Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study.

PURPOSE: The main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients. METHODS: Two studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years. RESULTS: In Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape. CONCLUSIONS: The present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body. Level of evidence III, well-designed cohort.

Psychometric properties of the Italian body shape questionnaire: an investigation of its reliability, factorial, concurrent, and criterion validity.

PURPOSE: This study was set up to investigate the reliability, factorial, concurrent, and criterion validity of the Italian version of the 34-item Body Shape Questionnaire (BSQ) and its shorter versions. METHODS: The study included 231 patients diagnosed with an eating disorder and 58 putatively healthy people (comparison sample). The Italian BSQ-34 was administered to participants together with the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. Information on body mass index, caloric intake at baseline, and the number of episodes of self-vomiting per week was also acquired. RESULTS: Cronbach's alpha of BSQ-34 was 0.971 (95% confidence interval [CI] 0.965-0.976) in patients and 0.960 (0.944-0.974) in controls. Test-retest stability in patients (n = 69), measured with intraclass correlation coefficient, was 0.987 (0.983-0.991). Confirmatory factor analysis of the single-factor model yielded acceptable fit for all versions of the BSQ. On all BSQ versions, patients scored higher than controls with a large effect size when calculated as Cliff's delta. BMI and mean caloric intake at baseline had a stronger association with BSQ-34 than levels of anxiety and depression. The analysis with the receiver operating characteristics (ROC) curve showed that the BSQ-34 distinguished patients with an eating disorder from controls with good accuracy (Area Under the Curve = 86.5; 95% CI 82.2-90.7). CONCLUSION: The Italian version of the BSQ possesses good psychometric properties, in both the long and the shortened versions, and it can be applied to measure body dissatisfaction for both clinical and research purposes. LEVEL OF EVIDENCE: Level III, Evidence obtained from well-designed cohort or case-control analytic studies.

Validation of the Norwegian short version of the Body Shape Questionnaire (BSQ-14).

BACKGROUND: The Body Shape Questionnaire (BSQ) is a widely used self-report measure of body shape dissatisfaction. AIMS: We aimed to establish psychometric properties and report normative data for the Norwegian 14-item BSQ in a clinical and non-clinical sample. METHODS: A total of 423 female students, 267 male students and 49 female inpatients [anorexia nervosa (AN) and subthreshold AN] were administered the BSQ, the Body Checking Questionnaire (BCQ), and the Eating Disorder Examination Questionnaire (EDE-Q). RESULTS: On average, the male and female controls were aged (mean± standard deviation) 20.98 ± 5.68 years and 24.35 ± 9.89 years with mean body mass indexes (BMIs) of 23.34 ± 3.13 and 22.30 ± 3.62 kg/m(2), respectively. Patients were 19.04 ± 3.06 years with a mean BMI of 16.48 ± 1.81. Divergent validity was indicated by significantly (P < 0.001) different means between the patient group versus female controls, 56.80 ± 18.89 and 35.89 ± 15.19, respectively. Cronbach's alpha was satisfactory for all three groups (0.91-0.96), indicating excellent internal consistency. The BSQ correlated significantly (P < 0.001) with the BCQ and EDE-Q, indicating concurrent validity. BMI and BSQ scores did not correlate significantly within the population as a whole. However, when subdividing the sample, higher BMI was associated with higher BSQ scores among females and males within the non-clinical sample. CONCLUSIONS: Our study provides psychometric support for the Norwegian version of the BSQ-14 among a clinical and non-clinical sample of both young men and women.

Body Image Perception in High School Students: The Relationship with Gender, Weight Status, and Physical Activity.

Body image perception includes body size assessment, body desirability estimation, and perceptions concerning one's own body shape and size. Adolescence is a period of intense and prompt physical transformation, which changes the perception of one's body. This represents a critical period for the development of body image. Therefore, the present cross-sectional study aimed to evaluate body image perception and investigate the relationships between it, weight status, sex, and physical activity in a sample of high school students living in Italy. General demographic information and details about physical activity were collected. Body image perception was measured with a body silhouette and two indexes were calculated: the FID (Feel minus Ideal Discrepancy) to evaluate the discrepancy between the perceived current figure and the ideal figure; and the FAI (Feel weight status minus Actual weight status Inconsistency) to observe improper perception of weight status. In addition, body shape concerns were evaluated with the Body Shape Questionnaire (BSQ), in which participants reported the frequency of experiencing negative thoughts about their body shape in the last four weeks. Two hundred and four students were included in the study (155 = female, mean age = 17.13 ± 1.70; 49 = male, mean age = 17.25 ± 1.69). Females felt more concerned about body shape than males (χ2 = 11.347, p = 0.001). Distinctions emerged in terms of body mass index, the scores of Feel minus Ideal Discrepancy (FID), Feel weight status minus Actual weight status Inconsistency (FAI), the Body Shape Questionnaire (BSQ), and of the silhouette mean comparisons due to sex, weight status, and PA interaction effects (p < 0.001). Additionally, 94% of the BSQ variability could be explained by sex, weight status, and PA. Although no direct effects were observed on body image perception, healthy habit promotion, such as physical activity, could positively affect adolescent lives.

The Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34): Psychometrics and norms of the full version and the short version (BSQ8C).

Introduction: Saudi Arabia experiences elevated levels of body-shape dissatisfaction which might be related to the increased thin ideal. Studies on body-shape dissatisfaction are scarce, mainly because adapted assessment tools are unavailable. This study describes the Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34), preliminary examines the psychometric properties and provides normative data. Methods: The BSQ34 was administered in a convenience community sample (N = 867) between April 2017 and May 2018. Receiver-operating-characteristic curve analysis was used to establish discriminant validity, in a subsample (N = 602) in which the Eating Disorder Examination-Shape concern, was administered, the factor structure investigated with confirmatory-factor analyses and T-scores and percentile scores were determined. Results: The BSQ34 discriminated well between low and high levels of body-shape dissatisfaction (area-under-the-curve value = 0.93), had high internal consistency and a unidimensional factor structure, and 23.9% appeared at risk for body-shape dissatisfaction. Analyses were repeated for the shortened BSQ8C, which yielded similar results. Discussion: The results indicated that the BSQ34 and BSQ8C appeared suitable measurement tools to screen for body-shape dissatisfaction in a Saudi convenience community sample, mainly comprised young, unmarried, and highly educated women. The BSQ34 supplies more information on the type of concerns respondents have, which is worthwhile when the measure is used in a clinical setting; the BSQ8C is recommended as a short screener. As body-shape dissatisfaction is viewed as a risk factor for the development of eating disorder symptoms, screening for body-shape dissatisfaction with reliable tools is important to detect individuals at risk for eating disorder symptoms and may suggest subsequent preventive steps.

Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with lower levels of satisfaction with body image, which can affect sexuality and social well-being. Thus, we evaluated body image in women with PCOS and its association with body dis(satisfaction), anthropometric indices, sexual function, anxiety, and depression. METHODS: In this cross-sectional study, 94 women of reproductive age were grouped by body mass index (BMI) and sexual function. The Female Sexual Function Index (FSFI), Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), hospital anxiety (HADS-A) and depression (HADS-D) measurement scales, and anthropometric indices were used for data collection. RESULTS: Women with PCOS presented with perceptual distortions of self-image independent of sexual function and BMI. There were negative correlations between HADS-A and HADS-D scores and the FSFI total score, and HADS-D scores had positive correlations with weight, anthropometric indices, and BSQ total score. The degree of dis(satisfaction) was a predictor of FSFI total score, depression, and anxiety, and the FSFI total score was predicted by HADS-D. Desired and ideal-gender BMIs were risk factors for sexual dysfunction, and overweight and obesity were risk factors for the degree of dis(satisfaction). LIMITATIONS: This study had the limitations of using a cross-sectional design and it investigated a restricted number of clinical/biochemical parameters, as well as lacked objective measures of acne and hirsutism, and a control group. CONCLUSIONS: Perception and cognitive-affective dimensions appear to play important roles in body image dysfunction in women with PCOS, and impact sexual dysfunction and depression associated the syndrome. Furthermore, these results provide additional treatment considerations for women with PCOS.

Prevalence and Correlates of Body Image Dissatisfaction in Patients with Multiple Sclerosis.

BACKGROUND: Body image dissatisfaction (BID) strongly predicts undesirable outcomes, including disordered eating, depression, and low self-esteem. People with multiple sclerosis (MS) may have higher BID due to changes in mobility and functioning and high rates of depression; however, little research has explored BID in people with MS. Identifying factors predicting BID in people with MS would help providers become more aware of BID and its possible negative outcomes. METHODS: The sample included 151 adult patients with MS receiving care at the Cleveland Clinic Mellen Center for MS. The Body Shape Questionnaire was administered, and demographic information was collected from medical records. Data on MS-specific variables were collected via computerized testing. A one-sample t test, an independent-samples t test, and a hierarchical linear regression were conducted. RESULTS: Average scores on BID were not significantly different from the population mean. Patients with moderate/marked concern were more likely to be female and had higher body mass index values, Patient Health Questionnaire-9 scores, and Quality of Life in Neurological Disorders Stigma T-scores. There were no age differences. No MS-specific variables significantly predicted BID. CONCLUSIONS: People with MS show approximately the same levels of BID as the general population. Higher BID was associated with being female and with higher body mass index, depression, and stigma. No MS-specific variables predicted higher BID after controlling for significant variables. Given the evidence in the literature of the negative effects of BID on health behaviors and mood, it is important to explore whether other factors affect BID in people with MS.

Confirmatory factor analysis of different versions of the Body Shape Questionnaire applied to Brazilian university students.

This study aimed at evaluating the validity, reliability, and factorial invariance of the complete (34-item) and shortened (8-item and 16-item) versions of the Body Shape Questionnaire (BSQ) when applied to Brazilian university students. A total of 739 female students with a mean age of 20.44 (standard deviation=2.45) years participated. Confirmatory factor analysis was conducted to verify the degree to which the one-factor structure satisfies the proposal for the BSQ's expected structure. Two items of the 34-item version were excluded because they had factor weights (λ)<40. All models had adequate convergent validity (average variance extracted=.43-.58; composite reliability=.85-.97) and internal consistency (α=.85-.97). The 8-item B version was considered the best shortened BSQ version (Akaike information criterion=84.07, Bayes information criterion=157.75, Browne-Cudeck criterion=84.46), with strong invariance for independent samples (Δχ(2)λ(7)=5.06, Δχ(2)Cov(8)=5.11, Δχ(2)Res(16)=19.30).

Bienestar subjetivo e imagen corporal en estudiantes universitarias de Arequipa / Subjective wellbeing and body image in college students in Arequipa

Este estudio exploró la correlación entre el bienestar subjetivo y la imagen corporal de las estudiantes mujeres en una universidad de Arequipa. La muestra estuvo constituida de 155 estudiantes mujeres entre los 17 y 24 años de las tres carreras profesionales. Las participantes fueron evaluadas en sus respectivos salones. La validación del Cuestionario de la Imagen Corporal (BSQ) fue calculada con Alfa de Cronbach y se obtuvo un valor de 0.92. Los resultados indicaron que existe una correlación negativa significativa entre el bienestar subjetivo y la imagen corporal (r = -0.478; p < 0.001). Asimismo, se indicó que no existe diferencia estadísticamente significativa entre las carreras de administración y derecho con respecto al bienestar subjetivo (t = 0.201; p > 0.05) y a la imagen corporal (t = -0.606; p > 0.05). Esto muestra que la distorsión de la imagen corporal tiene un impacto negativo en el bienestar subjetivo de las estudiantes universitarias mujeres.

This study explored the correlation between subjective wellbeing and body image of female students at a university in Arequipa. The sample consisted by 155 female students between 17 and 24 years old from the three professional careers. The participants were evaluated in their respective classrooms. The validation of the Body Shape Questionnaire (BSQ) was calculated using CronbachÆs alpha and obtained a value of 0.92. The results indicated that there is significant negative correlation between the subjective wellbeing and body image (r = -0.478; p < 0.001). It was also noted that there is no statistical significant difference between management and law careers with respect to the subjective wellbeing (t = 0.201; p > 0.05) and body image (t = -0.606; p > 0.05). This shows that the distortion of body image has a negative impact on the subjective wellbeing of women university students.

Validez del Body Shape Questionnaire (BSQ) en Mujeres Mexicanas / Validity of Body Shape Questionnaire (BSQ) In Mexican Women

El objetivo de la presente investigación fue validar el instrumento en población mexicana femenina Body Shape Questionnaire (BSQ), creado con la finalidad de evaluar la insatisfacción corporal. Participaron 472 mujeres, 256 eran estudiantes (x‾ = 15.9, DE = 3.2) y conformaron el grupo control y 216 pacientes con Trastorno del Comportamiento Alimentario (TCA) (x‾ = 20.5, DE = 3.9) con un rango de edad de 13 a 30 años. Los resultados mostraron una excelente consistencia interna (a = .98), así como una estructura de 2 factores que explicaron el 63.8% de la varianza total. Estos fueron: 1) Malestar corporal normativo (α=.95) y 2) Malestar corporal patológico (α=.94). Respecto a la validez discriminante y predictiva, el BSQ mostró una buena capacidad de clasificar a individuos con TCA, en función de la insatisfacción corporal, y se observó que dicha capacidad es mayor cuando discrimina entre Anorexia, Bulimia y control (λ de Wilks = .485, χ²(gl=1)= 278.830, p≤ .001). Finalmente se exploraron 6 diferentes puntos de corte, de los cuales 110 fue el que demostró ser el más apropiado, de acuerdo a sus valores de sensibilidad (84.3%) y especificidad (84.4%). En conclusión el BSQ es un cuestionario de gran utilidad para detectar la insatisfacción corporal en mujeres mexicanas.

The aim of this study was to validate the instrument Body Shape Questionnaire (BSQ) in female Mexican population, created to assess body dissatisfaction. 472 women participated, 256 were students and formed the control group (x‾ = 15.9, DE = 3.2) and 216 patients with Eating Disorders (ED) (x‾ = 20.5, DE = 3.9) with an age range of 13 to 30 years. The results showed excellent internal consistency (a = .98) and a 2-factor structure that explained 63.8% of the total variance. These were: 1) normative body uncomfort (α=.95), and 2) pathological body uncomfort (α=.94). Regarding the discriminant and predictive validity, the BSQ showed good ability to classify individuals with eating disorders, depending on body dissatisfaction, noting that such capacity is greater when discriminating between Anorexia, Bulimia and control (λ de Wilks = .485, χ2(gl=1)= 278.830, p≤ .001). Finally we explored 6 different cut off points, of which the 110-was proved to be the most appropriate according to their values of sensitivity (84.3%) and specificity (84.4%). In conclusion, the BSQ is a useful questionnaire to detect body dissatisfaction in Mexican women.