Body Image, Anxiety and Emotional Eating

Body image, anxiety and emotional eating: How they influence BMI and are influenced by teasing in childhood.

Introduction:

A positive relationship is said to be had between mental health and eating habits. There has been increased study into the relationship between childhood experience and mental health and wellbeing later in life, and the relationship they have with body image and eating habits.

Research by (1) has shown that bullying, being teased and all round childhood experiences of being bullied are associated to eating disorders and the perpetuation of eating habits. Similar research has found that verbal commentary such as teasing is an important sociocultural influence in the development of body dissatisfaction and eating disturbance. More specifically being teased about physical appearance was seen to directly effect body dissatisfaction and eating disturbance [2].

Recent work has defined the term ‘self schema’ which attest that cognitive generalizations about oneself are derived from past experiences and shape the way one perceives themselves [3,4] and those experiences are generally shaped by social influences such as peer victimization.

Teasing is seen as the most common form of peer victimization, this is found to result in social anxiety, most commonly among children however is seen to carry over into adult life and result in various psychological dysfunctions one of which is anxiety [5].  Much research has linked anxiety to teasing and this is further explored by studies that found binge eating, or emotional eating a response to negative emotions [6] such as anxious feelings or depression.

As disordered eating patterns and anxiety rates around the world are rising, large amounts or research procedures analyzing the relationship between eating habits and mental health have conducted. Similarly much research has been conducted to identify the relationship between childhood experience and mental health. However limited research conducted to examine the interrelationships between BMI, childhood teasing, anxiety, body image and emotional eating. Our hypothesis is formed given the information from past studies that have found that a high BMI is linked to lower psychological health [7]. Thus this study aims to identify the causational relationship and correlation between these variables in hope to bridge the gap in the current findings. Based on previous research, we believe that those with history of being teased as a child will result in higher levels of anxiety and emotional eating. These will result in a higher BMI and lower body image. Further we hypothesize that Anxiety influences level of emotional eating and body image. As well that ones BMI levels are linked emotional eating and ones body image.

Methods:

Participants:

123 adults seeking weight loss treatment in an ongoing commercial healthy eating and dieting program. Of which 3 were male with the mean age (M) of 47.67 and 118 were females M= 41.80. The mean BMI for males (N=3) was M=33.60 and for females (n= 118) M= 34.94 with a combined (n=121) mean of 34.90.

Measures:

In order to measure body image and the evaluation of appearance the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS; Cash, 2000) was used. It is known as a well validated self report inventory for the assessment of body image. It is used to calculate ones mental and physical fitness. The evaluation presented the participants with a series of questions, a 34-item measure that consists of 5 subscales Appearance Evaluation, Appearance Orientation, Overweight Preoccupation, Self-Classified Weight, and the BASS [17]. Higher scores showed higher body image.

To analyze and assess depression and anxiety various scales and tests were used. Subscales of the Hospital anxiety and depression scale (HADS: Bjelland, I et al. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research 52 (2): 69–77.) Here, both subscale scales contained six items each. Scale from 0=not at all to 3=all the time, assessing depression (e.g., I feel downhearted and blue) and anxiety (e.g., I feel nervous and anxious). Scale items are summed.  Higher scores more depressed mood and anxiety.

Emotional and uncontrolled eating was revised using the 18-item Three Factor Eating Questionnaire [18]. Participants responded on a scale of 1-4 (agree/disagree) to a series of questions related to 3 subtopics. 1. Emotional eating (e.g., When I feel down, I often overeat), 2. Uncontrolled eating, (e.g., Sometimes when I start eating, I just can’t seem to stop). 3. Cognitive restraint (e.g., I do not eat some foods because they make me fat). Consistent with de Lauzon scoring method, raw scale scores were transformed to a scale ranging from 0-100 [((raw score - lowest possible raw score)/possible raw score range) x 100]. Cognitive restraint was not examined in the current study.

Three modified items from the Perception of Teasing Scale (POTS; Thompson et al., 1995) were used to assess weight related teasing. Participants were asked with a frequency of 1-5 “How often are you currently teased about your weight?” Participants responded using a scale ranging from 1=Never 2=once or twice a year, 3=A few times a year, 4=A few times a month, 5=At least once a week [19].

One further question was asked relating to childhood teasing, Participants were asked to respond using a scale from 1=never to 5=very often to answer the question of “How often as a child, people made fun of you because you were heavy?”

The variables of POTS scale and uncontrolled eating were not assessed in our current study as they were not found to be relevant to the question at hand.

Procedure

Participants who had already had a consultation were presented the option of participating in the study. Those who chose to study gave informed consent by signing a form, they were then given the short pencil and paper self-report questionnaire assessing demographic details (i.e., age, gender, height and weight for calculation of BMI) and containing measures of body image, anxiety, depression, eating behavior, and weight-related teasing. Once completed a hard copy of the questionnaire was returned to the researcher. Ethical consent for the study was requested and obtained from Monash Universities Human Research Ethics Panel.