BodiMojo: effective Internet-based promotion of positive body image in adolescent girls.

This study tested the efficacy of an Internet-based health promotion program, BodiMojo, designed to promote positive body image in adolescents. Participants were 178 students (mean age 15.2 years, 67.6% ethnic minority) in three public high schools. Intervention groups used BodiMojo for four weekly health class periods, while controls participated in their usual health curriculum. Body image measures were given at baseline, post-intervention, and 3 months. Girls reported decreased body dissatisfaction (p<.05), decreased physical appearance comparison (p<.05), and increased appearance satisfaction (p<.05), relative to controls. Effects were not maintained at 3-month follow-up. No significant differences were found between the intervention and control groups with boys. Moderation analyses suggested positive effects for diverse adolescents as well as those who were overweight or indicated baseline high body dissatisfaction. BodiMojo appears to be modestly effective in decreasing body image concerns among adolescent girls in the short term.

Race/ethnicity, education, and treatment parameters as moderators and predictors of outcome in binge eating disorder.

OBJECTIVE: Binge eating disorder (BED) is prevalent among individuals from minority racial/ethnic groups and among individuals with lower levels of education, yet the efficacy of psychosocial treatments for these groups has not been examined in adequately powered analyses. This study investigated the relative variance in treatment retention and posttreatment symptom levels accounted for by demographic, clinical, and treatment variables as moderators and predictors of outcome. METHOD: Data were aggregated from 11 randomized, controlled trials of psychosocial treatments for BED conducted at treatment sites across the United States. Participants were N = 1,073 individuals meeting criteria for BED including n = 946 Caucasian, n = 79 African American, and n = 48 Hispanic/Latino participants. Approximately 86% had some higher education; 85% were female. Multilevel regression analyses examined moderators and predictors of treatment retention, Eating Disorder Examination (EDE) global score, frequency of objective bulimic episodes (OBEs), and OBE remission. RESULTS: Moderator analyses of race/ethnicity and education were nonsignificant. Predictor analyses revealed African Americans were more likely to drop out of treatment than Caucasians, and lower level of education predicted greater posttreatment OBEs. African Americans showed a small but significantly greater reduction in EDE global score relative to Caucasians. Self-help treatment administered in a group showed negative outcomes relative to other treatment types, and longer treatment was associated with better outcome. CONCLUSIONS: Observed lower treatment retention among African Americans and lesser treatment effects for individuals with lower levels of educational attainment are serious issues requiring attention. Reduced benefit was observed for shorter treatment length and self-help administered in groups.

Social-cognitive correlates of fruit and vegetable consumption in minority and non-minority youth.

OBJECTIVE: Inadequate fruit and vegetable (FV) consumption signals a need for identifying predictors and correlates of intake, particularly in diverse adolescents. DESIGN: Participants completed an on-line assessment in early 2010. SETTING: Computer classrooms in 4 high schools. PARTICIPANTS: One hundred twenty-two Caucasian and 125 minority (African American and Hispanic) high school students (mean age = 15.3 years, SD = 1.0) with parental consent. Response rate was 89%. VARIABLES MEASURED: Self-efficacy as measured by confidence in goal setting and decision making about healthful eating; perceived benefits and barriers to eating FVs; healthful eating-related social support; body esteem; and FV intake. ANALYSIS: t tests were used to examine group differences, and binary logistic regression analyses were conducted to explore the predictors of 5-A-Day FV consumption. RESULTS: Thirty-four percent of the non-minority group and 28% of the minority group reported eating 5 or more portions of FVs a day (P = .34). Self-efficacy and perceived benefits predicted consumption in minority participants, whereas barriers and social support were significant predictors in the non-minority group. CONCLUSIONS AND IMPLICATIONS: These findings suggest different variables predict consumption for minority and non-minority groups and that self-efficacy is an important variable to consider in dietary change programs for minority adolescents.

Considering J.Lo and Ugly Betty: a qualitative examination of risk factors and prevention targets for body dissatisfaction, eating disorders, and obesity in young Latina women.

Latina women are vulnerable to poor body image, eating disorders, and obesity, particularly during the college years. This study sought to identify common cultural antecedents of these concerns in order to inform the development of prevention programs for this population. Six groups of university students who identified as Latina (N=27) discussed cultural aspects of body image, eating disorders, and obesity. Thematic analysis identified four main themes: (a) cultural disparities in body-ideal, including the influence of the media and acculturation issues; (b) messages about body shape and weight received by family, peers, and society; (c) difficulties making healthy eating and physical activity choices as a function of college life; and (d) the influence of peers and potential male partners on body satisfaction and body-ideals. These results have implications for the development of programs targeting body dissatisfaction and risk for eating disorders and obesity in Latina college women.

Psychometric properties of measures of eating disorder risk in Latina college women.

OBJECTIVE: Latina college women are at risk for eating disorders (EDs), but assessment is problematic, because the psychometric properties of risk factor measures have not been evaluated with this group. METHOD: Reliability and validity estimates of the Eating Disorder Examination Questionnaire, Body Esteem Scale, Sociocultural Attitudes Toward Appearance Questionnaire-3, and Body Shape Questionnaire were examined in a sample of 173 female Latina college students. RESULTS: Cronbach α coefficients (.75-.96) and intraclass coefficients (.65-.96) indicated good reliability. Most measures were significantly correlated, providing evidence for convergent validity. Confirmatory factor analyses resulted in good fit indices. DISCUSSION: These findings indicate that commonly used measures of ED risk have adequate reliability and validity in Latina college women. Comparison data suggest that ED risk may be similar or even higher in Latina college women relative to Caucasian college women. Prevention efforts with diverse groups are needed.

Racial/ethnic differences in adults in randomized clinical trials of binge eating disorder.

OBJECTIVE: Recent studies suggest that binge eating disorder (BED) is as prevalent among African American and Hispanic Americans as among Caucasian Americans; however, data regarding the characteristics of treatment-seeking individuals from racial and ethnic minority groups are scarce. The purpose of this study was to investigate racial/ethnic differences in demographic characteristics and eating disorder symptoms in participants enrolled in treatment trials for BED. METHOD: Data from 11 completed randomized, controlled trials were aggregated in a single database, the Clinical Trials of Binge Eating Disorder (CT-BED) database, which included 1,204 Caucasian, 120 African American, and 64 Hispanic participants assessed at baseline. Age, gender, race/ethnicity, education, body mass index (BMI), binge eating frequency, and Eating Disorder Examination (EDE) Restraint, Shape, Weight, and Eating Concern subscale scores were examined. RESULTS: Mixed model analyses indicated that African American participants in BED treatment trials had higher mean BMI than Caucasian participants, and Hispanic participants had significantly greater EDE shape, weight, and eating concerns than Caucasian participants. No racial or ethnic group differences were found on the frequency of binge eating episodes. Observed racial/ethnic differences in BED symptoms were not substantially reduced after adjusting for BMI and education. Comparisons between the CT-BED database and epidemiological data suggest limitations to the generalizability of data from treatment-seeking samples to the BED community population, particularly regarding the population with lower levels of education. CONCLUSIONS: Further research is needed to assess alternative demographic, psychological, and culturally specific variables to better understand the diversity of treatment-seeking individuals with BED.

A comparison of stigma toward eating disorders versus depression.

OBJECTIVE: The goal of this study was to compare the degree of stigma associated with anorexia nervosa (AN), bulimia nervosa (BN), and depression. METHOD: Participants read one of three vignettes describing clinical cases of AN, BN, or depression, and answered questions assessing stigma toward individuals with one of these three mental disorders. RESULTS: Attitudes toward individuals with eating disorders were significantly more stigmatizing than attitudes toward individuals with depression. Individuals with an eating disorder were rated as more fragile, more responsible for their disorder, and more likely to use their disorder to gain attention than individuals with depression. Furthermore, the majority of participants reported that they admired certain aspects of eating disorders, thought that there might be some benefits to having an eating disorder, and that others would be motivated to imitate eating disorder behavior. DISCUSSION: Stigma toward individuals with eating disorders is greater than stigma toward depression and includes unique features such as attitudes of envy. Implications of these results for the understanding of mental disorder stigma and eating disorders are discussed.

A Case Series of Family-Based Therapy for Weight Restoration in Young Adults with Anorexia Nervosa.

This case series aims to examine the preliminary efficacy, acceptability and feasibility of Family-Based Treatment to promote weight restoration in young adults with anorexia nervosa. Four young adults with sub/threshold anorexia nervosa were provided 11-20 sessions of Family-Based Treatment for young adults with pre-, post- and follow-up assessments. At post- and follow-up, 3/4 participants were in the normal weight range, 3/4 were in the non-clinical range on the Eating Disorders Examination and reported being not/mildly depressed. At post-treatment, 2/4 were in the good psychosocial functioning range and by follow-up, 3/4 were in this range. These results suggest that Family-Based Treatment for young adults with anorexia nervosa is a promising treatment.