change as we age, there is limited research exploring body image among middle-aged and older adults. This study considered 70 adults with diabetes' (Mage = 60.01 years) body image and revealed relatively high levels of body dissatisfaction in this sample. Furthermore, participants' own and perceptions of their partners' dissatisfaction with their bodies were moderately associated, and participants' body dissatisfaction was associated with higher levels of depressive symptoms. These findings highlight the need for further research, exploring the social and psychological correlates of body image among men and women in mid-late adulthood.

A review of research linking body image and sexual well-being.

The link between body image and sexual well-being is intuitive and increasingly supported by psychological research: individuals, particularly women, with greater body satisfaction and body appreciation tend to report more positive sexual experiences. Although both perceptions of one's body and one's sexual life are central to most adults' experiences, this area of research has remained somewhat understudied. In this review, we discuss the findings that are available and suggest directions for future research and applied implications of this work. We highlight Thomas Cash's contributions to this area of study, given his significant contributions to moving our understanding of body image and sexual well-being forward.