The validation of the Barcelona Orthorexia Scale-Spanish version: evidence from the general population.

PURPOSE: To validate the Spanish version of Barcelona Orthorexia Scale (BOS) in general population, analyzing its items and both its internal structure and psychometric properties (internal consistency and temporal stability). In addition, the relationship between ON and external measures of attitudes towards food was assessed. METHOD: The general population sample consisted of 446 women and 104 men, aged between 18.31 and 69.44 years (M = 36.03; SD = 12.46). Of these, 39 participants answered again the questionnaires after one month from the first application. The assessment instruments were a sociodemographic questionnaire, the BOS, the Eating Attitudes Test-26 (EAT-26) and the Dutch Eating Behavior Questionnaire (DEBQ). RESULTS: The final version of the BOS is composed of 35 items. Exploratory factor analysis extracted an internal structure of 5 factors (Behavioral, Concern for healthy food, Attitudes and beliefs about food, Vital achievement and Emotional discomfort). The BOS-35 and the factors presented good internal consistency (α = .80-.90), and an adequate temporal stability (r = .62-.88). The highest association was observed between the Emotional Distress (BOS) and the Diet subscale (EAT-26; r = .51). CONCLUSIONS: This first validation of the BOS has shown adequate psychometric properties, being a valid and reliable instrument to assess ON in the general population. Level of evidence Level II: Evidence obtained from well-designed controlled trials without randomization.

Weight discrimination, BMI, or weight bias internalization? Testing the best predictor of psychological distress and body dissatisfaction.

OBJECTIVE: This study aimed: (1) to compare psychological distress (PD) and body dissatisfaction (BD) in terms of BMI, weight bias internalization (WBI), and weight discrimination (current and past); (2) to assess the best predictor of PD and BD and assess the relationships with weight discrimination, BD, and WBI. METHODS: The sample consisted of 1283 participants across all BMI categories, recruited through the internet voluntarily. People with obesity were the most predominant (26.1%). Experiences of weight-based discrimination were reported by participants across all BMI categories, and they were more prevalent in people with obesity. RESULTS: People with obesity, those with WBI, and those who faced current and past weight discrimination reported higher PD and higher BD. However, WBI was the best predictor after controlling for BMI, WBI, and current and past weight discrimination. Mediation analyses revealed that the relationship between weight discrimination and BD through WBI was significant, as was the relationship between weight discrimination and WBI through BD. CONCLUSIONS: These results stressed the importance of WBI in PD and the role of weight discrimination in WBI and BD. Hence, there is a need to better understand how WBI is formed and to design effective interventions to reduce it.

Women's body dissatisfaction, physical appearance comparisons, and Instagram use throughout the COVID-19 pandemic: A longitudinal study.

OBJECTIVE: This study aimed to determine the evolution of Instagram use, body dissatisfaction and physical appearance comparisons throughout the coronavirus disease-2019 (COVID-19) pandemic, and to explore whether there was a relationship between the changes in Instagram use throughout the pandemic and body dissatisfaction and physical appearance comparisons. METHOD: A total of 272 Spanish women (16-70 years old) were followed-up across four waves of assessment between November 2019 (before the pandemic started) and July 2021. Body dissatisfaction, social appearance comparisons, and Instagram use were assessed using the Eating Disorders Inventory-3, the Physical Appearance Comparison Scale-Revised, and an ad hoc questionnaire for Instagram use, respectively. RESULTS: No statistically significant changes were found in the frequency of Instagram use, nor on the proportion of women following appearance-focused accounts on Instagram, among the data collection periods. Body dissatisfaction significantly increased from T1 to T4, and physical appearance comparisons significantly increased from T1 to T2, T3, and T4. These increases were not found to be significant for those with eating disorder risk. No significant differences were found in body dissatisfaction and physical appearance comparisons depending on whether participants' frequency of Instagram use had changed or remained the same, or whether they had started/stopped/continued following appearance-focused accounts on Instagram during the pandemic. DISCUSSION: Women's body dissatisfaction and physical appearance comparisons seem to have increased throughout the pandemic. The experiences of individuals with eating disorder risk throughout the pandemic, and the relationship between the pandemic and Instagram use, might be complex and need further research. PUBLIC SIGNIFICANCE: This study suggests that women's body dissatisfaction and physical appearance comparisons have increased throughout the COVID-19 pandemic. However, this increase might not be as clear for those who had eating disorder risk before the pandemic. Instagram frequency of use, and the percentage of women following appearance-focused accounts on Instagram, do not seem to have significantly increased. More research is needed to explore the impact of the pandemic.

A consensus document on definition and diagnostic criteria for orthorexia nervosa.

PURPOSE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE: Level V: opinions of expert committees.

Anti-fat attitudes among Spanish general population: Psychometric properties of the anti-fat attitudes scale.

Weight discrimination is one of the worst forms of prejudice and is deeply rooted in society. The aim of this study was to adapt the anti-fat attitudes scale (AFA) to the Spanish general population. The sample consisted of 1248 participants from the Spanish community population. They were recruited through the internet and participated voluntarily. Women (77.8%) were more predominant than men. Regarding body weight categories, 5.3% were underweight, 43.5% were normal-weight, 24.9% were overweight and 26.3% had obesity. A cross-validation method with an exploratory and confirmatory factor analysis confirmed the three-factor structure of the AFA. The Spanish version of the AFA showed a satisfactory internal consistency for all three factors, as well as adequate test-retest reliability after a 1-month interval. Finally, the Spanish version of the AFA seems to be an adequate tool to assess negative attitudes towards obesity in both clinical and research settings. Men presented more negative attitudes towards obesity and were convinced that obesity is under someone's control. Women presented more fear of gaining weight. Normal-weight people were those who discriminated more. Participants with overweight or obesity suffered more fear of gaining weight. There was no intra-group discrimination between individuals with overweight and obesity.

Validación española de la “Escala de comparación de la apariencia física” (PACS-R): propiedades psicométricas en una muestra comunitaria de hombres y mujeres / [Spanish validation of the “Physical Appearance Comparison Scale” (PACS-R): psychometric properties in a community sample of men and women]

Los objetivos de este estudio fueron examinar la validez y la fiabilidad de la versión española de la “Escala de comparación de la apariencia física-revisada” (Physical Appearance Comparison Scale-Revised; PACS-R) y evaluar su capacidad predictiva de la insatisfacción corporal y las alteraciones alimentarias en una muestra comunitaria española. 1405 participantes (83,6% mujeres; de entre 14 y 64 años) completaron la PACS-R y también medidas de imagen corporal, alteraciones alimentarias, influencias socioculturales relacionadas con la apariencia física, autoestima y comparación social. Los análisis factoriales exploratorio y confirmatorio apoyaron la estructura unidimensional original para la versión española de 11 ítems de la PACS-R. Las mujeres mostraron puntuaciones significativamente más elevadas que los hombres. Se halló una consistencia interna excelente, buena fiabilidad test-retest y buena validez convergente. Los análisis de regresión demostraron la utilidad de la escala para predecir la insatisfacción corporal y las alteraciones alimentarias tanto en hombres como en mujeres. Las excelentes propiedades psicométricas de la PACS-R la convierten en una herramienta útil para medir las comparaciones de la apariencia física en personas de habla española.

The objectives of this study were to examine the validity and reliability of the Spanish version of the Physical Appearance Comparison Scale-Revised (PACS-R) and to assess its ability to predict body dissatisfaction and disordered eating in a community sample in Spain. A total of 1405 participants (83.6% women; aged 14-64) completed the Spanish PACS-R along with measures of body image, eating disturbances, appearance-related sociocultural influences, self-esteem and social comparison. Exploratory and confirmatory factor analyses supported the original one-dimensional factor structure for the 11-item Spanish version of the PACS-R. Women had significantly higher PACS-R scores than men. Internal consistency of the measure was excellent, and results showed good test-retest reliability and convergent validity in men and women. Regression analyses demonstrated the utility of the scale in predicting body dissatisfaction and disordered eating in both genders. Results suggest that the Spanish PACS-R has excellent psychometric properties, therefore it might be a useful tool to measure appearance comparisons among Spanish speaking populations.

Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials.

BACKGROUND: Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). METHOD: From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. RESULTS: Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. CONCLUSIONS: Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

The number of people with overweight and obesity has tripled worldwide since 1975. Obesity has become a serious problem for public health. For that reason, the design of innovative treatments for people with overweight and obesity is an urgent need. This systematic review and network meta-analysis assesses the effectiveness of innovative interventions, concretely web-based programs for overweight and obesity, comparing them with traditional behavioral treatments and wait-list groups. Both web-based and traditional behavioral treatments were classified according to three feedback characteristics: personalization, frequency, and provider (human versus machine). The literature has suggested that a frequent feedback is an indicator of good prognosis in traditional interventions. The results of this study showed that for web-based interventions, an intensive and personalized feedback provided by a healthcare professional was the treatment option that led to a better prognosis. The second and third option were web-based guided self-hep programs and traditional self-help programs. These interventions empowered the participants, providing more sense of self-efficacy. Web-based minimal-contact programs, web-based self-help programs and wait-list were the last options. An accurate ranking of available treatment options only can be provided by a network meta-analysis, the statistic technique used in this study.

Validation of the modified weight bias internalization scale in a Spanish adult population.

Weight bias internalization has received considerable attention in recent years and has been associated with serious psychological and physical consequences in Westernized societies. The modified weight bias internalization scale (WBIS-M) is one of the most frequently used instruments for assessing internalized weight stigma across different body weight categories. The aim of this study was to adapt the WBIS-M for use in Spanish adult populations. The sample consisted of 678 participants from the Spanish general population recruited through the internet, 79.6% of whom were women. The scale was translated into Spanish and then backtranslated. To study the internal structure, a cross-validation analysis was carried out including both exploratory and confirmatory factor analyses to assess the scale's psychometric properties. Internal consistency was evaluated using Cronbach's alpha and McDonald's omega and a test-retest was conducted to assess one-month stability. Results confirmed that the Spanish adaptation of the WBIS-M is an 11-item unidimensional scale, like the original version and shows excellent psychometric properties. In conclusion, the Spanish WBIS-M version seems to be a robust psychometric tool for use in clinical and research settings.

The impact of COVID-19 lockdown on social network sites use, body image disturbances and self-esteem among adolescent and young women.

OBJECTIVE: This study aimed to determine the impact of COVID-19 lockdown on social network sites (SNS) use and to explore whether SNS use is associated with body image disturbances and low self-esteem. METHODS: A total of 2601 women living in Spain aged 14-35 years completed questionnaire measures of SNS use, self-esteem, body dissatisfaction and drive for thinness. In the survey, participants were asked about their use of SNS at the moment of answering the survey and before lockdown. RESULTS: A statistically significant increase was found in the frequency of use of all studied SNS (Instagram, YouTube, TikTok, Twitter and Facebook) during lockdown, as well as in the number of women following appearance-focused Instagram accounts. Moreover, significant relationships were found between the frequency of Instagram use and body dissatisfaction, drive for thinness and low self-esteem in the younger age group (14-24), and between the frequency of Instagram use and drive for thinness in the older age group (25-35). Following appearance-focused accounts on Instagram was related to body dissatisfaction and drive for thinness in the younger group, and only to drive for thinness in the older group (25-35). Following appearance-focused accounts on Instagram and a higher frequency of use of Instagram significantly predicted higher levels of drive for thinness. CONCLUSION: These results suggest that lockdown has had an impact on SNS use, and this might be linked to increased drive for thinness and eating disorder risk among adolescent and young women.

El impacto de la pandemia por covid-19 y del confinamiento en las alteraciones alimentarias y el malestar emocional en adolescentes y jóvenes de España / The impact of the covid-19 pandemic and confinement on eating disorders and emotional distress in adolescents and young people in Spain

sumen El objetivo de este estudio fue determinar el impacto psicológico del confinamiento por COVID-19 en una muestra comunitaria española. 2847 participantes de entre 14 y 35 años (95% mujeres) completaron medidas de depresión, ansiedad, estrés, autoestima y alteraciones alimentarias. Considerando la pequeña proporción de hombres y al hallar diferencias significativas entre sexos, la mayoría de resultados fueron informados solo para las mujeres. Un 30,8%, 25,4% y 20,5% de la muestra presentó niveles graves o muy graves de depresión, ansiedad y estrés respectivamente. La calidad del sueño, los hábitos alimentarios, las preocupaciones por la apariencia física, por el futuro y por la salud habían empeorado a raíz del confinamiento. Una menor edad, no tener pareja, el desempleo, no haber contraído COVID-19 o no estar seguro de ello, el fallecimiento de un ser querido por COVID-19, y no tener un lugar donde relajarse fueron factores asociados al malestar psicológico y las alteraciones alimentarias. El análisis de ecuaciones estructurales confirmó la influencia directa de las variables relacionadas con el confinamiento en la psicopatología. Esto sugiere que la pandemia puede haber tenido un impacto significativo en la salud mental y en la conducta alimentaria (AU)

This cross-sectional study aimed to determine the impact of COVID-19 lockdown on emotional distress and disordered eating in a community sample of Spanish youngsters. A total of 2847 participants (95% women; aged 14-35 years) completed depression, anxiety, stress, self-esteem, and disordered eating measures. Given the small proportion of men and as significant differences were found between genders in several variables, most results were only reported for women. Severe levels of depression, anxiety and stress were found in 30.8%, 25.4% and 20.5% of the sample, respectively. Sleep quality, eating habits, appearance concerns, preoccupation about one’s future, health concerns and other life domains were also affected by lockdown. Younger age, being single, being unemployed, not having contracted COVID-19 or not being sure about it, having a loved one infected or deceased due to coronavirus, and not having a place to relax at home were significantly associated with psychological distress and disordered eating. A structural equation model confirmed the direct influence of lockdown-related variables into psychopathology symptoms. The findings of this study suggest that COVID-19 and its associated lockdown might have a significant effect on psychological wellbeing and eating disturbances (AU)

The behavioral pathway model to overweight and obesity: coping strategies, eating behaviors and body mass index.

PURPOSE: Obese and overweight people deal with more daily problems and stressful situations than normal-weight individuals, for example, discrimination and bias. The aims of the present study were twofold: to identify differences between overweight and normal-weight people in coping strategies and eating behaviors, and to examine the relationship between coping strategies, eating behaviors and BMI. METHODS: Sample of the present study consisted of 473 participants, 76.7% women (mean age = 32.7; SD = 11.4). Participants completed an ad hoc sociodemographic data questionnaire, the Coping Strategies Inventory, and the Dutch Eating Behavior Questionnaire. Welch's t test and X2 comparison analysis were used to identify differences in coping strategies and eating behaviors, according two BMI groups, normal weight and overweight. To analyze the relationship between coping strategies, eating behaviors and BMI, a structural equation modeling was conducted. RESULTS: Overweight participants score significantly higher in passive coping strategies such as self-criticism, wishful thinking and social withdrawal, and unhealthy eating behaviors such as emotional eating and restrained eating. Structural equation modeling included these variables, coping strategies are more likely to conduct to unhealthy eating behaviors and these are more likely to promote and maintain a high BMI. The model showed an adequate data fit. CONCLUSIONS: This research proposes a relationship between the variables analyzed. It has been proved that passive coping strategies predict a high BMI via unhealthy eating behaviors, especially emotional eating. These results are promising to improve the current prevention obesity programs and weight control treatments. LEVEL OF EVIDENCE: Level III, case-control analytic study.

En_Línea. An online treatment to change lifestyle in overweight and obesity: study protocol for a randomized controlled trial.

BACKGROUND: Obesity has become a major public health problem. Innovative treatments are necessary. Internet and new technologies have been reported effective results in weight control programs, especially those with personalized feedback. This paper presents the protocol for a randomized controlled trial to test the effectiveness of an online weight control program, called en_línea, comparing with a standard group therapy and a control group. METHODS: This is a randomized controlled trial with three intervention arms: en_línea, standard group therapy and control group. To perform this study, 305 adults (18-65 years) with overweight type II (27-29.9 kg/m2) or obesity type I (30-34.9 kg/m2) will be invited to participate. Interventions will last 17 weeks with follow-ups 1, 3, 6 and 12 months after the post-treatment appointment. The primary outcome will be post-treatment weight loss and the maintenance during the follow-ups. Secondary outcomes will be adherence rates, drop outs and quality of life. Participants will be assessed before randomization and they will be sign an inform consent. DISCUSSION: The future challenge is to design innovative obesity treatments. Internet could be a useful tool to improve traditional weight control programs. This new intervention format is appropriate for patients who prefer not to share their intimate problems with a group, and for the new generations who feel comfortable using new technologies. Besides, Internet allows reaching a large amount of people at the same time, even if they live far away. TRIAL REGISTRATION: ClinicalTrials.gov NCT04127201. Retrospectively registered 15th October 2019.

Assessing Motivational Stages and Processes of Change for Weight Management Around Bariatric Surgery: a Multicenter Study.

INTRODUCTION/PURPOSE: The assessment of the patients' motivation as a predictor of behavioral change via five stages (pre-contemplation, contemplation, preparation, action, and maintenance) and four processes (emotional re-evaluation, weight management actions, environmental restructuring, and weight consequences evaluation) of change. MATERIALS/METHODS: A total of 542 participants (251 waiting for bariatric surgery (BS), 90 undergoing BS, and 201 controls) completed the Stages (S-Weight) and Processes (P-Weight) of Change in Overweight and Obese People questionnaires in a multicenter cross-sectional study. RESULTS: A higher percentage of subjects seeking BS (31.7%) were in the action stage (16.7% of post-BS patients, p < 0.001; 14.9% of controls, p < 0.001). The referred body mass index (BMI) reduction was higher in subjects in active stages (3.6 ± 4.4 kg/m2 in maintenance versus 1.4 ± 1.4 kg/m2 in contemplation, p < 0.001). In the P-Weight questionnaire, patients looking for BS scored significant higher in the four processes of change than controls. In addition, a positive and significantly correlation between BMI and the four processes was observed. In the stepwise multivariate analysis, BMI and the S-Weight allocation were constantly associated with the four processes of change. CONCLUSION: Obesity is accompanied by a modifying behavioral stage, suggesting that subjects before BS are seriously thinking about overcoming excess weight. To identify subjects on the waiting list for BS who will be more receptive to weight lost interventions remains a challenge.

Estudio transcultural de los diferentes componentes de la insatisfacción corporal en muestras comunitarias de España y Chile / Cross-cultural study of the different components of body dissatisfaction in community samples from Spain and Chile

Introducción: el estudio de la insatisfacción corporal se ha centrado sobre todo en sus componentes perceptual y cognitivo-conductual, habiendo sido menos analizado el componente afectivo, tanto en España como en Chile. Hasta el momento, se ha observado mayor presencia de insatisfacción corporal en la población femenina y con sobrepeso. Esto se ha relacionado en gran parte con la mujer delgada y definida como ideal de belleza. Objetivo: comparar los diferentes componentes de la insatisfacción corporal (perceptual, cognitivo-conductual y afectivo) en la edad adulta en una muestra comunitaria de ambos sexos de España y de Chile. Método: se utilizó una muestra de 390 participantes, la cual se dividió en dos muestras según el país (n = 179 chilenos; n = 211 españoles). A su vez, los grupos por países se dividieron en dos grupos en función del índice de masa corporal (IMC) y también en función del sexo. Se evaluaron los diferentes componentes de la insatisfacción corporal mediante cuestionarios específicos para cada uno de ellos. Resultados y conclusión: tanto en España como en Chile, las personas con sobrepeso muestran mayor insatisfacción en las áreas perceptual y afectiva, especialmente las mujeres. Sin embargo, el componente cognitivo-conductual es el único en el que se hallaron diferencias entre países, mostrándose las mujeres con sobrepeso españolas más insatisfechas (t = 4,14, p < 0,001, d = 0,72, IC = 0,22-1,12). Estos resultados constatan la mayor presencia de insatisfacción corporal en mujeres con sobrepeso, asociada a la mayor presión sobre la apariencia en la población femenina

Background: the study of body dissatisfaction has been focused on their perceptual and cognitive-behavioral components, being the affective component the least analyzed, both in Spain and Chile. Until now, it has been observed more presence of body dissatisfaction in overweight women. This fact has been related with the thinness beauty ideal established by society. Objective: to compare the different components of body dissatisfaction (perceptual, cognitive-behavioral and affective) in adults in a community sample of both sexes of Spain and Chile. Method: the sample consisted of 390 participants and has been divided in two samples by country (n = 179 Chileans; n = 211 Spanish). At the same time, these groups were divided in two groups by body mass index (BMI) and also by sex. The different components of body dissatisfaction were evaluated using specific questionnaires for each of them. Results and conclusion: both in Spain and in Chile, people with overweight show more dissatisfaction in the perceptual and affective areas, especially women. However, cognitive-behavioral component is the only one where differences between countries were found, showing overweight Spanish women more dissatisfaction. These results verify a higher presence of body dissatisfaction in women with overweight (t = 4.14, p < 0.001, d = 0.72, IC = 0.22-1.12), related to the greater pressure on appearance in the female population

[Cross-cultural study of the different components of body dissatisfaction in community samples from Spain and Chile]. / Estudio transcultural de los diferentes componentes de la insatisfacción corporal en muestras comunitarias de España y Chile.

INTRODUCTION: Background: the study of body dissatisfaction has been focused on their perceptual and cognitive-behavioral components, being the affective component the least analyzed, both in Spain and Chile. Until now, it has been observed more presence of body dissatisfaction in overweight women. This fact has been related with the thinness beauty ideal established by society. Objective: to compare the different components of body dissatisfaction (perceptual, cognitive-behavioral and affective) in adults in a community sample of both sexes of Spain and Chile. Method: the sample consisted of 390 participants and has been divided in two samples by country (n = 179 Chileans; n = 211 Spanish). At the same time, these groups were divided in two groups by body mass index (BMI) and also by sex. The different components of body dissatisfaction were evaluated using specific questionnaires for each of them. Results and conclusion: both in Spain and in Chile, people with overweight show more dissatisfaction in the perceptual and affective areas, especially women. However, cognitive-behavioral component is the only one where differences between countries were found, showing overweight Spanish women more dissatisfaction. These results verify a higher presence of body dissatisfaction in women with overweight (t = 4.14, p < 0.001, d = 0.72, IC = 0.22-1.12), related to the greater pressure on appearance in the female population.

INTRODUCCIÓN: Introducción: el estudio de la insatisfacción corporal se ha centrado sobre todo en sus componentes perceptual y cognitivo-conductual, habiendo sido menos analizado el componente afectivo, tanto en España como en Chile. Hasta el momento, se ha observado mayor presencia de insatisfacción corporal en la población femenina y con sobrepeso. Esto se ha relacionado en gran parte con la mujer delgada y definida como ideal de belleza. Objetivo: comparar los diferentes componentes de la insatisfacción corporal (perceptual, cognitivo-conductual y afectivo) en la edad adulta en una muestra comunitaria de ambos sexos de España y de Chile. Método: se utilizó una muestra de 390 participantes, la cual se dividió en dos muestras según el país (n = 179 chilenos; n = 211 españoles). A su vez, los grupos por países se dividieron en dos grupos en función del índice de masa corporal (IMC) y también en función del sexo. Se evaluaron los diferentes componentes de la insatisfacción corporal mediante cuestionarios específicos para cada uno de ellos. Resultados y conclusión: tanto en España como en Chile, las personas con sobrepeso muestran mayor insatisfacción en las áreas perceptual y afectiva, especialmente las mujeres. Sin embargo, el componente cognitivo-conductual es el único en el que se hallaron diferencias entre países, mostrándose las mujeres con sobrepeso españolas más insatisfechas (t = 4,14, p < 0,001, d = 0,72, IC = 0,22-1,12). Estos resultados constatan la mayor presencia de insatisfacción corporal en mujeres con sobrepeso, asociada a la mayor presión sobre la apariencia en la población femenina.

The Barcelona Orthorexia Scale (BOS): development process using the Delphi method.

PURPOSE: Orthorexia nervosa is a currently investigated eating disorder proposed by US physician Steve Bratman, defined as pathological fixation on eating healthy food. This study aimed to develop, by consensus of experts, the basic items for a new questionnaire to evaluate some defining psychological features of orthorexia nervosa in English and Spanish language, the so-called Barcelona Orthorexia Scale (BOS). METHODS: The initial item pool was composed of 105 items divided into six different content areas. To analyse the content of the items, a three-round Delphi study was developed, in which participants had to evaluate the representativeness and clarity of each item. Participants were chosen because of their knowledge on orthorexia and/or eating disorders. RESULTS: 58 experts, from 17 different countries, participated in the initial round and 30 in the last round. Items were added, rephrased, changed into another content area, modified or eliminated according to the participants' suggestions, partly due to the group's response, analysed statistically, and partly due to participants' recommendations. CONCLUSIONS: 64 items were obtained, with two versions in Spanish and English. The future BOS aims to provide a possible solution to the shortage of valid instruments to evaluate psychological features of orthorexia and to promote research on this field. Further analysis regarding validity and reliability is necessary to prove the BOS' value on this matter.

Insatisfacción corporal y comportamientos alimentarios anómalos en una muestra comunitaria de adultos chilenos / Body dissatisfaction and abnormal eating behaviors in a community sample of Chilean adults

Resumen En Latinoamérica se han realizado estudios dirigidos a evaluar la insatisfacción corporal y los comportamientos alimentarios anómalos (CAA), sin embargo se han enfocado principalmente en adolescentes o estudiantes universitarios. El objetivo de esta investigación fue evaluar el porcentaje de insatisfacción con el peso corporal (INCP) en una muestra de hombres y mujeres adultos chilenos, analizando la relación de este factor con distintas variables sociodemográficas, psicológicas y conductuales, entre las que figuraron los CAA. Participaron 654 adultos de 18-64 años de edad (436 mujeres, 218 hombres ; con rango de edad de 18-64 años, índice de masa corporal promedio de 25.49 kg/m2), quienes fueron evaluados con base a una batería de cuestionarios de autoreporte. La INCP estuvo presente en 45.9% de la muestra, resultando significativamente mayor en las mujeres que en los varones. Fueron identificadas diferencias significativas en las escalas que evaluaron CAA, en función del índice de masa corporal y el sexo de los participantes, registrando puntuaciones significativamente mayores las mujeres y los participantes con obesidad. Al comparar entre participantes con vs. sin INCP, los primeros mostraron más CAA y menor actividad física. Los resultados de este estudio muestran que la INCP puede interactuar e influir sobre los hábitos alimentarios y la práctica de ejercicio físico.

Abstract The aims of this research were to estimate the percentage of body weight dissatisfaction in males and females Chilean adults, assessing its relationship with different sociodemographic, behavioral and psychological variables, and analyzing whether the presence of body weight dissatisfaction acts as a risk factor for some disordered eating behaviors. The 654 participants (436 women, 218 men; age range 18-64 years, mean body mass index [BMI] 25.49 kg/m2) were evaluated with a battery of self-administered questionnaires. The percentage of body weight dissatisfaction in the whole sample was 45.9% and significantly higher in women than men. Significant differences were observed in the clinical scales that evaluated disordered eating in function of the BMI of the participants; in those scales females also showed higher scores than males. Comparing participants with and without body weight dissatisfaction, the first one showed more unhealthy eating behaviors. The results of this study show how body weight dissatisfaction can interact and influence healthy habits, such as a daily eating behaviors and physical exercise.

Eating behaviors in a male and female community sample: psychometric properties of the DEBQ / Comportamientos alimentarios en una muestra comunitaria de hombres y mujeres: propiedades psicométricas del DEBQ

The aim of this study was to assess the psychometric properties of the Dutch Eating Behavior Questionnaire (DEBQ) in a community sample of chilean adults. The sample comprised 627 participants who completed a battery of questionnaires. The mean age of the sample was 36.07 years (SD =12.49), and 66.2% of them were women. Mean body mass index (BMI) was 25.61 kg/m2 (SD =4.20). Item analysis suggested that one item yielded very low corrected item-total correlation. The internal structure analysis revealed that the three-factor model showed a good fit. Internal structure was adequate. A gender effect was found in DEBQ scores, and there was a positive significant association between BMI and DEBQ scores. The correlation analysis supported the adequate convergent validity of the scale. The present study provides evidence to support the adequate reliability and validity of the DEBQ when applied in a chilean population.

El objetivo de este estudio fue evaluar las propiedades psicométricas del Dutch Eating Behavior Questionnaire (DEBQ) en una muestra comunitaria de adultos chilenos. La muestra se compuso por 627 participantes que completaron una batería de cuestionarios. La media de edad fue de 36.07 años (DT=12.49), y el 66.2% fueron mujeres. El índice de masa corporal (IMC) medio fue 25.61 kg/m2 (DT=4.20). Uno de los ítems presentó una inadecuada correlación ítem-total corregida. El análisis de la estructura interna mostró un buen ajuste al modelo de tres factores. La consistencia interna fue adecuada. Se detectó un efecto de género en las puntuaciones del DEBQ y hubo una asociación positiva significativa entre el IMC y las puntuaciones del DEBQ. El análisis de correlaciones puso de manifiesto la adecuada validez convergente de la escala. El presente estudio proporciona evidencia para apoyar la adecuada fiabilidad y validez del DEBQ cuando se aplica a población chilena.

Aprendizaje experiencial de habilidades terapéuticas y análisis de su utilidad en función de la personalidad / Experiential learning of therapeutic skills and analysis of their usefulness depending on the personality

Se comparó la utilidad percibida de dos métodos de entrenamiento de habilidades terapéuticas en la formación del Psicólogo General Sanitario: el asesoramiento entre iguales (el alumno que hace de cliente expone una experiencia personal, es decir, se trabaja con experiencias reales) y la representación de papeles (el alumno que hace de cliente representa un papel). Además, se evaluó el grado de incomodidad que puede suponer al alumno compartir experiencias personales íntimas, así como la relación entre la personalidad de los alumnos y la utilidad percibida de ambos métodos docentes. Los participantes, 149 alumnos del Máster en Psicología General Sanitaria de la Universidad de Barcelona, cumplimentaron el NEO-FFI y un cuestionario ad hoc sobre la metodología docente. El asesoramiento entre iguales fue considerado más útil que la representación de papeles tanto para el trabajo del autoconocimiento como para la formación como psicólogo clínico y la utilidad de ambos fue predicha principalmente por la dimensión "Responsabilidad". La incomodidad experimentada fue significativamente menor que la anticipada. Tales resultados tienen importantes implicaciones docentes para la formación de habilidades terapéuticas

The perceived utility of two training methods of therapeutic skills was compared in the training of General Health Psychologist: the peer counseling (the student who plays the client role relates a personal experience and therefore the therapist works with real experiences), and the role-playing (the student who plays the role of patient always plays a role). The degree of discomfort that sharing intimate personal experiences may involve for students was also examined, as well as the relationship between personality and utility perceived The participants, 149 students of the Master in General Health Psychology at University of Barcelona, completed the NEO-FFI and an ad hoc questionnaire to assess the teaching methodology. The peer counseling was considered more useful than role-playing to learn therapeutic skills and the utility of both was predicted mainly by the dimension of Responsibility. The discomfort experienced was significantly lower than anticipated. These results have important implications for training in therapeutic skills