Niva Piran

The role of body image in the prevention of eating disorders

This article reviews theory and research pertaining to prevention of negative body image and eating disorders. Research derived from the social cognitive model (SCM) and non-specific vulnerability-stressor (NSVS) model indicates that sustained prevention effects for attitudes and behaviors are possible, but not easy to achieve or explain. These limitations are considered in the context of promising research derived from a third model, critical social perspectives (CSP). We conclude that (1) research on practice should aim beyond the examination of efficacy in order to clarify the active ingredients contributing to prevention; and (2) research informed by each of the divergent perspectives can be used to enrich theory and practice in the field of eating disorders prevention.

The Social Construction of Women and Disordered Eating Patterns.

This investigation examined the impact of the social construction of women on the development of disordered eating. Based on a survey completed by 394 young women from the community, self-silencing of needs and voice, thesuppression of the outward expression of anger, and the internalization of the objectified gaze toward ones own body were found, in multiple regression analyses, to significantly predict scores on eating disorder measures. Together, they explain between 27% and 46% of the variance on these measures. This study supports the need to consider the development of disordered eating within the context of multiple gender-based social constructions.

Eating Disorders: A Trial of Prevention in a High Risk School Setting

The study describes the long-term outcome of a program aimed at the prevention of eating disorders in a world-class, residential ballet school for female and male students, ages 10–18. The prevention program followed the paradigm of health promoting schools outlined by the World Health Organization and involved systemic changes as well as direct interventions with students. Three all-school surveys have been conducted, the baseline survey was conducted in 1987, within the first year of implementation of the program, and the second and third ones in 1991 and 1996, respectively. Measures included the Diagnostic Survey for Eating Disorders, the Eating Attitude Test, and the Eating Disorder Inventory. Comparisons between the baseline cohort and the two latter cohorts, revealed significant reductions in disordered eating patterns and disturbed attitudes about eating and body shape, as well as significant increases in healthy eating patterns. The study suggests the benefits of implementing multifaceted prevention programs for eating disorders in high risk settings.

Personality disorders in anorexic patients

This study was designed to compare personality disorders in restricting and bulimic anorexics. Thirty patients fulfilled DSM-III criteria for anorexia nervosa and 38 patients fulfilled, in addition, DSM-III criteria for bulimia. Patients were given Axis I and II, DSM-III diagnoses. They were administered Gundersons Diagnostic Interview for Borderlines, the MMPI, and the Childhood Events Questionnaire. We find from these different lines of evidence that both restricter and bulimic anorexics requiring hospital treatment equally display a major character pathology. However, there are characterological differences in that bulimics tend to discharge impulses and conflicts through action, similar to their family members.

Multiple Types of Harassment: Associations With Emotional Well-Being and Unhealthy Behaviors in Adolescents

PURPOSE To explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents. METHOD Cross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income). RESULTS Having experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26). CONCLUSIONS Having had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents.

Skin-Color Preferences and Body Satisfaction Among South Asian-Canadian and European-Canadian Female University Students

Skin-color preferences and body satisfaction among 100 South Asian-Canadian and 100 European-Canadian female university students were examined. South Asian-Canadian females were found to desire lighter skin than they possessed and had lower body satisfaction compared with European-Canadian females. Among South Asian-Canadians, the desire to be lighter skinned was greater the more participants differed from the cultural White ideal. Light- and medium-skinned South Asian-Canadians had the highest and lowest levels of body satisfaction, respectively.

A trial of isocarboxazid in the treatment of bulimia nervosa.

Eighteen women completed a double-blind, placebo-controlled crossover study designed to investigate the effects of isocarboxazid in the treatment of bulimia nervosa. There was a significant reduction in binge eating and vomiting during isocarboxazid treatment. Response was not influenced by either the presence or absence of current major depression or personality disorder. There were no serious adverse effects from this monoamine oxidase inhibitor therapy, although over 50% of patients elected to discontinue isocarboxazid 1 year after the study.

Two year follow-up of bulimia nervosa: The importance of abstinence as the criterion of outcome

The goal of this pilot follow-up study was to implement operationally defined criteria to classify outcome status of female patients with a DSM-111-R diagnosis of bulimia nervosa 2 years after completion of an intensive group treatment program (N = 43). Specifically, the importance of abstinence from bulimic behaviors as a marker of well-being was investigated. Repeated measures analysis of variance revealed that across most measures of psychopathology, scores for patients who were totally abstinent of hinging and purging were found to be significantly lower than even mildly symptomatic patients (p <.05). A secondary goal of the study was to extend the results of an earlier evaluation of the treatment program by reporting posttreatment results on a larger sample of bulimic patients (N = 86). Overall, the results suggest that a behavioral criterion of abstinence from hinging and purging is critical for the assessment of treatment response and long-term outcome status in bulimia nervosa.

The reduction of preoccupation with body weight and shape in schools: A feminist approach

Abstract This paper explores key aspects of a feminist-informed approach to the prevention of body weight and shape preoccupation in schools and extends principles of feminist counseling to prevention programs. A feminist-informed prevention program acknowledges the transformative power of lived knowledge and relies on inquiry and dialogue to derive and give a voice to this knowledge. The program critically examines the many varied contextual factors that affect womens experience of themselves, their bodies, and their eating. Guided by participants, it then targets aspects of the social and political environment for direct intervention. A feminist prevention program respects processes of change and growth that occur within a matrix of relationships and facilitates the opening of relational dialogues among peers and across generations, positions of power, race, and other social barriers. Creating an intervention milieu that does not collude with adverse societal structures, prejudices, or mores is another...

A Feminist Perspective on Risk Factor Research and on the Prevention of Eating Disorders

This review utilizes a feminist lens to discuss risk factor research and prevention work in the field of eating disorders. The article suggests that feminist informed risk factor research needs to consider gender as it intersects with other social variables as a relevant higher level risk factor and examine its relationship to individual level risk factors such as the internalization of thinness or negative body image. The article also highlights the key elements of participatory approaches and systemic changes to feminist informed prevention work. Prevention work conducted to date suggests the relevance of these elements to achieving behavioral changes in prevention work.