Changes in body image and body weight and shape goals associated with weight loss and maintenance in overweight/obese adults diagnosed with type 2 diabetes mellitus

Abstract

The primary aim of this study was to test for changes in body image in males and females in a randomized controlled trial of weight loss for older overweight/obese adults who have been diagnosed with type 2 diabetes (Look AHEAD: Action for Health in Diabetes). A computerized morphing assessment program (The Body Morph Assessment; BMA 2.0) was used to assess estimates of perceived current body size (CBS), ideal body size (IBS), acceptable body size (ABS), body dissatisfaction based on the discrepancy between participants’ perceived CBS and IBS (CBS-IBS) and ABS (CBS-ABS), as well as participants’ weight loss goals in terms of both body weight (in pounds) and visual body size/shape. Participants randomly assigned to the Intensive Lifestyle Intervention (ILI) arm of the study (compared to the Diabetes Support and Education [DSE] arm) were hypothesized to report greater changes in estimates of CBS, IBS, ABC, CBS-IBS, and CBS-ABS, and to lose more body weight from baseline to end of year one. The primary hypothesis tested in this study was that changes in weight would mediate treatment effects on body image variables. This hypothesis was partially supported for both genders. Change in weight mediated treatment effects on estimates of CBS for males and ABS for both genders, but did not mediate change in body image dissatisfaction (CBS-IBS) for either gender. Estimates of body image dissatisfaction decreased (improved) for participants in the ILI, but greater body image dissatisfaction at baseline was not related to greater weight losses at year one. Also, moderate weight loss goals were not associated with greater weight losses at year one. Both males and females erred in their estimates of what body size/shape the opposite gender finds most attractive. These findings indicate that participation in an intensive behavioral weight loss program can lead to changes in body image and decreased body image dissatisfaction in an older overweight/obese population diagnosed with type 2 diabetes. Changes in body image constructs could not be attributed solely to weight changes.