The distinct role of body image aspects in predicting eating disorder onset in adolescents after one year.

Abstract

Recent research suggests specific body image aspects, namely weight/shape dissatisfaction, overvaluation of weight/shape, weight/shape preoccupation, and fear of weight gain, have distinct roles in eating disorder (ED) onset and maintenance. The aim of this study was to investigate unique associations between these body image aspects and ED onset, distress, and quality of life in a community sample of adolescents prospectively after 1 year. Adolescents (n = 1,327; 51% female; age range 11-19 years) who completed Waves 1 and 2 of the EveryBODY Study and did not meet criteria for an ED at Wave 1 completed measures of ED symptoms, distress, and quality of life impairment. Results showed that 18.2% of participants (70% female) met criteria for an ED at Wave 2. Only weight/shape dissatisfaction was prospectively associated with onset of any ED. No other body image aspect was uniquely associated with greater distress nor lower quality of life in longitudinal analyses. However, all body image aspects were independent correlates of ED diagnosis within Wave 2. These findings suggest that dissatisfaction might operate as a risk factor for ED development in adolescence, whereas overvaluation, preoccupation, and fear of weight gain could be more proximal markers of ED psychopathology. Therefore, these body image phenomena should be assessed as separate constructs as they may play unique roles in ED onset and classification. ED prevention efforts in adolescence may need to target dissatisfaction first, whereas a focus on other aspects of body image may be more important for early intervention programs.

Risk factors for eating disorders: findings from a rapid review

“…In an eight-year longitudinal study of adolescent girls, higher levels of perceived pressure to be thin, thin-ideal internalisation, and body dissatisfaction were significant predictors of later onset ED (BN, BED, and purging disorder) [ 294 ]. Among an adolescent sample, dissatisfaction with weight and shape, but not overvaluation or preoccupation, was a predictor of onset of an ED after 12 months [ 295 ]. The authors suggest that while body dissatisfaction may impart risk for ED development, the other body image-related constructs of overvaluation and preoccupation, may indicate presence of ED psychopathology.…”

Identifying components of drive for muscularity and leanness associated with core body image disturbance: A network analysis.

“…In men, it has been observed that the aspiration for increasing muscle mass and obtaining a highly muscular body can lead to an increased concern around body shape/weight and eating, which, when taken to an extreme, characterize ED symptomatology (Jones et al, 2008). Specifically, in males, DM is strongly linked to body dissatisfaction (Baker et al, 2019;Bucchianeri et al, 2014)-a risk factor for ED development (Prnjak et al, 2021;Stice et al, 2011)-which does not seem to be the case in females (Schaefer & Blodgett Salafia, 2014). Despite this, current ED classifications do not recognize muscularity-oriented attitudes and behaviors as potential markers of ED psychopathology.…”

“…Body dissatisfaction, overvaluation of shape/weight, and fear of weight gain are considered by many authorities to be aspects of body image disturbance with distinct correlates and diagnostic significance (Fairburn et al, 2003; McLean & Paxton, 2019). They also play unique roles in explaining ED psychopathology concurrently (Grilo et al, 2019; Linardon et al, 2018; Lydecker et al, 2017) and prospectively (Prnjak et al, 2021). Body dissatisfaction is a widely researched aspect of body image disturbance that is thought to promote dieting and hence increase risk for ED development (Stice et al, 2011).…”

Testing the Identity Disruption Model among Adolescents: Pathways Connecting Adverse Childhood Experiences to Body Dissatisfaction

“…Another important consideration is the potential for gender differences in the constructs and pathways outlined in the Identity Disruption Model. It is fairly well-established that boys tend to show lower levels of body dissatisfaction than do girls (Prnjak et al, 2021 ), and there is also evidence of gender differences in internalization of cultural ideals and appearance-based comparisons (e.g., Palmeroni et al, 2021 ). However, there is some evidence (at least among adults) that the associations among variables in the Identity Disruption Model do not differ for men and for women (Vartanian et al, 2018 ).…”