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Assessment of the symptoms of body image disorder (BID) is crucial in anorexia nervosa (AN). Recent technological advancements such as virtual reality (VR) have improved the visual perception with 3D avatars and the feeling to be the avatar with the immersive conditions. This retrospective study examines the hypothesis that VR with standardized 3D avatars would improve body image perception and then body image evaluation by adolescents with AN, compared to the paper-based figure rating scales (FRS). Data of 31 female adolescents with AN were retrospectively studied. Paired data of perceived and desired body forms in addition to body perception index (BPI) (p = 0.2) and body dissatisfaction (p = 0.6), obtained by both VR and FRS were compared. Furthermore, correlation with validated psychometric questionnaires was also studied. Head-tracking technology allowed for the implicit measurement of explicit choices of patients. Participants with AN overestimated own body size regardless of the assessment tool used. BPI and body dissatisfaction did not differ significantly between FRS and VR. VR-based evaluation was correlated with the psychometric parameters BID and body dissatisfaction. Head tracking revealed significantly longer participant engagement with avatars representing malnutrition and underweight states, while those least engaged corresponded to obesity. Results of BID evaluation by VR standardized 3D avatars are comparable to those obtained by paper-based FRS. These findings suggest that comparable results obtained by both tools of evaluation reflect primarily the role of affective-cognitive perturbation in BID. The perceptive component could be better evaluated using biometric-enhanced assessment tools. Level V, cross-sectional descriptive study (evaluation data retrospectively studied).

Made available in DSpace on 2015-08-06T16:13:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2015 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Online data collection is becoming increasingly common and has some advantages compared to traditional paper-and-pencil formats, such as reducing loss of data, increasing participants' privacy, and decreasing the effect of social desirability. However, the validity and reliability of this administration format must be established before results can be considered acceptable. The aim of this study was to evaluate the validity, reliability, and equivalence of paper-and-pencil and online versions of the Weight Concerns Scale (WCS) when applied to Brazilian university students. A crossover design was used, and the Portuguese version of the WCS (in both paper-and-pencil and online formats) was completed by 100 college students. The results indicated adequate fit in both formats. The simultaneous fit of data for both groups was excellent, with strong invariance between models. Adequate convergent validity, internal consistency, and mean score equivalence of the WCS in both formats were observed. Thus, the WCS presented adequate reliability and validity in both administration formats, with equivalence/stability between answers. Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Odontologia Social, Faculdade de Odontologia de Araraquara, Araraquara, Rua Humaitá 1680, Centro, CEP 14801-385, SP, Brasil Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Odontologia Social, Faculdade de Odontologia de Araraquara, Araraquara, Rua Humaitá 1680, Centro, CEP 14801-385, SP, Brasil FAPESP: 2010/18279-3

Although eating disorders primarily affect adolescents and young adults, much of the recent medical and psychiatric literature fails to consider the unique physiologic, psychologic, and developmental issues relevant to younger patients, more often describing older patients with more chronic and intractable disease. Pediatricians and adolescent medicine specialists see younger patients who have a shorter duration of illness and a different set of physiologic and psychologic responses to weight control. The Practice Guidelines for Eating Disorders, published in 1993 by the American Psychiatric Association (1), provide an excellent overview of the

Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder.We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia.The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity with anorexia nervosa. However, future research needs to utilize more appropriate measures of male eating disorder pathology. Muscle dysmorphia is also inclusive of obsessive compulsive features that are typical to those seen in eating disorder presentations.We suggest that muscle dysmorphia be reanalyzed through the lens of an eating disorder spectrum. Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category.

There is evidence that gender as well as sexual orientation can affect body image. In particular, heterosexual women and homosexual men seem to be more vulnerable to a negative body image compared to homosexual women and heterosexual men. One reason for this may be derived from the fact that heterosexual women and homosexual men try to attract male romantic partners: As men place more importance on physical attractiveness than do women, the pressure to fulfill the sociocultural beauty ideal is thus increased. The present online study investigated differences in appearance-related partner preferences and their associations with measures of body image and eating pathology in homosexual and heterosexual women and men. The non-representative sample consisted of 893 participants (n = 201 lesbian women,n = 192 gay men,n = 349 heterosexual women, andn = 151 heterosexual men), who completed silhouette measures assessing their perception and expectations regarding body fat and muscularity of their own body and the body of a potential romantic partner, as well as questionnaires on drive for thinness, drive for muscularity, and eating pathology. Overall, few differences in appearance-related partner preferences emerged between the four groups. However, compared to heterosexual women, homosexual men appeared to prefer higher muscularity in potential romantic partners, which was also associated with increased drive for thinness and muscularity and increased eating pathology. The present findings indicate that, irrespective of sexual orientation, women and men tend to share similar standards regarding their own and a potential partner’s physical appearance, potentially suggesting an increased hegemony of heteronormative beauty ideals in women and men in general.

Background: Evidence suggests social media use is associated with mental health in young people but underlying processes are not well understood. This paper i) assesses whether social media use is associated with adolescents' depressive symptoms, and ii) investigates multiple potential explanatory pathways via online harassment, sleep, self-esteem and body image. Methods: We used population based data from the UK Millennium Cohort Study on 10,904 14 year olds. Multivariate regression and path models were used to examine associations between social media use and depressive symptoms. Findings: The magnitude of association between social media use and depressive symptoms was larger for girls than for boys. Compared with 1–3 h of daily use: 3 to

Mukbang is a recent Internet phenomenon in which video recordings of hosts eating large amounts of food are streamed on an online video platform. It originated in South Korea around 2014 and has since become a global trend. The aim of this study was to explore how viewers of mukbang videos relate their audience experiences to symptoms of disordered eating. A qualitative analysis of YouTube comments and Reddit posts on the topic of mukbang and disordered eating was performed, employing a netnographic approach. Two overarching themes were identified: a viewer perspective, by which users discuss mukbang without describing any personal involvement, and a participant perspective, by which users describe their own experiences of affects and behaviors in response to watching mukbang. Several topical categories emerged, describing how watching mukbang can both limit and increase eating, reduce loneliness and guilt, and become self-destructive. For some, mukbang appears to be a constructive tool in increasing food intake, preventing binge eating, or reducing loneliness; for others, it is clearly a destructive force that may motivate restrictive eating or trigger a relapse into loss-of-control eating. Notably, watching mukbang is not necessarily experienced as either helpful or destructive, but instead as simultaneously useful and hurtful.

Background Previous research on body image distress mainly relied on samples that were small, generally homogeneous in age or sex, often limited to one geographical region, and were characterized by a lack of comprehensive analysis of multiple psychosocial domains. The research presented in this paper extends the international literature using the results of the web-based Global Health and Wellbeing Survey 2015. The survey included a large sample of both men and women aged ≥16 years from Australia, Canada, New Zealand, the United Kingdom, or the United States. Objective The main objectives of this study are to examine body image distress across the adult life span (≥16 years) and sex and assess the association between body image distress and various psychosocial risk and protective factors. Methods Data were extracted from the Global Health and Wellbeing Survey 2015, a web-based international self-report survey with 10,765 respondents, and compared with previous web-based surveys conducted in 2009 and 2012. Results The body image distress of young Australians (aged 16-25 years) significantly rose by 33% from 2009 to 2015. In 2015, 75.19% (961/1278) of 16- to 25-year-old adults reported body image distress worldwide, and a decline in body image distress was noted with increasing age. More women reported higher levels of body image distress than men (1953/3338, 58.51% vs 853/2175, 39.22%). Sex, age, current dieting status, perception of weight, psychological distress, alcohol and other substance misuse, and well-being significantly explained 24% of the variance in body image distress in a linear regression (F15,4966=105.8; P Conclusions This study demonstrates the significant interplay between body image distress and psychosocial factors across age and sex.

ObjectiveTo 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.DesignCross-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.SettingPublic 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).ResultsReliability 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).ConclusionsReliability 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.

Introduction Menopause is the last natural menstruation, followed by a period of 12 months during which no bleeding occurs (WHO). This natural process results from the phasing out of the physiological activity of the ovaries and involves numerous psychological and somatic disturbances. Although perimenopausal ailments are experienced by most women, the correlation between their perception of the bodies and biopsychosocial functioning in the climacteric period is not fully understood. The aim of the study was to determine whether women's body image varies depending on the period of their reproductive life. Material and methods 113 women aged 25-60 were examined (both menopausal and postmenopausal) with the control group comprising 58 women. The following scales were used: the Appearance-Related Picture Self-Appraisal Form and the Appearance Self-Appraisal Scale. Results The study demonstrated statistically significant differences between the groups on 7 scales and the overall score. It can be said that postmenopausal women, whose ovarian activity has nearly ceased, in comparison with those in the premenopausal and menopausal groups attribute lower importance to the following areas of the body: eyes, nose, mouth, stomach, buttocks, thighs, and calves. The mean values of satisfaction in the three groups under comparison were not statistically different. Conclusions The subjects of the postmenopausal group attribute lower importance to different body areas, deriving greater satisfaction from their own bodies.

Background: The common thread running through all forms of sexual objectification is the experience of being treated as a body (or collection of body parts) valued predominantly for its use to (or consumption by) others. If girls and women adopt a peculiar view of the self, an effect called self-objectification, this may contribute to depression, sexual dysfunction, and eating disorders. The objective of this study is to investigate the impact of modesty (in terms of veiling, i.e., hijab) on objectification, by others and by the self, body image, and behaviors indicative of eating disturbance in veiled and unveiled Muslim women in Kuwait. Methods: This is a community-based, cross-sectional study conducted through an online survey. The respondents were females living in Kuwait. Results: Unveiled women experienced more objectification by others than veiled women. There were no significant differences found between veiled and unveiled women in self-objectification and eating disorder symptomatology. There is a significant negative relationship between modesty of clothing and objectification by others. No significant relationship was found between modesty of clothing and the self-objectification and eating disorder scales. For the objectification by others scale, data show that there is a positive relationship between this scale and eating disorders. Eating disorders were found to have a negative relationship with self-objectification. Conclusion: The results of the study are significant as they clearly demonstrate a weak negative relationship between clothing preferences/affiliations and eating disorders.

Physical activity has a high importance for cancer patients. The present study aimed to evaluate the influence of ballroom dancing on fatigue, body image, self-efficacy, and functional exercise capacity for patients with cancer. We collected data among participants of a regular dance training program for cancer patients with a questionnaire including the Body Image Scale (BIS), Brief Fatigue inventory (BFI), Short Scale for Measuring General Self-efficacy Beliefs (ASKU), and the 6-min walking test (6-MWT). 66 participants took part in the study, and among them, 39 participants also engaged in the 6-MWT: dance experience and the weeks of dance training were significantly associated with a higher walking distance in the 6-MWT. Participants with dance experience showed higher self-efficacy scores than participants without. Participants rated the influence of dancing on partnership positively. However, the dance training had no significant effects on fatigue or body image. Ballroom dancing may improve functional exercise capacity, and dance experience may be associated with a high self-efficacy and active lifestyle, which can be beneficial for cancer patients during and after treatment. Further studies are needed to assess the influence of ballroom dancing more deeply on physical activity and fitness and to learn more on impact on the partnership. As ballroom dancing seems to improve physical activity and wellbeing and can promote intimacy between partners, this intervention has the potential to support cancer survivors in various levels. Supplementary Information The online version of this article (10.1007/s12032-021-01459-0) contains supplementary material, which is available to authorized users.

Objective:To investigate the association between body image disorders and the lifestyle and body composition of female adolescents.Design:Cross-sectional study.Setting:The Body Shape Questionnaire (BSQ) and Silhouette Scale and Sociocultural Attitudes Towards Appearance Questionnaire-3 were used to evaluate the participants’ body image. Body composition was evaluated by a Dual-Energy X-ray Absorptiometry equipment, and lifestyles were identified by latent class analysis (LCA) using the poLCA package for R.Participants:Female adolescents aged 14–19 years old, in the city of Viçosa-MG, Brazil.Results:In total, 405 girls participated in the study. Almost half of the participants were dissatisfied with their current physical appearance (51·4 %), presented body perception distortions (52·9 %). 47·3 % of the adolescents were dissatisfied with their body according to the BSQ, and another 8 % severely so. Subjects with an ‘Inactive and Sedentary’ latent lifestyle were 1·71 times as likely to feel dissatisfied as those with active and sedentary or inactive and non-sedentary lifestyles (95 % CI 1·08, 2·90, P = 0·047). Body image disorders showed an association with decreased amounts of moderate and vigorous physical activity, high screen time, increased alcohol consumption and excess body fat.Conclusions:Particular patterns of lifestyle and body composition seem to be associated in female adolescents with dissatisfaction with, distortion of and excessive concern about appearance. Specifically, physical inactivity, sedentary behaviour, alcohol consumption and high body fat percentage may be strongly linked to body image disorders.

Body image dissatisfaction (BID) and weight self-stigma are prevalent and associated with physical and psychological ill-health. Acceptance and Commitment Therapy (ACT) is increasingly employed for both, yet little is known about its effectiveness. Searches of 12 databases identified six studies using online, face-to-face or self-help ACT interventions for BID or weight self-stigma, of varying duration and intensity. Their effectiveness and quality were evaluated. Two reported improved BID, three improved weight self-stigma, and one reported no impact on weight self-stigma. Methodological issues (small sample sizes, lack of allocation concealment, attention control and long-term follow up) impacted the validity of findings. Due to the small number of studies and poor study quality, the effectiveness of ACT for BID and weight self-stigma remains unclear. Nonetheless findings suggest psychological flexibility may facilitate reduction in BID and weight self-stigma and indicate that brief online as well as lengthy face-to-face delivery may be useful. Suggestions for further research are made.

Objectives In published clinical and autobiographical accounts of eating disorders, patients often describe their disorder in personified ways, that is, relating to the disorder as if it were an entity, and treatment often involves techniques of externalization. By encouraging patients to think about their eating disorder as a relationship, this study aimed to examine how young female patients experience their eating disorder as acting towards them, how they react in response, and whether these interactions are associated with symptoms, illness duration, and self-image. Design Structural Analysis of Social Behavior (SASB) was used to operationalize how patients experience the actions of their eating disorder and their own reactions to the disorder. Method The relationship between patients (N = 150) and their eating disorders was examined with respect to symptoms, duration of illness, and self-image. Patients were also compared on their tendency to react with affiliation in relation to their disorder. Results Patients’ responses on the SASB indicated that they tended to conceptualize their eating disorders as blaming and controlling, and they themselves as sulking and submitting in response. Greater experience of the eating disorder as being controlling was associated with higher levels of symptomatology. Patients reacting with more negative affiliation towards their disorder were less symptomatic. Conclusions When encouraging patients to think about their eating disorder as a relationship, comprehensible relationship patterns between patients and their eating disorders emerged. The idea that this alleged relationship may resemble a real-life relationship could have theoretical implications, and its exploration may be of interest in treatment. Practitioner points Patients were able to conceptualize their eating disorder as a significant other to whom they relate when encouraged to do so. Patients tended to experience their disorder as controlling and domineering. Exploring the hypothetical patient–eating disorder relationship may prove helpful in understanding dysfunctional relational patterns. Helping patients to rebel against their eating disorder could potentially aid in symptom reduction.

ObjectiveWaist-to-height ratio (WHtR) has been reported to be more strongly associated with cardiometabolic risk factors among non-obese individuals than BMI and waist circumference (WC). A body shape index (ABSI) and body roundness index (BRI) have been proposed recently to assess obesity-related disorders or mortalities. Our aim was to compare the ability of ABSI and BRI with that of WHtR to identify cardiometabolic risk factors in Chinese adults with normal BMI and WC.DesignReceiver-operating characteristic curves and areas under the curve (AUC) were employed to evaluate the ability of the indices (WHtR, BRI, ABSI) to identify metabolic risk factors and to determine the indices’ optimal cut-off values. The value of each index that resulted in maximization of the Youden index (sensitivity + specificity – 1) was defined as optimal. Differences in the AUC values between the indices were also evaluated.SettingIndividuals attending a voluntary health check-up in Beijing, China, July–December 2015, were recruited to the study.SubjectsNon-obese adults (n 1596).ResultsAmong both genders, ABSI exhibited the lowest AUC value for identifying each risk factor among the three indices; the AUC value of BRI for identifying each risk factor was very close to that of WHtR, and no significant differences were observed between the AUC values of the two new indices.ConclusionsWhen evaluating cardiometabolic risk factors among non-obese adults, WHtR was a simple and effective index in the assessment of cardiometabolic risk factors, BRI could be used as an alternative body index to WHtR, while ABSI could not.

BackgroundDisfigurement (visible difference) from wide-ranging congenital or acquired conditions, injuries, or treatments can negatively impact adolescents’ psychological well-being, education and health behaviours. Alongside medical interventions, appearance-specific cognitive behavioural and social skills training to manage stigma and appearance anxiety may improve psychosocial outcomes. YP Face IT (YPF), is a Web-based seven session self-help program plus booster quiz, utilising cognitive behavioural and social skills training for young people (YP) struggling with a visible difference. Co-designed by adolescents and psychologists, it includes interactive multimedia and automated reminders to complete sessions/homework. Adolescents access YPF via a health professional who determines its suitability and remotely monitors clients’ usage.ObjectiveTo establish the feasibility of evaluating YPF for 12-17 year olds self-reporting appearance-related distress and/or bullying associated with a visible difference.MethodsRandomized controlled trial with nested qualitative and economic study evaluating YPF compared with usual care (UC). Feasibility outcomes included: viability of recruiting via general practitioner (GP) practices (face to face and via patient databases) and charity advertisements; intervention acceptability and adherence; feasibility of study and data collection methods; and health professionals’ ability to monitor users’ online data for safeguarding issues. Primary psychosocial self-reported outcomes collected online at baseline, 13, 26, and 52 weeks were as follows: appearance satisfaction (Appearance Subscale from Mendleson et al’s (2001) Body Esteem Scale); social anxiety (La Greca’s (1999) Social Anxiety Scale for Adolescents). Secondary outcomes were; self-esteem; romantic concerns; perceived stigmatization; social skills and healthcare usage. Participants were randomised using remote Web-based allocation.ResultsThirteen charities advertised the study yielding 11 recruits, 13 primary care practices sent 687 invitations to patients on their databases with a known visible difference yielding 17 recruits (2.5% response rate), 4 recruits came from GP consultations. Recruitment was challenging, therefore four additional practices mass-mailed 3,306 generic invitations to all 12-17 year old patients yielding a further 15 participants (0.5% response rate). Forty-seven YP with a range of socioeconomic backgrounds and conditions were randomised (26% male, 91% white, mean age 14 years (SD 1.7)); 23 to YPF, 24 to UC). At 52 weeks, 16 (70%) in the intervention and 20 (83%) in UC groups completed assessments. There were no intervention-related adverse events; most found YPF acceptable with three withdrawing because they judged it was for higher-level concerns; 12 (52%) completed seven sessions. The study design was acceptable and feasible, with multiple recruitment strategies. Preliminary findings indicate no changes from baseline in outcome measures among the UC group and positive changes in appearance satisfaction and fear of negative evaluation among the YPF group when factoring in baseline scores and intervention adherence.ConclusionsYPF is novel, safe and potentially helpful. Its full psychosocial benefits should be evaluated in a large-scale RCT, which would be feasible with wide-ranging recruitment strategies.Trial RegistrationISRCTN registry ISRCTN40650639; http://www.isrctn.com/ISRCTN40650639

Background The recent Australian National Agenda for Eating Disorders highlights the role technology can play in improving accessibility and service development through web-based prevention, early access pathways, self-help, and recovery assistance. However, engagement with the eating disorders community to co-design, build, and evaluate these much-needed technology solutions through participatory design processes has been lacking and, until recently, underresourced. Objective This study aims to customize and configure a technology solution for a nontraditional (web-based, phone, email) mental health service that provides support for eating disorders and body image issues through the use of participatory design processes. Methods Participants were recruited chiefly through the Butterfly National Helpline 1800 ED HOPE (Butterfly’s National Helpline), an Australian-wide helpline supporting anyone concerned by an eating disorder or body image issue. Participants included individuals with lived experience of eating disorders and body image issues, their supportive others (such as family, health professionals, support workers), and staff of the Butterfly Foundation. Participants took part in participatory design workshops, running up to four hours, which were held nationally in urban and regional locations. The workshop agenda followed an established process of discovery, evaluation, and prototyping. Workshop activities included open and prompted discussion, reviewing working prototypes, creating descriptive artifacts, and developing user journeys. Workshop artifacts were used in a knowledge translation process, which identified key learnings to inform user journeys, user personas, and the customization and configuration of the InnoWell Platform for Butterfly’s National Helpline. Further, key themes were identified using thematic techniques and coded in NVivo 12 software. Results Six participatory design workshops were held, of which 45 participants took part. Participants highlighted that there is a critical need to address some of the barriers to care, particularly in regional and rural areas. The workshops highlighted seven overarching qualitative themes: identified barriers to care within the current system; need for people to be able to access the right care anywhere, anytime; recommendations for the technological solution (ie, InnoWell Platform features and functionality); need for communication, coordination, and integration of a technological solution embedded in Butterfly’s National Helpline; need to consider engagement and tone within the technological solution; identified challenges and areas to consider when implementing a technological solution in the Helpline; and potential outcomes of the technological solution embedded in the Helpline relating to system and service reform. Ultimately, this technology solution should ensure that the right care is provided to individuals the first time. Conclusions Our findings highlight the value of actively engaging stakeholders in participatory design processes for the customization and configuration of new technologies. End users can highlight the critical areas of need, which can be used as a catalyst for reform through the implementation of these technologies in nontraditional services.

ObjectiveThe present study aimed to compare body dissatisfaction, food choices, physical activity and weight-management practices by gender and school type.DesignA questionnaire was used to obtain height, weight, body image perception using Stunkard’s figure rating scale, food choices, physical activity and weight-management practices.SettingNine single- and mixed-gender schools located in Bangkok Metropolitan Region, Thailand.SubjectsStudents in 10th–12th grade, aged 15–18 years (n2082).ResultsOnly 18 % of females and 21 % of males did not indicate body dissatisfaction. About 66 % of females selected a thinner ideal figure than their current figure. Among males, 44 % wanted a thinner figure, but 35 % wanted a bigger figure. However, univariate analysis found differences by school type but not gender in the degree of body dissatisfaction; students in single-gender schools had more body dissatisfaction. Females reported using more weight-management practices but less physical activity, while males reported healthier food choices. Participants in single-gender schools had healthier food choices compared with those in mixed-gender schools. Adolescents who were at increased risk of a greater degree of body dissatisfaction were females, attended single-gender schools, had lower household income, higher BMI and less physical activity.ConclusionsMost participants reported being dissatisfied with their current body shape, but the type and level of dissatisfaction and use of weight-management practices differed by gender and type of school. These findings suggest that programmes to combat body dissatisfaction should address different risk factors in males and females attending single- and mixed-gender schools.

ObjectiveTo investigate weight concerns among adolescent boys and relationships with health indicators and family factors.DesignAnalysis of the 2010 Health Behaviour in School-aged Children survey of 10–17-year-olds.SettingSchools in the Republic of Ireland.ResultsAmong 6187 boys, 25·1 % reported a desire to lose weight (weight ‘loss’ concern) and 7·7 % reported a desire to gain weight (weight ‘gain’ concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys’ weight concerns. In adjusted analyses, the risk of weight ‘loss’ concerns decreased with daily family breakfasts (OR=0·80; 95 % CI 0·66, 0·97). The risk of weight ‘gain’ concerns decreased with frequent family evening meals (OR=0·77; 95 % CI 0·60, 0·99). Ease of communication with mother was associated with a decreased risk of weight ‘loss’ and weight ‘gain’ concerns among boys (OR=0·74; 95 % CI 0·60, 0·90 and OR=0·61; 95 % CI 0·44, 0·82, respectively). An open father–son relationship and having a father present in the home decreased the risk of weight ‘loss’ concerns (OR=0·69; 95 % CI 0·57, 0·82 and OR=0·81; 95 % CI 0·67, 0·98, respectively).ConclusionsBody weight concerns were reported by a sizeable minority of boys and were associated with negative health outcomes. The findings support the need to promote frequent family meals and facilitate open communication in families.

BackgroundReceiving insufficient sleep has wide-ranging consequences for health and well-being. Although educational programs have been developed to promote sleep, these have had limited success in extending sleep duration. To address this gap, we developed a Web-based program emphasizing how physical appearances change with varying amounts of sleep.ObjectiveThe aims of this study were to evaluate (1) whether participants can detect changes in appearances as a function of sleep and (2) whether this intervention can alter habitual sleep patterns.MethodsWe conducted a 5-week, parallel-group, randomized controlled trial among 70 habitual short sleepers (healthy adults who reported having ResultsIn total, 35 participants were assigned to each group. Validating the intervention, participants in the appearance group (1) were able to identify what they looked like at baseline and (2) judged that they would look more attractive with a longer sleep duration (t26=10.35, PConclusionsOur findings suggest that an appearance-based intervention, while not sufficient as a stand-alone, could have an adjunctive role in sleep promotion.Trial RegistrationClinicalTrials.gov NCT02491138; https://clinicaltrials.gov/ct2/show/study/NCT02491138.

BackgroundMass media exposure has been associated with an increased risk of eating pathology. It is unknown whether indirect media exposure – such as the proliferation of media exposure in an individual's social network – is also associated with eating disorders.AimsTo test hypotheses that both individual (direct) and social network (indirect) mass media exposures were associated with eating pathology in Fiji.MethodWe assessed several kinds of mass media exposure, media influence, cultural orientation and eating pathology by self-report among adolescent female ethnic Fijians (n = 523). We fitted a series of multiple regression models of eating pathology, assessed by the Eating Disorder Examination Questionnaire (EDE–Q), in which mass media exposures, sociodemographic characteristics and body mass index were entered as predictors.ResultsBoth direct and indirect mass media exposures were associated with eating pathology in unadjusted analyses, whereas in adjusted analyses only social network media exposure was associated with eating pathology. This result was similar when eating pathology was operationalised as either a continuous or a categorical dependent variable (e.g. odds ratio OR = 1.60, 95% CI 1.15–2.23 relating social network media exposure to upper-quartile EDE–Q scores). Subsequent analyses pointed to individual media influence as an important explanatory variable in this association.ConclusionsSocial network media exposure was associated with eating pathology in this Fijian study sample, independent of direct media exposure and other cultural exposures. Findings warrant further investigation of its health impact in other populations.

Background: In spite of many similarities in the psychopathology of anorexia nervosa (AN) and bulimia nervosa (BN), the 2 groups seem to differ in terms of body image disturbances. Therefore, the aim of the present study was to compare neuronal correlates of viewing pho tographs of one’s own body and another woman’s body in patients with these forms of eating disorders as well as controls. Methods: We performed functional magnetic resonance imaging while women with AN ( n = 13), BN ( n = 15) and healthy controls ( n = 27) viewed 16 standardized pictures of their own body and another woman’s body, taken while the participants were wearing a bikini. Results: When viewing their own body, participants with AN and BN showed reduced activity in the inferior parietal lobule compared with healthy women. In response to looking at another woman’s body, participants with AN had higher amygdala activity than did those in the BN and control groups. Limitations: The generalizability of the results is limited by the small sample size. Conclusion: Our data suggest decreased attentional processes in AN and BN toward one’s own body, possibly reflecting body-related avoidance behaviour. Enhanced limbic activity elicited by looking at another woman’s body in participants with AN might be a neural correlate of stronger emotional activation and en hanced vigilance, possibly resulting from social comparison processes. Our study reveals hints about body image‐associated alterations in brain activity, which seem to be more pronounced among women with AN than among those with BN.

Background: Visual imagery plays a key role in health communication; however, there is little understanding of what aspects of vaccine-related images make them effective communication aids. Twitter, a popular venue for discussions related to vaccination, provides numerous images that are shared with tweets. Objective: The objectives of this study were to understand how images are used in vaccine-related tweets and provide guidance with respect to the characteristics of vaccine-related images that correlate with the higher likelihood of being retweeted. Methods: We collected more than one million vaccine image messages from Twitter and characterized various properties of these images using automated image analytics. We fit a logistic regression model to predict whether or not a vaccine image tweet was retweeted, thus identifying characteristics that correlate with a higher likelihood of being shared. For comparison, we built similar models for the sharing of vaccine news on Facebook and for general image tweets. Results: Most vaccine-related images are duplicates (125,916/237,478; 53.02%) or taken from other sources, not necessarily created by the author of the tweet. Almost half of the images contain embedded text, and many include images of people and syringes. The visual content is highly correlated with a tweet’s textual topics. Vaccine image tweets are twice as likely to be shared as nonimage tweets. The sentiment of an image and the objects shown in the image were the predictive factors in determining whether an image was retweeted. Conclusions: We are the first to study vaccine images on Twitter. Our findings suggest future directions for the study and use of vaccine imagery and may inform communication strategies around vaccination. Furthermore, our study demonstrates an effective study methodology for image analysis.

Background: There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective: To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods: Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results: The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions: This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings suggest that Facebook metrics of intervention post engagement (ie, likes and comments) may vary based on post types and that designing specifically labeled discussion posts may be helpful for soliciting engagement as well as challenging beliefs. [JMIR Res Protoc 2018;7(2):e54]

Introduction Breast cancer and its treatment change the perception of mastectomized women of their physical appearance, which leads to depression and has a negative effect on the overall quality of life of those woman. Aim We wanted to assess the quality of life and the degree of depression of patients suffering from breast cancer, on the basis of a standardised questionnaire to assess the patients' quality of life (QLQ-C-30 BR-23), and the degree of depression using Beck's Depression Inventory (BDI, II). Materials and methods The research was conducted on a sample of 160 patients, who were surveyed before and after the surgical procedure. The inclusion criteria for the research were: patients suffering from breast cancer aged between 18 and 70 years, cancer diagnosed by FNB or CORE biopsy. The patients were divided into two groups: patients having breast-conserving surgery and patients having radical surgical treatment. Results There were 47 or 39.37% patients who underwent breast-conserving surgery and 113 or 70.62% patients who underwent radical surgery. The results of the survey conducted show that there was no difference in the quality of life of patients before and after surgery, regardless of the type of surgical procedure undertaken. However, there was a significant different in the degree of depression between patients subjected to different surgical procedures, where the patients surveyed post-surgery after radical mastectomy showed a higher degree of depression than the patients surveyed after breast-conserving surgery. Conclusion There is no difference in the quality of life before and after surgery, regardless of the type of operation. However, there is a significant difference in the degree of depression in patients after radical mastectomy, who showed a higher degree of depression than the surveyed patients who underwent breast-conserving surgery.

We explored self-reported rates of individual on-schedule breast, cervical, and colorectal cancer screenings, as well as an aggregate measure of comprehensive screenings, among unmarried women aged 40-75 years. We compared women who partner with women (WPW) or with women and men (WPWM) to women who partner exclusively with men (WPM). We also compared barriers to on-schedule cancer screenings between WPW/WPWM and WPM.Comparable targeted and respondent-driven sampling methods were used to enroll 213 WPW/WPWM and 417 WPM (n = 630). Logistic regression models were computed to determine if partner gender was associated with each measure of on-schedule screening after controlling for demographic characteristics, health behaviors, and cancer-related experiences.Overall, 74.3% of women reported on-schedule breast screening, 78.3% reported on-schedule cervical screening, 66.5% reported on-schedule colorectal screening, and 56.7% reported being on-schedule for comprehensive screening. Partner gender was not associated with any of the measures of on-schedule screening in multivariable analyses. However, women who reported ever putting off, avoiding, or changing the place of screenings because of sexual orientation were less likely to be on-schedule for comprehensive screening. Women who reported barriers associated with taking time from work and body image concerns were also less likely to be on-schedule for comprehensive screening.Barriers to cancer screening were comparable across types of examinations as well as between WPW/WPWM and WPM. Developing health promotion programs for unmarried women that address concomitant detection and prevention behaviors may improve the efficiency and effectiveness of healthcare delivery and ultimately assist in reducing multiple disease risks.

ObjectiveTo examine gender-specific associations of weight perception and appearance satisfaction with slimming attempts and eating patterns among young Norwegian adolescents.DesignCross-sectional study. Adolescent dietary data were reported by parents using a retrospective FFQ. Eating patterns were identified using principal component analysis. Adolescents’ reported weight perception, appearance satisfaction and slimming attempts were analysed using cross-tabulation and Pearson’s χ2 test. Associations between perceived weight, appearance satisfaction and slimming attempts/eating patterns were examined using multiple logistic regression analysis.SettingPrimary schools, Telemark, Norway.SubjectsChildren (n 469), mean age 12·7 (sd 0·3) years, and parents.ResultsGender differences were observed in self-perceived weight and appearance satisfaction. Girls were most satisfied with appearance when feeling thin, boys when feeling just the right weight. Perceived overweight was the main predictor of slimming attempts across genders (adjusted OR=15·3; 95 % CI 6·0, 39·1 for girls; adjusted OR=18·2; 95 % CI 5·8, 57·3 for boys). Low appearance satisfaction was associated with slimming attempts (adjusted OR=3·3; 95 % CI 1·0, 10·5) and a dieting eating pattern (adjusted OR=2·8; 95 % CI 1·5, 5·2) in girls. Perceived underweight was associated with a junk/convenience eating pattern in boys (adjusted OR=2·8; 95 % CI 1·2, 6·4).ConclusionsGender differences were observed in subjective body concerns. Perceived overweight was the main predictor of slimming attempts by both genders. Different aspects of body dissatisfaction were related to different food behaviours in boys and girls. Health professionals should be aware of these gender differences when planning health promotion programmes targeting young adolescents.

Background: Recent research suggests Internet exposure, including Facebook use, is positively correlated with body dissatisfaction, especially among girls and young women. Canada has one of the highest Internet access rates in the world, yet no previous study has examined this relationship using nationally representative data. Objective: Our objective was to evaluate the relationship between Internet use and body dissatisfaction among a national, population-based sample of Canadian females 12-29 years of age. Methods: We used cross-sectional data from the Canadian Community Health Survey 2011-2012. Body dissatisfaction was measured using a 5-point Likert scale and defined as “very dissatisfied/dissatisfied” with one’s body. The explanatory variable was time spent using the Internet per week in the past 3 months, ranging from none/20 hours. We used multinomial logistic regression to investigate whether greater Internet use was associated with increasing odds of being very dissatisfied/dissatisfied, neutral, or satisfied with one’s body, using very satisfied as the referent. Probability survey sampling weights were applied to all analyses. Results: Of 2983 included participants, sampled to represent 940,786 young Canadian females, most were 20-29 years old (61.98%) and living in households with an annual income Can $80,000 or more (44.61%). The prevalence of body dissatisfaction was 14.70%, and 25- to 29-year-olds were more likely than 12- to 14-year-olds to be very dissatisfied or dissatisfied with their body (20.76% vs 6.34%). Few (5.01%) reported none/20 hours online per week. Adjusting for age and income, the odds of being very dissatisfied/dissatisfied, relative to very satisfied, were greater in the highest versus lowest Internet use group (adjusted odds ratio [AOR] 3.03, 95% CI 1.19-7.70). The AORs for this level of body dissatisfaction increased across increasing levels of Internet use, ranging from 0.88 (95% CI 0.35-2.21) to 3.03 (95% CI 1.19-7.70). Additionally, those who spent 11-14 hours online were more likely to be neutral (AOR 3.66, 95% CI 1.17-11.45) and those who spent 15-20 hours online were more likely to be neutral (AOR 4.36, 95% CI 1.18-16.13) or satisfied (AOR 2.82, 95% CI 1.14-7.01) with their bodies, relative to very satisfied, compared with those spending no time or 20 hours) on the Internet each week, and body dissatisfaction was significantly more likely among this group. Those who spent 11-20 hours online were also more likely to be less satisfied with their bodies. Efforts are needed to support girls and young women to achieve and maintain a positive body image in today’s digital age.

This study focused on links between romantic attachment, positive body image, and sexual functioning. Dutch female university students (N = 399) completed an online survey that included self-report items about body appreciation, sexual functioning, and romantic attachment. A proposed conceptual model was tested using structural equation modeling and a good fit to the data was found. Results revealed that attachment avoidance in a romantic context was negatively related to sexual arousal, vaginal lubrication, the ability to reach orgasm, and sexual satisfaction. Attachment anxiety was negatively related to body appreciation which, in turn, was positively related to sexual desire and arousal. Findings indicated that romantic attachment is meaningfully linked to body appreciation and sexual functioning. Therefore, the concept of adult attachment may be a useful tool for the treatment of sexual problems of young women.

Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m2). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.

Obesity is associated with many chronic diseases, and weight loss can reduce the risk of developing these diseases. Obesity is highly prevalent among Black women, but weight loss treatment for black women has been understudied until recently. The Obesity Reduction black Intervention Trial (ORBIT) is a randomized controlled trial designed to assess the efficacy of a culturally proficient weight loss and weight loss maintenance program for black women. This paper describes the design of the trial, the intervention, and baseline characteristics of the participants.Two hundred thirteen obese black women aged 30-65 years were randomized to the intervention group or a general health control group. The intervention consists of a 6-month weight loss program followed by a 1-year maintenance program. Weight, dietary intake, and energy expenditure are measured at baseline, 6 months, and 18 months.More than 40% of participants had a baseline body mass index (BMI)40 kg/m(2) (class III obesity). Intake of fat and saturated fat was higher and consumption of fruit, vegetables, and fiber was lower than currently recommended guidelines. Self-reported moderate to vigorous physical activity was high (median 85 min/day). However, objectively measured physical activity among a subgroup of participants was lower (median 15 min/day).Weight loss among obese black women has received inadequate attention in relation to the magnitude of the problem. Factors that contribute to successful weight loss and more importantly, weight loss maintenance need to be identified.

BackgroundMembers of Indonesia's diverse male-to-female transgender community often describe themselves as waria. Waria do not equate being feminine with being female. They do not want to be women; they aspire to be like women. It entails cultivating mannerisms and wearing make-up and women's clothes, shaving one's legs and styling one's hair. But some go further in their practices of self-administered, chemically assisted bodily transformation.MethodsField research took place in Makassar, the capital city of South Sulawesi; in a smaller town in the regency of Bulukumba on the south coast of Sulawesi; and in the special region of Yogyakarta in Java. Data were collected through repeated in-depth interviews with ten waria youths aged between 18 and 26 in each site; interviews with pharmacists, drug and cosmetics store clerks; three focus group discussions at each site; and participant observation.ResultsOur respondents saw their bodies as ‘projects’ they can manipulate with pharmaceutical products and cosmetics. To lighten their skin, they experimented with different brands of exfoliating liquid, whitening cream, powder, foundation, face soap and skin scrub. To grow breasts and reduce muscle mass, they experimented with different brands and dosages of contraceptive pills and injections in order to get faster, better and longer-lasting results.ConclusionHarm reduction programs often neglect chemicals that are not narcotics, not related to sexually transmitted infections, and which are legally and freely available. Safety issues arise when otherwise safe products are used off-label in large quantities. Drug policy-makers are paying insufficient attention to the safety of cosmetics.

Contains fulltext : 116776.pdf (Publisher’s version ) (Open Access) Background: Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive personalized communication between the patient and the therapist. Objective: This pilot study evaluated the web-based treatment program using intensive therapeutic contact in a population of 165 patients with an eating disorder. Methods: In a pre-post design with 6-week and 6-month follow-ups, eating disorder psychopathology, body dissatisfaction, Body Mass Index, physical and mental health, and quality of life were measured. The participant's satisfaction with the web-based treatment program was also studied. Attrition data were collected, and participants were classified as noncompleters if they did not complete all 10 assignments of the web-based treatment program. Differences in baseline characteristics between completers and noncompleters were studied, as well as reasons for noncompletion. Furthermore, differences in treatment effectiveness, treatment adherence, and baseline characteristics between participants of the three major eating disorder diagnostic groups EDNOS (n=115), BN purging (n=24), and BN nonpurging (n=24) were measured. Results: Of the 165 participants who started the web-based treatment program, 89 participants (54%) completed all of the program assignments (completers) and 76 participants (46%) ended the program prematurely (noncompleters). Severe body dissatisfaction and physical and mental health problems seemed to have a negative impact on the completion of the web-based treatment program. Among the participants who completed the treatment program, significant improvements were found in eating disorder psychopathology (F=54.6, df=68, P

Background: Numerous digital health interventions have been developed for mental health promotion and intervention, including eating disorders. Efficacy of many interventions has been evaluated, yet knowledge about reasons for dropout and poor adherence is scarce. Most digital health intervention studies lack appropriate research design and methods to investigate individual engagement issues. User engagement and program usability are inextricably linked, making usability studies vital in understanding and improving engagement. Objective: The aim of this study was to explore engagement and corresponding usability issues of the Healthy Body Image Program—a guided online intervention for individuals with body image concerns or eating disorders. The secondary aim was to demonstrate the value of usability research in order to investigate engagement. Methods: We conducted an iterative usability study based on a mixed-methods approach, combining cognitive and semistructured interviews as well as questionnaires, prior to program launch. Two separate rounds of usability studies were completed, testing a total of 9 potential users. Thematic analysis and descriptive statistics were used to analyze the think-aloud tasks, interviews, and questionnaires. Results: Participants were satisfied with the overall usability of the program. The average usability score was 77.5/100 for the first test round and improved to 83.1/100 after applying modifications for the second iteration. The analysis of the qualitative data revealed five central themes: layout, navigation, content, support, and engagement conditions. The first three themes highlight usability aspects of the program, while the latter two highlight engagement issues. An easy-to-use format, clear wording, the nature of guidance, and opportunity for interactivity were important issues related to usability. The coach support, time investment, and severity of users’ symptoms, the program’s features and effectiveness, trust, anonymity, and affordability were relevant to engagement. Conclusions: This study identified salient usability and engagement features associated with participant motivation to use the Healthy Body Image Program and ultimately helped improve the program prior to its implementation. This research demonstrates that improvements in usability and engagement can be achieved by testing and adjusting intervention design and content prior to program launch. The results are consistent with related research and reinforce the need for further research to identify usage patterns and effective means for reducing dropout. Digital health research should include usability studies prior to efficacy trials to help create more user-friendly programs that have a higher likelihood of “real-world” adoption. [J Med Internet Res 2016;18(1):e7]

Contains fulltext : 97489.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To describe the evidence about factors influencing breast cancer patients' surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). BACKGROUND: A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients' representations of their breast cancer and predicting surgery choices. DESIGN: Literature search and narrative synthesis of data. SYNTHESIS: Twenty-six studies reported women's surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. CONCLUSIONS: The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients' surgery choices.

The study aimed at verifying the associated factors of self-perceived body changes in adults living with HIV in highly-active antiretroviral therapy (HAART) in the city of São Paulo, Brazil. This cross-sectional study was conducted among people living with HIV on HAART for at least three months. A standardized questionnaire was used for assessing self-perceived body changes. Associated factors relating to self-reported body changes in people living with HIV (PLHIV) were assessed with Student's t-test and chi-square test. In total, 507 patients were evaluated. The mean time since diagnosis was 6.6 years [standard deviation (SD) +/- 4.1], and the mean duration of HAART was 5.1 years (SD +/- 3.3). Self-perceived body changes were reported by 79.5% of the participants and were associated with viral load and duration of HAART. Fibre intake was lower among males who gained in abdominal fat (p=0.035). HAART-related body changes were reported by the large majority of the population and were associated with demographic and clinical variables.

Background: The diagnosis of breast cancer encompasses not only physical, but also social and psychological implications because of the importance of the breast in a woman's body image, sexuality and motherhood. Women may experience a range of concerns and fears including physical appearance and disfigurement, the uncertainty about recurrence and the fear of death. There are no Indian studies on this subject. Aim: This study explores the various concerns of mastectomized and lumpectomized (breast conserved) patients, determines the coping mechanisms employed and the resolution of concerns. The levels of anxiety and depression in both groups were also studied. Methods: Seventy-five patients with breast carcinoma (50 mastectomized and 25 lumpectomized) were evaluated. The concern and coping checklist of Devlen was used. The severity of anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). Results: Body image or disfigurement was a concern only in the mastectomized group. Concerns were equally resolved between the two groups except for sexual role and performance, wherein the concern was resolved to a lesser extent in the mastectomized group. Coping strategies employed were effective in the resolution of concerns except for sexual role and performance, and recurrence or relapse. No statistically significant difference was found in the depression and anxiety levels of the two groups. Conclusion: Concern regarding sexual role and performance was resolved to a lesser extent in the mastectomized group. Specific psychological intervention is necessary to enhance coping strategies with regard to concerns of body image, and sexual role and performance.

The objective of the study was to estimate abnormal eating attitudes influenced by associated factors among female students of the Universidade Federal de Santa Catarina, Florianópolis, southern Brazil. Abnormal eating attitudes were investigated using the eating attitudes test (EAT-26), according to the presence (EAT+) and absence (EAT-) of symptoms in a sample of 220 students. The body-image was assessed by the body-shape questionnaire (BSQ-34). Body mass index, body-fat percentage, waist-circumference, food intake (24-hour food recall), and socioeconomic characteristics (monthly household income, monthly per-capita income, and parental schooling) were also investigated. Statistical associations were tested by multivariate Poisson regression analysis. The prevalence of EAT+ and dissatisfaction with the body-image were 8.3% [confidence interval (CI) 95% 4.6–12.0] and 20.0% (CI 95% 14.7–25.3) respectively. Dissatisfaction with the body-image maintained its independent association with abnormal eating attitudes, indicating symptoms of anorexia nervosa. The results of this work highlight the importance of the planning of nutrition-education programmes in universities, aiming at assisting in the choices of food that comprise a healthful diet in a period of life of so many changes and decisions.

This cross-sectional study was conducted to investigate the prevalence and predictors of overweight and obesity by location of residence among randomly-selected 2,577 urban school girls aged 12–17 years in Rasht, Iran. Data on age, frequency of skipping breakfast per week, physical activity, hours of television viewing, self-perception about body condition, and home address were collected. Birthweight of the girls, educational levels of parents, weights and heights of parents, and employment status of mothers were asked to the parents using a self-administrated questionnaire. The overall prevalence of overweight and obesity in this population was 18.6% and 5.9% respectively. Overweight or obesity was more common among girls from low-income areas compared to high-income areas (21.6% vs 17.1%, p

Background: Adolescence and young adulthood are key periods for developing norms related to health behaviors and body image, and social media can influence these norms. Social media is saturated with content related to dieting, fitness, and health. Health and fitness–related social media content has received significant media attention for often containing objectifying and inaccurate health messages. Limited research has identified problematic features of such content, including stigmatizing language around weight, portraying guilt-related messages regarding food, and praising thinness. However, no research has identified who is “liking” or “following” (ie, consuming) such content. Objective: This exploratory study aimed to identify demographics, mental health, and substance use–related behaviors that predicted consuming 3 types of health and fitness–related social media content—weight loss/fitness motivation pages (ie, “fitspiration”), detox/cleanse pages, and diet/fitness plan pages—among young social media users. Methods: Participants (N=1001; age: median 21.06, IQR 17.64-24.64; female: 723/1001, 72.23%) completed a cross-sectional 112-question online survey aimed at social media users aged between 15-29 years residing in Victoria, Australia. Logistic regression was used to determine which characteristics predicted consuming the 3 types of health and fitness–related social media content. Results: A total of 378 (37.76%) participants reported consuming at least 1 of the 3 types of health and fitness–related social media content: 308 (30.77%) fitspiration pages, 145 (14.49%) detox pages, and 235 (23.48%) diet/fitness plan pages. Of the health and fitness–related social media content consumers, 85.7% (324/378) identified as female and 44.8% (324/723) of all female participants consumed at least 1 type of health and fitness–related social media content. Predictors of consuming at least one type of health and fitness–related social media content in univariable analysis included female gender (OR 3.5, 95% CI 2.5-4.9, P

OBJECTIVES: \ud \ud To investigate the psychosocial impact of bilateral prophylactic mastectomy for women with increased risk of breast cancer and to identify, preoperatively, risk factors for postoperative distress.\ud \ud DESIGN: \ud \ud Prospective study using interviews and questionnaire assessments.\ud \ud SETTING: \ud \ud Participants' homes throughout the United Kingdom.\ud \ud PARTICIPANTS: \ud \ud 143 women with increased risk of developing breast cancer who were offered bilateral prophylactic mastectomy and who accepted or declined the surgery; a further 11 were offered surgery but deferred making a decision.\ud \ud MAIN OUTCOME MEASURES: \ud \ud Psychological and sexual morbidity.\ud \ud RESULTS: \ud \ud Psychological morbidity decreased significantly over time for the 79 women who chose to have surgery (accepters): 58% (41/71) preoperatively v 41% (29/71) 6 months postoperatively (difference in percentages 17%, 95% confidence interval 2% to 32%; P=0.04) and 60% (39/65) preoperatively v 29% (19/65) 18 months postoperatively (31%, 15% to 47%; P

Purpose: Fashion is an important aspect in day-to-day life. There are various factors influencing fashion trends such as social, cultural, political, environmental, and psychological factors. A bigger interest in fashion has developed at present. This study is conducted to prove the importance of fashion trends to understand and develop the dynamic capacities to guarantee long-term Success the fashion. In clothing and apparel products, the aesthetic sphere is socially and culturally grounded. All groups have their likes and dislikes. This study explores clothing practices and personality traits among young college students. Daily choices of clothing depend on social, economic, and psychological reasons. Social recognition is a major part of an individual’s identity, attitude, and self-evaluation. Hence this article synthesizes many scholarly research articles on wearer perception, published in a few of the globally familiar journals. Design: The study was able to identify the key influencing variables and essential constituent aspects of the young adolescent’s fashion consciousness. This paper pertaining to the research agenda of body image and fashion trends, extensively evaluated personality traits of young adolescents for this study. Findings/ Results: This literature synthesis establishes that the concept of body image and clothing is highly interrelated. This study focuses on depicting the correlation between fashion adoption and personality traits. The researchers have found that the drive for a well-dressed fashionable presentation is highlighted among men and women. Social comparison and objectification together determine their confidence. Some expressed that they used to dress to confirm their selves young. Here we want to explore that fashionable clothing, accessories, makeover are the main means to meet their needs to be fashionable. Through clothing self-descriptions of a person can be presented. Discussion of the concept of self-presentation is included in this research taking into consideration of individual behavior according to their clothing, personal values, interest, religion, culture, and customs. Originality/ Value: Clothing practices reflect one's standard. Sociology is being used to study clothing and human confidence after being well-dressed. This review of literature focuses on the relationship between human behavior and fashion. Information in this review will be useful for the referrer to understand the social psychology of fashion. Body makeover illustrates the impact of changing standards of attractiveness on appearance in the presentation of one’s self. Paper Type: Literature Review

Anorexia nervosa is often regarded primarily as a disorder of the body image, with affected individuals submitting themselves to the dictate of a predominant model of slenderness. However, even though this frequently functions as a gateway to the disorder, the paper intends to show that the actual conflict in anorexia consists in a fundamental alienation of the self from the body. In order to analyze this alienation from a phenomenological point of view, the paper introduces the polarity of lived body (body-as-subject) and physical body (body-as-object). It then explores the phenomenology of anorexia, drawing on characteristic self-reports as well as on the phenomenological, psychoanalytic and cultural science literature. The anorexic conflict of embodiment arises in adolescence, where the body becomes an object of the other’s gaze in a special way. Starting with an attempt to comply with the ideal body image, the anorexic patient increasingly fights against her dependency on her body and its uncontrollable nature, above all its hunger and femininity. To be in total control of her body and to gain independence from it, becomes the source of a narcissistic triumph. Thus, in striving for autonomy and perfection, the anorexic patient alienates herself from her embodiment. This results in a radical dualism of ‘mind’ and ‘body’: pursuing the ideal of an asexual, angelic, even disappearing body. Anorexia is thus conceived as a fundamental conflict of embodiment.

It is important that scales that evaluate body image and related attitudes and behaviors are both reliable and valid to evaluate these constructs in different countries. This paper introduces a series of five papers that examine the measurement invariance of multiple scales for men and women across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain, and the US). The papers examined measures of: sociocultural influences (i.e., appearance-related pressures) on strategies to lose weight/increase muscle; internalization of the thin/muscular ideal; body image; personality constructs; body change strategies to increase muscles and lose weight; and eating regulation. Measurement invariance was generally well-established across the eight countries. One or more items were removed in some scales for some countries to establish invariance. Factor loadings were equivalent across countries and refined scales demonstrated acceptable levels of reliability. The most frequent difference in the scales was in the item intercepts across groups, although most item intercepts were equivalent across groups. This series of papers makes an important contribution to the body image literature by demonstrating the validity of measures of body image, disordered eating, and sociocultural factors that can be used to better understand the relationship between these variables across different countries.

The Breast Cancer overall survival rate has raised impressively in the last 20 years mainly due to improved screening and effectiveness of treatments. This increase in survival paralleled the awareness over the long-lasting impact of the side effects of treatments on patient quality of life, emphasizing the motto “a longer but better life for breast cancer patients”. In breast cancer more strikingly than in other cancers, besides the side effects of systemic treatments, there is the visible impact of surgery and radiotherapy on patients’ body image. This has sparked interest on the development of tools for the aesthetic evaluation of Breast Cancer locoregional treatments, which evolved from manual, subjective approaches to computerized, automated solutions. However, although studied for almost four decades, past solutions were not mature enough to become a standard. Recent advancements in machine learning have inspired trends toward deep-learning-based medical image analysis, also bringing new promises to the field of aesthetic assessment of locoregional treatments. In this paper, a review and discussion of the previous state-of-the-art methods in the field is conducted and the extracted knowledge is used to understand the evolution and current challenges. The aim of this paper is to delve into the current opportunities as well as motivate and guide future research in the aesthetic assessment of Breast Cancer locoregional treatments., Highlights • Past, present and future of objective assessment of aesthetic outcome of breast cancer treatments. • Critical discussion of the role and impact of deep-learning-based methodologies in the field. • Recommendation for future efforts in the objective assessment of aesthetic outcome of breast cancer treatments.

Accurate measurement of constructs under investigation is an often-overlooked ingredient of research. However, sound use of strategies to ensure valid and reliable assessment is the building block for any research design, data analysis, and outcome interpretation. In this paper, we note how Thomas F. Cash has pioneered and steered this process in the field of body image for over 30 years—in fact, in the inaugural issue of Body Image, the first article after the editorial introduction focused on measurement (see Thompson, 2004). In the current paper, we detail some of the seminal measures developed by Thomas Cash as well as update the common errors in the (mis)measurement of body image noted in Thompson (2004). The future of body image assessment is bright if we focus on the illumination of past work by Thomas Cash.