Adolescent girls with high body satisfaction: who are they and what can they teach us?

doi:10.1016/j.jadohealth.2004.08.008

Journal of Adolescent Health

Volume 37, Issue 5, November 2005, Pages 391-396

https://doi.org/10.1016/j.jadohealth.2004.08.008 Get rights and content

Abstract

Purpose

The purpose of this study was 2-fold: (1) to determine the prevalence of high body satisfaction in a multi-ethnic, urban population of adolescent females, and (2) to examine the demographic, socioenvironmental, personal, and behavioral factors associated with high body satisfaction among adolescent girls.

Methods

The study population included 2,357 female middle and high school students who completed surveys in 1998–1999. High body satisfaction and its association with a range of socioenvironmental, personal, and behavioral factors were assessed. Associations were examined through comparisons of means (unadjusted and adjusted for grade level, race, socioeconomic status, and body mass index [BMI]) for continuous variables, and percentages and odds ratios for dichotomized variables.

Results

Over a quarter (26.7%) of adolescent girls reported high body satisfaction. High body satisfaction was most common among African-American (40.1%) and underweight girls (39.0%). In adjusted analyses, girls with high body satisfaction were more likely to report parental and peer attitudes that encouraged healthy eating and exercising to be fit (p < .001) versus dieting, and less likely to report personal weight-related concerns and behaviors (p < .001).

Conclusions

The immediate subculture in which adolescent girls exist may play an important role in fostering high body satisfaction. Parents and health care providers often struggle with how to address the topic of weight management in teens without causing further injury to body image. Findings from the present study suggest the importance of providing a social environment that focuses on health and fitness, rather than on weight control, to increase adolescent girls’ likelihood of being satisfied with their bodies.

Section snippets

Study population and design

Data for the present study were drawn from Project EAT (Eating Among Teens), a comprehensive study of eating, physical activity, and weight-related issues among junior high– and high school–aged adolescents. The study population included 4,746 male and female adolescents from 31 public middle schools and high schools in the Twin Cities area of Minnesota. For the purpose of this study, only the female sample (n = 2,357) was investigated. Among girls, 45.6% were Caucasian, 20.1% were

Results

Overall, more than one quarter (27%) of girls endorsed high body satisfaction. Girls with high body satisfaction differed significantly from girls without high body satisfaction on demographic, socioenvironmental, personal, and behavioral factors (shown in Table 1, Table 2).

Discussion

Results of the present study indicate that more than one quarter of the girls have high body satisfaction. Consistent with previous literature, African-American girls were more likely than Caucasian girls to endorse high body satisfaction [8], [27], [28], [30], whereas Native American and Hispanic girls were about as likely as Caucasian girls to report high body satisfaction [28], [29].

High body satisfaction in adolescent girls in this study was associated with certain socioenvironmental

Acknowledgment

Supported by grant MCJ-270834 (D.N.-S.) and grant #5-T71-MC00006-24 (Leadership Education in Adolescent Health) from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Service Administration, U.S. Department of Health and Human Services.

References (37)

T.N. Robinson et al.
Ethnicity and body dissatisfactionare Hispanic and Asian girls at increased risk for eating disorders?
J Adolesc Health
(1996)
E. Stice et al.
Role of body dissatisfaction in the onset and maintenance of eating pathologya synthesis of research findings
J Psychosom Res
(2002)
D.L. Franko et al.
The role of body dissatisfaction as a risk factor for depression in adolescent girlsare differences Black and White?
J Psychosom Res
(2002)
J.A. Pesa et al.
Psychosocial differences associated with body weight among female adolescentsthe importance of body image
J Adolesc Health
(2000)
D.M. Ackard et al.
Dieting frequency among college femalesassociation with disordered eating, body image, and related psychological problems
J Psychosom Res
(2002)
D. Neumark-Sztainer et al.
Ethnic/racial differences in weight-related concerns and behaviors among adolescent girls and boysfindings from Project EAT
J Psychosom Res
(2002)
E. Stice et al.
Risk factors for body dissatisfaction in adolescent girlsa longitudinal investigation
Dev Psychol
(2002)
T.L. Dunkely et al.
Examination of a model of multiple socio-cultural influences on adolescent girls’ body dissatisfaction and dietary restraint
Adolescence
(2001)
P. Adams et al.
Body dissatisfaction, eating disorders, and depressiona developmental perspective
J Child Family Studies
(1993)
M. Kostanski et al.
Adolescent body image dissatisfactionrelationships with self-esteem, anxiety and depression controlling for body mass
J Child Psychol Psychiatry
(1998)

R. Ohring et al.

Girls’ recurrent and concurrent body dissatisfactioncorrelates and consequences over 8 years

Int J Eat Disord

(2002)

P. Tetlin

Reflections of RiskGrowing Up Female in Minnesota

(1990)

J. Rodin et al.

Women and weighta normative discontent

J. Rierdan et al.

Weight, weight-related aspects of body image and depression in early adolescent girls

Adolescence

(1997)

E. Stice et al.

Body image and eating disturbances predict onset of depression among female adolescentsa longitudinal study

J Abnorm Psychol

(2000)

D.C. Moore

Body image and eating behavior in adolescents

J Am Coll Nutr

(1993)

M.A. Katzman et al.

Bulimia and binge eating in college womena comparison of personality and behavioral characteristics

J Consult Clin Psychol

(1984)

G.R. Leon et al.

Personality and behavioral vulnerabilities associated with risk status for eating disorders in adolescent girls

J Abnorm Psychol

(1993)

Cited by (59)

Food Insecurity Is Associated with Body Dissatisfaction among Children in California
2019, Journal of the Academy of Nutrition and Dietetics
Citation Excerpt :
Food insecurity was measured using three items from a validated 5-item scale,20 and although the three items accurately differentiated the extent of food insecurity compared with the 5-item scale, using three items may have underestimated the prevalence of children’s experience of food insecurity. Because body satisfaction was measured using only five questions from a larger validated questionnaire11 and the validity of the five-item subset has not been assessed, the subset of questions may not accurately reflect body satisfaction in the present study. Lastly, data on several factors that might be related to both food insecurity and body dissatisfaction were not collected and therefore could not be adjusted or tested as mediators (eg, mental health, self-esteem, parental well-being, parental education, and income).
Food insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined.
The purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction.
This was a cross-sectional study.
This study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016.
The primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity.
Data were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex.
In this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P<0.001) and children with a normal children (odds ratio=1.76; P<0.001).
Experiencing food insecurity was associated with greater body dissatisfaction, with the magnitude of the association modified by BMI and race/ethnicity.
Disparities in Body Mass Index Trajectories From Adolescence to Early Adulthood for Sexual Minority Women
2017, Journal of Adolescent Health
Citation Excerpt :
Future research should also focus on adapting evidence-based healthy weight promotion strategies to be culturally relevant to adolescent SMW. There are strong data to support the roles of regular family meals [37], healthy body image irrespective of BMI [38], and provider-based motivational interviewing interventions [39] in healthy weight management for youth. These data lay the foundation for incorporating family support, body satisfaction, and motivational interviewing techniques into healthy weight interventions for adolescent SMW.
We aimed to estimate group-based trajectories of body mass index (BMI) in a longitudinal cohort of young women and determine the association between sexual identity and BMI trajectory group, adjusting for obesity risk factors.
We analyzed data from females in waves I–IV of the National Longitudinal Study of Adolescent to Adult Health. Sexual identity was categorized as heterosexual, mostly heterosexual, bisexual, or lesbian (homosexual/mostly homosexual). We conducted group-based trajectory modeling of BMI with a censored normal distribution and a cubic relationship with age to identify three BMI trajectory groups. Multinomial logit regressions predicted the risk of trajectory membership associated with sexual identity, adjusting for background characteristics.
At wave I, the mean (n = 7,801) age was 15.9 years (95% confidence interval: 15.6–16.1). Subjects were 16.3% African-American; and 80.0% heterosexual, 15.9% mostly heterosexual, 2.5% bisexual, and 1.7% lesbian. Group-based trajectory modeling identified three BMI trajectory groups characterized as (1) minimal obesity (62.2%), (2) developing obesity (29.9%), and (3) progressive obesity (8.0%). In multinomial logit regressions adjusted for age, race, parental obesity and education, sexual abuse, household income, screen time, depressive symptoms, and rural residence, lesbian women had a nearly two-fold higher relative risk of being in the developing obesity trajectory group (relative risk ratio = 1.91, 95% confidence interval: 1.10–3.32) relative to the minimal obesity group, compared with heterosexual women.
Lesbian women were at increased risk of membership in the developing obesity trajectory group compared with heterosexual women. Adjusting for obesity risk factors had minimal impact on the point estimates for this association.
Gender and racial/ethnic differences in binge eating symptoms in a nationally representative sample of adolescents in the United States
2016, Eating Behaviors
Citation Excerpt :
Based on past research and Bem's gender schema theory (Bem, 1981) – which highlights the transactional relationship between cultural beliefs about gender and individuals' development and expression of culturally-based expectations regarding males and females from an early age – we hypothesized that females would endorse more binge eating symptoms associated with loss of control and distress due to binge eating than males. Because gender- or race/ethnicity-specific psychosocial, environmental, and economic factors may play a role in the development and maintenance of problematic eating (George & Franko, 2010) and these factors may be interrelated, we further explored adolescent race/ethnicity (Kelly et al., 2005; Paxton et al., 2006; Perry et al., 2004; Ricciardelli et al., 2007) as a potential moderator of the associations between gender and binge eating symptoms. We examined each binge eating symptom individually to better understand which indicators of loss of control and distress are relevant across gender and racial/ethnic groups to inform treatment and prevention efforts.
Binge eating disorder (BED) is the most prevalent eating disorder in the U.S. adolescent population. Both BED and subthreshold binge eating disorder (SBED) are associated with physical and mental health problems. Gender and racial/ethnic differences in prevalence of binge eating in a nationally representative sample of adolescents have been reported but have not yet been assessed in relation to individual symptoms of binge eating. We examined gender and racial/ethnic differences in endorsement of eight binge eating symptoms in a nationally representative sample of U.S. adolescents.
We used data from the National Comorbidity Survey-Adolescent Supplement (NCS-A; 2001–2004), a nationally representative cross-sectional study of adolescents aged 13 to 18 years (n = 9336). We compared binge eating symptoms across gender and racial/ethnic groups using multivariable regression models.
Females endorsed more binge eating symptoms than males associated with loss of control (‘eat when not hungry’) (adjusted prevalence ratio [aPR] = 1.18, 95% confidence interval [CI] = 1.02, 1.37, p = 0.024) and distress (e.g., ‘afraid of weight gain while binge eating’ [aPR] = 3.29, CI = 2.43, 4.47, p < 0.001). Racial/ethnic minorities displayed different patterns of binge eating symptoms than non-Hispanic Whites. Hispanics reported being more ‘afraid of weight gain while binge eating’ (aPR = 2.05, CI = 1.25, 3.37, p = 0.006) than non-Hispanic Blacks.
Our findings suggest significant gender and racial/ethnic differences in binge eating symptom presentation. Future work should explore reasons for these gender and racial/ethnic differences and consider these differences when determining how best to prevent and treat binge eating in adolescents.
In it together: Mother talk of weight concerns moderates negative outcomes of encouragement to lose weight on daughter body dissatisfaction and disordered eating
2016, Body Image
Citation Excerpt :
It is possible these two items were, in some cases, tapping discussion of healthy eating behaviors related to minimizing unhealthy foods while maximizing proper nutrition. Kelly and colleagues (2005) found that adolescent girls with high body satisfaction perceived that their mothers were engaging in healthy eating (versus dieting to lose weight). There was also an emphasis within these dyads on getting fit rather than becoming thin.
Mothers’ influence on their daughters is important for understanding girls’ disordered eating and body dissatisfaction. Direct maternal encouragement of daughters to lose weight is linked to daughters’ development of bulimic symptoms, and additional findings indicate that daughters whose mothers merely talk about dieting and body dissatisfaction are more likely to be diagnosed with an eating disorder. The current study extends such research by examining the interactive contributions of maternal encouragement to lose weight and maternal dieting discussions to the prediction of early adolescent daughters’ body dissatisfaction and disordered eating over the middle school period. Participants were 89 adolescent girls who were in the 6th grade at Time 1. Regression analyses were conducted to examine interactive effects of mother encouragement to diet and talk of weight concerns on daughter body dissatisfaction, drive for thinness, and dieting behavior. Results suggest an interactive effect in which mothers’ dieting talk may act as a buffer against the negative effects of direct encouragement to lose weight.
Breasts, Butts, and Thighs—Oh My! Weight Spurt and Body Image Messages in Girls’ Puberty Books
2024, Journal of Adolescent Research
Realizing the untapped promise of single-session interventions for eating disorders
2023, International Journal of Eating Disorders

View all citing articles on Scopus

View full text

Original articleAdolescent girls with high body satisfaction: who are they and what can they teach us?

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Study population and design

Results

Discussion

Acknowledgment

J Adolesc Health

J Psychosom Res

J Psychosom Res

J Adolesc Health

J Psychosom Res

J Psychosom Res

Risk factors for body dissatisfaction in adolescent girlsa longitudinal investigation

Dev Psychol

Examination of a model of multiple socio-cultural influences on adolescent girls’ body dissatisfaction and dietary restraint

Adolescence

Body dissatisfaction, eating disorders, and depressiona developmental perspective

J Child Family Studies

Adolescent body image dissatisfactionrelationships with self-esteem, anxiety and depression controlling for body mass

J Child Psychol Psychiatry

Girls’ recurrent and concurrent body dissatisfactioncorrelates and consequences over 8 years

Int J Eat Disord

Reflections of RiskGrowing Up Female in Minnesota

Women and weighta normative discontent

Weight, weight-related aspects of body image and depression in early adolescent girls

Adolescence

Body image and eating disturbances predict onset of depression among female adolescentsa longitudinal study

J Abnorm Psychol

Body image and eating behavior in adolescents

J Am Coll Nutr

Bulimia and binge eating in college womena comparison of personality and behavioral characteristics

J Consult Clin Psychol

Personality and behavioral vulnerabilities associated with risk status for eating disorders in adolescent girls

J Abnorm Psychol

Original article
Adolescent girls with high body satisfaction: who are they and what can they teach us?