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Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.

Background Maternal feeding practices have been proposed to play an important role in early child weight gain and obesogenic eating behaviors. However, to date longitudinal investigations in young children exploring these relationships have been lacking. The aim of the present study was to explore prospective relationships between maternal feeding practices, child weight gain and obesogenic eating behaviors in 2-year-old children. The competing hypothesis that child eating behaviors predict changes in maternal feeding practices was also examined. Methods A sample of 323 mother (mean age = 35 years, ± 0.37) and child dyads (mean age = 2.03 years, ± 0.37 at recruitment) were participants. Mothers completed a questionnaire assessing parental feeding practices and child eating behaviors at baseline and again one year later. Child BMI (predominantly objectively measured) was obtained at both time points. Results Increases in child BMI z -scores over the follow-up period were predicted by maternal instrumental feeding practices. Furthermore, restriction, emotional feeding, encouragement to eat, weight-based restriction and fat restriction were associated prospectively with the development of obesogenic eating behaviors in children including emotional eating, tendency to overeat and food approach behaviors (such as enjoyment of food and good appetite). Maternal monitoring, however, predicted decreases in food approach eating behaviors. Partial support was also observed for child eating behaviors predicting maternal feeding practices. Conclusions Maternal feeding practices play an important role in the development of weight gain and obesogenic eating behaviors in young children and are potential targets for effective prevention interventions aiming to decrease child obesity.

Physical activity and team sports may be protective of substance use among adolescents, although there is mixed evidence on whether muscle-building exercise is associated with patterns of e-cigarette use (i.e., vaping), cigarette use, and cannabis use. Therefore, this study aimed to determine the association between muscle-building exercise and patterns of concurrent substance use among U.S. adolescents. Cross-sectional data from the 2019 Youth Risk Behavior Survey (N = 8,474) were analyzed in 2022. Muscle-building exercise was assessed by number of days of the behavior in the past week and categorized based on level of engagement (none, low, medium, and high). Concurrent vaping, cigarette use, and cannabis use within the past 30 days were assessed using a combined, four-category variable (no use, any single use, any dual use, and triple use). Multinomial logistic regressions, with coefficients transformed to relative risk ratios (RRR), were conducted to estimate the associations between muscle-building exercise and concurrent substance use among the overall sample, and by sex, while adjusting for relevant sociodemographic variables. Among the overall sample, high engagement (6-7 days) in muscle-building exercise was associated with greater relative risk of any single use (RRR 1.36, 95% confidence interval [CI] 1.06-1.72), any dual use (RRR 1.46, 95% CI 1.10-2.94), and triple use (RRR 1.81, 95% CI 1.05-3.12). While muscle-building exercise was associated with greater relative risk of concurrent patterns of vaping, cigarette use, and cannabis use among adolescent males, there were no significant relationships found among adolescent females. Healthcare professionals should consider this association when treating adolescent males, particularly given the high prevalence of muscle-building exercise and substance use among this group. More research is needed to understand the experiences of adolescent males who report high engagement in muscle-building exercise and substance use to uncover mechanisms of association.

Physical activity and team sports may be protective of substance use among adolescents, although there is mixed evidence on whether muscle-building exercise is associated with patterns of e-cigarette use (i.e., vaping), cigarette use, and cannabis use. Therefore, this study aimed to determine the association between muscle-building exercise and patterns of concurrent substance use among U.S. adolescents. Cross-sectional data from the 2019 Youth Risk Behavior Survey (N = 8,474) were analyzed in 2022. Muscle-building exercise was assessed by number of days of the behavior in the past week and categorized based on level of engagement (none, low, medium, and high). Concurrent vaping, cigarette use, and cannabis use within the past 30 days were assessed using a combined, four-category variable (no use, any single use, any dual use, and triple use). Multinomial logistic regressions, with coefficients transformed to relative risk ratios (RRR), were conducted to estimate the associations between muscle-building exercise and concurrent substance use among the overall sample, and by sex, while adjusting for relevant sociodemographic variables. Among the overall sample, high engagement (6–7 days) in muscle-building exercise was associated with greater relative risk of any single use (RRR 1.36, 95% confidence interval [CI] 1.06–1.72), any dual use (RRR 1.46, 95% CI 1.10–2.94), and triple use (RRR 1.81, 95% CI 1.05–3.12). While muscle-building exercise was associated with greater relative risk of concurrent patterns of vaping, cigarette use, and cannabis use among adolescent males, there were no significant relationships found among adolescent females. Healthcare professionals should consider this association when treating adolescent males, particularly given the high prevalence of muscle-building exercise and substance use among this group. More research is needed to understand the experiences of adolescent males who report high engagement in muscle-building exercise and substance use to uncover mechanisms of association.

Background The post-partum period is a vulnerable time for mothers in terms of eating disorder symptoms and is critical for the establishment of feeding patterns in infants. This study aimed to investigate the relationships between maternal eating disorder symptoms and objective indices of feeding regulation at 3 months, as well as perceived breastfeeding self-efficacy. Methods A sample of n  = 73 full-term mother-child dyads (44% female) participated in the study. Mothers self-reported eating disorder symptoms and breastfeeding self-efficacy and objective indices of infant feeding regulation were obtained in the home. Results Findings revealed the existence of relationships between higher maternal eating disorder symptoms, and objective indices of infant feeding regulation with substantial gender differences in the patterns emerging. Among mother-daughter dyads, maternal weight and shape concerns were associated with higher infant transfer volume and rate during bottle feeding. In contrast, among mother-son dyads, higher maternal eating disorder symptoms, including weight, shape, and eating concern, were associated with lower infant transfer volume and rate as well as lower levels of proficiency while taking their bottle. Conclusion Relationships emerged between higher maternal eating disorder symptoms and feeding regulation with substantial gender differences in these patterns. Additional research clarifying the underlying mechanisms of these associations is warranted and further efforts should be directed towards supporting mothers during the postpartum period.

Purpose Emerging research evidence suggests positive relationships between higher screen time and eating disorders. However, few studies have examined the prospective associations between screen use and eating disorder symptoms in early adolescents and how problematic screen use may contribute to symptom development. Methods We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study ( N  = 10,246, 2016–2020, ages 9–14). Logistic regression analyses were used to estimate the longitudinal associations between baseline self-reported screen time and eating disorder symptoms in year two. Logistic regression analyses were also used to estimate cross-sectional associations between problematic screen use in year two (either problematic social media or mobile phone use) and eating disorder symptoms in year two. Eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) included fear of weight gain, self-worth tied to weight, engaging in compensatory behaviors, binge eating, and distress with binge eating. Results Each additional hour of total screen time and social media use was associated with higher odds of fear of weight gain, self-worth tied to weight, compensatory behaviors to prevent weight gain, binge eating, and distress with binge eating two years later (odds ratio [OR] 1.05–1.55). Both problematic social media and mobile phone use were associated with higher odds of all eating disorder symptoms (OR 1.26–1.82). Conclusions Findings suggest greater total screen time, social media use, and problematic screen use are associated with more eating disorder symptoms in early adolescence. Clinicians should consider assessing for problem screen use and, when high, screen for disordered eating. Level of evidence Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

Background Muscle dysmorphia is a significant mental health condition that has been under-researched in epidemiological, community-based studies. Therefore, this study aimed to identify the prevalence and correlates of probable muscle dysmorphia among a sample of Canadian ( n  = 784) and American ( n  = 563) boys and men ages 15–35 years. Methods The sample comprised 1,488 boys and men who completed a variety of measures and items to capture sociodemographic characteristics and muscle dysmorphia symptoms. Diagnostic criteria were applied to identify probable muscle dysmorphia among the sample. Unadjusted (e.g., chi-square tests, independent samples t- tests) and adjusted (e.g., logistic regression) analyses were used to determine the sociodemographic factors (e.g., age, body mass index, gender, race/ethnicity, sexual orientation, education, relationship status, and country) associated with cases of probable muscle dysmorphia. Results The prevalence of probable muscle dysmorphia was 2.8% (95% confidence interval 2.0-3.7%). Aside from lower body mass index among those with probable muscle dysmorphia, there were no significant demographic differences between those with and without probable muscle dysmorphia across ages, genders, races/ethnicities, and sexual orientations. Those with probable muscle dysmorphia had significantly higher scores on standardized measures of muscle dysmorphia symptomatology and muscularity-oriented attitudes and behaviors compared to those without probable muscle dysmorphia. Conclusions Findings underscore that muscle dysmorphia may be more prevalent among boys and men in Canada and the United States than previously thought, highlighting the need for more research, prevention, assessment, and intervention efforts. The minimal differences across sociodemographic factors are notable, highlighting the need for an inclusive understanding of muscle dysmorphia. Plain english summary Probable muscle dysmorphia occurred at a prevalence of 2.8% among a sample of boys and men in Canada and the United States. There were minimal sociodemographic differences between those with and without probable muscle dysmorphia. The findings from this study underscore that muscle dysmorphia may be more common among boys and men than previously thought and that the condition occurs across sociodemographic groups. Prevention and intervention efforts for public health and healthcare professionals should consider the broad representation of muscle dysmorphia among boys and men.

Purpose of Review Eating disorders are recognized to occur across ethnic and racial groups. The aim of the present review was to examine recent advances in the understanding of the development, presentation, and intervention approaches specific to eating disorders among ethnic and racial minority groups. Recent Findings An increasing number of measures have been found to be useful tools for assessing eating disorder risk and symptoms among ethnic and racial minority populations. In addition, further evidence has emerged supporting the relationship between higher levels of eating disorder symptoms and acculturation stress, as well as investment in appearance ideals. In contrast, the relationship between ethnic identity and eating disorder symptoms is less consistent, although several studies suggest that positive ethnic identity may be protective. Finally, increasing efforts have been made to develop and implement culturally sensitive interventions by tailoring evidence-supported treatments. Summary Our understanding of and capacity to treat eating disorders among ethnic and racial minority groups continues to improve. However, further research is needed, particularly among neglected groups, such a smaller ethnic and racial groups, males, and intersecting minority statuses.

Background The COVID-19 pandemic has been associated with increased body dissatisfaction and disordered eating behaviors in adolescents. To better understand these associations, this study tested an explanatory model in which appearance-focused social media use, internalization of social media pressure, and mindfulness abilities mediated the relationship between COVID-related distress and body dissatisfaction, which in turn was associated with dietary restraint and binge eating episodes. Methods Adolescents ( N  = 493, M age = 16.7; 47.5% girls) recruited within high schools completed online measures. We conducted model testing through path analysis in MPlus, using modification indices to derive a well-fitting model. Results The initially hypothesized model was a poor fit for the data. The final well-adjusted model confirmed several significant paths and supported the parallel mediational roles of social media (specifically, the use of appearance-focused social media and internalization of social media pressure) along with mindfulness, on the relationship between COVID-19-related distress and body satisfaction. Model adjustments involved adding three paths, resulting in two additional significant indirect effects, and suppressing one path. Conclusions Findings suggest that mindfulness, media use and the internalization of social media pressure are potential key processes explaining body dissatisfaction and eating disorders among adolescents who experienced higher levels of COVID-related distress.

The majority of advertisements contain thin-ideal imagery that have been digitally modified. A robust body of research has suggested that exposure to these retouched images has negative effects on body image and increases eating disorder risk. Furthermore, these concerns are known to be highly gendered both in nature and in their extent, with women revealing higher levels of concerns predominantly related to thinness. Although not supported as a useful approach by empirical data, in 2017, France introduced a law requiring advertisers to label images featuring models whose weight and/or shape have been altered. These images must bear the label “photographie retouchée”, or “retouched image”. However, this legislation has been difficult to enforce, as unlike other French legislation related to labeling advertising, its lack of specificity makes it difficult to identify violations. Paradoxically, given its intentions, where applied, uses of the label disproportionately focus on women’s bodies in the media, as compared to men’s bodies. These findings highlight the need for legislation that is enforceable and supported by the allocation of sufficient resources. In addition, findings highlight the importance of grounding legislation and policy in the extant relevant data and involving strategic stakeholders in its creation.