Volume 23, Issue 2 (Summer 2017)                   IJPCP 2017, 23(2): 192-207 | Back to browse issues page


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Hosseini E, Talepasand S, Rahimian Boogar I. Body Image and Eating Problems: Testing a Tripartite Model . IJPCP 2017; 23 (2) :192-207
URL: http://ijpcp.iums.ac.ir/article-1-2349-en.html
1- , Department of Psychology, Faculty of Psychology & Educational Sciences, Semnan University
2- Department of Educational Sciences, Faculty of Psychology & Educational Sciences, Semnan University
3- Department of Psychology, Faculty of Psychology & Educational Sciences, Semnan University
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Extended Abstract
1. Introduction

Eating problem has a close relationship with lifestyle followed and culture.  In recent years, a large amount of research has focused on understanding the factors that play a role in the growth and maintenance of eating disorders and body image. Some studies focused on interpersonal and biological social factors while some of them have focused on factors such as internalization of media ideals [1], negative verbal feedback, low self-esteem, and elevated appearance comparison tendencies [2]. Three-factor influence model has been proposed by Thompson, Heinberg, Altabe, and Tantleff-Dunn. This model suggests that the three primary factors of peers, family and media are the basis of the next development of body image disorder and eating problems. Also, this model includes two intermediary communication loops, i.e., the internalization of social ideals based on appearance and increasing tendency to compare the appearance, which affects body image disorder and eating problems [3]. The basic assumption in this study was that eating problems early in life can be influenced by family, peers, the media and body mass index, and social comparison and dissatisfaction with the body image can act as mediators. The purpose of this study was to compile and test tripartite rival models to explain eating problems based on the threefold influence of the family, peers, and the media.
2. Method
The statistical population of the present study includes all 18-35-year-old women and girls in Mashhad who were referred to sports clubs and nutrition clinics in 2011. The sample size was classified to be 200. Stochastic random sampling method was used to select the sample. First, from the list of sports clubs for women and list of dietitians in Mashhad, 13 clubs and 7 clinics were randomly selected. Then from among members, ten subjects in the age range of 18 to 35 were selected randomly. Written consent was received from all participants. Their weight was measured using digital scales, and the heights of the participants were measured using tape measure without shoes. After division of weight (in kilograms) by squares of height (m), the Body Mass Index (BMI) was calculated. The participants completed the questionnaires such as Eating Attitudes Test, The Perception of Teasing Scale (POTS), Multidimensional Body- Self Relations Questionnaire, and Socio-cultural Attitudes towards Appearance Questionnaire were completed individually at the clinic site and the club. Data were analyzed using the path analysis model and the Lisrel V8.8 software.
3. Results
Average age of the participants in this study was 27 years, and the average BMI was 25.18. On an average, sample subjects of the study were slightly overweighed. Correlation coefficients showed that the severity of overeating depends on the attitude of family more than other variables. Next, overeating is mostly related to inhibition of eating. The severity of the relationship of overeating with peers' attitude, social comparison and dissatisfaction with body image was weak but statistically significant. 
Comparison of correlations shows that inhibition of intake has the most relationship with BMI, and like overeating, it has a significant relationship with family’s attitude. The relationship of intensity of inhibition of intake with peer's attitude, social comparison, and dissatisfaction with body image was weak but statistically significant (Table 1). To investigate the predictions of the three-factor influence model, three competing models were developed. The findings indicated that fitness indicators of all three models are not appropriate. Of models, one with more favorable fitness indices was selected for correction. Considering that among models, model 2 had a better fit than other models, this model was selected for correction. Results from modification indices to fit this model showed that exogenous variable path of peers on the indigenous variables of social comparison, inhibition of intake and overeating is not significant. Also, structural relation of exogenous variable of family on social comparison is not significant. Investigation of structural relationships of intrinsic variables showed that social comparison has no direct effect on dissatisfaction with body image, and the direct effect of dissatisfaction with the body image on overeating and inhibition of intake is not significant. According to modification indices and the covariance matrix of residues, the model was modified (Figure 1). Direct and indirect effects of the modified model are reported in Table 2. Family attitude had the most direct effect on overeating.


4. Discussion
The final model confirmed the assumption that peers have a structural direct effect on dissatisfaction with the body image. This finding is consistent with the findings of previous studies [4-9]. A possible explanation is that peers have a great influence on dissatisfaction with body image by way of mocking [10, 11]. Thompson et al. also showed that mocking (by family and friends) has a direct effect on dissatisfaction with the body image [10]. In the final model of this study, it was shown that family has a direct effect on overeating and has indirect effect on mediation of inhibition of intake on overeating. This finding is consistent with some of the previous findings [11-20]. A possible explanation is that when family does not evaluate the appearance of an individual as appropriate, they start to put pressure for slimming on the individual. 
The hypothesis of direct inhibition of intake on overeating is supported in the final model. A possible explanation is that self-imposed fictitious deterrence is accompanied more by eating behavior. This finding is consistent with the findings of Kerry et al. [21]. In the final model of this study, it became clear that BMI by mediating role of the inhibition of intake has an indirect effect on overeating. This finding is also consistent with the findings of Wilson [22]. The higher the BMI, the higher the inhibition of intake will be, and this, in turn, leads to an increase in the behavior of overeating in people.  Tripartite factor influence model can be used as an effective model in explaining eating problems.
Acknowledgments
This research was extracted from the MSc. thesis of the first author, in the Department of Psychology, Faculty of Psychology & Educational Sciences, Semnan University, Semnan, Iran.
Conflict of Interest
The authors declared no conflicts of interest.

 
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Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2015/09/21 | Accepted: 2016/12/3 | Published: 2017/07/1

References
1. Becker AE. Culture and eating disorders classification. International Journal of Eating Disorders. 2007; 40(S3):S111–S116. doi: 10.1002/eat.20435 [DOI:10.1002/eat.20435]
2. Wilfley DE, Bishop ME, Wilson GT, Agras WS. Classification of eating disorders: Toward DSM-V. International Journal of Eating Disorders. 2007; 40(S3):S123–S129. doi: 10.1002/eat.20436 [DOI:10.1002/eat.20436]
3. Classification of child and adolescent eating disturbances. International Journal of Eating Disorders. 2007; 40(S3):S117–S122. doi: 10.1002/eat.20458 [DOI:10.1002/eat.20458]
4. Pinheiro AP, Bulik CM, Sullivan PF, Machado PPP. An empirical study of the typology of bulimic symptoms in young Portuguese women. International Journal of Eating Disorders. 2008; 41(3):251–8. doi: 10.1002/eat.20497 [DOI:10.1002/eat.20497]
5. Thompson JK, Stice E. Thin-Ideal internalization: mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current Directions in Psychological Science. 2001; 10(5):181–3. doi: 10.1111/1467-8721.00144 [DOI:10.1111/1467-8721.00144]
6. Van den Berg P, Thompson JK, Obremski-Brandon K, Coovert M. The Tripartite Influence model of body image and eating disturbance. Journal of Psychosomatic Research. 2002; 53(5):1007–20. doi: 10.1016/s0022-3999(02)00499-3. [DOI:10.1016/S0022-3999(02)00499-3]
7. hroff H, Thompson JK. The tripartite influence model of body image and eating disturbance: A replication with adolescent girls. Body Image. 2006; 3(1):17–23. doi: 10.1016/j.bodyim.2005.10.004 [DOI:10.1016/j.bodyim.2005.10.004]
8. Hildebrandt T, Shiovitz R, Alfano L, Greif R. Defining body deception and its role in peer based social comparison theories of body dissatisfaction. Body Image. 2008; 5(3):299–306. doi: 10.1016/j.bodyim.2008.04.007 [DOI:10.1016/j.bodyim.2008.04.007]
9. Dohnt HK, Tiggemann M. Peer influences on body dissatisfaction and dieting awareness in young girls. British Journal of Developmental Psychology. 2005; 23(1):103–16. doi: 10.1348/026151004x20658 [DOI:10.1348/026151004X20658]
10. Stice E, Ziemba C, Margolis J, Flick P. The dual pathway model differentiates bulimics, subclinical bulimics, and controls: Testing the continuity hypothesis. Behavior Therapy. 1996; 27(4):531–49. doi: 10.1016/s0005-7894(96)80042-6 [DOI:10.1016/S0005-7894(96)80042-6]
11. Delvarian Zadeh M, Khosravi A, Razavian-Zadeh N, Bolbol-Haghighi N, Abbasian M, Taghavi N. [Nutritional knowledge, attitude and practice of guidance-school girls of two regions in Iran (Persian)]. Journal of Knowledge & Health. 2011; 6(1):19-26.
12. Choobineh MA, Nazari Hesari S, Hossein D, Haghighizadeh MH. [Study of nutritional knowledge of Ahwaz high school girls and the education effect (Persian)]. Journal of Birjand University of Medical Sciences 2009; 16(1):23-30.
13. AzadBakht L, Mirmiran P, Momenan AA, Azizi F. [Knowledge, attitude and practice of guidance school and high school students in district-13 of Tehran about healthy diet (Persian)]. Iranian Journal of Endocrinology and Metabolism. 2004;5(4):409-416.
14. Navabakhsh M, Mosanna A. [An introductory evaluation of nutritional changes in the present societies (Persian)]. Journal of Food Technology and Nutrition. 2012; 9(1):33-48.
15. Helfert S, Warschburger P. A prospective study on the impact of peer and parental pressure on body dissatisfaction in adolescent girls and boys. Body Image. 2011; 8(2):101–9. doi: 10.1016/j.bodyim.2011.01.004 [DOI:10.1016/j.bodyim.2011.01.004]
16. Reicks M, Banna J, Cluskey M, Gunther C, Hongu N, Richards R, et al. Influence of parenting practices on eating behaviors of early adolescents during independent eating occasions: Implications for obesity prevention. Nutrients. 2015; 7(10):8783–801. doi: 10.3390/nu7105431 [DOI:10.3390/nu7105431]
17. Rieves L, Cash TF. Social developmental factors & women body image attitudes. Journal of Social Behavior & Personality. 1996; 11(1):63-78.
18. Salarkia N, Amini M, Eslami M, Dadkhah M, Zoghi T, Haidari H, et al. [Mothers' views and beliefs about the role of complementary feeding in children under the age of two in Damavand: A qualitative study (Persian)]. Arak Medical University Journal. 2010; 13(2):63-74.
19. Pirzadeh A, Hazavhei M, Entezari M, Hasanzadeh A. [The effect of educational program on nutritional knowledge and behavior of middle school female second graders in Isfahan in 2009 (Persian)]. Iranian Journal of Medical Education. 2011; 11(2):94-102.
20. Ghaderi A, Scott B. Prevalence, incidence and prospective risk factors for eating disorders. Acta Psychiatrica Scandinavica. 2001; 104(2):122–30. doi: 10.1034/j.1600-0447.2001.00298.x [DOI:10.1034/j.1600-0447.2001.00298.x]
21. Kluck AS. Kluck AS. Family influence on disordered eating: The role of body image dissatisfaction. Body Image. 2010; 7(1):8–14. doi: 10.1016/j.bodyim.2009.09.009 [DOI:10.1016/j.bodyim.2009.09.009]
22. Rodgers R, Chabrol H, Paxton SJ. An exploration of the tripartite influence model of body dissatisfaction and disordered eating among Australian and French college women. Body Image. 2011; 8(3):208–15. doi: 10.1016/j.bodyim.2011.04.009 [DOI:10.1016/j.bodyim.2011.04.009]
23. Harrison K, Cantor J. The relationship between media consumption and eating disorders. Journal of Communication. 1997; 47(1):40–67. doi: 10.1111/j.1460-2466.1997.tb02692.x [DOI:10.1111/j.1460-2466.1997.tb02692.x]
24. Tiggemann M, McGill B. The role of social comparison in the effect of magazine advertisements on women's mood and body dissatisfaction. Journal of Social and Clinical Psychology. 2004; 23(1):23-44. doi: 10.1521/jscp.23.1.23.26991 [DOI:10.1521/jscp.23.1.23.26991]
25. Derenne JL, Beresin EV. Body Image, Media, and Eating Disorders. Academic Psychiatry. 2006; 30(3):257–61. doi: 10.1176/appi.ap.30.3.257 [DOI:10.1176/appi.ap.30.3.257]
26. Tiggemann M, Pickeringm AS. Role of television in adolescent women's body dissatisfaction and drive for thinness. International Journal of Eating Disorders. 1996; 20(2):199–203. doi: 10.1002/(sici)1098-108x(199609)20:2<199::aid-eat11>3.0.co;2-z https://doi.org/10.1002/(SICI)1098-108X(199609)20:2<199::AID-EAT11>3.0.CO;2-Z [DOI:10.1002/(SICI)1098-108X(199609)20:23.0.CO;2-Z]
27. Cusumano DL, Thompson JK. Body image and body shape ideals in magazines: exposure, awareness, and internalization. Sex Roles. 1997; 37(9-10):701–21. doi: 10.1007/bf02936336 [DOI:10.1007/BF02936336]
28. Groesz LM, Levine MP, Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders. 2001; 31(1):1–16. doi: 10.1002/eat.10005 [DOI:10.1002/eat.10005]
29. Thompson JK, Coovert MD, Stormer SM. Body image, social comparison, and eating disturbance: A covariance structure modeling investigation. International Journal of Eating Disorders. 1999; 26(1):43–51. doi: 10.1002/(sici)1098-108x(199907)26:1<43::aid-eat6>3.3.co;2-i https://doi.org/10.1002/(SICI)1098-108X(199907)26:1<43::AID-EAT6>3.3.CO;2-I [DOI:10.1002/(SICI)1098-108X(199907)26:13.3.CO;2-I]
30. Shamsaldin Saeed N, Aziz Zadeh Forouzi M, Mohammad Alizadeh S, Haghdoost AA, Gharousi B. [Relationship between body image and eating disorders (Persian)]. Iranian Journal of Nursing Research 2010; 4(15):33–43.
31. Amidi M, Ghofranipoor F, Hosseini R. [Body image dissatisfaction and body mass index in adolescent girls (Persian)]. Journal of Research in Behavioural Sciences. 2006; 4(1-2):59-65.
32. Thompson JK, Cattarin J,Fowler B, Fisher E. The Perception of Teasing Scale (POTS): A revision and extension of the Physical Appearance-Related Teasing Scale (PARTS). Journal of Personality Assessment. 1995; 65(1):146–57. doi: 10.1207/s15327752jpa6501_11 [DOI:10.1207/s15327752jpa6501_11]
33. Urvelyte E, Perminas A. The dual pathway model of bulimia: replication and extension with anorexia. Procedia-Social and Behavioral Sciences. 2015; 205:178–83. doi: 10.1016/j.sbspro.2015.09.054 [DOI:10.1016/j.sbspro.2015.09.054]
34. Rodgers RF, Paxton SJ, Chabrol H. Effects of parental comments on body dissatisfaction and eating disturbance in young adults: A sociocultural model. Body Image. 2009; 6(3):171–7. doi: 10.1016/j.bodyim.2009.04.004 [DOI:10.1016/j.bodyim.2009.04.004]
35. Wilson JMB, Tripp DA, Boland FJ. The relative contributions of subjective and objective measures of body shape and size to body image and disordered eating in women. Body Image. 2005; 2(3):233–47. doi: 10.1016/j.bodyim.2005.06.001. [DOI:10.1016/j.bodyim.2005.06.001]
36. Mueller, R. Basic principle of structural equation modeling: an introduction to LISREL and EQS. [S. Talepasand, Persian Trans]. Semnan: Semnan University Press; 2011.
37. Garner DM, Olmstead MP, Polivy J. Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders. 1983; 2(2):15–34. doi: 10.1002/1098-108x(198321)2:2<15::aid-eat2260020203>3.0.co;2-6 https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6 [DOI:10.1002/1098-108X(198321)2:23.0.CO;2-6]
38. Nobakht M, Dezhkam M. An epidemiological study of eating disorders in Iran. International Journal of Eating Disorders. 2000; 28(3):265-71. PMID: 10942912 https://doi.org/10.1002/1098-108X(200011)28:3<265::AID-EAT3>3.0.CO;2-L [DOI:10.1002/1098-108X(200011)28:33.0.CO;2-L]
39. Ganji H. [Evaluation of personality (Persian)]. Tehran: Savalan Publication; 2002.
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41. Thompson JK, Coovert MD, Richards KJ, Johnson S, Cattarin JA. Development of body image, eating disturbance, and general psychological functioning in female adolescents: Covariance structure modeling and longitudinal investigations. International Journal of Eating Disorders. 1995; 18(3):221–36. doi: 10.1002/1098-108x(199511)18:3<221::aid-eat2260180304>3.0.co;2-d https://doi.org/10.1002/1098-108X(199511)18:3<221::AID-EAT2260180304>3.0.CO;2-D [DOI:10.1002/1098-108X(199511)18:33.0.CO;2-D]
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