Features are more than just filling in the blanks on body size scales

Evolutionary psychology suggests that a woman's sexual attractiveness is based on cues of health and reproductive potential. In recent years, research has focused on the ratio of the width of the waist to the width of the hips (the waist-to-hip ratio (WHR). A low WHR (i.e. a curvaceous body) is believed to correspond to the optimal fat distribution for high fertility, and so this shape should be highly attractive. In this paper we present evidence that weight scaled for height (the body mass index (BMI)) is the primary determinant of sexual attractiveness rather than WHR. BMI is also strongly linked to health and reproductive potential. Furthermore, we show how covariation of apparent BMI and WHR in previous studies led to the overestimation of the importance of WHR in the perception of female attractiveness. Finally, we show how visual cues, such as the perimeter-area ratio (PAR), can provide an accurate and reliable index of an individual's BMI and could be used by an observer to differentiate between potential partners.

To study how waist circumference (WC) relates to body perception in adolescent girls and to maternal perception of the girl's body size. Three hundred and four girls, 11-18 years, were measured for height, weight and WC. 294 girls provided self-report data on weight, height and body image before anthropometric measurements. Paired data from 237 girls and mothers on perception of the girls' body size were collected. In girls, self-reported weight indicated awareness of actual body size. The girls' body perception showed an overestimation of body size relative to international reference values for body mass index (BMI) (p < 0.05), but not for WC. Girls' body perception exceeded that of their mothers (p < 0.05). Maternal perception agreed better than the girls' perception with international reference values for BMI (p < 0.05). No significant difference between mothers and girls were found concerning agreement of body perception with international reference values for WC. WC rather than BMI agrees with perception of body size, possibly due to its relation to abdominal fat at different ages. For effective prevention and treatment programmes for weight-related health problems among adolescent girls, we recommend measuring WC to diminish the discrepancy between measured and perceived body size.

On the basis of visual assessment of figure drawings and front/profile images, past researchers believed that the waist-hip ratio (WHR) and the body mass index (BMI) were two putative cues to female physical attractiveness. However, this view was not tested on three-dimensional (3D) female images. In the present study, 3D images of 31 Caucasian females having varying body weights (BMI ranged from 16 to 35) were shown to 29 male and 25 female viewers, who were asked to rate the physical attractiveness. The results showed that the body volume divided by the square of the height, defined as volume height index (VHI), is the most important and direct visual determinant of female physical attractiveness. In determining the female attractiveness, human observers may first use VHI as a visual cue, which is also a key indicator of health and fertility owing to its strong linear relation to BMI. To fine-tune the judgement, observers may then use body proportions, the most important of which are the ratio of waist height over the chin height (WHC) (a measure of the length of legs over total tallness) and the deviation of WHR from the ideal ratio. It also appears that the effect of the body's physical parameters on the perception of female physical attractiveness conforms to Stevens' power law of psychophysics.

To examine the relationship between pulmonary function, nutritional status, body image, and eating attitudes in children with cystic fibrosis (CF) compared with healthy controls. Seventy-six children with CF (39 girls) and 153 healthy control children (82 girls) were recruited. All children were between 7 and 12 years of age. After being weighed and measured, participants undertook a structured 1-to-1 interview. Four measures were used to assess body image: body size (perception and satisfaction) were ascertained using the Children's Body Image Scale (CBIS), which uses photographs of children of various body mass index (BMI) representative of the range of BMI percentiles for children 7 to 12 years of age. Body size satisfaction was measured by the response to the questions, "Do you think your body is 1) much too thin, 2) too thin, 3) just right, 4) too fat, and 5) much too fat?" Body weight satisfaction was measured by the question, "Would you like your body to be 1) much thinner, 2) a little bit thinner, 3) stay the same, 4) a little bit fatter, and 5) much fatter?" Global self-esteem was measured using the children's version of the Rosenberg Self-Esteem Scale and Body Esteem Scale using a 24-item scale. Dieting behavior was measured by asking directly about previous weight control behaviors, use of the Dutch Eating Behavior-Restraint Scale (DEBQ-R), and, in children who acknowledged previous dieting behavior, the Children's Eating Attitude Test (ChEAT) was additionally administered. Results. Both girls and boys with CF had significantly reduced BMI percentiles compared with control children. Boys with CF did not have a significantly different BMI compared with girls with CF. There were significant positive correlations between forced expiratory volume in 1 second (FEV(1)) (% of predicted) and BMI percentile in girls (r =.35) and boys (r =.50) with CF. Body image perceptions in boys and girls with CF were examined in relation to the healthy control group using 2 (CF and control groups) by 2 (male and female) analysis of variance. The interaction effect was examined to explore the prediction that girls compared with boys with CF would have greater acceptance of their body shape and less desire to become larger. There were no differences between groups or sex in body esteem. On the CBIS body dissatisfaction score, children with CF were significantly more likely to perceive their ideal body size as a little larger than their current size while control children desired a smaller body size than their current size. CF children had a significantly lower mean score for body size satisfaction (an item assessing perception being too thin) and a significantly higher mean score on body weight satisfaction. There was a significant main effect of gender for only 1 measure, difference between the CBIS body dissatisfaction score, with girls being more likely to nominate a smaller ideal than their current figure. There were no significant interaction effects. Of children with CF and a low BMI (</=10th percentile), 25% of girls and 38% of boys thought they were too thin. Fewer girls (19%) than boys (38%) would have liked to be fatter. The CF group had significantly lower mean scores on the DEBQ-R scale compared with controls. Of the children with CF completing the ChEAT (n = 13), none obtained a score of clinical significance compared with 6 (4%) for controls. To examine predictors of BMI a multiple regression analysis was conducted separately for boys and girls with CF and control boys and girls in which the dependent variable was BMI and the independent variables were FEV(1) (% of predicted) (in CF children only), body esteem, self-esteem, and body dissatisfaction score. In the case of boys with CF, the regression equation was significant (Adjusted R(2) = 0.30). In the case of girls with CF, the regression equation was significant (Adjusted R(2) = 0.25) with body dissatisfaction making a significant independent contribution. For control boys the regression equation was significant (Adjusted R(2) = 0.18). Variables making a significant contribution to the equation were body esteem and body dissatisfaction. Finally, for control girls the regression equation was significant (Adjusted R(2) = 0.13). The only variable to make a significant contribution to the equation was body dissatisfaction. Children with CF had very similar body esteem and general self-esteem as controls. A consideration of body image constructs does reveal group differences between perception and satisfaction with body size between groups. Children with CF were more likely to perceive their body size as larger than it actually was and have greater satisfaction with their current body size in contrast to control children. The girls and boys with CF with a higher BMI frequently selected a smaller body size as their ideal. (ABSTRACT TRUNCATED)

Black women are at high risk for obesity and obesity-related health problems (1). Nearly 50% of black women compared to 30% of white women are obese (2,3). While many women who attempt to lose weight do so through caloric restriction and/or physical activity, smoking has been identified as an alternate strategy used for weight loss among black women with weight concerns or body image concerns (4). Nicotine's suppression of body weight facilitates initiation and maintenance of smoking among women (5,6,7). Despite the deadly health risks associated with tobacco use, 23.1% of women smoke (8). Female smokers are more likely to report smoking cigarettes to control weight (6,9) and less likely to quit smoking due to weight concern (10). Perkins et al. and Pirke and Laessle note that women tend to suffer more postcessation weight gain than men (as cited in Copeland) (11). Smoking cessation is less likely among women who fear postcessation weight gain or benefit from weight control when smoking. Additionally, women with the intention to control body weight by restrictive eating are more likely to smoke to control appetite and weight (12). Black women tend to have lower rates of smoking cessation and physical activity and higher dietary fat intake (13,14,15). Factors contributing to low prevalence of weight management among black women need to be identified for the development of appropriate interventions. Less reported social pressure to achieve thinness and greater perceived attractiveness at higher body weights may limit motivation for healthy weight management among many black women. The 2003–2008 National Health and Nutrition Examination Survey found weight control through physical activity or dietary change to be positively associated with weight perception (odds ratio women 3.74; 95% confidence interval 2.96, 4.73) (16). Several authors assert that historical black-white differences in ideal female body image (17) and acceptance of overweight (18) may contribute in part to explaining racial differences in weight loss efforts and modifiable weight management behaviors. It has been indicated that black women have a high prevalence of obesity partly because self-image is not strongly dependent on body size (19). Body shape perception often varies by race and gender with blacks generally perceiving their bodies as lighter than indicated by their BMI (20). An understanding of factors such as body image and their relationship to weight loss behaviors is necessary to promote healthier lifestyles. This review investigates the association between body image satisfaction and dietary behavior, physical activity, and smoking as tools for weight control among black women. Due to the paucity of literature focusing solely on black women, this article considers both the experiences of black women alone and with other groups. Studies were identified through computerized searches of biomedical and psychological databases, namely PubMed, CINAHL, Psych Abstracts, Science Direct, and Web of Science and manual searches of article bibliographies focusing on dietary behaviors, physical activity, and smoking/alternative weight control techniques since 1990. Searches were performed on recurring authors and in recurring journals for additional articles on the topics. Variations of the term "body image," including "body dissatisfaction," "satisfaction," and "esteem," as well as "size," "shape," and "weight" were sought. Searches included these terms in combination with the target health behaviors, namely diet, physical activity, and smoking. The search was limited to studies including black or African-American females. We did not restrict our search to only studies that investigated ethnic differences because it is our aim to understand body image as it relates to health behaviors among black women to determine whether it may be a factor to address in designing interventions. We were not specifically investigating racial differences in regards to body image. Additionally, we found that many studies did not distinguish results by race or ethnicity. Thirty-one articles have been cited in this article. The list may not be exhaustive. Some identified articles were excluded for several reasons. Studies investigating dietary disorders were omitted as well as those that did not evaluate body image in association with the health behaviors. Findings and critiques of the remaining articles follow. Over the last decade, several seminal papers have documented the positive association between components of body image dissatisfaction and dieting frequency or dieting status among US adults and adolescents. An accumulating body of research has directly evaluated the relationship between dimensions of body image and dieting behavior or dieting status specifically in black women (see Table 1). Two studies bear mentioning first as findings have acknowledged the importance of identifying potential within group variation among black women with respect to dieting and body image disturbance (see Table 1). Kumanyika and colleagues were among the first to begin to clarify the link between dieting and weight satisfaction in a large sample of black women from the Washington DC community (1). Results showed that less satisfaction with weight and a history of dieting were more likely among the overweight women. Similarly, among black female participants in the CARDIA multisite investigation, a positive relationship between dimensions of body dissatisfaction and dieting for weight reduction was evidenced across BMI tertiles despite women of greater BMI reporting poorer body image (19). It is unclear however, whether results varied by study site. A series of cross-sectional studies assessed body image (using diverse instrumentation) among multiethnic samples of self-identified dieters inclusive of appreciable numbers of black females (21,22,23,24,25,26). In both adults and adolescents few differences in body image disturbance were observed between black and white female dieters (Table 1). This parity was particularly evident when analyses were adjusted for covariates correlated with both dieting status and body image perceptions (e.g., age, BMI regardless of race (21,23,25). Only a few studies to date have examined these relationships including nondieting controls as a comparison (22,24). In one early report, adolescent dieters residing in the Midwest irrespective of race, gender, and actual overweight status typically endorsed more disturbed body image attitudes relative to nondieting peers (24). Similarly, in a more recent investigation conducted in Los Angeles, both black and white adult female chronic dieters exhibiting high dietary restraint reported greater distortions in aspects of body image than nondieting females and male chronic dieters (22). However, these results were not controlled for BMI, age, or socioeconomic status. Another series of cross-sectional investigations compared the relationship between dimensions of body image and dietary restraint/dieting in ethnically diverse groups of black and white adult and adolescent females. Again, it appears that in general, the correlations between these factors are robust independent of age and race in community (22,27,28,29,30) and in-patient (26) samples. Notable exceptions, however, were observed in a few instances where patterns of relationships between indicators of poor body image and dieting behavior differed between women of both racial groups (Table 1 and see refs. 26,28,29). Interestingly, the one investigation in which no significant relationship emerged between components of body dissatisfaction and dieting among black females was conducted in the southern US region (26). A few recent reports have begun to explore the association between measures of body image and various dietary consumption patterns among black females and others (Table 2; please see Ard et al., for a description of findings using qualitative methodology) (31). Dependent variables included frequency of skipping meals (32,33), fast food consumption (34), and composite measures of dietary weight control (35) in predominantly black or ethnically diverse samples spanning a spectrum of ages and US regions. Components of body image disturbance tended to covary positively with poorer nutritional content (35) and behavior patterns (36) and negatively correlated with healthy dietary intake (37) with some exceptions (38,39). However, BMI and other socioeconomic status variables were not consistently controlled in analyzing these relationships. There have been varied findings regarding the association between body satisfaction and participation in physical activity (see Table 3). One study identified body image as a motivating factor for engaging in physical activity (14). Taylor et al. (14) investigated reasons for adolescent girls' participating or not participating in physical activity. Focus groups of black and Latina girls revealed that concerns with body image facilitated physical activity. The girls reported that extra body fat and size affected how they felt about themselves. Some noted positive effects of exercise were "keeping your right size," "a flat stomach," and "losing weight" as well as the desire to be skinny like the people on the exercise programs on TV and to lift weights to give shape to your body. Although there is qualitative evidence of body image being a motivating factor for physical activity, several other studies have found that low body satisfaction is associated with low physical activity. In a 5-year longitudinal study of socioeconomically and ethnically diverse adolescents, Neumark-Sztainer and colleagues (40) found that lower body satisfaction predicted lower levels of physical activity among females. Separate findings for black and white females were not presented. However, results were weighted by ethnicity, race, and socioeconomic status of respondents. Similarly, Yancey et al. (41) found that overweight black women and men were less likely to perceive themselves to be overweight than overweight Latinos or whites. Average weight blacks and Latinos who perceived themselves as being overweight were more likely to be sedentary than their white counterparts. In subgroup analyses by race/ethnicity, black and Latina women were grouped together due to small numbers (41). In another study, adolescents who perceived themselves as overweight were less likely to engage in physical activity despite trying to lose weight. Exercising was the method more often reported by whites than by other racial and ethnic groups (32). Some studies support the notion of cultural acceptance of fatness suggesting that blacks are less likely to engage in weight loss behaviors due to acceptance of large body shapes (42,43). Kelly et al. (33,42) found that black girls were more likely than white girls to report high body satisfaction. Results suggested that adolescent girls with high body satisfaction were less likely to use healthy or unhealthy weight control behaviors, including exercise, eating more fruits and vegetables, and eating fewer sweets and high-fat foods (42). Similarly, Mabry and colleagues (43) found that black adolescent girls demonstrated more acceptance and self-esteem with regards to having a larger body size than their white peers. This acceptance was associated with less participation in physical activity (43). Although many investigators are concerned with the impact of body image satisfaction on engagement in physical activities, others have investigated the opposite relationship. Some studies have found participation in physical activity to lead to improved body image (20,44,45,46). In a convenience sample with 60% black women Smith and Michel found that pregnant women who participated in an aquatic aerobic program reported improved body image scores. While analyses were not stratified by race/ethnicity, the diversity of the sample suggested that this association was true across race and ethnic groups (44). Likewise, Miller and Levy found that female athletes exhibited significantly more positive body image self-concept than female nonathletes (45). Again, results were not stratified by race. In a biracial population of young adults aged 18.5–35 in Bogalusa, LA, physical activity was not found to be a significant predictor of body image perception (20). While both black women and white women expressed negative body image views that countered the cultural tolerance of fatness theory attributed to black women, these groups expressed differences in ideal weight-loss methods. White women emphasized physical activity whereas black women emphasized food characteristics with no mention of physical activity (46). Some studies investigated both body image and physical activity but did not assess the association between these two factors; however, racial/ethnic differences were noted. Studies suggest that there is no significant difference between blacks and whites over age 22, whereas white teens and college-aged women are more dissatisfied with their looks than black women at this age (47). Perry et al. found that white girls had greater physical activity whereas black girls had higher ideal body sizes and greater body satisfaction than white girls. There was no significant difference between black girls and Hispanic girls on body satisfaction or physical activity (48). Contrarily, another study found that black women had higher ideal body image and more sedentary behaviors than Latin-American women (49). While there is evidence of contrary findings of the relationship between body image and physical activity and differences by race/ethnicity, in general the association tends to vary by age. Several researchers have examined the relationship between body image and smoking among females. However, the sample sizes of many of these studies assessing the role of body image on decisions to start smoking or smoking cessation included few blacks. King (13) noted that researchers had not examined the role of tobacco use for weight management among black women. Several clinical trials regarding tobacco cessation have assessed the impact that body image or weight image has in influencing smoking patterns among females. The studies can be separated into two types—those examining smoking initiation or smoking cessation. Several cross-sectional studies examined whether perceptions of attractiveness influenced smoking behaviors (50,51,52). Findings suggest that women smokers felt less attractive and disliked their bodies more than nonsmokers (52) (Table 4). Women with weight concern were more likely to smoke to achieve a smaller figure. Knauss and colleagues (50) found that female smokers considered other smokers to be more attractive and rated smoking as appealing. Utilization of media (magazines and television) may encourage smoking among weight-concerned adolescents. Carson surveyed 967 12th graders to examine whether exposure to media and drive for thinness influenced smoking among this population. Teens who read fashion, entertainment, and gossip magazines were more likely to be current smokers. The authors asserted that smoking is used by these teens in order to maintain a thin figure (51). Among studies of smoking for weight management, few studies have assessed the use of smoking for weight management among black women (53). An earlier review of barriers to smoking cessation among minority women did not include weight control as a barrier to quitting smoking (13). Many prior studies included small numbers of blacks. However, four studies examined the relationships between smoking and weight concern among larger numbers of black females. Several clinical trials have assessed factors affecting smoking cessation among black females. One study examined smoking cessation among blacks with HIV/AIDS (54). Another examined smoking cessation among low-income blacks (55). Both found black females with less weight concern were more likely to smoke. Only one study has assessed the role of weight concerns in smoking initiation among black females (53). Whereas 5.6% of African-American women initiated smoking as a result of weight concern, 11.3% of white women felt that weight was an important factor in smoking initiation. Using data from the National Longitudinal Survey of Youth (NLSY97) Cawley and colleagues (56) found that adolescent females with a higher BMI who were trying to lose weight were more likely to initiate smoking than the females who did not consider themselves overweight. Results were not stratified by race. Several studies assessed whether weight concern reduced smoking cessation among black women. Pomerleau et al. (53) found that overweight black smokers were less willing to risk weight gain by quitting smoking and concluded that weight concerns may motivate black women as powerfully as white women to continue to smoke. Two studies found that the majority of black female smokers were not concerned about postcessation weight gain (54,57). Obese black females were least concerned about postcessation weight gain. In contrast, another study reported that black female smokers were concerned about postcessation weight gain (56). Concerns about body shapes or the fear of postcessation weight gain differ from those of white females, yet have influenced some black women's decisions about smoking cessation. Further efforts must be made to provide weight gain education and prevention among black females (57). Numerous studies have investigated the association between body image and modifiable weight-loss behaviors among black females. In general, body dissatisfaction was found to be associated with poorer health behaviors. Females who were dissatisfied with their bodies were more likely to practice poor nutritional behaviors and less likely to participate in physical activity or to stop smoking. There were variations in findings due to race, age, and overweight status. Notable aspects of some previous studies regarding body image and weight control measures were the use of diverse populations, longitudinal study designs, and the consideration of inverse relationships. Several studies of body image and dieting behavior are particularly noteworthy for their methodological rigor of executing prospective longitudinal study designs (34,57) and for strategically sampling from both traditionally underrepresented groups in health research (e.g., ethnically diverse female hospital workers in an urban locale: (55) and from large regional segments of the US adolescent population (36,58,59). With small numbers of black females generally included in body image studies, two studies on smoking cessation are also noteworthy for investigating large groups of black females (54,57). The women in these studies were low-income, and in one study, the black women were HIV-infected. The bidirectional association between components of body image and weight control behaviors was highlighted by physical activity studies which investigated the impact of body image satisfaction on participation in physical activity(14,40,41,42,43,60) as well as the inverse influence of physical activity on body satisfaction (38,39,40,42) to assess motivators and barriers to weight control. Contrary to the strengths of a few studies, many studies suffered from analytical, methodological, and inclusion deficiencies. Little is known about the bidirectional relationship between changes in specific weight control behaviors and shifts in how black females may perceive their bodies and whether these patterns correspond with those reported by white females in this country. Most studies were cross-sectional in nature and unable to infer a clear directional relationship. The variations in findings of the associations suggest the need for more longitudinal research to clarify the directionality of this association. Additionally, there was great variation in measures of body image and classifications for dieting and physical activity status and perception. Most studies utilized a measure of self-perceived body image or weight status. It has been found that black females tend to be more accepting of larger bodies and generally underestimate their actual weight status with those who are overweight less likely to perceive themselves as overweight compared to other races (41,61). Those who are overweight perceive themselves as normal weight, and the obese consider themselves overweight (61). This discrepancy suggests the need for more culturally tailored programs to increase self-awareness of weight status, health consequences, and healthy lifestyle changes. Many studies on body image were mainly conducted on white females. Unfortunately, only small percentages of black females were usually included in the studies, therefore making any efforts to test for the potential differential impact of race on the relationship between measures of body image and behaviors untenable. Most authors discussed general findings irrespective of race (59,62), used race simply as a sociodemographic control variable versus testing it as a possible effect modifier (35,58), or tended to prefer emphasizing differences observed due to gender (37,59) or to overweight status (58). Additionally, studies were performed on a broad range of age cohorts suggesting an influence of body image throughout the stages of development and the need for further studies at each age level. Further investigation into differences by race/ethnicity within various age groups is needed. To design appropriate interventions to reduce obesity among black females it is necessary to understand whether body image is gaining influence in promoting dietary, physical activity, and smoking changes within the context of weight control. Based on the review of the literature offered here, the current state of the evidence is insufficient to adequately address this question at present. There are several factors to consider in improving the quality of the research produced and therefore strengthening confidence in the validity and applicability of findings. Chief among these is the need for greater attention to designing prospective longitudinal studies that would provide a more robust test of how dimensions of body image may act as determinants of weight control behaviors among black females. Additionally, with perceived overweight as well as high satisfaction with body image both being associated with more sedentariness, this presents quite a challenge for identifying motivators for black females to engage in health-promoting activities. A central question to target in future efforts is: What factors may modify the impact of weight and body dissatisfaction on engaging in dieting, physical activity, and smoking cessation among black females? The current review has provided some preliminary clues that may be involved in further delineating important individual differences in this line of research. These include overweight status (1), level of acculturation to mainstream US culture (22), and likely regional variation in the value placed on weight loss and tuning into feelings about the body as a mechanism of change (35,39). It is our hope that this critique may serve as a preliminary roadmap for both existing and future qualitative and quantitative research in this area to be effectively translated into culturally attuned healthy weight management promotion efforts among ethnically diverse females. The authors declared no conflict of interest.

BackgroundBody image variables such as body size perception (BSP) and body size dissatisfaction (BSD) can influence health-related behaviors. However, few studies have investigated these body image variables in adolescent girls participating in a physical activity intervention. Therefore, the study objectives were to examine the 1) associations between health-related behaviors (physical activity, screen-time, eating habits and sleep duration) and BSP and BSD among girls participating in FitSpirit, a physical activity intervention for girls; and 2) influence of weight control practices on the association between health-related behaviors and BSP and BSD.MethodsThis cross-sectional study assessed a sample of 545 adolescent girls (mean age: 15.0±1.5 years) from 240 schools. Body mass index, health-related behaviors, perceived actual body size and desired body size variables were self-reported and collected via an online questionnaire at the end of the FitSpirit intervention. A negative BSP score [perceived actual body size – calculated BMI z-score] indicates an underestimation of body size. A positive BSD score [perceived actual body size – desired body size] indicates a desire to reduce body size. A multiple linear regression analysis examined the effects of age, zBMI and health behaviors on BSP and BSD. A second multiple linear regression analysis examined the independent associations between BSP and BSD by weight control practice. The linear relationships between BSP and BSD were evaluated with Pearson’s correlations.ResultsUnderestimation and dissatisfaction of body size are more prevalent in participants living with overweight/obesity. Screen-time and sleep duration were independently associated with BSP score (Beta=0.02; P<0.05 and Beta=-0.07; P<0.05, respectively), whereas only screen-time was associated with the BSD score (Beta=0.07; P<0.001). Physical activity was independently associated with the BSP score only in participants trying to control (maintain) their weight (Beta=-0.18; P<0.05).ConclusionsBody size overestimation and dissatisfaction are associated with health-related behaviors, specifically with more screen-time and less optimal sleeping habits. Physical activity level does not appear to be associated with body image in girls engaged in a physical activity intervention and who want to lose or gain weight. Health promotion interventions could include screen-time and sleep components as they may influence body image.

Besides genetic factors and energy-related behaviors, psycho-cultural factors are also important in obesity etiology. Previous studies have suggested that improving body image might be an effective method for managing body weight. Thus, this study aimed to evaluate the effects of a multifaceted intervention on the body image of children and explore whether body image played a mediating role in changes in adiposity indicators. This study was embedded in a cluster randomized controlled trial, involving 1287 children from 24 primary schools in three cities in China (Beijing, Changzhi and Urumqi). The 9-month multifaceted intervention on childhood obesity included five components (three targeted children and two targeted environments), and randomization was performed by an independent person who was blinded to the schools. Two indicators (body size perception and body size expectation) were chosen to characterize body image and were measured by Ma figural stimuli at baseline and the end of the trial. Changes in body image indicators were classified as conducive to weight loss or not. Other anthropometric measures and self-reported behaviors were also collected at both time points. Generalized linear mixed models were used in the analyses. Compared to the controls (n = 648), the proportion of body size perception conducive to weight loss increased in the intervention group (n = 639), with an odds ratio of 2.42 (95%CI: 1.70~3.45, p < 0.001). The proportion of body size expectation conducive to weight loss also increased more in the intervention group than in the controls (OR = 1.74, 95%CI: 1.14~2.66, p = 0.010). In children whose baseline nutritional status was "normal weight with higher BMI" or "overweight/obese", the improvements in body size perception and body size expectation partly mediated the association between the intervention and changes in BMI, BMI Z score, waist circumference and body fat percentage (p < 0.05). This multifaceted study effectively improved the body image of children, which, in turn, led to beneficial changes in adiposity indicators. For the first time, body size perception and body size expectation have been confirmed to be important factors associated with the beneficial effect of a childhood obesity intervention, suggesting that body image components should be generalized in the future.

Objective. The purpose of this study was to assess grade, race, socioeconomic status and gender differences in perceptions of body size, weight concerns, and weight control practices between 4th and 7th grade students in South Carolina. Design. Two random samples, consisting of a total of 1,597 children (53.1% white, 51.97% female, 44.9% 4th graders) participated in two questionnaire surveys. Both surveys included a series of seven female and seven male body size drawings, body image and weight concern questions, and questions pertaining to weight control practices. Responses to the questionnaire were analyzed using chi-square analysis and the General Linear Model. Results. Using socioeconomic status (SES), race, gender, and grade as independent variables, differences in ideal adult body size, opposite gender ideal adult body size, weight concerns, perceptions of family/peer weight concerns, perceptions of own body size and weight control practices were studied. Analyses revealed that 4th grade males select a larger ideal adult body size and opposite gender ideal adult body size when compared to 7th grade males ( p < 0.0001 and p = 0.0078, respectively). Fourth grade females indicated less personal concern about their weight than 7th grade females ( p = 0.0009). Fourth graders also perceived less family/peer concern about weight than 7th graders ( p = 0.0027) and 7th graders described themselves as being more overweight than 4th graders ( p = 0.0039). Blacks selected a significantly larger body size than white children for ideal adult ( p = 0.0287) and ideal opposite gender adult body size ( p < 0.0001 for males, p = 0.0030 for females). Blacks also perceived less personal and family/peer concern about weight when compared to whites ( p = 0.0083). More whites reported that they were trying to lose weight, as compared to blacks ( p = 0.0010). Males also selected significantly larger body size silhouettes than females for ideal adult body size ( p = 0.0012). Males expressed less personal concern about weight ( p < 0.0001), perceived less family/peer concern about weight ( p < 0.0001), and were less likely than females to be engaged in weight loss ( p < 0.0001). Females in the high SES category selected a significantly smaller ideal male adult body size than females in the low SES group ( p = 0.0124) and more females in the high SES category were trying to lose weight when compared to females in the low SES group ( p = 0.0055).) Conclusion. This study indicates that early in a child's sociocultural development, grade level, gender, race, and SES are influential in the perception of ideal adult body size and opposite gender ideal adult body size. These factors are also influential in determining concerns about weight and weight control practices. The findings of this study support the need to begin health and wellness education efforts early in childhood while taking into account racial, gender, age, and SES disparities. This knowledge can also be useful in targeting interventions for both obesity and eating disorders.

Body image and size perceptions of Mexican American women

Effects of body mass and body image on exercise motives in adolescence

Perception of body size is an important psycho-cultural cause of obesity with wide racial and ethnic variations. Cross-sectional household survey using multistage cluster-randomised sampling. Prevalence estimates were weighted. Logistic regressions were done to determine the impact of perception of large body size on obesity and the impact of perception of own body size on weight-management behaviour. Adjusted odds ratios (AOR) were reported. The survey involved 6628 adults from 2843 households. More than a quarter of the population is either obese or overweight. Nearly half, 44.07% (95% confidence interval [CI]: 42.48-45.66%) of the population perceive large body size as desirable. Positive perception of large body size significantly increases the odds of obesity by 1.5 (AOR: 1.45; 95% CI: 1.09-1.9). Some 42.03% (95% CI: 35.52-48.55%) obese persons misperceive their weight to be normal. Perceiving own body size as normal decreases the odds of weight-losing behaviour (AOR: 0.019; 95% CI: 0.014-0.026). There is a high level of veneration of large body size in southeast Nigeria, and this has a significant impact on obesity burden. Perception of own body size has a significant impact on weight-management behaviour. Health-promotion policies aimed at changing the social desirability of large body size and misperception of body size are recommended.

The present study investigated the nature and extent of changes in body image following weight loss treatment in an obese sample and examined the role of weight loss in predicting body image improvement. Participants were 53 obese individuals (BMI > 30) recruited from the Pennington Biomedical Research Center in Baton Rouge, the Scripps Clinic in San Diego, CA, and the Weight Management Center at the St. Charles Hospital in New Orleans. Measures of psychological functioning and a figural body image rating procedure (Body Image Assessment for Obesity; BIA-O, Williamson, et al., 2000) were administered at baseline and after a 6-month follow-up (average 195 days). Body image dissatisfaction was operationally defined as the discrepancy between BIA-O current body size and ideal body size estimations. Weight loss for the total sample averaged 30.66 lbs, or a loss of 12.7% body weight. Body image significantly improved between T1 and T2, resulting from a decrease in participants' estimations of current body size, while selections of an ideal body size remained stable. Results from a stepwise MRA revealed that a higher initial BMI, the tendency to overeat, and depression were significant predictors of initial body image discrepancy at T1 (r= .712.). At follow-up, weight loss consistently performed as the strongest predictor of body image improvement. Data suggest that weight loss brought participants' perceptions of current body size closer in congruence with their ideal body size, thereby reducing levels of body image dissatisfaction. Several limitations of this study are discussed as well as clinical implications in relation to future directions for the assessment and treatment of body image concerns in obese individuals.

Purpose: The goal of this study was to examine body image satisfaction and perception according to weight status, and to investigate those associations with dietary habits and nutritional status among preadolescent children. Methods: Body image and dietary habits and intake were assessed in 134 elementary school students in grade 4. Children were categorized according to normal and overweight or obese groups. Figure rating scales were used to assess body image perception (identification of perceived current body size) and dissatisfaction (difference between perceived current body size and ideal body image). Results: There were sex differences in body image perceptions. Normal-weight girls, overweight or obese girls and boys were more likely to desire a leaner body size than their perceived body size compared with normal-weight boys. Body image satisfaction and perception showed an association with weight status. More overweight or obese children indicated dissatisfaction or underestimation of body image than normal-weight children. Children with body image dissatisfaction due to heavier perceived body size than ideal body image showed lower frequencies of consumption of meals and vegetables, compared to those who were satisfied with their body image. Children who underestimated their body image were more likely to have a lower frequency of breakfast and meal regularity and a higher frequency of eating out of home or food deliveries than those with accurate body image perception. In addition, body image underestimation showed an association with lower intakes of protein, dietary fiber and calcium, and the higher percentage of calories derived from fat. Conclusion: Body image dissatisfaction as well as underestimation in children before puberty showed an association with overweight or obesity, and was also related to unhealthy dietary habits. These findings highlight the importance of accurate perception and satisfaction with body image in preadolescent children in order to prevent development of obesity in adolescents and adults.

One hundred and sixty-five Mexican American and Euro-American preadolescents' and their parents' perceptions of healthy and attractive female body sizes and shapes were examined in this study. Participants' perceptions of healthy and attractive female figures were assessed using a pictorial measure that systematically manipulated 3 levels of body size and 4 levels of body shape (i.e., waist-to-hip ratio; WHR). All participants tended to perceive females' with small WHRs as most healthy and attractive looking, while preadolescents expressed a preference for thinner female figures than did adults. Results further suggest that Euro-American and Mexican American participants report similar preferences for females' body sizes and shapes. However, little agreement was found between preadolescents' and their parents' preferences. Principles of evolutionary theory and social learning theory are used to interpret these findings, and implications for preadolescents' perceptions of their own developing bodies, body image, and related eating behaviors are discussed.

Objectives Body image dissatisfaction and anthropometry-related issues are a growing public health concern in Nigeria, particularly among young adults. Tertiary students, including those in Nigerian university campuses, may be susceptible to sociocultural influences that promote unrealistic body ideals. This study investigates the relationship between perceived body size and anthropometric measurements among this population. Material and Methods A cross-sectional study was conducted among 232 female university students in a selected tertiary educational institution in Ibadan, southwestern Nigeria. Participants completed a demographic questionnaire and the Silhouette Rating Scale (SRS) to assess their perceived body size. Height and weight were measured to calculate the Body Mass Index (BMI). Descriptive statistics were used to summarise demographics and body image scores. Correlations were conducted to examine the relationship between perceived body size, anthropometry, and gender. Statistical significance was set at 0.05. Results The average age of the participants was 21.4 years. The participants reported a significant discrepancy between their perceived and actual body size. Most of them (65%) overestimated their body size, regardless of gender or BMI category. Correlations revealed a negative association between perceived body size and BMI, indicating that participants with higher BMI tended to perceive themselves as larger in body size. Conclusion This study found a significant body image discrepancy among Nigerian university students. Despite variations in BMI, a substantial portion of the sample overestimated their body size. These findings highlight the need for culturally sensitive interventions to promote healthy body image and aid effective anthropometry interventions among young adults.