PDF Ebook Relationship Between Weight Loss And Body Image In Obese Individuals Seeking Weight Loss Treatment
The present study investigated the nature and extent of changes in body image following weight loss treatment in an obese sample and examined the role of weight loss in predicting body image improvement. Participants were 53 obese individuals (BMI > 30) recruited from the Pennington Biomedical Research Center in Baton Rouge, the Scripps Clinic in San Diego, CA, and the Weight Management Center at the St. Charles Hospital in New Orleans. Measures of psychological functioning and a figural body image rating procedure (Body Image Assessment for Obesity; BIA-O, Williamson, et al., 2000) were administered at baseline and after a 6-month follow-up (average 195 days ? 41.9 days). Body image dissatisfaction was operationally defined as the discrepancy between BIA-O current body size and ideal body size estimations. Weight loss for the total sample averaged 30.66 lbs, or a loss of 12.7% body weight. Body image significantly improved between T1 and T2, resulting from a decrease in participant’s estimations of current body size, while selections of an ideal body size remained stable. Results from a stepwise MRA revealed that a higher initial BMI, the tendency to overeat, and depression were significant predictors of initial body image discrepancy at T1 (r= .712.). At follow-up, weight loss consistently performed as the strongest predictor of body image improvement. Data suggest that weight loss brought participants’ perceptions of current body size closer in congruence with their ideal body size, thereby reducing levels of body image dissatisfaction. Several limitations of this study are discussed as well as clinical implications in relation to future directions for the assessment and treatment of body image concerns in obese individuals.
Obesity is a serious health problem worldwide. In the United States, the number of obese people (defined as BMI>30) has reached epidemic proportions, affecting approximately one-quarter of the American population. The prevalence of obesity is increasing worldwide, and the percentage of people who are overweight has steeply risen more than 30% since 1980 (Bray, 1998). Data from the National Center for Health Statistics indicate an uneven distribution of obesity, with African-American and Mexican- American females most affected (Flegal, Carroll, & Kucfzmarski, 1998). Children and adolescents are not immune to this epidemic. Data suggest that over 20% of children are currently overweight, and 30% of these individuals become obese adults later in life. Excess weight increases the risk of serious medical consequences such as hypertension, diabetes, coronary heart disease, and some forms of cancer. It has been argued that the “preponderance of evidence suggests that even mild overweight is probably associated with some increase in mortality risk" (Solomon, Willett, & Manson, 1995). In addition to the tremendous health risks, the financial cost of obesity is staggering. Obesity-related problems are estimated to cost the United States 39.3 billion dollars annually (Colditz, 1998). Given this backdrop, it is not surprising that the study of obesity has received an increasing amount of attention from local and federal policy-makers, health care professionals, and researchers.
Despite the well-established relationship between medical risks and obesity, the relationship between psychological functioning and obesity remains less
clear. Common beliefs implicating psychological distress as a contributing factor in the development of obesity has not been well supported by research(Hill & Williams, 1998). scale studies, each involving at least 500 subjects, found no consistent evidence to support the claim that severely obese persons show higher levels of psychopathology than normal-weight controls (Moore, Standard, & Srole, 1996; Silverstone, 1968; Hallstrom & Noppa, 1982; Kittel, Rustin, Dramaix, DeBacker, & Kornitzer, 1978; Hill & Williams, 1998; Stunkard & Wadden, 1992). Wadden, et al. (2001) contend that a substantial minority of extremely obese patients seeking bariatric surgery present with significant emotional complications.
Despite the bulk of support indicating a lack of relationship between psychopathology and obesity, a few studies have demonstrated the opposite, suggesting the presence of significantly higher levels of depression and anxiety in the obese (Sullivan, et al, 1993; Goldsmith, et al., 1992). However, many research trials include a high proportion of treatment-seeking individuals, who demonstrate a higher percentage of psychopathology, similar to other treatment-seeking medical populations. Thus, it has been argued that these clinical samples may be overrepresented in the literature, resulting in a selection bias (Williamson & O’Neil, in press). A review of the literature concluded that divergent findings were often the result of methodological inconsistencies, and it would be premature to make firm conclusions regarding the relationship between psychopathology and obesity (Friedman & Brownell, 1995). A complex association between obesity and psychopathology appears to exist, and importantly, obese individuals constitute a heterogeneous population, making it very difficult to draw generalized conclusions.
CONTENTS
DEDICATION
ACKNOWLEDGEMENTS
LIST OF TABLES
LIST OF FIGURES
ABSTRACT
INTRODUCTION
Definition of Body Image
Cognitive Model of Body Image
Developmental and Socio-cultural Theories of Body Image
Effect of Weight Loss on Body Image
Summary of Surgical and Non-Surgical Approaches
Other Approaches to Body Image Improvement
Summary of Research Findings
PILOT STUDY
Participants
Procedure
Assessment Measures
Results
Discussion
DISSERTATION STUDY
Study Purpose and Rationale
Primary Research Questions and Hypotheses
Methodology
Results
Discussion
REFERENCES
APPENDIX A: CONSENT FORM
APPENDIX B: DEMOGRAPHIC QUESTIONNAIRE
VITA
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