Body Dissatisfaction, Distorted Body Image and Disordered Eating Behaviors in University Students: An Analysis from 2017-2022.

University students, as young adults, are at risk for Body Dissatisfaction (BD) and Distorted Body Image (DBI), which are related to Disordered Eating Behaviors (DEBs). This study aimed to assess changes in the prevalence of these three conditions over six years; and the associations between them. Data was collected through an annual online survey from 2017 to 2022 at a private university in Mexico City. Students between 18-30 years old were invited to participate. Body image-related variables were assessed by the Stunkard's Silhouettes and Body Mass Index, by self-reported height and weight. Disordered Eating Behaviors were measured by the Brief Disordered Eating Behaviors Questionnaire. A median of 250 students participated per year, with a median age of 21 years old. The prevalence was 63.5-71.7% for BD, 40.4-49.1% for DBI, and 25-38.3% for DEBs. DEBs and BD showed associations during the whole period (OR from 3.6 to 15.9, p ≤ 0.001); as well as DBI with DEBs (OR from 1.9 to 3.3, p < 0.05). Alterations in Body Image and eating behaviors are common conditions, mainly in women and in the young population. Therefore, it is important to promote screening for these conditions, as they usually remain undiagnosed, their prevalence is increasing worldwide, and their impact on physical and mental health has already been acknowledged.

Programa de prevención universal para factores de riesgo de trastornos alimentarios en adolescentes mexicanas: un estudio piloto / Universal prevention program for eating disorders risk factors in Mexican adolescents

El objetivo general de este estudio fue describir el efecto de un programa interactivo de prevención universal sobre las conductas alimentarias deriesgo (CAR), la insatisfacción corporal (IC), la influencia del modelo estético de delgadez (IMED), conocimientos de nutrición, ansiedad y depresiónen adolescentes entre 12 y 15 años de edad. Se trabajó con una muestra de 98 adolescentes mexicanas, quienes contestaron, antes y después dela intervención, el Test de Actitudes Alimentarias-26, el Cuestionario de Imagen Corporal-8D, el Cuestionario de Influencias sobre el Modelo EstéticoCorporal-26, la Escala de Ansiedad y Depresión Hospitalaria y el Cuestionario de Nutrición. En el grupo experimental se encontraron diferenciasestadísticamente significativas entre el pretest y el postest (U de Mann Whitney, p < ,05), con menores puntuaciones totales en las CAR, la IMED,IC y ansiedad, y un aumento en los conocimientos de nutrición en la fase postest, con un tamaño del efecto de pequeño a grande (r = ,18 - ,58). Lasparticipantes presentaron un cambio clínico objetivo positivo en las CAR (54%), IMED (59%), conocimientos de nutrición (54%) y ansiedad (50%),y poco más de la tercera parte presentaron una disminución depresión (31%) e IC (37%). Se concluye que el programa de intervención basado enalfabetización de los medios generó efectos positivos en adolescentes respecto a la prevención de las CAR, IC, IMED, ansiedad, depresión y aumentóde los conocimientos en nutrición. (AU)

The purpose of this research was to describe the effect of aninteractive universal prevention program on risky eating behaviors (REB), body dissatisfaction (BD), the influence of the aesthetic model of thinness(ITAM), nutritional knowledge, anxiety, and depression in adolescents between 12 and 15 years old. We worked with a sample of 98 Mexican adolescents, who answered, before and after the intervention, the Eating Attitudes Test-26, the Body Image Questionnaire-8D, Questionnaire of Influenceson the Body Aesthetic Model-26, the Hospital Anxiety and Depression Scale, and the Nutrition Questionnaire. In the experimental group, statisticallysignificant differences were found between the pretest and the posttest (Mann Whitney U, p <.05) with lower total scores in the REB, ITAM, BDand anxiety, and an increase in nutrition knowledge in the post-test phase, with a small to large effect size (r = ,18 - ,58). Most of the participantspresented a positive objective clinical change in CAR (54%), IMED (59%), nutrition knowledge (54%) and anxiety (50%), just over a third presenteda decrease in depression (31%), and BD (37 %). It is concluded that the intervention program, based on media literacy, generated positive effectsin adolescents regarding the prevention of REB, BD, ITAM, anxiety, depression, and increased knowledge of nutrition. (AU)

Ideales estéticos, imagen corporal, actitudes y conductas alimentarias en hombres con diferente orientación sexual / Aesthetic ideals, body image, eating attitudes and behaviors in men with different sexual orientation

Resumen Aun cuando existe amplia información disponible sobre imagen corporal y trastornos alimentarios, se sabe poco sobre estos tópicos en minorías sexuales, y especialmente en Latinoamérica. Por tanto, el propósito de este estudio fue comparar la satisfacción corporal, la interiorización de ideales estéticos (delgadez y musculatura), así como las actitudes y las conductas alimentarias entre varones con diferente orientación sexual. Participaron 217 varones (94 heterosexuales, 30 bisexuales y 93 gais), de 14 a 41 años de edad (M = 22.0, DE = 4.59). Los hombres bisexuales y gais reportaron mayor malestar con la imagen corporal, interiorización del ideal de delgadez y motivación por adelgazar, en comparación con los varones heterosexuales. Los bisexuales informaron mayor preocupación por la comida que los heterosexuales y los gais, pero estos últimos presentaron mayor restricción alimentaria. Los resultados apoyan la hipótesis de que en la insatisfacción corporal de los hombres de minorías sexuales predomina el deseo de adelgazar, resultado de una mayor interiorización del ideal corporal de delgadez. Por el contrario, los resultados relativos a la muscularidad no registraron una tendencia clara en función de la orientación sexual, de lo que destaca la necesidad de profundizar en su análisis, priorizando el empleo de instrumentos de evaluación más específicos sobre la motivación de incrementar musculatura.

Abstract Although there is a lot of information available about body image and eating disorders, little is known about the issue in sexual minority groups, especially in our culture and context. Therefore, the purpose of this study was to compare the body satisfaction, the internalization of aesthetic ideals (thin and muscular), the attitudes and eating behaviors in a sample of Mexican men with different sexual orientation. A total of 217 men (94 heterosexuals, 30 bisexuals and 93 gays), with an age range from 14 to 41 (M = 22.0, SD = 4.59) participated in the study. Bisexual men and gay men, compared to heterosexual men, reported greater body image discomfort, influence of thin shape and more motivation to lose weight. Bisexual men reported more concern about food than heterosexual men and gay men, but gay men had greater food restriction. These results support the hypothesis that body dissatisfaction in men of sexual minority groups is not oriented towards the development of the musculature, since they have internalized a thinner ideal body. On the contrary, the results related to muscularity did not register a clear tendency based on sexual orientation, which highlights the need to deepen its analysis, prioritizing the use of more specific evaluation instruments on the motivation to increase muscle.

Body Image Self-Perception and Risky Eating Behaviors in Medicine Undergraduate Students in Xalapa, Veracruz, Mexico (2014) / Autopercepción de la imagen corporal y conductas alimentarias de riesgo en estudiantes universitarios de medicina en Xalapa, Veracruz, México (2014) / Autopercepção da imagem corporal e condutas alimentares de risco em estudantes universitários de medicina em Xalapa, Veracruz, México (2014)

Abstract Introduction: The current beauty standard is associated with thinness, a situation that alters the body perception and can lead to the development of an eating disorder. Objective: To determine the relationship between the indexes of body image dissatisfaction and body image distortion and risky eating behaviors (REB) in a university population of medicine students in Veracruz, Mexico. Materials and Methods: Cross-sectional analytical study, with a sample of 187 students. A register was drawn up that included the SFS-test to evaluate the body image and to estimate the indices of dissatisfaction and distortion of the body image, the Brief Questionnaire of Risky Eating Behaviors validated in Mexican population, as well as social variables. A descriptive analysis was carried out with basic measures of frequency and dispersion, bivariate and multimodal analyses were performed too. Results: 43 % were female, and the average age was 21 (± 1.7) similar in both sexes. The prevalence of high risk of REB was 8.6 %, higher in men (9.4 % versus 7.4 %) and medium risk (23.5 %) with the distribution reversed by sex (28.4 % in women and 19.8 % in men). The dissatisfaction index was 59.4 % covering those who perceived having a higher weight than they would like to have. Concerning the distortion of the own body image it was observed that 41.2 % supposed to haveing a higher weight than what resulted from the anthropometric evaluation. Discussion: Dissatisfaction rates showed a positive correlation gradient with REBs, being this more evident in men.

Resumen Introducción: el estándar de belleza actual se asocia con la delgadez, situación que puede alterar la percepción corporal y consecuentemente conducir al desarrollo de algún trastorno alimentario. Objetivo: determinar la relación de los índices de insatisfacción y distorsión de la imagen corporal y las conductas alimentarias de riesgo (CAR), en una población universitaria de estudiantes de medicina en Veracruz, México. Materiales y métodos: estudio transversal analítico en una población de 187 estudiantes. Se elaboró una cédula que incluyó el SFS-test para evaluar la imagen corporal y estimar los índices de insatisfacción y distorsión de la imagen corporal; el Cuestionario Breve de Conductas Alimentarias de Riesgo validado en población mexicana, así como variables sociales. Se realizó análisis descriptivo con medidas básicas de frecuencia y dispersión, bivariado y multimodal. Resultados: el 43 % eran mujeres y la edad promedio 21 años (±1.7) similar en ambos sexos. La prevalencia de alto riesgo de CAR fue de 8.6 %>, superior en los hombres (9.4 % frente a 7.4 %>) y del mediano riesgo 23.5 % con la distribución invertida por sexo (28.4 % en las mujeres y 19.8 % en los hombres). El índice de insatisfacción fue del 59.4 %, quienes percibieron tener mayor peso del que les gustaría tener y en la distorsión de la imagen corporal se observó que un 41.2 % suponía tener mayor peso que el arrojado por la evaluación antropométrica. Conclusión: los índices de insatisfacción mostraron gradiente de correlación positivo con las CAR, siendo más evidente en los hombres.

Resumo Introdução: o standard de beleza atual associa-se com a magreza, situação que pode alterar a percepção corporal e consequentemente conduzir ao desenvolvimento de algum transtorno alimentar. Objetivo: determinar a relação dos índices de insatisfação e distorção da imagem corporal e as Condutas Alimentares de Risco (CAR), em uma população universitária de estudantes de medicina em Veracruz, México. Materiais e métodos: estudo transversal analítico, em uma população de 187 estudantes. Elaborou-se uma cédula que incluiu o teste SFS para avaliar a imagem corporal e estimar os índices de insatisfação e distorção da imagem corporal; o Questionário Breve de Condutas Alimentares de Risco validado em população mexicana, assim como variáveis sociais. Se realizou a análise descritiva com medidas básicas de frequência e dispersão, bivariado e multimodal. Resultados: o 43 % foram mulheres e a idade média 21 anos (±1.7) similar em ambos os sexos. A prevalência de alto risco de CAR foi de 8.6 %, superior nos homens (9.4 %> versus 7.4 %>) e do mediano risco 23.5 %> com a distribuição invertida por sexo (28.4 % nas mulheres e 19.8 % nos homens). O índice de insatisfação foi de 59.4 %, quem percebera ter maior peso do que gostaria ter, e a distorção da imagem corporal observara-se que um 41.2 %>, quem supunha ter maior peso que o obtido pela avaliação antropométrica. Conclusão: os índices de insatisfação mostraram gradiente de correlação positivo com as CAR, sendo mais evidente nos homens.

Prevalencia y factores asociados a conductas de riesgo alimentario en población indígena de Colombia / Prevalence of risky eating behaviors and associated factors in indigenous population in Colombia

Resumen La información sobre conductas alimentarias de riesgo (CAR) entre indígenas latinoamericanos es escasa. El objetivo de este estudio fue estimar la prevalencia de CAR en población indígena de Colombia, así como identificar factibles factores de riesgo sociodemo-gráficos e individuales. De la Encuesta Nacional de Salud Mental se retomaron los registros de 493 indígenas adultos (Medad =29.5 años, DE =7.39), hombres y mujeres. Las CAR evaluadas fueron: dieta restrictiva, malestar al comer, atracón y vómito autoinducido. El 19.5% de los participantes reportaron presentar al menos una CAR, y aquellas con mayor prevalencia fueron la dieta (8.5-9.6%) y el atracón (6.1%). Ninguno de los factores sociodemográficos evaluados se asoció a la presencia de CAR; por el contrario, de entre los factores individuales, la presencia de trastorno afectivo mostró ser un factible factor de riesgo de estas conductas. Las CAR no son infrecuentes en la población indígena adulta colombiana, e incluso su prevalencia puede duplicar la documentada en población general. Este estudio pretende aportar al escaso conocimiento existente sobre el tópico en poblaciones indígenas. Hallazgos que, ya sea a mediano o largo plazo, deberán incidir en el planteamiento de políticas de salud públicas acordes a las minorías indígenas presentes en Latinoamérica.

Abstract Data on risky eating behaviors (REB) in Latin American ethnic groups is scarce. The aim of this study was to determine the prevalence of REB in adult indigenous from Colombia, as well as to identify feasible sociodemographic and individual risk factors. A total of 493 records of adult indigenous men and women (Mage = 29.5 years, SD = 7.39) were retrieved from the National Survey of Mental Health. The REB assessed were: restrictive dieting, eating discomfort, binge-eating and self-induced vomiting. Participants (19.5%) reported having at least one REB, being restrictive dieting (8.5-9.6%) and binge eating (6.1%) those with higher prevalence. None of the sociodemographic factors evaluated was associated with the presence of REB, on the contrary, among the individual factors, the presence of affective disorder showed to be a feasible risk factor for these behaviors. The REB are common in the indigenous population in Colombia, even its prevalence may double the one reported in general population. This study aims to contribute to the scarce existing knowledge about the topic in indigenous populations. Findings that, whether in the medium or long term, should influence the approach of public health policies according to the indigenous minorities in Latin America.

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.

Conductas alimentarias de riesgo e imagen corporal de acuerdo al índice de masa corporal en una muestra de mujeres adultas de la ciudad de México

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Abstract: Studies conducted in adolescent and young women have showed that body image perception and dissatisfaction are highly related with risk eating behaviors, particularly with compensatory behaviors. It has also been found that these women tend to overestimate their body size, showing more dissatisfaction. Many studies on eating disorders have been developed in adolescents, but, what happens with adult women? Adult women show periods of pregnancy, nursing, menstrual disorders and, a decrease in physical activity and, at the psychological level there is a lack of emotional stability and depression. These episodes in general, have influence in feeding and body image, that could lead to risky eating behaviors (restricted dieting, fasting, skipping meals among others) affecting directly the state of health, because latter they can develop into eating disorders. Undoubtedly, inadequate feeding can cause malnutrition and nutrimental deficiencies, provoking physiological alterations such as osteoporosis, anemia or hypokaliemia, and also, somatic complications during pregnancy, including abortions and low weight in the new born. Objective. To determine the relationship between body mass index (BMI), risky eating behaviours, body perception and body dissatisfaction in Mexican adult women from 25 to 45 years of age in Mexico City. Methods. A non probabilistic sample of 659 women from 25 to 45 years of age (X=38.27; SD=4.4) was used. To collect the sample, an area of the Questionnaire for Health and Feeding called scale of risk factors associated to eating disorders (EFRATA) and body image was used. This is a self-report questionnaire, validated for this population. Its main purpose is to measure risk eating behaviors and body image. Questions refer to risky eating behaviors (binge eating, compensatory behaviors, restricted dieting, preoccupation about weight and figure), with 4 answering options: 1) Never, 2) Sometimes, 3) Frequently, and 4) Always. Body Image was measured through two dimensions: (a) Body perception was measured through five specific items and (b) Body dissatisfaction was measured with a nine body figure scale, from thin to obese. The BMI was obtained from weight and height self-report (BMI=kg/m2). Self report measures of weight and height have been found reliable; as there is a high correlation with data taken directly, the difference between them is 1.14 kg/m2, which does not interfere significantly. The cut points recommended by the Expert Committee (OMS), are: low weight from 15 to 18.5; normal weight from 18.51 to 24.99; overweight from 25 to 29.99; obesity from 30 to 39.99 and morbid obesity higher than 40. Results. Body Mass Index distribution of the sample was: 1.1% low weight, 53.6% normal weight, 32.3% overweight, 12.4% obesity, and 0.6% of women were morbidly obese. Body perception distribution was: 0.9% very thin, 15.3% thin, 44.4% normal, 32.6% overweight and 6.8% obese. Results related to body dissatisfaction, showed that more than % of the sample was dissatisfied; 70.1% of the women were dissatisfied with their body image and wanted to be thinner and, 8.7% wanted to gain weight. It was found that a large percentage of women (79%) are dissatisfied with their body image. From this percentage 70.1 wanted to be thinner and, 8.7% wanted to gain weight. As to the relationship between BMI distribution and body dissatisfaction it was found that 14% of underweight and 54.2% normal weight women want to be even thinner. The findings of the study showed that women with higher BMI, displayed more risky eating behaviors. Women with overweight and obesity displayed the higher percentages in binge eating. A Pearson correlation was carried out to look for significant differences between BMI, risky eating behaviors and the two dimensions of body image (perception and dissatisfaction). Results indicated that BMI was significantly correlated with binge eating, body dissatisfaction and body image perception. Discussion. This study supported important information about the relation between BMI and risky eating behaviors in Mexican adult women. The most important result was to confirm the presence of disordered eating typical of eating disorders among adult women. Even though the data obtained do not demonstrate the diagnosis of an ED, it shows the presence of some of the characteristic symptoms, which means that these are commonles found among the general population. Although isolated symptoms are not a necessary indicator of the development of the disease, in a way they point out the individuals who are at risk of threatening their physical and mental health. On the other hand, one of the risks that adds to this particular population is the fact that all of them are mothers, as some research findings have confirmed the relationship between the mother's eating behaviors and the appearance of eating disorders in their children. The results obtained in this research show that the BMI of the sample tends to be in the overweight (32.3%) and obese ranges (13%). These results agree with those of the National Nutrition Survey of 1999, were 52.5% of the women were classified as overweight or obese (30.8% as overweight and 21.7% as obese). These scores are important not just because they favor chronic-degenerative diseases, but also because of the great association between overweight and obesity with risky eating behaviors, something that could be confirmed in this study, as individuals with higher BMI, displayed more risky eating behaviors. The results of this study have consistently supported the positive relationship between BMI, binge eating, body dissatisfaction and body image perception, although group differences attributed to age were not statistically significant. Finally, another important contribution of this study, is the use of a reliable and valid multidimentional questionnaire developed in Mexico, specifically designed for the study of two very complex issues such as risky eating behaviors and body image. The main limitations of the study were that the findings were primarily based on self-report data and the use of a non-probabilistic sample of Mexican adult women.