Body Image and Health Behaviours

Scoping Review of Body Image and Physical Activity

  • A scoping review of body image and physical activity is in progress, conducted by Beadle, Cain, and Troop.
  • NHS recommendations for adults (aged 19+):
    • 150 minutes of moderate physical activity per week OR
    • 75 minutes of vigorous activity each week
    • Strength-based exercises two or more times a week
  • Benefits of physical activity:
    • Lowers the risk of heart disease, stroke, diabetes, some cancers, early death, depression, and dementia.
  • Statistics:
    • 63% of men and 52% of women are insufficiently active (Sports England, 2013).
  • Aims of the scoping review:
    • Systematic search for studies linking body image and physical activity.
    • Identify the nature of this link and the limitations of the evidence.
    • Identify possible moderators of this link.
    • Propose recommendations for future research to test the causal link.
  • Inclusion criteria for studies:
    • Must have a body image (BI) component, measuring BI as a correlate, covariate, barrier, facilitator, goal, motivator, mediator, moderator, or interview component/question/topic.
    • Must have a physical activity (PA) component as an outcome.
    • Should examine/consider the effect of body image on physical activity.
    • All articles, articles in press, book chapters/sections, and books will be considered, as will MSc and PhD theses where these are unpublished
    • Must be from 1990 onwards.
    • Must be written entirely/mostly in English, French, or Spanish.
  • Exclusion criteria for studies:
    • No body image component or body image as an outcome only.
    • No physical activity component or physical activity is not an outcome (e.g., physical activity intervention to improve body image).
    • Considers the inverse relationship only (i.e., the effect of PA on BI).
    • Considers athletes only, with no comparison of activity levels.
    • Conference papers are not considered.
    • Full-text inaccessible due to language or copyright/access.
    • Reviews (will be used only as a source of further publications)
  • Headline results:
    • 185 studies published between 1990 and 2019.
    • More positive body image is related to more physical activity.
    • Poorer body image is related to less physical activity.
  • Gender differences:
    • BI-PA in men and women (6 studies).
    • No BI-PA in men or women (8 studies).
    • BI-PA in women but not men (7 studies).
    • BI-PA in men but not women (9 studies).
    • BI-PA in both men and women but different directions (9 studies).
    • Differences may be due to country/ethnicity, age, measures of BI and PA.
    • In female-only samples, BI could be a facilitator (e.g., developing desired feminine physique) or a barrier (e.g., self-consciousness, unflattering PE uniforms).
  • Other factors:
    • Country/ethnicity.
    • Age.
    • Disability.
    • Motivation types: Extrinsic goals (improving appearance or losing weight) vs. Intrinsic goals (health, fitness, social, and enjoyment factors).

Body Shame, Pride, Dietary Restraint, and Caloric Intake (Troop, 2016)

  • Previous studies using the Body Shame Scale (BSS):
    • Current and anticipated body shame predicts eating disorder symptoms in clinical and non-clinical samples (Troop et al., 2006).
    • Over 2.5 years, current body shame predicts increases in degree of underweight and misperception of body size, while anticipated body shame predicts increases in fear of weight gain.
  • Limitations of the BSS:
    • Only measured body shame, not pride.
    • Only in relation to current weight or weight gain, not weight loss.
  • This study:
    • Examines the effect of current and anticipated body pride and shame in relation to normative eating behaviors.
  • Participants rated their agreement (1-10) with statements on body shame and pride:
    • Current body weight and shape.
    • Imagined significant weight gain (half to one stone).
    • Imagined significant weight loss (half to one stone).
  • Principal components analysis of the Body Pride and Shame Scale (Study 1):
    • Table 1 shows factor loadings for each BPS item.
BPS ItemFactor 1Factor 2Factor 3
BPS10.130.330.05
BPS20.05-0.60-0.02
…………
*   Fig. 1 shows the Scree plot of the Principal Components Analysis.

  • Table 2 shows means, intercorrelations, and internal reliabilities of the Bodily Pride and Shame Scale and validating measures (Study 1).

    • Whole sample (n=242):
      • BPS-current: Mean = 5.2, SD = 1.9, α = 0.89
      • BPS-gain: Mean = 7.6, SD = 2.0, α = 0.91
      • BPS-loss: Mean = 3.8, SD = 2.2, α = 0.90
    • Online sub-sample (n=125):
      • TOSCA-shame: 40.9, SD=8.4
      • TOSCA-guilt: 54.0, SD=7.8
      • TOSCA-alpha pride: 19.6, SD=3.3
      • TOSCA-beta pride: 19.5, SD=3.3
      • DHS: 12.6, SD=3.8
      • BCQ: 48.1, SD=16.1

  • Study 2:

    • Table 3 shows sample characteristics:
      • Age: Mean = 22.2, SD = 5.1
      • BMI: Mean = 21.5, SD = 3.5
      • FFQ total calories: Mean = 1887.5, SD = 575.9
      • Dietary restraint: Mean = 25.3, SD = 5.9, α = 0.86
      • BPS-current: Mean = 4.9, SD = 1.5, α = 0.83
      • BPS-gain: Mean = 7.1, SD = 1.6, α = 0.84
      • BPS-loss: Mean = 4.0, SD = 1.7, α = 0.90
    • Table 5 shows regression of caloric intake onto dietary restraint and body pride and shame:
      • Step 1: Dietary restraint (B = -35, p < 0.05)
      • Step 2: BPS-current (B= -22, p=0.19), BPS-gain (B=34, p<0.05), BPS-loss (B=-0.50, p<0.01)

  • Body shame and caloric intake:

    • Current body shame: Positive correlation with caloric intake.
    • Anticipated Gain body shame: Positive correlation with caloric intake.
    • Anticipated Loss body shame: Negative correlation with caloric intake.

Behavioral Regulation and Physical Activity (Beadle, 2020)

  • Research question: Does behavioral regulation (type of motivation) account for the link between body shame and physical activity?
  • Methods:
    • 80 participants.
    • Behavioral Regulation in Exercise Questionnaire 3 (BREQ-3; Markland & Tobin, 2004).
    • Online Self-Report Walking Exercise Questionnaire (OSWEQ; Taylor et al., 2013) measuring physical activities over the last 7 days.
    • MVPA-minutes (moderate-vigorous PA, derived from metabolic equivalent minutes).
    • Strength.
    • Met NHS guidelines.
    • Body Pride and Shame Scale.

Self-Determination Theory (Deci and Ryan, 1985/2000)

  • Self-determination continuum:
    • Amotivation → External Regulation → Introjected Regulation → Identified Regulation → Integrated Regulation → Intrinsic Regulation.
    • Locus of causality: Impersonal → External → Somewhat External → Somewhat Internal → Internal → Internal.
  • External regulation: Behavior is externally driven, controlled by reward or punishment.
  • Introjected regulation: Behavior to improve feelings of self-worth or avoid self-disapproval.
  • Identified regulation: Behavior is valued and independent of environmental reward or punishment.
  • Integrated regulation: Behavior aligns with personal values and beliefs; high level of autonomy.
  • Model to be tested:
    • Amotivation, External, Introjected, Identified, Integrated, Intrinsic influence Physical Activity.
  • Model found:
    • BPSS current -> amotivation -> MVPA (Beadle (2020) Chapter 6, page 137).
    • External 0.27
    • Introjected 0.14
    • Identified 0.17
  • Simplified Model:
    • Body pride/shame with weight gain -> Amotivation -> External -> Introjected -> Identified -> Integrated -> Intrinsic -> Physical Activity.
  • Even More Simplified Model:
    • Current AnticipatedGain Motivation Body shame Non self- determined Self- determined Physical activity.
    • Anticipated body shame predicts MORE physical.
    • Current body shame predicts LESS physical activity.

Surveillance, Body Shame, and Physical Activity (Pila et al., 2021)

  • Multiple mediation model:
    • Body Surveillance (Baseline) -> Experienced Body Shame (2-yr follow-up) -> Physical Activity (2-yr follow-up).
    • Body Surveillance (Baseline) -> Anticipated Body Shame (2-yr follow-up) -> Physical Activity (2-yr follow-up).
    • Indirect effect through experienced body shame = -0.13 (0.05), [-0.23, -0.03].
    • Indirect effect through anticipated body shame = 0.07 (0.04), [0.01, 0.15].
    • Direct effect of body surveillance on physical activity = -0.06 (0.09), [-0.24, 0.13].

Summary

  • Complex relationship between Body Image and Physical Activity.
  • Body image: can be a facilitator and a barrier.
  • Behavioral regulation (types of motivation) may account for this complex relationship
  • Current and anticipated body shame also seem to make a difference (i.e. play different roles).

How to Read a Paper in 10 Minutes

  • Hint: This works if you know something about the area or if you’re following up on a specific paper with a known theory or method

Reflection

  • Write down 3 things you learned that you didn’t know before (could be big things or little things, broad concepts or specific facts)
  • What do you think was the most important thing you got from today’s lecture? Write it down.
  • Write down 1 thing you don’t understand from this lecture
  • From what we covered today, write down one thing that you want to go away and find out more about
  • If you had one follow-up question about the material in today’s lecture, what would it be?
  • What was the most interesting thing and what was the least interesting thing you got from today’s lecture? Why were they the most and least interesting things?

For Next Time

  • Recommended reading
  • Explore what interests you from the Reading list When you read papers, think about …
  • What is the aim of the paper?
  • What are the key findings?
  • What are the implications? (Theory, Research and Practice)
  • What factors might influence the perceived importance of this paper
    • e.g. methodological strengths/limitations that make some of the conclusions more/less certain
    • e.g. implications for theory or practice that make a significant step forward in the literature