Objective Sexual minority (SM) groups (e.g., those who identify as lesbian, gay, bisexual, questioning, queer, asexual, or those who feel their sexual orientation identity cannot be captured with existing terminology [LGBQA+] and those who report same‐sex or same‐gender attraction and/or behavior) are at elevated risk for eating disorder (ED) symptoms and behaviors. However, the ways in which this risk varies across SM is less clear, and findings are not fully convergent. Evolution in the definition and assessment of SM status may contribute to this divergence. The aim of this study was to systematically review how sexual orientation and SM status have been assessed in the ED literature and how this may relate to patterns of associations between SM status and ED symptoms. Methods A systematic review of the literature focused on ED symptoms and behaviors and SM groups was conducted, yielding 182 studies. Results Five categories were created reflecting SM status assessment: identity only (n = 105), attraction only (n = 8), behavior only (n = 4), combinations of identity, behavior, or attraction (n = 58), and articles with unclear or insufficient information about SM status assessment (n = 7). SM status operationalizations varied across studies, with more inclusive assessments in more recent work. Findings revealed persistent conflicting patterns of disordered eating symptomatology for some SM groups. In addition, decisions to selectively combine SM participants in some studies, most often to increase power, decreased the specificity of their results in relation to differential risk and protective factors within specific LGBQA+ groups. Discussion Findings highlight the importance of inclusive assessments of sexual orientation in the ED literature and research focused on underrepresented groups with intersecting identities. Identifying modifiable targets for intervention is a critical next step. Public Significance Sexual minority (SM) groups have been identified as presenting elevated risk for eating disorder symptoms and behaviors. Our findings suggest that the level of risk is variable across SM groups and points to the need for multi‐dimensional assessments of SM status, and increased focus on the function of disordered eating behaviors and different profiles that might emerge related to efforts to modify physical appearance or to regulate emotion.
Objective: The pursuit of thinness and fear of gaining weight have been found to play an important role in eating disorder symptomatology. While these dimensions have typically been considered conjointly, emerging evidence suggests they may be distinct dimensions. The aim of this study was to explore the subjective experiences of fear of fatness and drive for thinness in young women with body image concerns.Method: Young women endorsing weight concerns (N = 29, mean age = 20.86, SD = 2.70 years) were interviewed and asked to describe an experience of fear of fat and drive for thinness, respectively.Results: Qualitative analysis was conducted and identified four themes: (1) precipitating events; (2) physiological, emotional, cognitive, and proprioceptive experiences;(3) coping strategies; and (4) sociocultural influences. While similarities emerged, the experiences of fear of fatness, and of drive for thinness also evidenced clear differences situating the former in the context of fear-based avoidance patterns, and the latter in approach-based reward models.Discussion: These findings provide additional support for the usefulness of considering fear of fat and drive for thinness as distinct constructs. Further research examining the contributions of each of these constructs to eating pathology is warranted.disordered eating, drive for thinness, fear, fear of fatness, qualitative, reward, weight and shape concerns | INTRODUCTIONBody image concerns have been shown to be important drivers of eating pathology (Stice, Marti, & Durant, 2011). Specifically, the pursuit of thinness, that is efforts to obtain and maintain a very slender body, and fear of fatness, that is fear of gaining weight, body fat, or becoming larger bodied, have been found to play an important role in eating disorder symptomatology, and indeed overvaluation of weight and shape is an important clinical criterion for eating disorders (Fairburn, Cooper, & Shafran, 2003). Typically, both of these dimensions have been considered conjointly, for example in assessment tools (Fairburn & Beglin, 1994). However, there is emerging evidence that these may be distinct dimensions (Levitt, 2003;Rodgers, DuBois, Frumkin, & Robinaugh, 2018), which would have important theoretical and intervention implications. Specifically, findings from a study among nonclinical college students using a network approach revealed that drive for thinness was a central symptom in the eating disorder network and highly interconnected with other core symptoms such as body dissatisfaction (Rodgers et al., 2018). In contrast, fear of fatness was a more peripheral symptom and was less strongly related to other core elements of the network. Given the centrality of these dimensions to the development and maintenance of eating disorder pathology, as well as the importance of increasing our understanding of the potential independence of these dimensions, this study sought to
Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.
Objective: Research focused on developing risk and protective models of body image concerns and disordered eating among older women is scant. Models including biological, psychological, and sociocultural elements may be useful explanatory frameworks in this group. Thus, the aim of this study was to conduct formative research exploring the constructs that form part of biopsychosocial models of body image concerns and disordered eating among older women.Method: A sample of 184 women aged 60-75 years completed an online survey assessing media pressures, thin-ideal internalization, depression symptoms, weight and shape concerns, and disordered eating as well as positive reappraisal and acceptance of aging-related changes to appearance.Results: After the addition of two supplemental pathways, the model revealed good fit to the data. In the final model, age, depression, and media pressure were associated with media internalization, that was in turn associated with weight and shape concerns, and then disordered eating. Depression was also directly associated with both weight and shape concerns and disordered eating. The model varied across older women with high versus low levels of positive reappraisal and acceptance of aging-related changes to appearance. Specifically, among those high on this trait, the pathways between depression and thin-ideal internalization, and between weight and shape concerns and disordered eating were significantly weaker.Discussion: These findings support the usefulness of biopsychosocial models for grounding research on body image concerns and disordered eating among older women, and suggest positive reappraisal and acceptance of aging-related changes to appearance as a useful dimension to focus on.
The majority of advertisements contain thin-ideal imagery that have been digitally modified. A robust body of research has suggested that exposure to these retouched images has negative effects on body image and increases eating disorder risk. Furthermore, these concerns are known to be highly gendered both in nature and in their extent, with women revealing higher levels of concerns predominantly related to thinness. Although not supported as a useful approach by empirical data, in 2017, France introduced a law requiring advertisers to label images featuring models whose weight and/or shape have been altered. These images must bear the label “photographie retouchée”, or “retouched image”. However, this legislation has been difficult to enforce, as unlike other French legislation related to labeling advertising, its lack of specificity makes it difficult to identify violations. Paradoxically, given its intentions, where applied, uses of the label disproportionately focus on women’s bodies in the media, as compared to men’s bodies. These findings highlight the need for legislation that is enforceable and supported by the allocation of sufficient resources. In addition, findings highlight the importance of grounding legislation and policy in the extant relevant data and involving strategic stakeholders in its creation.
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