Body image dissatisfaction and eating disorders are more prevalent in today's society than ever. As a result, several prevention programs targeting the common eating disorder risk factors have been developed. The purpose of the current study was to investigate a new kind of prevention program that is based on the dual pathway model of eating disorders within the context of an individual?s romantic relationship. The current prevention program reduced eating disorder risk factors but failed to affect relationship satisfaction. Effect sizes were small to medium in magnitude for most of the targeted risk factors. The inclusion of men and women alike in eating disorder prevention programs appear to be a successful way of addressing the thin ideal and its detrimental effects. Limitations and future directions are discussed.

A cross-sectional and longitudinal examination of thin-ideal internalization and self-objectification was conducted within the context of an eating disorder prevention program. The sample consisted of 177 undergraduate women enrolled in a sorority between the ages of 18 and 22 who participated in a dissonance-based eating disorder prevention program. Participants completed self-report assessments at baseline, post-intervention, 5-month, and 1-year follow-up. Measures included the Ideal-Body Stereotype Scale-Revised, Self-Objectification Questionnaire, Body Shape Questionnaire, and Eating Disorder Examination-Questionnaire. A cross-sectional path analysis indicated that thin-ideal internalization and self-objectification predict each other and both predict body dissatisfaction, which in turn, predicts eating disorder symptoms. A longitudinal examination of the prevention program indicated that participants showed significant reductions in thin-ideal internalization, self-objectification, body dissatisfaction, and eating disorder symptoms after participating in a cognitive dissonance eating disorder prevention program. Significant reductions of all symptoms were maintained at 1-year follow-up, with the exception of self-objectification, which had a significant reduction up to the 5-month assessment. A longitudinal path analysis indicated that post-intervention thin-ideal internalization and self-objectification predicted body dissatisfaction at 5-month follow-up assessments which in turn predicted eating disorder symptoms at this same time point. This model was replicated for 1-year follow-up body dissatisfaction and eating disorder symptoms with the exception of the direct path from self-objectification to body dissatisfaction. Assessment of temporal sequence of change between self-objectification and thin-ideal internalization revealed that neither variable significantly predicted meaningful change in the other variable. Finally, individuals who showed meaningful change in self-objectification before showing meaningful reduction in thin-ideal internalization from baseline to post-intervention assessments had greater reductions in eating disorder symptoms 1-year following the intervention. Collectively, these results suggest that eating disorder prevention programs should focus on targeting both thin-ideal internalization and self-objectification simultaneously to increase further the reduction of eating disorder symptoms.

Thesis advisor: Stephen J. Pope / The aim of this dissertation is to expand a contemporary multidimensional discourse on the nature of eating disorders to encompass also a moral dimension. Eating disorders are complex phenomena which include biomedical, psychological, and sociocultural components. This dissertation brings the psychosocial literature on eating disorders and body dissatisfaction into dialogue with contemporary studies in Thomistic moral theology, and argues that such a multidisciplinary dialogue can illuminate new insights both for the study of eating disorders and for recent efforts to recover Thomistic moral theology in a contemporary context. Beginning empirically, the dissertation examines recent evidence showing that exposure to &ldquo;thin-ideal images&rdquo; in the mass media is positively correlated with an increase in body dissatisfaction and eating disorder symptomatology. Socioculturally, the explanation for this phenomenon is called &ldquo;thin-ideal internalization,&rdquo; and basically measures the extent to which individuals &ldquo;buy into&rdquo; the validity of images using ultra-thin female models as a paradigm of beauty. Women who have a high level of internalization desire to conform to a thin-ideal, and behave accordingly, even when they are rationally aware of the unrealistic and unhealthy nature of such an ideal. Turning to Thomas Aquinas' moral theology, the dissertation argues that thin-ideal internalization is a form of connatural knowledge, an affective form of knowing (<italic>per modum inclinationis</italic> or <italic>ex instinctu</italic>) which is at the very basis of Aquinas' moral theology, both in explaining the operation of habits and in explaining the role of grace in the moral life through charity and the gifts of the Holy Spirit. This dissertation argues that Aquinas' theory of connatural knowledge provides a relevant and constructive contribution to the study of eating disorders, especially on the relationship between body dissatisfaction and eating disorder symptamatology. Additionally, the incorporation of the psychosocial literature on eating disorders into Thomistic moral theology provide a valuable contribution to Thomistic moral theology in the effort to understand the role of the affections in moral deliberation, the development of habits, and the importance of Christian practices in the moral life. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Theology.

The purpose of the study is to confirm the reasons behind young Chinese women’s eating disturbances and self-esteem. The researcher uses the Tripartite Influence model to illustrate the relationship between internalization and pressures in the form of peer, family, and media pressure. It further reveals the relationship between internalization and self-esteem and eating disorders. Besides conforming with the mode of young Chinese females, it aims at finding out the reasons behind each relevant relationship. One point of the study is the different impact of media pressure on young Chinese females; the influence of media tends to be much lower in China and the reasons have been discussed in their entirety.

The sociocultural model of eating disorders suggests that awareness of a thin physical ideal directly affects internalization of that ideal, which in turn, directly affects body dissatisfaction. The current study evaluated the general accuracy of the sociocultural model and examined the potential for ethnicity to protect against eating disorder symptomatology by moderating the relationships between awareness and internalization and between internalization and body dissatisfaction. Spanish (n = 100), Mexican American (n = 100), and Euro-American (n = 100) female participants completed various questionnaires measuring sociocultural attitudes towards appearance and body dissatisfaction. Analysis of covariance with tests of homogeneity of slope and path analysis using maximum likelihood with robust standard errors tested the two relationships by ethnic group. Results supported the sociocultural model: there was strong evidence for the mediational effect of internalization on the relationship between awareness and body dissatisfaction. Furthermore, ethnicity moderated the relationships such that both relationships were significantly stronger for Euro-American women than for Mexican American or Spanish women. Within the Mexican American group level of acculturation also moderated these relationships. Taken together, the results of this study highlight how ethnicity can protect against the development of eating disorder symptoms. Denouncing the thin ideal, minimizing appearance as an indicator of female value, and emphasizing personal traits other than appearance as determinants of worth are important in protecting against the development of body dissatisfaction and more severe eating pathology.

The greater body mass of African American females relative to Caucasian females is a well-documented finding implicated in ethnic disparities in health outcomes. The principal aim of the current study was to evaluate a theoretical account that may explain ethnic differences in body mass index. The proposed theoretical account focused on appearance-related concerns regarding the desirability of a thin body type as motivation to engage in weight control behavior. It was hypothesized that Caucasians would evidence greater internalization of the thin ideal than African Americans, which would then be associated with greater dietary restriction and physical activity, thereby predicting lower body mass among caucasians relative to African Americans. It was expected that this model would demonstrate greater applicability to individuals who lack constitutional thinness, i.e., individuals who have struggled with weight management in the past or at present. The study's design w as cross-sectional. African American (n=113) and Caucasian (n= 633) undergraduate, unmarried, heterosexual females between the ages of 18 and 30 completed online questionnaires in which they provided information on their ethnicity,socioeconomic status, ethnic identity, thin-ideal internalization, the perceived romantic appeal of thinness, the importance of romantic need fulfillment, dietary restriction, physical activity, height, current weight, and their highest weight since attaining their current height. Structural equation modeling with LISREL 8.72 was used to evaluate the proposed model. Support for hypotheses was mixed. Among the subset of participants categorized as lacking constitutional thinness, the relationship between ethnicity and body mass was mediated by thin-ideal internalization and the perceived romantic appeal of thinness, each of which contributed independently to dietary restriction, which in turn evidenced a curvilinear relationship with body mass. Results ar e consistent with the notion that ethnic differences in body mass may be partially accounted for by differences in standards for physical appearance, which may then motivate weight control behavior to a greater extent in Caucasians than African Americans.

The sociocultural model of eating disorders suggests that awareness of a thin physical ideal directly affects internalization of that ideal, which in turn, directly affects body dissatisfaction. The current study evaluated the general accuracy of the sociocultural model and examined the potential for ethnicity to protect against eating disorder symptomatology by moderating the relationships between awareness and internalization and between internalization and body dissatisfaction. Spanish (n = 100), Mexican American (n = 100), and Euro-American (n = 100) female participants completed various questionnaires measuring sociocultural attitudes towards appearance and body dissatisfaction. Analysis of covariance with tests of homogeneity of slope and path analysis using maximum likelihood with robust standard errors tested the two relationships by ethnic group. Results supported the sociocultural model: there was strong evidence for the mediational effect of internalization on the relationship between awareness and body dissatisfaction. Furthermore, ethnicity moderated the relationships such that both relationships were significantly stronger for Euro-American women than for Mexican American or Spanish women. Within the Mexican American group level of acculturation also moderated these relationships. Taken together, the results of this study highlight how ethnicity can protect against the development of eating disorder symptoms. Denouncing the thin ideal, minimizing appearance as an indicator of female value, and emphasizing personal traits other than appearance as determinants of worth are important in protecting against the development of body dissatisfaction and more severe eating pathology.

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Pediatric overweight is defined as a body mass index (BMI) for age of 85th-95th percentile, and occurs in approximately 33.6% of adolescents 12-19 years of age. Hispanic adolescents are disproportionately at risk for overweight. Excess weight can predispose adolescents to develop diabetes mellitus type 2, coronary artery disease, hypertension, hypercholesterolemia, sleep apnea, osteoporosis, asthma, and certain types of cancer, whereas physical activity can help prevent and treat these diseases. Little is known about the factors that contribute to physical activity in Hispanic adolescent girls. The purpose of this study was to examine and compare the influence of personal characteristics, perceptual influences, interpersonal influences and sociocultural influences on physical activity in White and Hispanic adolescent girls. The theoretical framework for this study was self-designed--the Physical Activity Lifestyle Model. Data for this cross-sectional study was collected from girls age 11-14 who presented to the Children's Wellness Center in Del Valle, TX (N = 121) in the summers of 2011 and 2012. Most participants self-identified as Hispanic (n = 106). Participants completed a survey consisting of a 1-day physical activity recall, a demographic questionnaire, and several validated (primarily Likert-type) questionnaires. Height and weight were measured in the clinic. Data analysis began with descriptive analysis (mean, standard deviation and percentage) of demographic characteristics, dependent and independent variables, then Pearson correlations, and finally multiple linear regression to determine the influence of the independent variables on physical activity. No significant differences were found between ethnic groups on age, grade or school (p > .05). Physical activity was significantly related to body image (r = .189, p < .05), friend social support (r = .279, p < .01), and family social support (r = .401, p < .01). In addition, physical activity significantly predicted BMI percentile (B = -.043, SE = .019, t = -2.249, p = .027), appearance-related media messages (B = .259, SE = .127, t = 2.038, p = .044), pressures to be thin (B = .311, SE = .149, t = 2.082, p = .040), family social support for physical activity (B = .089, SE = .042, t = 2.139, p = .035), body image (B = .367, SE = .123, t = 2.987, p = .004), and physical activity enjoyment (B = .083, SE = .040, t = 2.089, p = .040). When designing an intervention to promote physical activity, health care providers and educators should consider that multiple external factors influence physical activity participation in Hispanic adolescent girls. Healthcare providers should involve parents and siblings in physical activity interventions for overweight adolescent girls. Interventions should be tailored to work with the adolescent girls' physical and social environment. Public health nurses should work with schools and communities to increase physical activity opportunities for adolescent girls in physical education classes, girls' sports, and after-school programs. / text