Body image, weight stigma, health behaviors among adolescents

Published: 1 July 2024| Version 1 | DOI: 10.17632/pyywj9hd3f.1
Hannah Weisman


Measures include: Perceived weight status. Very underweight, somewhat underweight, about the right weight, somewhat overweight, or very overweight. Experiences of weight-based victimization. 3-item measure that assessed how frequently they had been teased or bullied because of their weight at school, home, or somewhere else on a scale from 1 (never) to 5 (very often). Based on a longer measure of weight-based victimization (Puhl et al., 2011; Puhl, Peterson, & Luedicke, 2013a; Puhl et al., 2013b). Weight-stigmatizing attitudes. Fat Phobia Scale (F-scale; Bacon, Scheltema, & Robinson, 2001). Internalization of body ideals. The Ideal-Body Stereotype Scale-Revised (IBSS-R; Stice et al., 1996) was used to assess thin ideal internalization among females. The 6-item Drive For Leanness Scale (DFLS; Smolak & Murnen, 2008) was included to assess internalized body image ideals among males. Body image concerns. Weight and Shape Concerns Scale (WCS; Killen et al., 1993, 1994) was used with female participants. Body image concerns among males was assessed with the Male Body Image Concerns Scale (MBICS; Weisman et al., 2014b). Both the WCS and the MBICS produce standardized scores that range from 0 to 100. Eating psychopathology. Youth Eating Disorder Examination Questionnaire (YEDE-Q; Goldschmidt, Doyle, & Wilfley, 2007) global composite score. Physical activity. PACE+ Adolescent Physical Activity Measure (Prochaska, Sallis, & Long, 2001). Nutrition. The PACE+ Fruit and Vegetable Measure (Prochaska & Sallis, 2004). Acculturation: Practices. Bicultural Involvement Questionnaire – Short Version (BIQ-S; Guo et al., 2009). Values. Sixteen items developed by Triandis and Gelfand (1998) were used to determine individualism and collectivism subscale scores. Some items were adapted to be more appropriate for an adolescent population. Identifications. The Multigroup Ethnic Identity Measure – Revised (MEIM-R; Phinney & Ong, 2007) was used to assess identification with the heritage culture. The American Identity Measure (AIM; Schwartz et al., 2012) was used to assess American identification. The measure was adapted for this study to only include the six items on the MEIM-R; hence, it is referred to as the American Identity Measure – Revised (AIM-R). Mischievous or dishonest responding. Students were asked in the demographics section (a) if they were deaf or had a hearing impairment, (b) if they were blind or had a severe vision impairment, and (c) when their last visit to the dentist occurred (within the past 6 months, about a year ago, or about 2 years ago). It is not plausible that an honest participant would endorse all these low incidence items. Two questions were included on the last page of the survey: How many questions in this survey did you answer honestly? And, how many other students at your school do you think answered the questions in this survey honestly? (All of them, most of them, only some of them, hardly any of them).


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Participants were 371 high school students ages 12-18 recruited from large public high schools in two regions, described as a north and south region, on the central coast of California. The student population in this area is majority Latinx and White. Schools ranged from approximately 30%-80% socioeconomically disadvantaged students and 40%- 75% Latinx. Schools in the northern region were marked by lower SES and higher free/reduced lunch, whereas schools in the southern region were marked by higher levels of affluence, comparatively. A total of six participants were excluded from analyses: two for low English proficiency (identified by the teachers and apparent during survey completion), and four who reported that they answered “only some” or “hardly any” items honestly. Study implementation took place in spring 2016 in 18 health classes, two physical education classes, and one freshman seminar course. It was noteworthy that the two physical education classes were comprised of an all-male freshman and varsity football team, making up 22% of the males in the current study. Recruitment took place in classrooms from four high schools who agreed to participate in the study. Interested students took home a letter and consent form explaining the study to their parents. Consent forms were available in English and Spanish. Students also had to provide their assent to participate. All study materials were completed during class. There were four different versions of the survey, each containing the same measures in different orders; this was done to minimize repeated missing data patterns.


Adolescent Health, Social Stigma, Body Image, Acculturation, Bullying