Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 40: (i) Prevention (n = 2); (ii) Soc Media, Pt. 2 (n = 2); (iii) BI, Pt. 3 (n = 2); (iv) DE, Pt. 2 (n = 2); and (v) Weight Stigma, Pt 1 (n = 2)
Colleagues (N now = 1198 in 48 countries),
Please (a) continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications); and (b) pass along the following to anyone who would like to join this free email list.
RECOVERY/SUPPORT-ADVOCACY-IN-ACTION
Free MORNINGSIDE CHAT in THE LIVING ROOM:
SATURDAY, July 6, 2024
11:00 a.m. - 12:00 p.m. Eastern |
8:00 a.m. - 9:00 a.m. Pacific
and, once again (in a reversal)
hosted by former guest
Ms. Hannah Juliano, BS, RYT, Nutritionist
and featuring our own
Ms. Sondra Kronberg, MS, RD, CDN, CEDRD
(Founder and Host of the Morningside Chats Program)
Received 21 June 2024 via a Chats in the Living Room email from my friend and Bolder Model, our own Ms. Sondra Kronberg (see, e.g., https://sondrakronberg.com/).
ML NOTE 1: The content of the Morningside Chats email I received was prefaced by the following (bold and CAPS in the original).
PLEASE FORWARD AND OFFER THIS RESOURCE TO PATIENTS & Colleagues to add to their support - it is a completely collegial, non-competitive, non-promotional joint effort by experts.
ML NOTE 2: In what promises to be another interesting, informative role reversal, in contrast to several previous Chats, this time Ms. Juliano (see, for example, https://www.linkedin.com/in/hannahjuliano/) will be serving as host and Ms. Kronberg will be the guest on her own program . . . .
ML NOTE 3: For information about previous Morningside Chats, various forms of support for recovery and self-care, and other resources that Ms. Kronberg and her staff provide, go to: https://www.chatsinthelivingroom.com/
Professionals across the eating disorder field are coming together to support your recovery, healing, and growth in these challenging times. From the comfort of your home, and anonymously, grab a coffee and join us on Zoom for…
Choose Support • Choose Connection • Choose Recovery
MORNINGSIDE CHATS in THE LIVING ROOM
developed and hosted by Sondra Kronberg
FREE! - live on Saturday morning 6 July 2024, 11:00 am ET | 8:00 am PT
RSVP through by clicking the following to sign up and receive your Zoom invite via email: https://www.chatsinthelivingroom.com/sign-up
ML Note 4: For information about Sondra and her multifaceted work and contributions to the field, see Sondra Kronberg
REQUEST FOR RESEARCH PARTICIPATION AND/OR ASSISTANCE IN RECRUITING
from [our own] Dr. Tiffany Brown, Department of Psychology, Auburn University, for a study
[which ML, paraphrasing, has] entitled
The Impact of Amenorrhea on Sexual, Psychological, and Social Wellbeing
Received (California time) 24 June 2024 via an email from our own Dr. Tiffany Brown (USA; see ML NOTE 6 below).
ML NOTE 5: Dr. Brown, her students and colleagues, and I would appreciate it if you would (a) participate in this study, if eligible; and/or (b) pass this along to any people who might be eligible and/or who (e.g., physicians, nurses, psychologists, dietitians, coaches, trainers, dance instructors, social workers, etc.) who “work with” people who might be eligible.
[Dr. Brown writes:]
Have you ever missed a period? You may be eligible to participate in an ongoing study about amenorrhea.
Researchers at Auburn University are studying the impact of amenorrhea on sexual, psychological, and social wellbeing. They're recruiting participants with amenorrhea to participate in an online, anonymous Qualtrics survey. The survey will take 20-30 minutes to complete. VISIT aub.ie/ABSENCE TO TAKE THE ANONYMOUS SURVEY. Email Regan Moss ram0083@auburn.edu with questions. [Auburn University IRB Approval Number: 23-656 EX 2401]
Tiffany A. Brown, PhD (she/her) | Assistant Professor, Department of Psychological Sciences | Director, ACCEPT Lab [and] Co-Director, Auburn Eating Disorders Clinic (AED) | Auburn University
Research Publication Categories in This Newsletter
(i) Prevention (n = 2); (ii) Social Media, Part 2 (n = 2); (iii) Body Image, Pt. 3 (n = 2); (v) Disordered Eating, Part 2 (n = 2); and (v) Weight Stigma, Part 1 (n = 2)
CONGRATULATIONS to our own
Dr. Zali Yager (Australia/USA) for publication of the Prevention commentary/review article in #2.
Drs. Rachel Rodgers (USA/France; see also #4), Allegra Gordon (USA), Natasha Burke (USA), and Anna Ciao (USA) for publication of the Prevention review/commentary article in #2.
Drs. Kyle Ganson (Canada), Rachel Rodgers (USA/France; see also #1), and Jason Nagata (USA) and colleague for publication of the Social Media research article in #4.
Dr. Giuseppe Riva (Italy) and colleague for publication of the Body Image commentary/review article in #5.
Mr. Wesley Barnhart (USA) and Dr. Jinbo He (Hong Kong/China) and colleagues for publication of the Disordered Eating research article in #7.
Drs. Mun Yee Kwan (USA) and Dorian Dodd (USA) for publication of the Disordered Eating research article in #8.
Drs. Jeffrey Hunger (USA) and A. Janet Tomiyama (USA) and colleagues for publication of the Weight Stigma research article in #9.
Prevention
ML NOTE 6: The articles described below in #1 and #2 are in effect (sort of/kinda) Part 7 (of many) of my description of the articles in the forthcoming Special Issue of Eating Disorders: The Journal of Treatment & Prevention, which is co-edited by our own Dr. Leslie K. Anderson (USA) and distinguished prevention expert-researcher-clinician-mentor and Bolder Model, Dr. Catherine Cook-Cottone (USA).
The Guest Co-Editors of this Special Issue, which is entitled Identifying and Closing the Gaps in the Prevention of Disordered Eating and Eating Disorders, are our own Drs. Anna Ciao (USA; see also #2 below) and Tiffany Brown (USA), and me. The previous 6 parts, comprised of 7 articles, are available in the Newsletters of 26 March, 28 March, 2 April, 7 April, 11 April, and 18 April 2024.
1. Yager, Z. (2024). Something, everything, and anything more than nothing: stories of school-based prevention of body image concerns and eating disorders in young people. Eating Disorders: The Journal of Treatment & Prevention. Advance online publication. https://doi.org/10.1080/10640266.2024.2364523
Full text available for download, for a limited time, at: https://www.tandfonline.com/doi/full/10.1080/10640266.2024.2364523
Email address for correspondence: zali.yager@gmail.com
ABSTRACT. Much work has been done to promote the development of positive body image in schools. This paper aims to tell some stories from the past 35 years of work in this field that illuminate important issues in developing, evaluating, and disseminating programs, and in removing policies and practices that could trigger weight stigma and body shame or disordered eating attitudes and behaviours. The need for, goals of, and approaches to body image programs, problematic activities we have ‘good enough’ evidence to avoid, and next steps for advocacy, research, and action are explored as we celebrate how far we’ve come and have hope for the future.
2. Rodgers, R. F., Gordon, A. R., Burke, N. L., & Ciao, A. (2024). Parents and caregivers as key players in the prevention and identification of body image concerns and eating disorders among early adolescents. Eating Disorders: The Journal of Treatment & Prevention. Advance online publication. https://doi.org/10.1080/10640266.2024.2366546
Full text available for download, for a limited time, at: https://www.tandfonline.com/doi/full/10.1080/10640266.2024.2366546
Email address for correspondence: r.rodgers@northeastern.edu
ABSTRACT. Early adolescence (ages 11–14 years) is a key period for the emergence of body image and eating concerns, and early identification and access to treatment are imperative for positive outcomes. Despite research identifying this critical developmental period, few prevention resources are available for early adolescents. Parents are key players for this age group and important socializing agents. As such, they are well positioned to help youth access resources or support where needed. However, programs to position and involve parents as interventionists are lacking.
Our aims are two-fold. First, we review the evidence for the effectiveness of parents as body image interventionists and the existing data regarding parental needs. Second, we provide directions for future research and outline a framework for empowering parents as interventionists, identifying key domains in which parents may play a role in addressing body image and eating concerns among early adolescents. Based on the extent literature, these domains include facilitating engagement with or co-utilizing intervention content to decrease body image and eating concerns in at-risk children, which may also help to increase parents’ effectiveness in their efforts to support youth.
In addition, parents may deliver content to decrease or reverse risk-factors and early symptoms, or disrupt the early disorder phase of illness. To date, parents constitute an underutilized resource in eating disorder and disordered eating prevention, and efforts should be made to increase the evidence-based strategies to leverage their relationship with at-risk children.
Social Media, Part 2 of 2
ML NOTE: #7 - The articles described below in #3 came to my attention via the Obesity and Energetics Offerings online newsletter of 28 June 2024. For more information about free participation in this ongoing and valuable exercise in education, research methods, and critical thinking, see Obesity and Energetics Offerings.
3. Kamiński, M., Wieczorek, T., Kręgielska-Narożna, M., & Bogdański, P. (2024). Tweeting about fatphobia and body shaming: A retrospective infodemiological study. Nutrition, 125. Advance online publication. https://doi.org/10.1016/j.nut.2024.112497
Email address for correspondence: tobiasz.wieczorek00@gmail.com
ABSTRACT. Background: We aimed to analyze reactions to tweets that employed weight-based discrimination terms and to compare them to others posted by the same users on X (formerly Twitter). Methods: We collected tweets featuring weight-based discrimination terms (the study group) and created a control group by randomly selecting up to five tweets from each account that did not mention any such terms. Descriptive statistics, sentiment analysis, and logistic regression modeling were used to compare the numbers of likes and retweets of the study and control groups, and to understand the emotions associated with these tweets.
Results: Our analysis included 22,075 study group tweets and 50,341 control group tweets. Sentiment analysis was conducted on 41,403 (57.2%) tweets, with 65.7% of the study group tweets being found to contain negative sentiments. The study group had a higher median of likes (1 [0–4]) and retweets (0 [0–0]) than the control group (1 [0–2] and 0 [0–0], respectively, with the study group obtaining higher mean ranks in both comparisons, P < 0.001). Multivariable logistic regression analysis revealed that tweets using weight-based discrimination terms gained more likes (OR = 1.22; 95% CI: 1.16–1.28) and retweets (OR = 1.61; 95% CI: 1.49–1.74), independent of, for example, verification status, follower count, year and season of the tweet, and emotional expression of the tweet. Conclusions: Tweets concerning fatphobia, body shaming, and similar terms gain more reactions than others posted by the same accounts.
4. Ganson, K. T., Testa, A., Rodgers, R. F., & Nagata, J. M. (2024). Use of photo filters is associated with muscle dysmorphia symptomatology among adolescents and young adults. Body Image, 50. Advance online publication.https://doi.org/10.1016/j.bodyim.2024.101750
Full text available for download at: https://www.sciencedirect.com/science/article/pii/S174014452400072X
ABSTRACT. It has been documented in the literature that the use of photo filters to alter one’s appearance may negatively impact body image and increase the risk for thinness-oriented disordered eating behaviors. However, the prior research has neglected to investigate the association between use of photo filters and muscle dysmorphia symptomatology, which was the aim of this study. Data from the Canadian Study of Adolescent Health Behaviors (2022; N = 912), a national study of adolescents and young adults in Canada, were analyzed.
Linear regression analyses revealed that the use of photo filters was associated with greater muscle dysmorphia symptomatology, including total symptomatology and Appearance Intolerance, among the overall sample. Gender significantly moderated the association between photo filter use and muscle dysmorphia symptomatology, whereby boys and young men, compared to girls and young women, who reported photo filter use had greater Drive for Size and Functional Impairment symptomatology. Findings expand prior research by emphasizing that photo filter use is related to muscularity-oriented body image concerns and behaviors. Future research is needed to elucidate the mechanisms that underpin this association.
Body Image, Part 3 of (now) 5
5. Repetto, C., & Riva, G. (2024). "Embodiment in the metaverse: How real and virtual bodies in interaction affect cognition" [Editorial]. Journal of Cognition, 7(1):51. https://doi.org/10.5334/joc.374.
Full text available for download at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192097/
When we move into the world, we are immediately aware of being the owners of our bodies and being able to fully control our actions (Repetto & Riva, 2023; Riva, 2018). The first is referred to as the sense of ownership, and the second as the sense of agency, and both are key determinants of the sense of Embodiment (Longo & Haggard, 2012), which plays a fundamental role in bodily self-consciousness (BSC).
However, the study of BSC is not an easy task. Even if BSC is for the individual a unitary experience, neuroimaging and neurological data suggested that BSC includes different layers (Figure 1) that integrate both sensory and cognitive bodily data in a coherent experience.
For this reason, the study of BSC has centered on clinical populations exhibiting altered perceptions of their bodies and on healthy individuals subjected to experimental paradigms capable of disrupting multisensory integration. More recently, the advent of Immersive Virtual Reality (IVR) technology has ushered in a new era, allowing researchers to investigate embodiment in a completely novel way (Matamala-Gomez et al., 2021).
IVR shares a fundamental mechanism with the human brain—embodied simulations, which are central to the theory of predictive coding (Talsma, 2015). This concept in neuroscience suggests that the brain constructs and updates an internal model of the body and the environment around it to anticipate sensory inputs, rather than just reacting to it. IVR operates similarly by creating an avatar interacting in a computer-generated world that users can use and manipulate as if they were in (Riva et al., 2019).
6. Iqbal, S., Sultana, S., & Malik, A. (2024). Examining the relationship between exposure to Avengers action figures and men’s body dissatisfaction and eating disorders in Pakistan. Pakistan Journal of Humanities and Social Sciences, 12(2), 1110–1121. https://doi.org/10.52131/pjhss.2024.v12i2.21461110e
Full text available for download at: https://journals.internationalrasd.org/index.php/pjhss/article/view/2146/1461
ABSTRACT. This study investigates the relationship between social comparison, body dissatisfaction, and eating disorders among males in five major cities of Pakistan. The sample comprised 400 male participants drawn from diverse socioeconomic backgrounds. The Social Comparison Theory serves as the theoretical framework for examining how individuals' perceptions of their bodies are influenced by comparisons with others. Results revealed significant correlations between eating disorder symptoms and body dissatisfaction as well as social comparison tendencies. More specifically, there was a larger tendency toward disordered eating practices and higher degrees of body dissatisfaction among those who participated in upward social comparison.
The results emphasize the importance of considering social comparison processes in understanding body image concerns and eating disorders among males in Pakistan. Implications for intervention and prevention efforts aimed at promoting positive body image and healthy eating behaviors are discussed. The implications of these findings extend to intervention and prevention strategies geared towards fostering positive body image and cultivating healthy eating behaviors among this demographic.
Disordered Eating, Part 2 of (now) 4
7. Xu, Y., Song, J., Ren, Y., Barnhart, W. R., Dixit, U., Ji, F., Chen, C., & He, J. (2024). Negative emotional eating patterns in general Chinese adults: A replication and expansion study examining group differences in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties. Eating Behaviors. Advance online publication. https://doi.org/10.1016/j.eatbeh.2024.101899
Email address for correspondence: yinuoxu1@link.cuhk.edu.cn
ABSTRACT. Previous research identified four patterns of negative emotional eating in American and Chinese university students and proposed future directions (e.g., exploring potential differences in emotion regulation across patterns and replicating the patterns in a general, non-student population). Furthermore, prior research has not explored group differences in muscularity-oriented eating disorder symptomatology or psychosocial impairment.
Therefore, the present study addressed these gaps in a sample of general Chinese adults, further testing group differences in thinness-oriented and muscularity-oriented eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties across patterns of negative emotional eating. A total of 600 Chinese adults were recruited. Latent class analysis (LCA) was used.
Results replicated the four patterns of negative emotional eating in previous research, including non-emotional eating (non-EE), emotional over- and under-eating (EOE-EUE), emotional over-eating (EOE), and emotional under-eating (EUE). Significant group differences were identified in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties. Specifically, individuals with EOE and EOE-EUE patterns exhibited higher eating disorder symptomatology, higher psychosocial impairment, and more emotion regulation difficulties than those with non-EE and EUE patterns.
Therefore, these two groups (i.e., EOE and EOE-EUE), especially the limitedly researched EOE-EUE group, should be further examined to elucidate research and clinical applications. Furthermore, findings also underscore the role of emotion regulation difficulties in further describing the differences across these negative emotional eating patterns, which can be considered in future interventions for reducing negative emotional eating.
8. Kwan, M. Y., & Dodd, D. (2024). Social cognition and bulimic symptoms in male undergraduate students: The conditional effect of emotion dysregulation. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.3120
Email address for correspondence: munyee.kwan@hofstra.edu
ABSTRACT. Objective: Research demonstrates associations between poor social cognition and eating disorder (ED) pathology. Moreover, research shows that individuals with EDs struggle with emotion regulation. The present study replicates and extends the literature on social cognition and ED pathology, which previously focused largely on symptoms of anorexia nervosa among women while the present study focuses on symptoms of bulimia nervosa among undergraduate men. Further, this study tests the hypothesis that better emotion regulation mitigates the association between social cognition and ED pathology. Methods: At a single timepoint, undergraduate males (N = 520) completed a series of questionnaires, and a task assessing mentalising, a key element of social cognition.
Results: Consistent with hypotheses, bulimic symptoms were associated with worse mentalising and worse self-reported emotion regulation. Moreover, the association between mentalising and bulimic symptomatology was conditional on emotion regulation, such that it was strongest among those with more difficulties regulating their emotions. Conclusion: Results are consistent with existing theories that highlight an interplay between interpersonal (e.g., mentalisation) and intrapersonal (e.g., affective functioning) factors in relation to ED symptomatology. Among undergraduate males, bulimic symptoms were associated with worse mentalisation. However, a good ability to regulate emotions interrupted this association.
Weight Stigma, Part 1 of 3
9. Lee, K. M., Wang, C., Du, H., Hunger, J., & Tomiyama, A. J. (2024). Weight stigma as a stressor: A preliminary multi-wave, longitudinal study testing the biobehavioral pathways of the Cyclic Obesity/Weight-Based Stigma (COBWEBS) model. Appetite. Advance online publication. https://doi.org/10.1016/j.appet.2024.107573
Email address for correspondence: krstnl@g.ucla.edu
ABSTRACT. Higher weight individuals often face significant weight stigma. According to the Cyclic Obesity/Weight-Based Stigma (COBWEBS) model, weight stigma operates as a stressor that increases the stress hormone cortisol and promotes comfort eating, thus resulting in weight gain. Such weight gain is harmful as it exposes individuals to further stigmatization. Thus far, no study has yet tested the mechanistic pathways of the COBWEBS model and prospective longitudinal studies are severely lacking.
To fill this gap, the current study tested the biobehavioral pathways of the COBWEBS model using a 4-wave yearlong longitudinal study comprising 348 higher weight individuals. Using a structural equation modeling framework, we tested three cross lagged panel models for the putative mediator, comfort eating. The models examined either synchronous and/or lagged effects across weight stigma, perceived stress, comfort eating, weight, and future weight stigma.
The best fitting model revealed significant associations between baseline weight stigma, perceived stress, and comfort eating within the same month. However, comfort eating did not significantly predict weight four months later. Weight status and baseline weight stigma both predicted future weight stigma as expected. Additionally, a separate path model with hair cortisol found that weight stigma predicted perceived stress four months later, but stress did not predict aggregate cortisol levels from months 10 and 11. Hair cortisol also did not predict later weight. This preliminary work lays the foundation for identifying modifiable targets of weight stigma, thereby offering potential avenues to reduce weight stigma’s harm on higher weight individuals.
10. Layman, H. M., Fields Creech, K., Patel, D., Keirns, N. G., Garza, L., Tsotoros, C. E., Krems, J. A., & Hawkins, M. A. W. (2024). The association of adverse childhood experiences and weight stigma above and beyond parental, peer, and media influences. Stigma and Health. Advance online publication. https://doi.org/10.1037/sah0000533
Email address for correspondence: hlayman@okstate.edu
ABSTRACT. Adverse childhood experiences (ACEs: abuse, neglect, and household dysfunction) have been associated with greater experienced weight stigma (EWS) and internalized weight stigma (IWS). The current work examines whether ACEs are uniquely associated with weight stigma after adjusting for sociocultural pressures (i.e., parents, peers, and media) related to body image. Participants include 394 college students from a large southern university (N = 394, Mage = 19.6, 68.5% female, 72.1% White). Participants completed an online survey assessing ACEs, sociocultural body image pressures (i.e., tripartite influence model), weight stigma, and demographic characteristics. Hierarchical linear regressions were conducted to identify associations between ACEs or ACE subtypes and EWS and IWS after adjusting for tripartite influences on body image.
Higher total ACE scores were uniquely related to higher EWS (β = 0.169, p < .001) and IWS (β = 0.131, p = .002) after adjusting for sociocultural influences. The abuse subtype and neglect subtype ACEs were most consistently related to weight stigma. This work confirms and expands upon previous work establishing a relationship between ACEs and weight stigma, unique to sociocultural body image pressures. The abuse and neglect subtypes may drive this association. This study’s findings may be used to inform interventions to deter the impact of ACEs and societal pressures on weight stigma to reduce physical and mental health consequences.