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I 3-,. .. 1.. \.'-.x-- . . 2 G I» .5 (fir _,V, rfifi This is to certify that the thesis entitled Health Behaviors and Attitudes of College Women Classified According to Body Satisfaction and Unrestrained Eating Behaviors presented by Gail M. Mortenson has been accepted towards fulfillment of the requirements for Masters #um Human Nutrition Major professor b’b’ 531—511$ LIBRARY mail..- Cute University PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. DATE DUE DATE DUE DATE DUE ~ ‘3’ l. .V" .- MSU In An Affirmative Action/Equal Opportunity lmflluim K7 , i , HEALTH BEHAVIORS AND ATTITUDES OP COLLEGE WOMEN CLASSIFIED ACCORDING TO BODY SATISFACTION AND UNRESTRAINED EATING BEHAVIORS BY Gall Margaret Mortenson ‘ A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of .ummy . MASTER OF SCIENCE ,. “‘IaltliLiL’; \ [for 1 n. n4'n \\.r l .4‘ ‘Jirjfr. ainsmerivya: sin 10 sergefi and 103 rI: In} ; mirage {le imam -7 'I , . . ABSTRACT HEALTH BEHAVIORS AND ATTITUDES 0F COLLEGE WOMEN CLASSIFIED ACCORDING TO BODY SATISFACTION AND UNRESTRAINED EATING BEHAVIORS BY Gail Margaret Mortenson The purpose of this study was to determine body satisfaction and unrestrained eating in a sample of college women and compare this group to other college women in terms of body weight, self-esteem, food group intake, eating patterns, physical activity and roles of women. A questionnaire was administered to 249 college women and anthropometric measurements were taken. In the final analysis, there were 103 women classified into one of three groups based on body dissatisfaction or satisfaction and restrained or unrestrained eating behaviors. The group of satisfied/unrestrained women (n=35) had significantly lower BMI values (20.5 vs. 26.7, p<.01), higher self—esteems (13.9 vs. 19.3, p<.01), consumed greater amounts of meat, high fat foods and calorie dense snacks and consumed lunch and supper more frequently than the dissatisfied/restrained women (n-48). The findings suggest that further caloric restriction for dissatisfied/restrained women might not be f.. rteconnended. u dprd ‘339m 10 :jxrnmu _.-« TDAHYBBA aauurrrra aux PHCEVnHEH usuasu or ourosonca 0813733h31 usa:u session an elorvenas narraa asuznsranaqu 3r: u91rwaaazrae race O l " I.‘ M Ma - in afztrssfi ; :11 - x i :: it 7;" H r ‘ "HI. ~- ‘ 13 “3, ."c ' ., V ~ . : . 98.9mm," In honor. of Janet and Paul, who are two of my closest friends, my best supporters .-. U: 1‘) , a and my parents. It! inV‘aluu’. ;,. Wauesttcnms : a:- 3. 3 mum; v i Hi7; LA? I '.?“-l I . “v"! '3' . H10” “1 L . ' ' '-“ arr. Jrj'. '3“ actuadly makes statistics understandable. ACKNOWLEDGEMENTS To members of my Guidance Committee: To Dr. Sharon Hoerr, Department of Food Science and Human Nutrition, who served as my major professor, for the amount of time she invested in me. She was easily available for my questions and had a genuine desire for me to learn and improve. She taught me the true meaning of hard work I and I am a better person today because of her. To Dr. Jenny Bond, Department of Food Science and Human Nutrition, for providing me with the insight to think of my research as it relates to broader issues. I will not forget her genuine concern and care for me. To Dr. Rachel Schemmel, Department of Food Science and Human Nutrition, for her incredible editorial abilities and interest in my research. Her guidance throughout my research and the annual research review are appreciated. I will also always remember her generosity and love for Iowa. To Dr. Larry Hembroff, Center for Survey Research, for his invaluable comments and guidance during the development of the questionnaire. He should also receive an award for his incredible ability to explain statistics, because he 1 3‘ .3," .‘ , , . .. ’_ :H.q:1":"‘.'fu" 3"! ‘1- 1K . > v f'» 233411725”: 07’ f V "IL. . . . 1 . I. . V 4 -« , 3 I . 3.. ‘(w [‘7' ‘-')." fr.‘ 1’ I '.‘ To Dr. David Garner, Department of Psychiatry, who helped me formulate the original idea for this research project. I truly appreciate the hours of discussion he spent during the planning stages of the research and his constant encouragement and confidence in me. I am grateful to Dr. John Wagner who allowed the questionnaire to be administered to his students. To Carol Freisen, Pat Smith, Victoria Louden and Mary Greeley, graduate students who went before me, who provided much encouragement and wisdom in the art of successfully completing graduate school. I would also like to thank Marci Askegard, Gail Haus, Amy Riley and Tan-yi Hung for making these last few years not only fun, but also very rewarding. I want to thank Linda Hudson for her invaluable assistance in the office, but also for her cherished friendship. To the members of MSU's Graduate InterVarsity Christian Fellowship, I thank you for all the support and encouragement that goes along with being a part of a great fellowship of believers. Thanks to Chris, Karen, Jill, Tommy and Lisa. Most of all, I want to thank my husband, Kirk, for his continuous encouragement throughout the many months of work on this thesis and whose assistance I could not have done without. I thank you for the many sacrifices you have had to make in helping me obtain this degree. is 7% J ‘3‘ - .‘ v . ' -&’ ggmiriweq 30 insmirsqsa .1911st [:1sz .10 O! rT' _ ‘ ' ' Wdflxssesx aid: roi ssbl [snipiro ed: sisiumxoi am 3.01.“ ad noieeunei to eruod an: 515;n93qqs ylu1: i .3seterq aid has r..:-*.aa.;~_‘~i ~ri3 “v 3;: p :5 WLLJHslq as: gnsrub fined! ,‘ r: . yumri «.v.* 1' s ‘ l( v , n I . .. .‘I / 7"T._‘l-':‘ 4105“ .' “1638.103 _. ., - , e v 32* -< I: r "I 'L '. . "r ‘ .tl‘ilr ' F‘ . {3” ;°i ‘x3i3.15354535 KW finfiV? if 5V?“ ' -. ‘. . 1D "idquv sun S? 9“3_.3“mfi'°m¢ mimopeioosno cumin: 3.13:1 ,. . ' 'masnm .p . TABLE OF CONTENTS Chapter H 0 III III IV. List of Tables List of Figures INTRODUCTION Conceptual Model Definitions Purpose Research Questions Research Hypotheses REVIEW OF THE LITERATURE Prevalence of body dissatisfaction Cultural expectations of thinness for women Body dissatisfaction Implications of body dissatisfaction Restrained eating Food intakes of college women Eating patterns of college women Physical activity Self—esteem Roles of women Metabolic differences in women Treatment of body dissatisfaction METHODS Subjects Procedures Measurements 1. Survey Instrument 2. Anthropometrics Data analysis Funding and Equipment RESULTS Demographics Research Hypothesis HO-l: Prevalence of unrestrained eating HO-Z: Prevalence of body satisfaction . , -A _," -‘.- HO-3: Behavioral and attitudinal differences flgV-Vungfalt lating patterns and food intake " sweeter: - a }. Roles ( Select: Height IQIICI Lilita VI. menu Conclu Reco- "13 Append A B C I! l‘ I i l i i l 1 snowwbfi VIII. Lug assuaxi 831 rigs-1pc 2m." eiesndoqxu dorssass iflssfevaxfi :I-OR IV. VI. VII. VIII. ' fl.n£atiOiaLLLd “SUI." (cont) HO-3c: Body Mass Index values HO-Bd: Self-esteem HO-3e: Roles of women Correlations in Conceptual Model Selected Behaviors related to Weight Control Weight perceptions DISCUSSION Prevalence of unrestrained eating Prevalence of body satisfaction Food intake Eating patterns Physical activity Body Mass Index values Self-esteem Roles of women Selected Behaviors related to Weight Control Weight perceptions Implications Limitations and strengths CONCLUSIONS Conclusions Recommendations for Future Research Appendices Correspondence with Dr. John Wagner B Human Subjects Approval: UCHRIS, Michigan State University's Committee for the Review and Investigation of Human Subjects Informed Consent Form Questionnaire Questionnaire Evaluation Form Data Codebook Correlation matrix of key study variables Correlations in Conceptual Model IQ'UMUO List of References ( 99 100 101 102 123 124 134 135 136 Ir ruff. "c ). Ar -_ A ‘Isf()i\l£u1;‘t; bs’aele?‘ O W ‘ ‘I'J'r eouisv 7.2::an sang." .3 V m , , m59539?3§98 tit-OI 3 ‘3 narrow in ash”! :oSrm Jar:.._-~.:::o'.v n: Enr'lJbISIIOI) “"3310: 13:4 japjgfi' what. - , . ... 5's ‘7’1-‘1 v - i k ' '_ "r." - ‘ LIST OF TABLES Table Page 4.1 Average weekly number (:SD) of servings from the 52 food groups consumed by each category of women. 4.2 Percentage of women categorized by restrained 54 eating and body satisfaction who reported eating breakfast. 4.3 Percentage of women categorized by restrained 54 eating and body satisfaction who reported eating lunch. 4.4 Percentage of women categorized by restrained 55 eating and body satisfaction who reported eating supper. 4.5 Percentage of women categorized by restrained 55 eating and body satisfaction who reported consuming 0-3 meals per day. 4.6 Percentage of women categorized by restrained 56 eating and body satisfaction who reported eating morning snacks. 4.7 Percentage of women categorized by restrained 56 eating and body satisfaction who reported eating afternoon snacks. 4.8 Percentage of women categorized by restrained 57 eating and body satisfaction who reported eating evening snacks. 4.9 Percentage of women categorized by restrained 57 eating and body satisfaction who consumed snacks per day. 4.10 Percentage of snacking frequency throughout the 58 : day of women categorized by restrained eating and 3 body satisfaction. .,Lfl 4.11 Percentage of women in activity categories by body 59 . ; ““-’%e;. satisfaction and restrained eating behaviors. . _.¥« "‘ " ' viii . -. g ' I u fitt'flfli/ x to : ( , {an In» - Machine! L 1.15 Illfl‘ ideal 3 _ . L16 Puree , . cateq iatis L11 Peres I 4.19 High» of « eati 4.20 Pere- ; eati 7.1 Corr ‘. l ~ I.- - . ' r. -- h,n:..},..'>‘.-‘ -. . our}, . we. _ adorns Lsmnzrei ”Me ,i. .‘ .7 3‘s mamas is gab ,. ;~‘3¥$k3d 4.15 4.16 4.17 Body Hass Index values of women classified 60 according to body satisfaction and restrained eating behaviors. Self—esteem values for women classified according 61 to body satisfaction and restrained eating behaviors. Mean total score of women's views on perceived 63 important traits of women in society. Mean total score of women's own perception of an 63 ideal woman in today's society. Percentage of weighing frequency of women 65 categorized by restrained eating and body satisfaction. Percentage of women categorized by restrained 66 eating and body satisfaction who reported vomiting at least once after a meal. Percentage of women categorized by restrained 67 eating and body satisfaction who reported binge eating. Highest and lowest adult Body Mass Index values 68 of women who were categorized by restrained eating and body satisfaction. Percentage of women categorized by restrained 69 eating and body satisfaction who reported smoking. Correlation matrix of key study variables. 134 yggii, o nanow do ssuisv raisin use 3658153389; no acidosieiass vane 6-3 portions. . eroivuiad patios .93 9411530355 beliteesi; nsmcw :mj eeuisv mates-1198 61.5 polls-3 bsnlaites: rm. n. Juirfise (bod 03 .aioivcdsd £3 bsvl_.7fiq do 'w;:? A'HJTuJ ‘ . U“é lain! use" Ei.4 ' .1. “5' . 3,‘ . ‘.. . _‘. f 'f'_ I- ”11",! an. Ca 37." _' "(.934 4 lo M. .3’ hi' ‘ is»! 31.? 1‘1 ‘ , , I P ‘1‘ l ‘1- ) :'.L“‘_,'to laaiVLiija _ 5‘;_i"i"load _-‘ ”I Figure 1.1 LIST OF FIGURES Page Conceptual Model of variables measured relating 3 to body dissatisfaction and unrestrained eating. Classification of women (n=105) in final sample, 50 from 249 women in total sample, according to body satisfaction and restrained eating behaviors. Percentage of women in each weight categorya 70 according to their actual and perceived body weights and classification of body satisfaction and restrained eating. Desired weight changes for women in each actual 72 weight category.a Desired weight changes for women categorized by 72 body satisfaction and restrained eating. Strength of relations between variables in 135 Conceptual Model. y'lrr.‘ -' ' -‘-'rr,.- . . \" . ‘ I'J‘. _' little .“ ruxthu .DO')‘ .01. ‘1' V” 13'0“ s ham, 3: liming to not mean (India at a any fouls 19") and (1 learn, 191 :1: il., 19! to be a vol I the diagnog it increasing l “In, at I “sure . The c Psychologi “Nessa: Miviaun ‘ I "strum INTRODUCTION In our society today, thinness for women is equivalent to beauty, acceptance and competence. Many young women are striving to attain an unrealistically slim female figure and most women have a preoccupation with weight and thinness (Rodin et al., 1984). This preoccupation has resulted in many females feeling dissatisfied with their bodies (Moore, 1988) and dieting for women has become the norm (Polivy and Herman, 1987) whether the woman is overweight or not (Moses et al., 1989). Unfortunately, many young women believe that to be a woman means feeling too fat (Rodin et al., 1984) and the diagnoses of eating disorders have been rapidly increasing in women (Garner et al., 1983). Many young women, at all weight levels, are dieting to attain a slim figure. The chronic dieting practices of young women have psychological and economic implications that can impose unnecessary emotional, physiological and monetary strains on individuals (Allen, 1979; Moore, 1988). Chronic dieting, or restrained eating, is associated with negative self-esteem (Polivy et al., 1988). Individuals seeking weight loss 1m; ‘l‘hoal mo; floors are satisf dietary in are not at characteri physical a eaten and i “y’a- 2 4 thousands of dollars on quick weight loss methods that f‘have little longterm success (Moore, 1988). 03‘. . VB? about individuals who are dissatisfied with their bodies and fFurther research and methods for gaining information who have inappropriate eating behaviors are needed (Gray, 1977; Thomas et al., 1988). Several studies (Miller et al., 1980; Moore, 1988; Moses et a1. 1989) have identified these women who are dissatisfied with their bodies and their eating behaviors but no study to date has studied women who are satisfied with their bodies and who do not restrict dietary intake. Information about body satisfied women who are not dieting is needed regarding lifestyle characteristics, such as eating patterns, food intake, physical activity, body weight and attitudes such as self- esteem and views of the ideal woman in society. Such information would be useful in education and prevention for women who are dissatisfied with their bodies and who are restrained eaters. 1.0/7" . m Belt-eats Sociocult Perceived Body veig l I l l / Body Dissa Figure 1. fi ,- ”alum ti . The following is a conceptual model of the study variables and their possible interrelationships. This model was used only in the design of the study and was not tested. CONCEPTUAL MODEL Psychosocial Variables: — — — — ——9 Behavioral Variables: Self-esteem 1 Activity Food group intakes Eating Patterns Vomiting & bingeing lWeighing frequency Sociocultural views of women Perceived roles of women lBody weight perceptions l \ \\ ‘Smoking l \ \ | \/ I / \ l l / \ 1 BMI | / / I / / I / l / \. l / Body Dissatisfaction-—- ——- —- -—-——-€> Unrestrained eating Figure 1.1 Conceptual Model of variables measured related to body dissatisfaction and unrestrained eating. statistical mm habitual (ii to control eating was regulation terns of e terns of a Satin frequency with snack slipping. Iood foods cati character .W' pgfiipitions Body dissatisfaction is a part of body image 6 ) disturbances which includes dissatisfaction with body weight and shape. It is one of the diagnostic criteria for anorexia nervosa and bulimia nervosa in the Diagnostic and Statistical Manual of Mental Disorders, DMS-IlI-R (1987). Restrained eating is a term to identify behaviors of habitual dieters or those who restrain food intake in order to control body weight (Herman and Polivy, 1980). Restrained eating was defined in an attempt to understand the regulation of body weight by humans and is defined more in terms of effort expended toward weight suppression than in 4....— ‘1" terms of achieved success. Eating patterns in this study, are defined as the frequency of breakfast, lunch and supper consumption along with snack consumption and the frequency of meal skipping. Food intake is the intake and consumption of different foods categorized into groups based on similar nutrient characteristics. Physical activity is the frequency and duration of participation in physical activities such as running, swimming, walking, aerobics, lifting weights, etc. Self-esteem, as defined by Rosenberg (1979). is the ‘Ifiqq tOtility of an individual's thoughts and feelings towumtoiu‘._w the pol behaviors, Ibo were :1 unrestraine: into groups unrestraine satisfied 0 Comparison: eating pott weight, so] 5 one's self which includes social identity, disposition and physical characteristics. Purpose The purpose of this study was to determine health behaviors, attitudes and body weights of college-aged women who were classified according to body satisfaction and unrestrained eating behaviors. Subjects were classified into groups based on whether they exhibited restrained or unrestrained eating behaviors and whether they were satisfied or dissatisfied with their body weight and shape. Comparisons were made between four groups on measures of eating patterns, physical activity, food group intake, body weight, self—esteem and views of women's roles in society. Research Questions 1) What is the prevalence of unrestrained eating in a sample of college—aged women at H80? 2) What is the prevalence of body satisfaction in a sample of college—aged women at MSU? 3) Are there differences in self—reported behaviors between college women who are classified into four groups based on restrained or unrestrained eating behaviors and body satisfaction or dissatisfaction with respect to eating patterns, physical activity, food intake, body mass index (3H1) values, self-esteem and perceptions of women's role in society? I _flblfiulogslb .viltasbi Istsoa aebuioa! usinw ilsa 8'... .eoiasixsfioaxsda issievdq 3. am an Aria ' -a->:~~'r"*‘u ‘9 g [3’ :l.‘ i' W hat r‘t‘ “will. .3. . A -‘ i y w Manon "“ ' " ' ’ ‘ ' " ‘- hotvooo ‘ ' ' ‘ ‘ ' , ‘ accordin unrestra dissati: a) Th: pa “"‘ ‘ i 98 C) Ti "99'3“ 51'“)! bei id i.":=_,' ._ 'QJI'Qgggd‘agyosp :uol nzn. .3 _ ”mivwsd 9111759 b5r:ifi’2.73_ :rn :5 ; _.r q. "7'T1 “!.¢¢£w noidusiaixscpgj 3p fiogjfisjez3b£ mm 1) There are college-aged women at HSU who exhibit ‘ unrestrained eating behaviors. 2) There are college-aged women at MSU who are satisfied 5 with their bodies. 3) There are behavioral, attitudinal and weight differences between the four groups of college women classified according to whether they exhibit restrained or unrestrained eating behaviors and body satisfaction or dissatisfaction: . a) There are differences in daily meal and snacking patterns and food group intakes between women who exhibit unrestrained eating and body satisfaction and other groups of women. b) There are differences in physical activity between women who exhibit unrestrained eating and body satisfaction and other groups of women. c) There are differences in BMI values between women who exhibit unrestrained eating and body satisfaction and other groups of women. d) There are differences in self-esteem scores between women who exhibit unrestrained eating and body satisfaction and other groups of women. f~ e) There are differences in perceptions of women's roles in society between women who exhibit é}; ., ;:-.i;.MV‘ .a:u3vzdea guijee bonirzjesxnn l '.A "“ L 7 .,, Jo«;.ot win sxsdT (S ‘1 ;‘=>: x: v: “ '“3udto Ficr 1ho 1)‘ . :5 mamaw -Oo- wuau I nssqud 59‘0~ .13: 1175:i.:":1' 1’- Ybod bns ghibss hen} .fl/u . .1 ”‘7‘.“ ‘a-br: -.’_ U. . Sznaprnr .hc ‘ x_; ig‘VIioat :- . ‘1‘ 3.. .._..- " 1 Q“Fjd~iitrained eating and body satisfaction and audit . kflylrQIoups'of women. I .ww‘)‘ 31,.3y.n. L wl“ A‘ .- , V -w’4 V.The litc:n* . ' ‘ ' - “‘Lc‘ l I .u‘g'lCldtcd to . ; ; , dllsat15:3"‘ expectszi- topics ' ' A 5 L '5 -"2':1 , 2 .1-.. “ ‘ pm‘ . M V _ . A " ‘ ‘“V“‘L‘**-- " ' , . L.;o is 5 ‘ .‘1 { %§'§.YBIQnt in icw="~ a$:.~ ». '4 , i' I...“ . . .. — - . .,'- ’. ‘ lv'. . V Bin” ' 'Wo bns nouoszailoe ins“- 0“» v‘"”" Denis!!! ;:M.-w 3o equoxp Hilly cane meme“ unearth dilfltilfl' ' .upoceati-u ; topics rel l mo, eel physical a '1“ m M! which indi accurately oi dispara al.,isei, their bod) diesatisf: body tug dieturban Receive LITERATURE REVIEW The literature reviewed in this section includes topics related to the research questions such as body dissatisfaction, restrained eating and the cultural expectations of thinness for women. Also reviewed are topics related to the dependent variables such as roles of women, self-esteem, food group intakes, eating patterns and physical activity levels of college—aged women. Prevalence of body dissatisfaction Body dissatisfaction has been defined as a condition in which individuals "assess their physical dimensions accurately but they react to their bodies with extreme forms of disparagement and occasionally aggrandizement" (Garner et al.,1981, pp. 265). In other words, they accurately assess their bodies, but discredit them at the same time. Body dissatisfaction is considered to be one of two components of body image disturbance. The other component of body image disturbance is the inability to accurately assess and perceive one's body shape. Investigators have found that body dissatisfaction is prevalent in female adolescent populations at all weight levels. Huenemann et a1. (1966) reported the predominant attitude of 1000 teenagers regarding their bodies was one of .7 . . | « 515%.}: , . «at . in. I i v2.31“ -..-.11 i .1. ei nonexéain fl”) 5““ 4115 as 35.0335559‘303' of their ml “anemia you old ad conference though on weight. 0| and m pr the study. diaeatisfa teaalea at m of the trying to intake. I (II-051) o thiItien were dis: Clusitie mm; ! Winn 9 dissatisfaction. Approximately 50% of the girls described themselves as fat; over 50% reported they were extremely or fairly concerned about being overweight. Counts and Adams (1985) surveyed 49 undergraduate females and found that all of their subjects, at all weight levels, were body dissatisfied. Eisele et a1. (1986) found 86% of 12 to 14 year old adolescents (n=385) attending a midwestern career conference were dissatisfied with their current weight, even though 81% of these females were underweight or normal weight. Only 14% were satisfied with their current weight and 78% preferred to weigh less than they did at the time of the study. In a study by Miller et al. (1980), weight dissatisfaction was expressed by 70% of undergraduate females at an eastern university health service (n=46), and 48% of these women who expressed body dissatisfaction were trying to control their weight by restricting dietary intake. Moore et a1. (1988), surveyed a large sample (n=854) of 12 to 23 year old females from a military outpatient clinic on the west coast. Of this sample, 62% were dissatisfied with their weights. 0f the women who were classified as underweight, 40% were dissatisfied with body weight; 53% of normal weight women were dissatisfied with body weight. Moreover, 82% of all subjects who were not overweight wanted to lose weight, and 32% perceived themselves as having an eating problem. Kurtzman et a1. (1989) reported that the mean self-reported desirable weight 9 bolusesb eIxip ed: is me '{I‘Cicnilro‘zqqfi In yismeuxe 319w 1911-: m7 mm; 111' 1‘ emsbA (an {Jruvfi ,fifip wk' ,1: ‘ 115 Jed? “HJM. i 1 I 1“ I , -gr ghee . ~,_) . H s A p ‘ H ’ 1 U3iw bi; film-.31". «1:1,; tn . I v zioi ee aevioaaedi? '11 .no mum“ "-1*.Jflou nyIIQ "‘ -( .‘if’l '=.’3€I) 0&an _»r;.1 lo :11 «his ‘ 1‘ meeting b S we in we (Carroll et vented to l underweight years (null diaeatiefa. Purnhaa, 1 college ed M. area and sot to flight, ti 10v calor exercieim 119m 3., “'05) to “19hr co “‘10“ 114 10 of a sample of 716 college women of varying heights was 93.7 i pounds. Results of these studies confirm the conclusion of Mintz and Betz (1988), that "having no concern with dieting and weight seems almost rare among college women" (pp. 470). This dissatisfaction with body weight and the effects on eating behaviors is widespread among adolescent girls and women in westernized countries. Researchers in Australia (Carroll et al., 1986) reported adolescent women (n=79) wanted to lose weight even though the majority were underweight. Adolescent girls from London, aged 11 to 18 years (n=182), were dissatisfied with body parts and body dissatisfaction increased as age increased (Davies and Furnham, 1986). Thomas et a1. (1988) surveyed 102 young college educated African-American women in the Washington D.C. area and reported 55% were unhappy with their bodies and 60% felt they were too fat. In attempts to control weight, these women were restricting food intake, following low calorie diets and taking diet pills along with exercising as ways to maintain body weight. Rosen et a1. (1988) surveyed a tribe of Native American women in Michigan (n=85) to determine weight concerns and the prevalence of weight control behaviors. Seventy-four percent were trying to lose weight and 75% of those trying to lose weight were using potentially dangerous techniques such as diet pills, fasting, vomiting, laxatives and diuretics. The quest for a slim figure has been observed in a variety of social and .2 an" 30 L soluesflinth ‘ shed In Iii r n a” g‘.,, yu.“* T 'E at!!! ,1, 4' 1 .1 " _ .11 no ”(v-,5 .2 cm “"1 :53) .LV EU :1; mi? ,: 1.1 _: (38am) {51:351. t",i’»‘n’ _: .1 - - - , x 1 . . .- retinas 3d910V 319” JnFLSW biul ni p~1uvs .- 3 . . .. >_ I. _ Z.‘ .._.: 1.: .i '. 3C1— ,:;WH “,1noHIS‘Q'3QJQv8g.Baug I . -.'.' “sq-511' . '5‘ ‘ - > V‘ am; 31191:»: seafront. Imus" cox mil" W“ " children in stimuli! reported it to lose we the aaiori intake to 1 dangerous It is diff adolescen thinness » that the - decade co Body but is In 1909) . have love because : ability , ' -"‘ ‘W 11 ethnic groups of women in North America, Great Britain and Australia. In a recent study by Maloney et a1. (1989), researchers assessed dieting behavior and eating attitudes of 318 children in the third through sixth grades from Ohio. A staggering 45% of the children desired to be thinner and 37% reported they had tried to lose weight. Desire and attempts to lose weight increased as age increased in these subjects. The majority of children were using restriction of food intake to control weight, rather than engaging in more 4 dangerous weight loss methods such as vomiting and bingeing. It is difficult to speculate on future impacts in adolescence and adulthood of these children's obsession with thinness and the concurrent dieting, but it is a possibility that the prevalence of eating disorders within the next decade could increase. Body dissatisfaction in male populations does exist, but is much less prevalent than in female populations (Hsu, 1989). Males tend to express body dissatisfaction, if they have lower body weights rather than higher body weights, because for men, greater body weight represents athletic ability and strength (Dwyer et al., 1969; Kaplan et al., 1988; Silberstein et al., 1988). Cgltural expectations of thinness for women a In recent decades there has been a shift in the ideal II 1 "3],. -‘ fine Medias :15er ‘L'Jitame‘i Marv. r1! names lo equoap “if“. 1 1'.1:_‘ . reinstate“). .. l_ ( "1| ‘ tween 5 n1 ‘4’“- 1 in.“ i 1 .g; .s ‘ t" in 11 8391131553511 ‘1‘“? _ 1_, . :11.‘ , ,1 .- _ . 11 1 .1 .(zvs "..li.1-.‘ accesses to: thinnea . of eating d (Inch, 19' 1903; Ludh docuaented unrealisti 1 _ fluenelann store, 19! al., 1906. iioore, 191 in unnece . 1 Iiber, 19 . “11.; 1.. . 1909). 23:2: .1 a 1 , The 5.2;? . ' ~, 1 » ~ flouting Malta 1 -‘7\‘;v..niss America pageant contestants (n=20) and Playboy .L.' I..‘ 12 standard for female attractiveness. Bruch (1973) stated that social attitudes toward the body, the emphasis on beauty in our society, the preoccupation with appearance and the condemnation of overweight as undesirable have caused mild forms of body image disturbance in non-obese individuals. It has been speculated that the sociocultural standard for thinness is the main reason for the increased incidence of eating disorders in young females in society today (Bruch, 1973; Garner and Garfinkel, 1980; Garner et al., 1983; Ludholm and Littrell, 1986). It has also been documented in the literature that adolescent females have unrealistic perceptions of their bodies (Gray, 1977; Huenemann et al., 1966; Kaplan et al., 1988; Moses, 1989; Storz, 1983) and are dissatisfied with their bodies (Cash et al., 1986; Counts et al., 1985; Eisele, 1986; Miller, 1980; Moore, 1989). In many instances, these adolescents engage in unnecessary dieting behaviors to lose weight (Hesse- Biber, 1989; Miller et al., 1980; Moore, 1988; Moses et al., 1989). The mass media have played an important role in promoting this standard of thinness to women. For example, results of studies on women in magazines and on television indicate a gradual shift in the cultural ideal body shape for women over past decades. Garner et a1. (1980) reported a gradual reduction, since 1959, in body weights of both ‘ S! 4 __1 bfim 9‘8 v” .sigmtxc no? . 5' e . >_ _ W ‘ m} Ufiensie (£11211 aura .eesnsvmusuas since} so! MIN! 1 at Yiuesd no eeaednpa .33 .chj 3%? irawoj unbuiifds 13“i7 ad.) for -.1-,,.‘x§n_r;’.-a.'. j- i 7_ - :..‘131"-"3’-““q ‘ ' “sag rev-9 nemew :03 Wall outdo not related ad‘ significan' also found thin while Additional stars in i than do c1 aessages and sagas control i Coup negative et al., 1 and list-.1 children ”mm- ____________—_""""""""""""""""""!l"~'ll 13 centerfolds (n=240). A study by Morris et a1. (1989) found that between the years 1967-1987 the bodies of women models became less curvaceous and more "tubular". A study by Silverstein and colleagues (1986) found that women's magazines have more diet and weight related messages than do men's magazines. Garner et a1. (1980) reported diet related advertisements in women's magazines increased significantly between 1959-1979. Silverstein and colleagues also found that 69% of female television characters were thin while only 18% of the male characters were thin. Additionally, these investigators reported that female movie stars in the early 1900's had much more curvaceous bodies than do current movie stars. The diet and weight related messages from the media are of concern because television and magazines are two of the leading sources of weight control information for adolescents (Desmond et al., 1986). Compounding the thin standard for women is the strong negative stigmatization of obesity in society today (Vooley et al., 1979). Obese individuals are discriminated against and mistreated in educational and vocational settings. Even children have attributed negative traits such as "dirty”, ”sloppy", "lazy" and "cheaters" to obese children (Stafferri, 1967). The sociocultural concept equating thin with good, and fat with bad, is pervasive even in young children. A'V‘ "V‘.' JP {banal ( a 's e I , airbom n~~w 11.1 i «I r '~ :~ <1) ebioix- ,ie is 311144 w: 'w-. n .10 S) ’ . ‘ '- .vnwmd :1 7....‘r'j a ‘ . . A V; l 'e-a.‘ weaned ‘ an . , _ ., . . ‘x' -- vhvffi Q I. 7 eating be lmore the peri also affec reported - figure an anorexia- ln the pa weight an literatur dioeatisi a study ¢ Idoleecg; tiMiler n 14 It appears that within the last two decades there has been a significant change in the idealized female body type. The ideal female in American society today is less curvaceous and thinner than in previous decades. These cultural pressures for thinness in women have been hypothesized to be the reason for the increase in abnormal eating behavior in many young women today. There is also some early evidence that for an isolated time period, at least in the 1920's, cultural influences also affected the body weights of women. Ryle (1939) reported that in the Flapper era when a slender, boyish figure was fashionable for women, there was an outbreak of anorexia-like behaviors. Body dissatisfaction Body dissatisfaction has become increasingly prevalent in the past few decades and has been associated with body weight and restrained eating. It is well documented in the literature that body weight is related to body dissatisfaction. Lundholm and Littrell (1986) reported from a study of 751 female high school cheerleaders that those adolescents with greater body dissatisfaction also had higher body weights. In 1984, Garner et al. reported comparisons between women with anorexia nervosa, weight- preoccupied women and not-weight—preoccupied women. The weight-preoccupied women had greater body dissatisfaction. ll . . a ll ‘ ‘ V. . . _ f p ,. . .. . -, H .. “a L h e .. A “ ‘ “'-"‘ ‘5 4' - ., Maxi: :w-m’lf‘w ' v a need .. L . ~ fl“ .0413 vbod sign,- “.rl. ‘ aw 933d? eebbasb ow: jes. 3.4.: »1‘.d*-i‘e' jerirexesqqfi 2’! , A -. 2‘- . MW“ new“ chairman . 1.. 1 author”! ' y»‘: 1 \z" . , M . 1.4.1.0. 23a . 'eétr MIT . ' ‘fi :Efiflq ' . banana and negati aatiafacti weight (M body ilage Body related t levels (P that chro in cooper __ j, . ‘ Hardle an college a {1:031 l':":"' 3 . . . ‘ “to!“ m 520:5? 4:111; ,- 7- , , Who were 681i 08in xvi/:3": ': _ _ , ' ' that m .boaroqsx. .i‘f- T‘s 15"12'27. .(-:'~I~'-,V. :' , . A ‘ greater (Wiggle; 51393055 (1.23:3: lye-not; ;-..~_..,g.3-_».._l - . Ev'ic- ‘-.’.f '.-; .:-::v_-‘J ‘ Ilium -‘u‘ ,. ,H‘Ptittv-zoa bus nsmow beiquaaosrq . ', litll- . I . . ;. uv.-, :. . . ,7 'cgba "mom 15 height compared to the not-weight—preoccupied women. Seggar et a1. (1988) reported that in a sample of 323 undergraduate women, the heavier subjects had greater body dissatisfaction than the subjects with lower body weights. Wiedel and Dodd (1983) surveyed 103 undergraduate and graduate students at a southern university and completed height and weight measurements. Pearson-product correlations were calculated and negative body image, a component of which is body satisfaction, was positively correlated with percent ideal weight (p<.01). As percent ideal weight increased, negative body image or body dissatisfaction also increased. Body dissatisfaction has also been reported to be related to restrained eating patterns in women at all weight levels (Polivy et al., 1987). Mintz et al., (1988) found that chronic dieters (n=73) had greater body dissatisfaction in comparison with normal subjects (n=211). Similarly, Wardle and Foley (1989) found that in normal weight female college students (n=20) that women who were restrained eaters had lower levels of body satisfaction than the women who were unrestrained eaters. Rosen et a1. (1987) reported that women who were classified as weight reducers had greater body dissatisfaction than women who were weight maintainers. Implications of body dissatisfaction Body dissatisfaction and inappropriate eating behaviors such as chronic dieting, bingeing, self-induced vomiting and m L". .- s. ‘ ‘ u .;. . e I. ‘ 4:: R ' . ' ' '- ~ * : ammo: Ml upper .nsuzow ESIQL'DUU‘!!~.‘J{H'; » ...1 ed. oi b (1 Q i :9" ‘ ‘ ' '~ " ”I "".;»~‘ IIHQC”) . 5 “ atsyhsrprabm i’L” :- w. . -, . .m‘ L _ . - - ' . . . - 1 1“ .»")l 51", \FAMW ”013'.'L".l.“.';'lf.' - 4 , .. ~- 2 -‘.--".'1 (15111 :.[-n_v' Lu?“ I (.531, C r 7 i I ’1' in. ~ 3‘ 5 .fimflfiim . -wahz' bum-la aateel vim level and inert aig macceeei (Allen, 1! weight eta others, d1 activitle al., 1987 theuelve lose cyc] lndi frequent] her-fol l 0f nigh M veig the econ 16 fasting all have psychological as well as economic implications. Potential negative impacts of body dissatisfaction on the psyche have been hypothesized. It is possible that continuously striving to lose weight, yet failing in the longterm, has a negative impact on self- esteem which subsequently affects an individual's confidence level and body perception (Allon, 1979). This negative impact might actually deter weight loss efforts, because an unsuccessful diet attempt can reaffirm a negative body image (Allon, 1979; Dwyer et al., 1969). Excessive emphasis on weight status can hinder an individual's interactions with others, decrease the amount of involvement in other activities, or cause withdrawal from activities (Polivy et al., 1987). Weight obsessed individuals can seclude themselves which would perpetuate the weight gain weight loss cycle (Allon, 1979). Individuals who are dissatisfied with their bodies frequently engage in expensive, ineffective and potentially harmful behaviors to lose weight (Moore, 1980). Purchases of weight loss books and diets, memberships at health clubs and weight loss clinics contribute billions of dollars to the economy annually (Marketdata Enterprises, 1989). Many of these books and diets are perceived to be quick methods for weight loss that frequently have no scientific background to guarantee successful or longterm weight loss. Individuals might also decide to participate in an exercise T Hid} m , .e . . J in :1~':.'2- Otis-var; even (is will ' . ‘5 .301 r u-‘.~ v. realign; ' J. .. .(z .1. . streleznlb Ii“ \ | . . . .‘ Tara-sq 61 ootantiall attain th ideals re '1; . , Lli‘ lest: Mack (19') intake in in terns in terns distinct R The i ‘ eating b I 8Chachte Donal a floral a .{tL-’.l ‘3' \ no, _.?{JJ.zalgv’.vizi 35.11 84.416 4.95516 30‘: .,.;,. 93 5390131 I. .. 3;“; : . 'Z‘TWH-x 17 program and be motivated to exercise initially, but do not continue to do so regularly over time, subsequently wasting only large amounts of money. People also spend thousands of dollars on laxatives and diuretics which are neither safe nor effective means of weight loss. Dissatisfied women might be persuaded by ineffective, unscientific and potentially harmful weight loss methods in attempts to attain the ideal female body, because they have unrealistic ideals regarding body weight and shape (Moore, 1988). Restrained eating Restrained eating is a term introduced by Herman and Mack (1975) and refers to the tendency to restrict food intake in order to control body weight. It is defined more in terms of effort expended toward weight suppression than in terms of achieved success. This is an important distinction in the definition of restrained eating. The concept of restrained eating was developed from the eating behavior theories of Schachter and Nisbett. Schachter (1971) believed eating behavior differed between normal weight and obese individuals. He hypothesized that normal weight individuals responded to internal cues while the obese responded to external cues such as appearance of food or time of day. Nisbett (1968) found that not all obese individuals were externally controlled in their eating behavior, but tended to eat extreme amounts, either very large or small beds don ob :sd D Dutiesw viznousu;.\? , 30 35.1.5.1? Cum as“. Run. 3,156; have: n.‘r .' y. — e. vine! ad has noa' _ 1, ”since" . ‘V H ex we ob ‘ .u.‘ . t ""1": .'" “hit! '{Ifla 'rk'“r_ ‘\ ‘44] ‘4‘, 0'” am. ‘ '. . v L. ‘il ‘3 ' Sif’Jb i],‘ new 1" magical] W 3| this total individual lxpen proposed t weight ind Iisck deve] perceived to unrest Insure 1: It h iron very disorder: with nor: has been W let: (832E? 7315 inf-3, v 18 quantities of food. He developed the set-point theory (1972) to explain inconsistencies in the eating behavior of individuals overall, but specifically, obese individuals. The set-point theory was based on the idea that in order to maintain weight, both normal and overweight individuals had biologically determined set-points. These set-points depended upon the number of adipocytes in an individual, and this total number of adipocytes varies widely among individuals. Expanding on Nisbett's theory, Herman and Mack (1975) I proposed that set—point discrepancies exist for normal weight individuals, not only obese individuals. Herman and Mack developed the concept of restrained eating and perceived it as a continuum ranging from highly restrained to unrestrained. They also developed the Restraint Scale to measure restrained eating behavior. It has been suggested that many college women suffer from varying degrees of disturbed eating. An eating disorders continuum which ranges from no concern for weight with normal eating behaviors to anorexia nervosa and bulimia has been used to identify unhealthy eating behaviors (Hintz and Betz, 1988). Between the extremes on the continuum are unhealthy behaviors such as bingeing, purging, fasting and chronic dieting. Restrained eaters are people who continuously attempt g¥:‘ to restrict dietary intake. They are also frequently is d3 ‘~£r‘"‘~ «r‘ ‘HJC-*“DC 9H .booi 10 39133 VIC-3 ' .u. _<_.; .1...‘ v i. - . “Kevan”: E’aublvlbal .eisut 5;“n' 23' 7 ‘w ' ' wv1q~soe 3d? 9:; "3f ': . . '..I...-'.i$ll 51+ ‘ :f'i ) 0 'i I I i i I rt. —-‘1 xA ~4’llf‘ ‘97 '“ '4iissdnu .pniJeib niacin: ‘ “a! ' ‘ . ~.‘~ ifiw a. nieiqxs 03 (ifllg, . noivsfiun pnjgrv “u » . . ..- vk‘. 11ml!t ‘“V fllflflllm to a large dosonstret are high 1 also have (Bill) veil values th restraine due to a Tuschi et Rest Helen t0! increase) between in the 1 1990b; a Mien. a low fit 19 preoccupied with food and experience emotional stress when eating a variety of food or large quantities of food (Kirkley et al., 1988). Interestingly, studies have demonstrated that even though restrained eaters continuously attempt to restrict dietary intake, they might actually consume more calories than unrestrained eaters, if subjected to a large amount of food (Wardle, 1980). One study demonstrated that restrained eaters consume less foods that are high in fat (Tuschl et al., 1990b). Restrained eaters also have been identified as having higher Body Mass Index (BMI) values (Tuschl et al., 1990a) and higher maximal BMI values than unrestrained women. This suggests that restrained eaters might exhibit restrained eating behaviors due to a previous high body weight (Laessle et al., 1989; Tuschl et al., 1990a). Restrained eating is prevalent in a majority of young women today and has been suggested to be one reason for the increased incidence of binge eating. The association between restrained eating and bingeing has been documented in the literature (Kirkley et al., 1988; Tuschl et al., 1990b; Wardle, 1980). This association was described by Herman and Polivy (1988) who assumed it resulted from the low fat and less hedonic eating of restrained eaters which might be a source of frustration due to a lack of satiety. This'frustration then would place extra stress on the self- control of the restrained eater, increasing the chance of _ ... boar . iv tolqu <- , ‘. i ‘31 . -A_" .o‘ r' H I|U I L. ,‘ ' ' . a 43.x.sv a Pal"“ ' _f .-- .;.. J. ._ Ia' ~ ‘ ‘ ' J ‘ 1‘ ' ,3 .“ “.‘ < . ' .~.'9i)(‘113’ I’lmrdi’l v. . , ' ' m‘ . ' ‘ ",p‘.'_"'a1'9b‘ri'}..li( ‘ V V \ ‘ ' ‘l . .. males“! 3 , . ' _ 1 A have: ‘ ‘ “um; - ”MM haveheen 19m The weight. 8 understood expenditur aethods . a due to as consuapti Overall, found to 1977; m individu levels. '- 4‘— ' filer: Mes e 7 “,ul 20 overindulging in attempts to satisfy the eating frustration. Also, Vardle (1987) has suggested that psychological and physiological deprivation states increase the likelihood of binge eating. Restrained eaters also tend to engage in unsafe dieting practices. Behaviors such as self-induced vomiting, bingeing, fasting and consumption of laxatives and diuretics have been reported in the literature (Moore, 1988; Moses 1989) These females restrict dietary intake to control body weight. Searles et a1. (1986) found that adolescent women understood weight loss methods in terms of energy intake and expenditure but did not know safe and reasonable weight loss methods. Food intakes of college women Food intakes of college students are highly variable due to meal skipping (Jakobovits et a1. 1977) and consumption of very low calorie diets (Miller et al., 1980). overall, mean nutrient intakes of college women have been found to be adequate, except for iron (Gottschalk, et al., 1977; Jakobovits et al., 1977), but nutrient intakes of individual college women are still well below recommended levels. Hernon and colleagues (1986) assessed food consumption of 245 college women at a southern university using three- day food records. The sample was divided into two groups based on.energy intakes of greater than 1200 calories auii. o: ‘ .. toe-nsuz‘: pflifse 9:13 ~12an m 23quzsi3s «1 9.139111be Av.) .flb f f...nflm,-,P ,hfl .“ .; 5!: «"*P;} -besw ‘°.“”iflwflfl bnb A..." H- U“... -,9:; LG:('-(“I-;2!qu 59 apfild “ “ nus-“M1 . “It! of t] f - 1"” :sta few a'?= let the r M Group nutrient d the venen assessed 1 have had c It a] i choose 61 Laessle e You!) won 3* and unres restraine veil as c i ‘33 Restrainq Debusmmwhr; w‘ 7v 1°88 that lei L If, “1851:7002 s .15 nemow epsilon 8H 30 > 21 less than 1200 calories. The women who consumed less than 1200 calories per day had fewer mean number of servings of milk and milk products, meat and eggs, bread, starchy vegetables, desserts, added fat and added sugar than the women who consumed greater than 1200 calories per day. The diets of the group consuming less than 1200 calories did not meet the recommended number of servings from the Basic Four Food Groups, even though they did consume foods with greater nutrient density than did the other college women. Although the women consuming less than 1200 calories per day were not assessed for restrained eating behaviors, they might well have had characteristics of this type of eating. It appears from recent studies that restrained eaters choose different food items than unrestrained eaters. Laessle et al.(1989) compared the eating behaviors of 60 young women who were divided into groups based on restrained and unrestrained eating. Seven—day food records indicated restrained eaters avoided calorie dense foods high in fat as well as carbohydrate-fat and protein-fat combinations. Restrained eaters also consumed approximately 400 calories less than the unrestrained eaters. A similar study by Tuschl et al. (1990b) examined the frequency of consumption of food items in 19 unrestrained and 20 restrained eating, young, normal weight women. The restrained eaters avoided foods that were high in fat, specifically pure fats such as oils, mayonnaise and butter, . v, - ‘30 apr1;‘.":t':: {.1 . (11.x. .x_\ X “fin-,4» -’ )- 15 3t. ' 9 ~ an“ I, “:13 east immunncs or‘m «my; m; ”47111.45? 00$! my. -:_. :(iin bar: it“. V 9111;121:1533: i‘:r,~;,--,: fir; tug-(.4. mt tat ureteia or Mall at .‘. Heal of certai character of the fr Snacking calories are not . 1907; x . In it is ev lleliileen My an me; u 22 but they did not avoid foods that were high in sugar. There were no differences in consumption of other foods and snacks between the restrained and unrestrained women. In both of these studies assessing food intake of restrained and unrestrained eaters, the restrained eaters consumed less total fat in either combinations with carbohydrate or protein or as fat in pure forms (Laessle et al., 1989; Tuschl et al., 1990b). Eating patterns of college women Meal skipping (Jakobovits et al., 1977) and avoidance of certain nutritious foods (Wakefield et al., 1971) characterize eating patterns college students. Assessment of the frequency of snacking is relevant to eating patterns. Snacking is an important way to supplement diets with needed calories and certain nutrients because all needed nutrients are not always consumed during meals (Bigler—Doughten et al. 1987; Khan et al. 1982). In examination of eating patterns of college females, it is evident that there are differences in eating patterns between groups of women categorized by weight concerns and body dissatisfaction (Wakefield et al., 1971; Hernon et al. 1986; Kirkley et al. 1988). Identification of characteristic eating patterns might provide information beneficial for prevention or education of women who are body HE J‘ dissatisfied and restrained eaters. i ‘33 y . b ’ n' ' . . . n - Ari 835-: 3:1? 1*)": t'”‘ “m D! I" ‘ ”“01” ypgnfl. .1- If- .' out, A 1 .z. 3.5..- -.-wl.'.h on I?“ exasnc W? " 1 sad? .1sew?8¢"h,~lgx \‘I -‘-‘ NW" 15‘ my L x.» .4 v 1" o I .v if” F _ ' ‘ ‘l ' C; ’89“, IL ‘12 ‘ ( \_ n u. — .1 5‘1 _ , . 1' mugl mm m inch ever at and 10 \ .wJYflU J .‘J harra regarding randoaly s universit} consuaed, ‘ data indi ' least two I aeals per ’1 reported Khan “Idle c: ‘ 5'5 tile: . rz'r'~' , tVie-(1st . . . ‘7"- I" ,~ , -.— t . - , 'k‘npmg ‘ g. ‘. ' ;' f ,5 , j :11 _, "JG-I173 23 Several studies have assessed eating patterns of college women. Jakobovits et al. (1977) surveyed upperclass women at Cornell University (n=l95) who completed seven-day food records. Subjects averaged 5.3 eating times per day, including meals and snacks. Lunch was the most frequently skipped meal. Only 24% of the subjects reported eating lunch everyday while breakfast and supper were consumed by 47% and 70% of the subjects everyday. Marrale et al. (1986) sent mail questionnaires regarding dietary practices and dietary needs to 1150 randomly selected undergraduate students at a northeastern university. To determine the number of meals and snacks consumed, the students completed 24-hour food records. The data indicated that 49% of the students reported eating at least two meals per day, while 36% reported eating three meals per day. All subjects reported eating snacks, and 70% reported consuming at least one to two snacks per day. Khan and Lipke (1982) surveyed midwestern male and female college students (n=250) and found that students ate 5.5 times per day including meals and snacks. Breakfast was the most frequently skipped meal with 24% of the students skipping it. Dinner was skipped least often; only 4% of students missed this meal. Twelve percent of the students skipped lunch. Most students (77%) snacked in the evening while morning and afternoon snacking was done by 39% and 46% of students, respectively. Even though this study I'I V: eeaia:9qg: Hoynu.u . 1 _ . : - \ w.o-uorw- .“ ‘ — I i I o n W ’ ii 7 I if} ’9‘ V F _ ‘i a '7 A} iu JRSOIgc 9.'~¢ ".“r . , M“\e louse (semi, ' ‘ h ~‘itr 3r°”f“ reafiwaft 9V6“ 29 it aha-..., _.p .resow 59’ Y?) sunshade Jaod I! ‘ . v .19" ~ ‘“ n . CHI/13.3") I 5001“. I'.‘H13nt ~;lifla vi m (m . i- breakfast intake of ”-50 yea Breakfast surveyed . one of th In a Patterns Provides Penulati . college Laessle - “nouns . “hich ap. 4 j '53 £0].le 5- I558 .nsae‘ 24 assessed eating patterns of both men and women, the results generally agree with those from other college studies. The one exception was that Khan and Lipke found breakfast was skipped most frequently and Jokobovits et al. (1977) found lunch was skipped most frequently. Data from the nationwide food consumption survey by USDA (NCHS) provide some information regarding frequency of breakfast consumption. In the Continuing Survey of Food Intake of Individuals (CSFII), approximately 1000 women aged I 19—50 years of age completed four, 24-hour food recalls. Breakfast was consumed by 53% of the women on all four surveyed days; only 2 percent reported not eating breakfast one of those four days. In addition to providing information regarding eating patterns of college women in general, the literature also provides evidence that a large subset of the college female population has eating behaviors different from the rest of college women (Hernon et al., 1986; Kirkley et al., 1988; Laessle et al., 1989). These women appear to be more concerned with body weight and have attitudes toward weight which appear to affect their dietary intake. Several of the following studies report such differences in eating patterns. A study by Kirkley et al. (1988) determined dietary behavior patterns of chronic dieters. The sample consisted of well educated women (n=50) with a mean age of 28 years s" 'I gg'grrtr' {Wu '1 1"“'.i.,"‘. ..' i . ' meme-w but. .'~w :33; '1 3;“.;-3?'J£q pnlfilo ,‘. a . m argw sup. vile: ‘-=": ‘ i.-si:;qidl:."‘¥.W' J m5.“ ' ' .l mail 1 metsand these 1 . , . i'mui -. ‘1 al. (1986) college on iron three than 1200 hours, al ‘l Porty-nin - 1200 calo 59h repor Ilolen Uh: :1 25h of ti tile the l . ~ ' a{linkers } V i V ‘ ‘ Vere lee .. .. . . mac“ n accordin ““1”, w 25 who responded to a newspaper announcement. Restrained eaters were determined using Herman's Restraint Scale (Herman and Mack, 1975). High and low restraint scale scorers ate a similar number of meals and ate their meals at similar times. However, the restrained eaters consumed more snacks and ate more frequently than the unrestrained eaters. These results are contradicted by those of Hernon et a1. (1986) in which meal and snack patterns in a sample of college women at a southern university (n=245) were examined from three—day food records. Subjects who consumed greater than 1200 calories per day ate meals during traditional meal hours, although food was consumed throughout the day. Forty—nine percent of the subjects who consumed less than 1200 calories per day ate three or more meals a day while 59% reported they usually ate two or more snacks daily. Women who ate less than 1200 calories per day responded that 25% of the time they ate three meals a day and 41% of the time they usually ate two or more snacks per day. It appears that women consuming less than 1200 calories per day were less likely to eat three meals per day and two or more snacks per day. These subjects were not classified according to the Restraint Scale like the subjects in the Kirkley et al. (1988) study. There are also data from a study by Wakefield (1971) which assessed breakfast consumption by weight status. Forty college students from a midwestern university were q A v: e 0:! 593::qu . . " u'f.‘ .-...- e. . vb huniezje9fl ."nwv°1“fi' Hr -'s‘:~W?” .l 9 ' l ‘ ,. ll 7 a r,; . 7»; mxe‘flh 919v a! w . dlfifi :‘t:' A“ ,, . , r - ,.‘-.L.:t).': ”J‘lfa Hm}. ‘ u ; ‘ r - P133030 ‘KL. F -i-nll! II!‘ ID 8' IMF- the: . ell colle However , eetesl . general . ‘ college - l but bree ‘ Weight 3 l literal: ‘ fitness '1': 19; '1': 19» no}! fiJBb caie 315 :IJAT .6 26 interviewed to determine factors affecting food preferences, habits and food intake. As subject weight increased, the frequency of breakfast consumption decreased. The underweight, normal weight and overweight women did not eat breakfast, 9%, 35% and 70% of the time, respectively. No subjects in the overweight group skipped lunch and there were no subjects who skipped supper in the underweight group. The normal weight group skipped the most meals. There are differences in eating patterns when comparing all college women to the subset who are restrained eaters. However, the data are inconclusive regarding whether they eat a similar number of snacks or more snacks than the general population of college women. The general female college population appear to consume three meals per day, but breakfast is frequently skipped. There might be a weight status factor related to breakfast skipping. Physical activity It is well known and extensively reported in the literature that exercise both improves cardiovascular fitness (Kannel et al., 1979; Morris et al., 1980; Powell et al., 1987; Siscovick et al., 1985) and mortality (Blair et al., 1989). Exercise might also affect the way in which some women feel about their bodies (Davis et al., 1990). Exercise habits of college females are important to investigate because type, frequency and duration of exercise . n : . . iii 1' fl .aoanexsisxq booi bodies. m n: \(bw 211;: ’W .._ , - . . ‘19 elven) afiibuU 111‘ Panorama '2’C-'.’:..L1 wszssdsb or have”! .. ‘w I h ’d"' :cr‘v fun,“ v“ "‘ ’\ . {’lh’f‘.‘ I‘m“? r'nE‘ 331‘“: 'l tit ' waisted um 4 meeting . , :1 i'.‘ vane-115933 ...b r~‘ fl 1:‘iw:3tn” .4, {I‘m to reported I nut 31! ruining weekly. i year old 1905, lat were regu Fen exercise their hot inappropl negative Hannah lore reg ‘VV-4 > A . an} .2.‘J'.‘fi 410.; "1.1113 5. resisaei $901102 30 ejidsd ssiuzsxa M.'-‘ ".m‘ n,”- 27 are all factors that affect caloric expenditure and energy balance, as well as overall health and well-being. A few studies have reported physical activity patterns of college women. Seggar et a1. (1988) reported that 94% of 323 college women at Brigham Young University participated in some form of physical activity. Twenty-three percent reported exercising between one and three hours per week. Almost 31% reported between four and six hours and the remaining 40% reported more than six hours of activity weekly. Caspersen et a1. (1986) reported that of the 19-29 year old women from the National Health Interview Study in 1985, 18% were sedentary, 30% were irregularly active, 42% were regularly active, and 10% were regularly highly active. Females with body satisfaction might have different exercise habits from those women who are dissatisfied with their bodies. Energy expenditure between women with inappropriate eating behaviors and either positive or negative feelings towards their bodies could be different. Women who are satisfied with their bodies might exercise more regularly and therefore be more satisfied with their bodies. Conversely, it could be hypothesized that women who are body dissatisfied exercise in attempts to improve body weight or shape. Unfortunately, there is little literature regarding exercise habits of body satisfied or dissatisfied women . TS Vbépiene bns eanzifinéth “7‘ '5" (”-4133 . .1 ... ;.1, Bfllfl‘Jr J is V” . . .i' ‘w . . I I } odw Eaton "mfl" 5.: L 9 “Mud. ’fihod_svcrqm1 a: aiypw;., n . . -. I Irgiddil a} 9331: ‘(.-*£ a e »s ‘0‘ 0d! ‘ :' V T L' LL; .‘ I excise! [In K i5 r,r V53 A ‘ f3,x§od 30 saidfid aatzrex: pnibxspsz ‘1 \ssnnt ,3 mum eel dieti to incree Several o eating di dancers ( et al., 1 Self totality one's sel Physical cosponen - Personal are seve. 08 relat. Young . . In Jfipisu 28 One study by Davis (1990) compared young women who were exercisers (n=86) with nonexercisers (n=76) and found that the exercising women felt their physical appearance was important to their self—esteem. The exercisers were more body dissatisfied and had greater concerns regarding weight and dieting. The authors proposed this might have been due to increased body awareness as a result of the exercise. Several other studies have reported a high prevalence of eating disorders and body distortion in female athletes and dancers (Braisted et al., 1985; Garner et al., 1980; Weight et al., 1987). Self-esteem Self-esteem, as defined by Rosenberg (1979), is the totality of an individual's thoughts and feelings toward one's self which includes social identity, disposition and physical characteristics. Self-esteem is an integral component of the human being and is especially important in personality development during the adolescent years. There are several studies in the literature regarding self—esteem as related to both body weight and body satisfaction in young women. An investigation by Ford and Drake (1982) examined 68 African-American and 164 Caucasian undergraduate females at two southern universities. Subjects completed Rosenberg’s Self-Esteem Scale and a Body Characteristics Descriptive scale. For analysis a pooled estimate of coefficients of main: '4 'm..“ In“ mm ""“d ' x“ “college also posit students i Garfinkel L satisfacti ; the level: bodies th< a1. (1987 and self- !abian an (r=.47, p esteee in A101 associatq the self Five hum Southern ‘ “4 heiq I | ‘ : ‘ I . ll"hate .asiaiersvimx ."x .5” , .- :47. d as ‘ 9-“ ‘5') 3‘ ‘1. “(...9r.,. .i‘v h g , ..!.. . LII-4'7 ,_-, w- . , 4 Mn. 1%? '.'—~ 29 correlation was calculated and self-esteem was positively related to body satisfaction (r=.26, p<.001). Secord et a1. (1953) found a positive correlation between body satisfaction and self—esteem (r=.66, p<.01) in 56 college females. Body satisfaction and self-esteem were also positively correlated (r=.62) in 82 undergraduate students in a study by Rosen et a1. (1968). Garner and Garfinkel (1981) found a similar relationship between body satisfaction and self-esteem in anorexic women. The higher the levels of self-esteem, the more satisfied with their bodies the individuals tended to be. A study by Rosen et al. (1987) found an association between body dissatisfaction and self-esteem in 675 high school girls (r=-.46, p<.001). Fabian and Thompson (1989) also found a high correlation (r=.47, p<.01) between body esteem (satisfaction) and self— esteem in female adolescents (n=121). Along with body satisfaction, body weight appears to be associated with self-esteem. Martin et a1. (1988) examined the self—esteem of adolescent girls as related to weight. Five hundred and fifty 14—16 year old girls from eight southern states completed the Rosenberg Self-Esteem Scale, and height and weight measurements were taken. The results indicated that self—esteem of adolescent girls was related to weight. Self-esteem decreased as BMI values increased. The girls in low and middle weight-by—height categories had -Al',u]§ Q§ visvijI-oq new mesrah-Jiea ("as bonus”: on noiiiIe ......' w .1 .-n,<- towijfip "50d 0:9 bsj‘r“ h," ' IL‘ ‘ ~ . -. . | I U .- . “H a if”.‘ ! (th' .16 59 310392 I: '1‘ r: “ . J .. r ‘0 )'t .SIEDE mfiuij OUEELDHL :3 Tu>‘.$-’{ (because: mamas-died " ‘ 'Lw . . fad gesszd -1 no 32 716 . ) _‘ 3. 4 . . "’~ "3. .edp.sw cfll’.k . figures A ’ M4 perceived the voles Belf- restrained IIints and different feaales a that vose than vole Poli restraint feeaies. on restr “(In or largest self-est 910w. "strain 5 30 higher self-esteems than the girls in the high weight-by- height category. Perception of weight appears to be related to self- esteem as well as actual weight. Powers and Erikson (1986) surveyed 164 undergraduate women and reported the women who perceived themselves as thin had higher self—esteems than the women who perceived themselves as heavy. Self—esteem has also been found to be lower in restrained eaters than unrestrained eaters. A study by Hintz and Betz (1988) examined self—esteem in relation to different types of eating behaviors in 682 undergraduate females at a midwestern university. The results indicated that women who were chronic dieters had lower self—esteem than women who were normal eaters. Polivy and colleagues (1988) examined self—esteem, restrained eating and eating behavior in 78 undergraduate females. Subjects were divided into four categories based on restrained or unrestrained eating patterns and either high or low self—esteem. The results indicated that the largest number of subjects were classified into the low self-esteem, restrained eating group than into any other group. Self—esteem was significantly lower in the restrained subjects than in unrestrained subjects (p< .02) and self-esteem was negatively correlated with unrestrained eating (rs-.32, p<.01). A stud and weight esteem and evaluated. maintainer lover self that weigh self-este< In a (1986) to eating be esteem 81 in the p] Negative behavior bingeing It related behaviO' dissati eaters Satisfi eaters. % V in man 31 A study by Rosen et al. (1987) also linked self-esteem and weight control behavior. Body dissatisfaction, self- esteem and dieting behavior of 675 high school girls was evaluated. The subjects were classified as weight reducers, maintainers or gainers. The weight reducers or dieters had lower self-esteem than the weight maintainers, suggesting that weight loss attempts are strongly related to negative self-esteem. In a study of 168 high school students Grant and Fodor (1986) found that self—esteem was a predictor of abnormal eating behaviors. Regression analysis determined that self— esteem significantly contributed 9% of the variance (p<.01) in the prediction of a tendency for anorexic behavior. Negative self-esteem was related to abnormal eating behaviors such as restricting food intake, chronic dieting, bingeing and purging. It appears from the literature that self—esteem is related to body satisfaction, body weight and eating behaviors such as restrained eating. Subjects who are dissatisfied with their bodies, overweight or restrained eaters have lower self-esteem than other subjects who are satisfied with their bodies, not overweight or unrestrained eaters. Roles of women Women in society today have pressures to be successful in many areas of their lives, both in traditional and modern roles. T1 rearing, 1 expectatil power and teenager' eating di completed completed groups em views of the curr ideas to These "Vi determini integral scored 1 1979) in of women Women" 1 Success: With a sYmpto abnor there 30cm;a women ‘ 32 roles. Traditional roles and attributes include child rearing, nurturing and sensitivity while the modern expectations consist of successful careers outside the home, power and independence. Steiner-Adair (1986) investigated teenager's perceptions of cultural values as related to eating disorders. Randomly selected female subjects (n=32) completed a 20 minute interview and three weeks later completed a questionnaire assessing eating patterns. Two groups emerged with different eating patterns and different views of women. One group termed "Wise Women” identified the current cultural expectations of women, and linked these ideas to the thin and successful cultural ideal for women. These "Wise Women" rejected the cultural values and determined for themselves the need for relationships as an integral part of the female identity. These "Wise Women" scored low on the Eating Attitudes Test (Garner et al., 1979) indicating normal eating behaviors. The second group of women identified was termed the "Super Women". "Super Women" identified an ideal woman in today's society as successful in career, home life as well as being beautiful with a thin figure. These "Super Women" scored in the symptomatic range on the Eating Attitudes Test indicating abnormal eating behaviors. From this study, it appears there might be a relation between the attitudes regarding societal expectations for women and eating patterns for women. However, the sample size of this study was small (“:32) and the obser‘ today atte many colic the ”Wise Silve college 5 slimness . noncurvac professio pressures perceived male figL success a roles ha: nasculin male pro Hetaboli Wit for lear Underlyj their b. their b Who are COHSUme 33 (n=32) and all subjects were interviewed indepth. Based on the observation that nearly 70% of college women are dieting today attempting to achieve a thin figure, it is likely that many college women do not have the personal philosophy of the "Wise Woman". Silverstein and Perdue (1988) surveyed 212 female college students regarding role concerns, preferences for slimness and symptoms of eating problems. Desire for a slim, noncurvaceous body was associated with intelligence and professional success. It is speculated that societal pressures have led to body dissatisfaction in women and a perceived need for masculine characteristics such as the male figure and traditional masculine roles associated with success and power. These needs to compete in masculine roles has pressured women to attain a less feminine and more masculine figure, plus compete with men in traditionally male professional positions (Silverstein et al., 1986). Metabolic differences in women Within this cultural climate of the social desirability for lean female figures, metabolic differences might be the underlying reason why some women become dissatisfied with their bodies. It is a possibility that women satisfied with their bodies have higher basal metabolic rates than those who are dissatisfied with their bodies and therefore can consume more food without gaining weight. A Sti difference examinati¢ weight. ' in Munich unrestraii Energy eX' water tec' intakes f significa unrestrai veight. body comp 96: day ] eaters aj energy t] that low for the eating 9 If eaters + factors, indivim indiv1d. PIeSSUI dietary 34 A study by Tuschl et al. (1990a) assessed the metabolic differences in restrained and unrestrained eaters by examination of energy intakes, energy expenditures and body weight. Twenty-three normal weight women from universities in Munich, Germany were classified as restrained or unrestrained eaters by Stunkard's Restrained Eating Scale. Energy expenditure was determined by the doubly labeled water technique and subjects self-reported their dietary intakes for fourteen days. Restrained eaters had significantly higher body weights (p<.03) than the unrestrained eaters even though all subjects were of normal weight. The energy expenditure, adjusted for height and body composition, for the restrained eaters was 620 calories per day less than the unrestrained eaters. The restrained eaters also reported consuming 410 calories per day less energy than the unrestrained eaters. The authors speculated that low basal metabolic rates were the most probable reason for the diminished energy requirements in the restrained eating group. If true, these low energy requirements for restrained eaters might be due to both biological and behavioral factors. Weight gain might occur more rapidly in an individual with low energy requirements, which might lead an individual to restrict dietary intake. Sociocultural pressures for thinness could also lead to restriction of dietary intake and repeated weight loss and weight gain cycles. 0‘ associated 1990a). I investigat restrained continuous so, this 1 eaters ha treatment The underveig potential of body ( Programs percepti few stud Cognitiv With boc intervei b°dY si difflcu dissati the sho Rosen e longtel 35 cycles. Overall caloric restriction has also been associated with heightened food efficiency (Tuschl et al., 1990a). It is important to point out that only one investigator has suggested the basal metabolic rates of the restrained subjects might have been reduced due to continuous dietary restriction (Tuschl et al. 1990a). Even so, this does not indicate nor suggest that the unrestrained eaters have abnormally high basal metabolic rates. Treatment of body dissatisfaction The high prevalence of body dissatisfaction in underweight and normal weight college females and the potential psychological, metabolic and economic implications of body dissatisfaction have formed the basis for education programs for those individuals who have unrealistic weight perceptions and who are dissatisfied with their bodies. A few studies have used cognitive therapy interventions or cognitive-behavioral approaches to treat college-aged women with body image disturbances and body dissatisfaction. The interventions include topics such as correcting inaccurate body size perceptions, positive reinforcement, and avoiding difficult situations which might affect body dissatisfaction. These programs were somewhat successful in the shortterm (Butters et al., 1987; Dworkin et al., 1987; Rosen et al., 1989), but no follow up work has been done on longterm effectiveness. Obtai characteri their bodi order to 1 young wome Informati< vho are d irequentl education restraine Stei disregard roles anc relation: Women" 3 Professi Protect eating b in the 1 36 Obtaining information regarding lifestyle characteristics of college-aged women who are satisfied with their bodies and unrestrained eaters would be useful in order to learn more about potential factors which protect young women against the effects of restrictive dieting. Information on if, and how, these women differ from those who are dissatisfied with their bodies and those who frequently restrict dietary intake could be useful in the education of young women who are body dissatisfied and restrained eaters. Steiner-Adair (1989) described women who are able to disregard societal pressures for thinness, gender-prescribed roles and to base self-concept on self-fulfillment and relationships as "Wise Women". Identifying these ”Wise Women" and gaining new information about them might aid professionals in understanding the potential factors which protect women against body dissatisfied and restrained eating behaviors. There have not been such studies reported in the literature. Subjects The students Organizat Universit students the majo this sur particip points. course p complete measure On for thi body di female Hereaft Sample» four gr Satisf with e bEhavi METHODS Subjects The initial sample was 550 male and female college students who were enrolled in a business course titled Organizational Behavior, Management 302, at Michigan State University (See Appendix A). Approximately 60% of the students who participated were males and 40% were females; the majority were Caucasian. Incentive for participation in this survey was 10 points which went towards the participating student's final course grade of 300 total points. Approximately 97% of the students enrolled in the course participated in this research study, and all subjects completed both the questionnaire and anthropometric measurements. Only the data collected from 249 females were analyzed for this study under the assumption that the prevalence of body dissatisfaction and restrained eating is greater in female populations than in male populations (Hsu, 1989). Hereafter, these 249 women will be referred to as the "total sample". These 249 were then either classified into one of four groups based on restrained eating behaviors and body satisfaction or were omitted from the study because women with extreme feelings regarding their bodies and eating behaviors were desired for the purposes of this study. The 37 four groui body satii (D/R) and One I were actia satisfact; analysis. pilot Stil restraint. remaining for corrt two women and were 9I00p si: Vomr analysis subiects qutstiom Here alt( hf Commute question recitatl term 199 Particip 38 four groups were the body satisfied/unrestrained (S/UR), body satisfied/restrained(S/R), body dissatisfied/restrained (D/R) and the body dissatisfied/unrestrained (D/UR) group. One hundred and five women called the "final sample” were actually classified into the four groups based on body satisfaction and restrained eating and included in the data analysis. The final sample consisted of 26 women from the pilot study and 79 women from the main study, based on restrained eating behaviors and body satisfaction. The remaining women were omitted from the data analysis except for correlational analysis in the conceptual model. Only two women were classified in the satisfied/restrained group and were omitted from the data analysis due to the small group size. Women from the pilot study were included in the final analysis because they were classified the same as those subjects in the final study and were asked the same questions except for a few food group intake questions which were altered after the pilot study. Procedures After approval of this study by the University Committee of Research Involving Human Subjects (UCRIHS) the questionnaire was administered to students in three recitation sections (n=120) of Management 302 during Winter term 1990 (See Appendix B). Subjects were asked to participate in the study at a time scheduled outside of regular cl nights fro through re Upon arriv (Appendix included form was were uncl of the qu semi-priv This with adm' question clarific the pilo be used Dur this at Without Iecitat for adm Pilot 5 T Statis for th 39 regular class time. The scheduled times were four week nights from 7:00 pm-8:00 pm and students were notified through recitation teaching assistants in Management 302. Upon arrival, students completed the informed consent form (Appendix C) and the questionnaire (Appendix D) which included an evaluation form (Appendix E). This evaluation form was included to assess if portions of the questionnaire were unclear or difficult to understand. After completion of the questionnaire, each subject was weighed and measured semi-privately in one of the two auditorium exits. This pilot study provided needed insight into problems with administration of the questionnaire and with the questionnaire itself. Fortunately, these corrections and clarifications were minor enough to allow data from women in the pilot study, classified into one of the four groups, to be used in the final analysis. During Spring term 1990 the final data collection for this study was completed. At that time, the questionnaire, without the evaluation form, was administered to all recitation sections of Management 302. The same procedures for administering the questionnaire were followed as in the pilot study. The data collected were analyzed using SPSS-PC+ statistical analysis program (Norusis, 1988). A codebook for the data can be found in Appendix F. w Survey Ins The c of the ei< any; assessed being use Examinati regarding month, t} physical Sub activity activiti 1) Hi bicycle for 5-5 lift we Per wee 2) M biCYcle three d lifted Per Wei 3) dbOVQ 40 Measurements Survey Instrument. The questionnaire used in the present study consisted of the eight parts described in the following paragraphs. Physical Activity. The first part of the questionnaire assessed physical activity and the questions are currently being used in the third National Health and Nutrition Examination Survey (NCHS, 1990). There are 12 questions regarding type and frequency of exercise during the past month, typical physical activity and self-perceptions of physical activity. Subjects were categorized into one of three physical activity categories based on frequency and duration of activities (Blair, 1989). 1) Highly active: Subjects had to run, swim, dance, bicycle or do aerobics for at least thirty minutes each day for 5-6 days per week or walk two miles in 20-24 minutes, lift weights, garden or do calisthenics at least 5-6 days per week. 2) Moderately active: Subjects who ran, swam, danced, bicycled or did aerobics less than thirty minutes at least three days per week or walked two miles in 30—40 minutes, lifted weights, gardened or did calisthenics at least 4 days per week. 3) Inactive: Subjects who did not meet either of the above criteria were classified as having low physical activity ‘ ggli Self-Este 10, 4-poi. self-este 4 points points, I of possi? esteem s indicate §o_ of the s a scale society the sub: (Garner each sc indicat Ea extreme alterne POint, 12-48. tradyt indica 41 activity levels. self-Esteem. Self—esteem was assessed using Rosenberg's Self-Esteem Scale (Rosenberg, 1965). This scale consists of 10, 4-point Likert scale questions assessing individual self-esteem. Extreme negative responses received a score of 4 points while the adjacent alternatives were scored 3 points, 2 points and 1 point, respectively. The total range of possible scores was 10-40. A high score on the self- esteem scale indicated a low self-esteem and a low score indicated a high self esteem. Societal and Personal Viewsggf Women. The third portion of the survey consisted of 24 questions each on two scales, a scale pertaining to the subject's perception of how society views women (Societal Scale) and a scale regarding the subject's perception of the ideal woman (Subject Scale) (Garner, 1989). There were two types of questions within each scale, those indicating traditional views and those indicating the modern or contemporary views of women. Each scale consists of a 4-point Likert scale in which extreme responses were scored 4 points, while adjacent alternatives were weighted as 3 points, 2 points, and 1 point, respectively. The total range of possible scores was 12-48. A high score indicated strong feelings pertaining to traditional and modern roles of women while a low score indicated less intense feelings pertaining to these roles. Body Satisfaction. The fourth section consisted of the Body Dissa Inventory beliefs r: specific 2 dissatisf. of a 6-po responses points, w points an a score 0 The would clc 27) of it al. (198: Percenti 0f less satisfac Garner e Either e to insur each grc Le; cOHSistq (Stunka t001 av et al. 42 Body Dissatisfaction subscale of the Eating Disorder Inventory (Garner et al., 1983). This subscale reflects beliefs regarding satisfaction or dissatisfaction with specific body parts, as well as overall body satisfaction or dissatisfaction. The Body Dissatisfaction subscale consists of a 6-point, forced choice Likert scale in which extreme responses in the "anorexic" direction were scored as 3 points, while the adjacent alternatives were weighted as 2 points and 1 point, respectively. Lowest responses received a score of 0. The assumption made was that the sample distribution would closely correspond to published norm scores (range 0- 27) of female college students (n=770) reported by Garner et al. (1983). A raw score of 15 or greater ( 3 75th percentile) indicated body dissatisfaction and a raw score of less than 3 (gZSth percentile) indicated body satisfaction. The upper and lower quartiles reported by Garner et al. (1983) were used to classify subjects with either extreme body satisfaction or dissatisfaction and also to insure that a sufficient number of subjects would be in each group. Restrainedggating. The fifth part of the survey consisted of the Three-Factor Restrained Eating Scale (Stunkard and Hessick, 1985) which is regarded as the best tool available for assessment of restrained eating (Laessle et al. 1989) Its factor of cognitive restraint, which focuses 0 consists scale for adjacent so on dep Lowest re scores we the eatin restraine Stunkard' behavior, indicator (Stunkar< m. question percepti (Garner Past and QUSStior Vomiting t0 asses satisfi. of Home gender, reslden 43 focuses on conscious attempts to restrict dietary intake, consists of questions in Agree/Disagree and 4-5 point Likert scale formats. Extreme responses received 3 or 4 points and adjacent responses received 2 or 3 points, respectively and so on depending on the number of responses in each question. Lowest responses received 0 points. The total range of scores was 0-21; the higher the score, the more restrained the eating habits. Subjects were classified as having restrained eating behaviors, if they scored 114 points on Stunkard's restraint scale, and unrestrained eating behavior, if they scored 310 points. These cutoff points are indicator values from the published normative guidelines (Stunkard and Hessick, 1985). Weight Perceptions and History; Demographics. The questionnaire also contained a section on current perceptions of weight (Miller, 1980) and past weight history (Garner et al., 1983) to assess weight loss or gains in the past and determine how subjects perceived their weight. Two questions pertaining to binge eating and self-induced vomiting (Garner, 1989) were also included in this section to assess whether these behaviors were prevalent in body satisfied/unrestrained women in comparison with other groups of women in the study. Demographic questions included gender, age, ethnic background, year in college, place of residence, smoking habits and current grade point average. Eeil! and snaci they typil snacks ai food cons' 1989; H8]' al. 1982 meals an< per groul et a1. 11 from the Science a survey ti m Questionl included Question: Portion ; Categor1~ bread an Calorie freQUenc Piece, 3 data use onadal category 44 Eating Patterns. The questionnaire also assessed meal and snack consumption. Each subject reported how frequently they typically ate breakfast, lunch and supper along with snacks at different times during the day and whether the food consumed was considered a meal or snack (Bailey et al. 1989; Hernon et al. 1986; Jakobovits et al. 1977; Khan et al. 1982). Eating patterns were determined by the number of meals and snacks consumed and the frequency of meal skipping per group (Bailey et al. 1989; Jakobovits et al. 1977; Khan et a1. 1982; Wakefield et al. 1971). Experts in nutrition from the Michigan State University Department of Food Science and Human Nutrition reviewed this portion of the survey to insure adequate face validity. Food Grogp,Intake. Gladys Block's Food Frequency Questionnaire (Block et al., 1986) was the last section included in the questionnaire. The Food Frequency Questionnaire (FFQ) was modified to include only the medium portion size for 75 different food items. Foods were categorized into six different categories: milk and cheese, bread and cereal, fruit and vegetable, meat and poultry, calorie dense snacks and high fat foods. These food frequency data were scored to the nearest 1/4 cup, ounce, piece, slice or bag depending on the food. The food intake data used for analysis was the mean number of foods consumed M - mv~cm«~g‘n u. h, I - r . on a daily basis from each of the six food groups for each #M‘J‘. category of women. Foods categorized as high fat were foods such as 1 high cal: cookies, We Heig standarci measuritg and undcl voluntetl two mea:l anthropil Laborat« at Mich. shoes w heels t: device . COIIESpv the nea‘ the nea aVerage height Und8rw from t 80), 45 such as margarine, chips, bacon, whole milk, etc. and the high calorie foods consisted of foods such as chocolate, cookies, and regular pop. AnthropometrigiMeasurements. Height and weight measurements were taken following standardized procedures (Lohman et al., 1988) using a measuring tape and a portable, calibrated scale. Graduate and undergraduate students studying human nutrition volunteered to measure the subjects. At least one of the two measurers at each measuring station was trained in anthropometric measurements in the Nutrition Assessment Laboratory, Department of Food Science and Human Nutrition at Michigan State University. Height was measured without shoes with the back of the head, shoulders, buttocks, and heels touching the wall. A flat edged, right angled wooden device was placed on top of each subject's head and the corresponding height on the measuring tape was recorded to the nearest 0.25 cm. Weight was measured without shoes to the nearest 0.5 kg. Each measurement was taken twice and averaged. Body Mass Index [wt(kg)/ht(m)2) was computed from height and weight measurements. Each subject was classified as overweight, slightly overweight, normal weight, slightly underweight or underweight based on reference data for females aged 20-29 from the National Center for Health Statistics (NCHS, 1976- 80). Subjects who had a BHI g 19.1 (ngthttile) were classifie $20.0 (>1 underweic (>25th ti subjects were cla: am _>_26. margin 0 differen potentia scale in M Aft groups b restrain analyzed aPpropri Characte The analei: Variablv analysi snack c four qr by cn1 aCtivi+ 46 classified as underweight. Subjects with BMI's >19.2 and $20.0 (>15th to gZSthttile) were classified as slightly underweight, subjects with BMI values >20.1 and (24.5 (>25th to <75thttile) were classified as normal weight and subjects with BMI's 124.6 and (26.7 (375th to <85thttile) were classified as slightly overweight. The subjects with a BHI 326.8 were classified as overweight (gBSthttile). A margin of error of :3lbs (1.4kg) was used in determining differences in the actual vs self-reported weights due to potential fluctuations in water and food weight and home scale inaccuracies. Data analysis After subjects were classified into one of the four groups based on body satisfaction or dissatisfaction and restrained or unrestrained eating behaviors, the data were analyzed using parametric and nonparametric analyses, as appropriate. Descriptive statistics were used to characterize the final sample of 105 subjects. The data on eating patterns were analyzed by Chi square analysis to determine whether observed frequencies of variables were different than those expected. Chi square analysis was used to determine if the frequency of meal and snack consumption was independent or related between the four groups of women. Physical activity was also analyzed by Chi square analysis to determine if three physical activity levels were independent between the four groups of women. C frequency of self-i independe One differenc scores or frequency views of groups, I to deter! test for Comparis mean, us HOpkins Comparis Compared Which 11 women, Su weight ever ad highest also Ci F [Estra 47 women. Chi square analysis was used to determined if frequency of weighing, frequency of eating binges, frequency of self—induced vomiting and frequency of smoking were independent between the groups of women. One way analysis of variance was used to determine differences in the variances between groups based on mean scores or values for the following variables: food frequency, self—esteem, BMI values and societal and personal views of an ideal woman. If a difference did exist between groups, Dunnett's t-test for multiple comparisons was used to determine if the difference was significant. Dunnett's test for multiple comparisons is designed to allow for comparisons of group means with one predesignated group mean, usually the mean of the control group (Glass and HOpkins 1984). Dunnett's test is a more powerful multiple comparison test than the Dunn test. Each contrast is compared against the mean of the predesignated control group which in this study was the group of satisfied/unrestrained women. Subjects reported their highest ever and lowest ever weight and from these values their highest ever and lowest ever adult BMI values [wt(kg)/ht (m)2] were calculated. The highest ever and lowest ever mean BMI values per group were also calculated. Finally, correlational analyses were run between BMI, restrained eating, body satisfaction, self-esteem, frequency of breakfa snacks for on 209 sul who were 1 the pilot MAE—a Esti research was prime informed the Depai year end measurin measurem Assessme Graduate by a Hea from the Michigal Protess and fac Nutriti and to 48 of breakfast skipping, high fat foods and calorie dense snacks for 209 women. Correlational analysis was completed on 209 subjects because preliminary data from the 40 women who were not categorized into one of the four groups from the pilot study were not entered into the computer. Funding and Equipment Estimated expenses for equipment and supplies for this research project were approximately $1000.00. This amount was primarily for printing costs of the questionnaire and informed consent forms. Funding for this study were from the Department of Food Science and Human Nutrition's annual year end funds for graduate student research. The scales, measuring tapes and training for the anthropometric measurements were provided by Dr. Hoerr in the Nutrition Assessment Laboratory at Michigan State University. Graduate research assistantship support was provided in part by a Healthy U grant from the Kellogg Foundation and in part from the Department of Food Science and Human Nutrition at Michigan State University. Approximately 100 hours of professional time was volunteered by 10 graduate students and faculty in the Department of Food Science and Human Nutrition to assist with the questionnaire administration and to conduct the anthropometric measurements. The 1 21 years. hispanics origin. 1 campus. others 1 mean gra< “YD The Of 249 v “Y1 Th women 1 Partici indicat unrest: women 1 RESULTS The mean age for the 105 women in the final sample was 21 years. The majority of subjects were White, non- hispanics (89%), 8% were Blacks and 3% were of Hispanic origin. The majority were juniors (77%) and 61% lived off campus. Only 18% lived in campus residence halls and the others lived in sororities or university apartments. The mean grade point average for the 105 women was 3.00. Hypothesis 1 Ho There are college-aged women at MSU who exhibit unrestrained eating behaviors. There were 83 women with unrestrained eating behaviors of 249 women in the total sample (33%). Hypothesis 2 Ho There are college-aged women at MSU who are satisfied with their bodies. There were 37 women who were body satisfied of 249 women in the total sample (15%). Crosstabulation of the participants on body satisfaction and restrained eating indicated that there were 35 women who were both unrestrained eaters and body satisfied out of total of 249 women in the sample (14%)(Figure 4.1). 49 BODY SATISFAV Figi RESTRAINED EATING S/R S/UR \\ + n 2 ((1%) n = 35 (14%) // V BODY SATISFACTION // - n = 20 (8%) // D/UR D/R n = 48 (19%) Figure 4.1 Classification of women (n=105) in final sample from 249 women in total sample according to body satisfaction and restrained eating behaviors. (Percentage of the total 249 in parentheses). in i classifie appears f that an i satisfiec satisfie: from all the fina Hypo Ther betw accc unre diss H) H( Th) three 0 Satisfi dissati group a Serving (14.0ig V5. 20. women . 51 An important finding was that there were only two women classified in the body satisfied/restrained group. It appears from these data that it is a contradiction to say that an individual is a restrained eater, yet body satisfied. Due to the small number of subjects in this body satisfied/restrained group, these two subjects were excluded from all further data analysis leaving 103 women included in the final data analysis. Hypothesis 3 There are behavioral, attitudinal and weight differences between the four groups of college women classified according to whether they exhibit restrained or unrestrained eating behaviors and body satisfaction or dissatisfaction. Hypothesis 3a Ho There are differences in daily meal and snacking patterns and food group intakes between women who exhibit unrestrained eating and body satisfaction and other groups of women. There were statistically significant differences for three of the six food groups between the satisfied/unrestrained (S/UR) women and the dissatisfied/restrained (D/R) women (Table 4.1). The D/R group ate a significantly lower (p<.01) number of weekly servings of meat (4.613.2 vs. 9.715.2) and high fat foods (14.019.6 vs. 24.8110.5) and calorie dense foods (10.7:7.6 vs. 20.0;11.9) (p<.05) than the satisfied/unrestrained women. A negative association was also found between restraine< snacks (r Tabl F001 Gro Hil che Bre CE! Fri vec He: 52 restrained eating and the consumption of calorie dense snacks (r= -.27, p<.001). Table 4.1 Average weekly number (15D) of servings from the food groups consumed by each category of wmmn.a 1 3 4 Satisfied Dissatisfied Dissatisfied Food Unrestrained Restrained Unrestrained Group (n=35) (n=20) (n=48) Milk and cheese 20.2:13.7 13.9:8.4 15.0:10.8 Bread and cereal 24.5:11.2 18.019.6 24.0:12.8 Fruit and vegetable 24.8113.9 24.6115.0 20.9:11.9 Meat, ** poultry 9.7:5.2 4.6:3.2 9.4:6.3 Calorie dense * snacks 20.0:11.9 10.7:7.6 18.9116.2 High fat ** foods b 24.8:10.5 14.0:9.6 23.0114.7 a Women were categorized by level of body satisfaction and restrained eating. b Includes foods from other food groups such as whole milk, cheese, fried chicken and fish, hot dogs, chocolate, doughnuts, etc. * Significantly different at p < .05, Dunnett's multiple contrast Group 1 vs. Group 3. ** Significantly different at p < .01, Dunnett's multiple contrast Group 1 vs. Group 3. The] among thq breakfasi in the n1 (Tables . appeared other gr For was 2.1. breakfas Fifty-on meals pa All Home Percent per day was 1,3. later 11 Snackinc afternov 53 There were no statistically significant differences among the women in the number of times they reported eating breakfast (Table 4.2) but there were significant differences in the number of times the groups ate lunch and supper (Tables 4.3 and 4.4). The satisfied/unrestrained women appeared to eat lunch and supper more frequently than the other groups of women. For all subjects, the average number of meals per day was 2.1. Thirty-four percent of the subjects skipped breakfast, making it the most frequently skipped meal. Fifty-one percent of the women reported eating at least two meals per day and 28% reported eating three meals per day. All women tended to eat more later in the day. Sixty-eight percent of the women ate snacks at least one to two times per day and the average number of snacks consumed per day was 1.8. Snacking was reported to occur most frequently later in the day (Tables 4.6—4.10). In all groups, evening snacking was most common followed by snacking in the afternoon. Tab FIE 4-7 (l/ Nev Tot 8N Tab (1 Ne TOI 54 Table 4.2 Percentage of women categorized by restrained eating and body satisfaction who reported eating breakfast a 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained Frequency (n=35) (n=20) (n=48) 4-7x/week 34 35 24 1-3x/week 37 20 40 <1/week— 28 45 36 Never Total 100 100 100 a No significant differences by Chi square analysis. Table 4.3 Percentage of women categorized by restrained eating and body satisfaction who reported eating lunch. a 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained Frequency (n=35) (n=20) (n=48) 4-7x/week 86 50 73 1-3x/week 11 20 23 15th - <85th percentile) BMI values for women aged 20-29 are >19.2-<26.8. The body satisfied/unrestrained women were not far from being in the underweight category which is 519.1 for women ages 20-29 (ngth percentile). Table 4.12 Body Mass Index values of women classified according to body satisfaction and restrained eating behaviors. Status MeaniSD a S/UR (n=35) 20.5 1 2.23 D/Rb(n=20) 26.7 1 4.28 ** D/URc(n=48) 24.2 1 2.71 ** a Body satisfied/unrestrained eater b Body dissatisfied/restrained eater c Body dissatisfied/unrestrained eater ** Dunnett's t-test for multiple comparisons with S/UR as the control group (p < .01). Hypc Ho The esteem 5 groups 0 Satisfie 13.914 v and diss scores 1 range(1( esteem. Ta “‘1 I’D-0U 61 Hypothesis 3d Ho There are differences in self-esteem scores between women who exhibit unrestrained eating and body satisfaction and other groups of women. There were significant differences (p<.01) in the self- esteem scores between the satisfied/unrestrained and both groups of dissatisfied women (Table 4.13). Satisfied/unrestrained women had a mean self-esteem score of 13.914 vs. 19.315 and 17.8:4 of the dissatisfied/restrained and dissatisfied/unrestrained women, respectively. The mean scores for each group are all below the middle of the range(10-40), indicating all women had fairly high self- esteem. a Table 4.13 Self-esteem values for women classified according to body satisfaction and restrained eating behaviors. Status MeanisD b S/UR (n=35) 13.914.23 c D/R (n=20) 19.315.34 ** d D/UR (n=48) 17.813.81 ** a Scores ranged from 10 (high esteem) to 40 (low esteem). b Body satisfied/unrestrained eater c Body dissatisfied/restrained eater d Body dissatisfied/unrestrained eater * * Dunnett's t-test for multiple comparisons with S/UR as the control group (p< .01). Hypothe Ho The percepti 4.14); i This in< should be of v Th scores in soci 40 OM women 1 roles 62 Hypothesis 3e Ho There are differences in perceptions of women's roles in society between women who exhibit unrestrained eating and body satisfaction and other groups of women. The scores for each groups' beliefs regarding society's perceptions were relatively high, approximately 40 (Table 4.14); there were no significant differences between groups. This indicated that the women believed society to think they should have both modern and traditional characteristics to be of value today. There were no significant differences between the scores for the women's own view of traits for an ideal women in society today (Table 4.15). Scores tended to fall around 40 on the scale indicating that the women perceived an ideal women to be characterized by both traditional and modern roles in society. 63 Table 4.14 Mean total score of women's views on perceived important traits of women in society. a,b Status Mean:SD c S/UR (n=35) 41.7114.04 D/Rd(n=20) 40.215.33 D/URe(n=48) 40.514.01 a Possible scores ranged from 12 (low) to 48 (high). b No significant differences, ANOVA. c Body satisfied/unrestrained eater d Body dissatisfied/restrained eater e Body dissatisfled/unrestrained eater Table 4.15 Mean total score of women's own perception of an ideal women in today's society. a,b Status MeanisD c S/UR (n=35) 39.513.71 D/Rd(n=20) 39.1:3.54 D/URe(n=48) 38.213.07 a Possible scores ranged from 12 (low) to 48 (high). b No significant differences, ANOVA. c Body satisfied/unrestrained eater d Body dissatisfied/restrained eater e Body dissatisfied/unrestrained eater Lures: Res the hypc Appendi) between BMI inc: and body p<.001) an decrv was pos P<.001) (r=0‘24 Selecte Fr in Tabl satisfi themsel Fifty F themse] VEi9hec‘ freQuer 64 Correlations in Conceptual Model Results of the correlation matrix of key variables in the hypotheses can be found in Appendix G in Table 7.1 and Appendix H in Figure 7.2. The highest correlation was between BMI and body dissatisfaction (r=.51, p<.001). As BMI increased, body dissatisfaction increased. Self-esteem and body dissatisfaction were negatively correlated (r=-.40, p<.001) in that with an increase in self—esteem, there was an decrease in body dissatisfaction. Unrestrained eating was positively correlated with calorie dense snacks (r=.27, p<.001) and negatively correlated with body dissatisfaction (r=.-24, p<.001) and BMI values (r=—.19, p<.01). Selected Behaviors Related to Weight Control Frequency of subjects weighing themselves is reported in Table 4.16. The majority (57%) of the satisfied/unrestrained women reported they weighed themselves once per month to several times per month. Fifty percent of the dissatisfied/restrained group weighed themselves at least once per week while 25% reported they weighed themselves at least once per day, if not more frequently. Tab Th Satisfl dissati a meal reportq While ‘ Vomiteq greate report 65 Table 4.16 Percentage of weighing frequency of women categorized by restrained eating and body satisfaction.a 1 3 4 Satisfied Dissatisfied Dissatisfied Weighing Unrestrained Restrained Unrestrained Freq. (n=35) (n=20) (n=48) le/day 3 25 8 Zl/wk 20 50 25 glx/mo. 57 15 51 Never 14 10 13 other 6 0 4 Total 100 100 100 a No significant differences by Chi square analysis. There was a significant difference between the satisfied/unrestrained women and both groups of body dissatisfied women who reported self-induced vomiting after a meal. Forty percent of the dissatisfied/restrained women reported that they had vomited at least once after a meal, while 21% of the dissatisfied/unrestrained reported they had vomited at least once after a meal. These values are much greater than the 6% of satisfied/unrestrained females who reported ever vomiting after a meal (Table 4.17). Tat V01 Ye “’| F1 reporte dissati reporte Interes the boc Classii Satisf 66 Table 4.17 Percentage of women categorized by restrained eating and body satisfaction who reported vomiting at least once after a meal.a 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained Vomited (n=35) (n=20) (n=48) Yes 6 40 21 No 94 60 79 a Significant difference by Chi square analysis (p<.01). Fifty-five percent of the dissatisfied/restrained women reported an episode of binge eating while 50% and 34% of the dissatisfled/unrestrained and the satisfied/unrestrained reported binge eating, respectively (Table 4.18). Interestingly, binge eating tended to be most prevalent in the body dissatisfied women whether or not they were classified as restrained eaters. Thirty-four percent of the satisfied/unrestrained women reported binge eating. Tab Bir Te: “‘l Ta in the values dissati Value 0 adult E 204:4. reporte dissatl leUe ( 67 Table 4.18 Percentage of women categorized by restrained eating and body satisfaction who reported binge eating.a 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained Binge (n=35) (n=20) (n=48) Yes 34 55 50 No 66 45 50 a No significant difference by Chi square analysis. Table 4.19 provides information regarding differences in the highest ever adult BMI and lowest ever adult BMI values between the three groups. The dissatisfied/restrained women had the highest adult BMI value of any group at 28.1:5.5 as compared to the lowest adult BMI value in the satisfied/unrestrained group of 20.414.1. The lowest adult BMI value of 18.013.6 was reported by the satisfied/unrestrained group and the dissatisfied/restrained group had the highest adult BMI value of 22.713.7. Tat BM Hi ra Lo ra Ti three c study dissat dissat Satisf t0 be body 3 differ 68 Table 4.19 Highest and lowest adult Body Mass Index values of women who were categorized by restrained eating and body satisfaction. 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained BMI (n=35) (n=20) (n=48) Highest 21.012.1 28.2:5.6 24.212.4 range (17.0-28.1) (21.9-45.5) (20.1-31.0) Lowest 18.711.9 21.8:6.1 20.7:2.1 range (15.8-25.0) (19.7-35.0) (16.1-25.1) The majority of the women classified into one of the three groups reported they did not smoke at the time of the study (Table 4.20). dissatisfied/restrained women, 17% of the dissatisfied/unrestrained and only 4% of the satisfied/unrestrained women smoked. Twenty-four percent of the Again, smoking tended to be most prevalent in body dissatisfied women than the body satisfied women, but the observed frequencies did not differ from expected by Chi Square. Tat Sm Ye N0 01 mm Tl percei‘ instant they a satisf based Percei underg the di weight Either QIOUps than 1 69 Table 4.20 Percentage of women categorized by restrained eating and body satisfaction who reported smoking. a 1 3 4 Satisfied Dissatisfied Dissatisfied Unrestrained Restrained Unrestrained Smoking (n=25) (n=15) (n=36) Yes 4 24 17 No 96 76 83 a No significant differences by Chi square analysis. Weight perceptions The women in all three groups did not accurately perceive their body weights (Figure 4.2). In most instances, the women perceived that they weighed more than they actually did. Twenty percent of the satisfied/unrestrained women were classified as underweight based on BMI percentiles. Of these 20%, none of the women perceived themselves to be underweight, but rather slightly underweight or of normal body weight. Forty-five percent of the dissatisfied/restrained women were actually normal weight, but all of these women perceived themselves to be either slightly overweight or overweight. In all three groups, the women perceived themselves to be more overweight than they actually were. Sui Un Co 70 Percent 60 i}? Sstisflsdl 40 \ Unrestrained y\ i x: 20 y \" - Actual wt. \ Perceived wt. 0 60 60 Dissatisfied! 4o Restrained 30 20 10 o 80 7o \ y; \\\\ i: so yy Dissatlsfled/ y» Unrestrained 40 ///% 2O 10 "cry/4 2.. “IV/x02 :» UW SLUW NW SLOW OW s UW - Underweight; BLUW - Slightly underweight; NW - Normal weight: SLOW - Slightly overweight; ON I Overweight. Figure 4.2 Percentage of women In each weight category ' according to their actual and perceived body weights and classification by body satisfaction and restrained eatlng. The desired desired Approxii weight lose we weight they di were a weight: T only w (Figur the sa more. satisi any 51 Percei desir Subse to ma group 71 There were also discrepancies between actual vs. desired weights of the subjects. Figure 4.3 shows the desired weights for women in each weight category. Approximately 45% of the underweight women desired to lose weight and 63% of the slightly underweight women wanted to lose weight. In general, 76% of the women at all five weight levels expressed that they wanted to weigh less than they did at the time of this study. Interestingly, there were a few overweight women who wanted to maintain their weights, but none in the slightly overweight category. The women in the satisfied/unrestrained group were the only women who expressed a desire to maintain or gain weight (Figure 4.4). Eighteen percent of the underweight women in the satisfied/unrestrained group actually wanted to weigh more. Of all three groups in the study, the satisfied/unrestrained women were the only group in which any subjects expressed a desire to gain weight. Thirty-four percent of the women in the satisfied/unrestrained women desired to maintain their current weight and were the only subset of all three groups in the study to express a desire to maintain current weight. All subjects in the other two groups desired to weigh less. 72 Percent 20 Maintain weight Weigh more - Welghlesa UW SL.UW NW SLOW OW a UW - Underweight; SLUW - Slightly underweight- NW - Normal weight; suow - Slightly overweigh’t; OW - Overweight. Figure 4.3 Desired weight changes for women In each actual weight category. Percent 120 100 80 60 4O Maintain weight Weigh more - Welghleae 20 S/UB ‘ D/Fl b D/UR ° a SIUR Satisfied/Unrestrained to DIR Dissatisfied/Restrained c D/UR Dissatisfied/Unrestralned Figure 4.4 Desired weight changes tor women categorized by body satisfaction and restrained eating. The the sub hundred 65% und reporte correct 73 There were differences in the self-reported weights of the subjects and the actual weights that were measured. One hundred three women self-reported their weights and of these 65% under reported their weights (range 4—19 lbs.), 3% over reported (range 5-8 lbs.) and 32% reported their weights correctly. DISCUSSION This study provides evidence that there are college age women at Michigan State University who are satisfied with their bodies and who are unrestrained eaters. These satisfied/unrestrained women have unique characteristics. High self-esteem, low body weights, more frequent intakes of meat, high fat and calorie dense foods as well as more frequent consumption of lunch and supper differentiate the satisfied/unrestrained from the dissatisfied/unrestrained and dissatisfied/restrained women. Prevalence of unrestrained eating In this study, there were college aged women who exhibited unrestrained eating patterns. The unrestrained eaters comprised 33% of the entire sample (n=249) and consisted of women who were both satisfied and dissatisfied with their bodies. Slightly more than half of these subjects were dissatisfied with their bodies. This indicates that some women, even though dissatisfied with their bodies, were not restricting dietary intake in attempt to change body weight. These subjects might have been engaging in other weight loss methods to alter body weight or shape, however. In this study, the unrestrained eaters 74 75 had lower body weights and higher self-esteem than the restrained eaters. There is little information in the literature regarding the prevalence of women who have unrestrained eating behaviors. The majority of research focuses on women who are dieting and the majority of college-aged and adolescent females restrict dietary intake (Herman and Mack, 1975; Miller, 1980; Mintz and Betz, 1988; Moore, 1989). Prevalence of body_satisfaction Only 15% of the 249 women who participated in this study were satisfied with their bodies. This figure is consistent with other reports in the literature regarding the prevalence of body satisfaction which has been reported from 14% (Eisele et al., 1986) to 38% (Moore, 1988). Even though body dissatisfaction is more prevalent and predominantly reported in the literature (Dwyer et a1. 1969; Counts and Adams, 1985; Eisele et al., 1986; Huenemann et al., 1966; Miller 1980; Moore 1988; Thomas and James, 1988), body satisfaction was reported in a small group of women in this MSU sample. Crosstabulation of the participants by body satisfaction and restrained eating indicated that there were 35 women classified as both body satisfied and unrestrained eaters. This was 14% of the total sample (n=249). The same percentage was reported in a study by Cooper et a1. (1987) who identified, as a result of factor analysis, a group of 76 79 undergraduate females (14% of n=554) unconcerned about body weight, unconcerned about slimness and who were not dieting. Even though different methods of assessment were used in these two studies to identify women who were not satisfied with their bodies or currently dieting, similar traits and percentages appear for both groups. Unfortunately, this very low percentage indicates that 86% of the women were either dissatisfied with their bodies, dieting or both. An important finding of this study was the lack of subjects who were categorized as body satisfied/restrained eaters. Only two women of 249 were satisfied with their bodies and restrained eaters. These results suggest there is a stronger association between restrained eating and body dissatisfaction than restrained eating and body satisfaction. The fact that restrained eaters are usually body dissatisfied has important implications. Society frequently promotes dieting as a positive means to achieve happiness with self. However, from the very small number of subjects in the satisfied/restrained group (n=2), body satisfaction, happiness and dieting do not appear to go together. The women who were dieting were by in large, not satisfied with their bodies. Food intake The satisfied/unrestrained women had slightly different food group intakes than women in the dissatisfied/restrained group. signif dense avera dissa with eater 1989) al., for sati grou diss calo dens Poss per to 198 int £00 res est hi in 77 group. The satisfied/unrestrained women consumed significantly greater amounts of meat and poultry, calorie dense snacks and high fat foods, approximately t!3,£l§3§_£99» axgélgpmuflmbeaeef .19 9&1. EEEXEBSEMC ”sum“ ”1’ t he dissatisfied/restrained women. This finding is consistent with other studies in the literature in which unrestrained eaters consumed more calorie dense foods (Laessle et al., 1989) and high fat foods (Tuschl et al., 1990a; Tuschl et al., 1990b) than restrained eaters. A possible explanation for the difference in food intake between the satisfied/unrestrained and the dissatisfied/restrained groups could be that in attempts to lose weight, the dissatisfied/restrained group consumed fewer foods with high caloric densities and few foods with perceived high caloric densities. The restrained subjects consumed less meat possibly due to the high fat content of some types of meat. However, the reports of underreported food intakes by persons with high body weight must be considered in regard to the differences in food intake between groups (Axelson, 1984; Bandini, 1990) There might have been errors in food intake estimates based on the standard portion sizes in the food frequency questionnaire used in this study. Several researchers have reported errors in food portion size estimation (Blake et al., 1989; Guthrie, 1984). Women with higher BMI values might have underreported their food intake, even though few were actually obese. The food freque previo H consc data fat a Searl subje food repo ques cons diss and qre ade cal res the cha res ea C0 C0 78 frequency questionnaire also does not detect current or previous bingeing behavior which might affect BMI values. It is difficult to determine if the food choices were conscious decisions by the subjects. It appears from these data that the subjects had a fairly good understanding of fat and caloric densities of food. However, a study by Searles et al. (1986) reported approximately half of the subjects (n=l38) misunderstood caloric and fat contents of food by high school students. A similar percentage was reported by Dwyer et al. (1970). On the basis of the portion sizes in the food frequency questionnaire it appears the satisfied/unrestrained women consumed the largest amounts of food of any group while the dissatisfled/unrestrained consumed the least food. Hernon and colleagues (1986) found that the women who consumed greater than 1200 calories per day had more nutritionally adequate diets than women who consumed less than 1200 calories. Their subjects were not categorized according to restrained or unrestrained eating, but it is not unlikely that those who consumed less than 1200 calories would have characteristics similar to the restrained eater, because restrained eaters consume less food than unrestrained eaters. According to the Basic Four Food Groups (National Dairy Council, 1989), on average, all women in the current study consumed the recommended number of two servings per day from 79 the milk group. However, they consumed just less than the recommended number of four servings per day from the bread and cereal group as well as the fruit and vegetable group. They also consumed just less than the recommended two servings per day from the meat group. These results confirm those of Hernon et al. (1986) in which 245 college women consumed less than the recommended number of food servings from the bread and cereal, fruit and vegetable and meat groups. It appears that college women have a tendency to consume slightly less than the recommended number of servings from the majority of the Basic Four Food Groups. However, care needs to be taken in interpreting the results of the food intake data. The food frequency tool used in this study used standard, or medium, rather than reported portion sizes. A recent study by Clapp et al. (1991) reported that the use of standard portion sizes for estimating nutrient intake underestimates actual intakes of w Wan.“ v-‘ vt-H.-u-u--...<' r; ,-r ~ '1“MH" certain nutrients. The women in this study might have had greater food intakes than the results indicate. Eating patterns The satisfied/unrestrained women in this study appeared to eat lunch and supper more regularly than the other groups of women and these results contradict those reported by Kirkley et al. (1988). In the Kirkley study, subjects who scored both high and low on the Restraint Scale were found to eat a similar number of meals. No data were presented in the K Howev eater eater patte this repor stud day perc (198 day cons eigh one of c per not Sna hut al. Thi ire 80 the Kirkley study on the actual number of meals consumed. However, Kirkley and colleagues did find that restrained eaters consumed snacks more frequently than the unrestrained eaters. In this study there was no difference in snacking patterns. The daily meal and snacking patterns of the subjects in this study are fairly consistent with other studies reporting eating patterns of college women. In the current study, 51% of the subjects consumed at least two meals per day and 28% reported eating three meals per day. These percentages are similar to those reported by Marrale et al. (1986) where 49% of the subjects ate at least two meals per day and 36% ate three meals per day. In this study, 97% of the college women reported consuming snacks, an average of 1.8 snacks per day. Sixty- eight percent of the subjects in this study reported eating one to two snacks per day which is consistent with the 70% of college students who reported eating one to two snacks per day in the study by Marrale et al. (1986). Snacking was not considered to be a negative food pattern because snacking can supplement the diet by providing necessary nutrients and calories not consumed during meals (Khan et al., 1982; Bigler-Doughten et al., 1987). Breakfast was the most frequently skipped meal. Thirty-four percent of the subjects in this study reported frequently skipping breakfast, which is similar to other studi (1982 women repor intak lower entir all i like ate conc and and cons weig deer with Sign had per bre dis dis bre 81 studies of college women in the literature. Khan and Lipke (1982) reported that 24% of undergraduate students, men and women, skipped breakfast and Jakobovits et al. (1977) reported that 53% of undergraduate women skipped breakfast. However, results from the Continuing Survey of Food Intake of Individuals of women 19-50 years indicate a much lower percentage of skipping breakfast. Only 2% of the entire U.S. sample of women reported skipping breakfast on all four days when the survey was administered. It is likely that the older women included in the national survey ate breakfast more frequently. Breakfast skipping is of concern because, as a meal, it provides necessary calories and nutrients. Also by skipping breakfast, these calories and nutrients might not be consumed later in the day. A study by wakefield (1971) assessed breakfast consumption by weight status and reported that as body weight increased, the frequency of breakfast consumption decreased. Skipping breakfast was negatively correlated with BMI in this current study as well. Also, although not significant, the women in the satisfied/unrestrained group had the lowest body weights of any group. Twenty-eight percent of these women reported frequently skipping breakfast while 36% of the women in the dissatisfled/unrestrained and 45% of the dissatisfied/restrained women reported frequently skipping breakfast. Women in the dissatisfied/restrained group had 82 the highest body weight of any group and skipped breakfast more frequently than women who had lower body weights. Skipping breakfast might have been perceived to be a method to lose weight by the dissatisfied/unrestrained women. Physical activity The results of most women in this study reporting moderate activity agree with the few data reported regarding physical activity levels of college women. The physical activity classifications were similar between the National Health Interview Survey (NHIS) report (Casperson et al., 1986) and the current study, although different methods of assessment were used to determine the levels of physical activity. The fewer women in the sedentary group in the Casperson report in comparison to the current study could be due to slight differences in categorization. Although one- third of the sample self-reported inactivity, it should be noted that on a large college campus like the one at MSU, it is difficult for the majority of undergraduates to attend classes and remain sedentary. It is not possible from the data available in this analysis to determine why some of the subjects were highly active. It has been reported in the literature that a high prevalence of eating disorders and body distortion exist in some female athletes and dancers (Braisted et al., 1985; Garner et el., 1980; Weight et al., 1987). Some of the women in this study might have been athletes participating on 83 college teams or those who enjoyed exercising and did so more often and intensely than other women. Subjects who were highly active could also have been exercising at extreme levels in order to control their body weights. It is not possible to determine whether athletes participated in the current study. It appears that for the women who participated in this study, exercise was not a determining factor between group classifications. Tuschl et al. (19903) also found no difference between groups for levels of physical activity after subjects were classified as either restrained or unrestrained eaters. Energy expenditure was not exceedingly high or low for any one group because no one group exercised excessively. Body Mass Index Values Body Mass Index values were less for the satisfied/unrestrained women than either group of the dissatisfied women. It appears that satisfied/unrestrained women did not maintain a low body weight by dieting, because they were unrestrained eaters. Analysis of physical activity data also did not indicate that these satisfied/unrestrained women were expending considerable energy in exercise. The differences in BMI values between the two groups of women might be due to the tendency of restrained eaters to binge eat more frequently than unrestrained eaters (Tuschl 84 et al., 1990; Kirkley et al., 1988). Over time, frequent binge eating episodes most likely would increase body weight. A study by Bandani et al. (1990) also indicates women with higher BMI values underreport food intake. These heavier women might actually be consuming greater amounts of food than they reported, even though the average BMI value was not excessive for this group. Metabolic differences in the satisfied/unrestrained women might be one possible explanation for the low body weights in this group. It could be that satisfied/unrestrained women have a higher basal metabolic rate and therefore can consume more food without gaining weight. The satisfied/unrestrained women in this study reported they consumed more food than the dissatisfied/restrained group. Tuschl et al. (1990a), using the doubly labeled water technique, found that average daily total energy expenditure of restrained eaters was 620 kilocalories less than the average daily total energy expenditure of unrestrained eaters. The authors reported that over time the restrained eaters most likely reduced their basal metabolic rates by chronic dieting, which lowered their daily total energy expenditure. However, this does not necessarily indicate that unrestrained eaters have high metabolic rates. The higher body weights of the restrained eaters in this study confirm results of other studies regarding higher 85 body weights of restrained eaters and dieters. Higher body weights have been reported in the literature in restrained eaters compared to unrestrained eaters (Laessle et al., 1989; Tuschl et al.,l990a) and in individuals who were dieting in comparison with those who were not dieting (Counts et al., 1985; Wiedel et al., 1983). The positive association between BMI and body dissatisfaction in this study (r=.51) was similar to the association reported by Davis (1990) (r=.52) in 185 young women. It appears that as body weights increase, body dissatisfaction also increases in young women. A few other studies in the literature show associations between body satisfaction and low body weights. Lundholm and Littrell (1986) studied adolescent cheerleaders from the midwest (n=751) and determined levels of restrained eating and body dissatisfaction. The women who had higher body weights and greater desires for thinness were dissatisfied with their bodies and had higher restrained eating scores than the other group of women who had low restraint scores and were body satisfied. Garner and colleagues (1984) compared differences between women with anorexia nervosa, and weight preoccupied and not-weight-preoccupied women. The not-weight-preoccupied women had greater body satisfaction and lower percent of average body weights for age and height than did other women in the study. Seggar et al. (1988) examined 323 undergraduate women at a western 86 university in the 0.8. and found that the heavier subjects were considerably less satisfied with their bodies than the normal weight subjects. It appears that the women who are body satisfied and not-weight—preoccupied or restrain their eating have lower body weights than those women who are body dissatisfied and are restrained eaters or are preoccupied with weight. Self-Esteem The satisfied/unrestrained group had the highest self- esteem of any group in the study and the lowest BMI values. Results from this current study regarding self-esteem in women are consistent with others in the literature indicating that the lower the body weight, the higher the individual self-esteem (Ford and Drake, 1983; Martin et al., 1988; Rodin et al., 1984; Wiedel and Dodd, 1983). The significant positive association in this study between self- esteem and body satisfaction is consistent with associations reported in other studies (Fabian et al., 1989; Rosen et al, 1987). In other studies, body dissatisfaction has been related to negative self-esteem (Ford and Drake, 1983; Garner et al., 1981). It appears that body dissatisfaction and self- esteem are so closely related that body dissatisfaction might be a part of self-esteem for women (Garner et al., n1981). It might not be that the high body weight makes an individual have a reduced self—esteem, but that the higher 87 body weight elicits increased body dissatisfaction and therefore reduced self-esteem in young women. The satisfied/unrestrained women with high self-esteem along with low body weights in this study were also unrestrained eaters. Self-esteem has been found in the literature to be related to restrained eating (Mintz et al.,1988; Polivy et al., 1988; Rosen et al., 1987). Researchers have found that women with restrained eating behaviors have lower self-esteem than women with unrestrained eating behaviors indicating an interaction between the two. It is difficult to determine the direction of the interactions between the body weight, body dissatisfaction and self-esteem (See Figure 1.1). It is plausible that body weight would affect self-esteem but self-esteem could also affect body weight by increasing or decreasing food intake via restrained or unrestrained. Restrained eating could also promote feelings of inadequacy or poor self-esteem from dieting failures which might encourage a young woman to begin dieting in attempts to be "happy”. It is evident from the literature that body dissatisfaction and restrained eating are associated with self-esteem and body weight. Perceptions of women's roles All women in this study perceived society's view of an ideal woman as including both traditional and modern attributes. There were no differences between groups 88 regarding their perception of society's view of women's roles. It also appeared that the women in this study perceived an ideal women in today's society as characterized by both modern and traditional roles. Most women believed that a successful career, thinness, independence and a successful family and home life all corresponded with their image of an ideal woman in today's society. This perception of an ideal woman could be a product of the societal pressures that impact women today. Results of this study contradict the results reported by Steiner-Adair (1986) in which two groups of college women differently identified their image of an ideal woman in society and also had different eating patterns. One group perceived an ideal woman as beautiful and successful in a career while the other group perceived her as valuing herself and her qualities. This second group had fewer abnormal eating problems than the other group of women. The differences in the results between the current study and these by Steiner-Adair could be due to the small sample size in the Steiner-Adair study (n=20) and the fact that her subjects were interviewed for 20 minutes regarding their perceptions of an ideal woman. There also might be differences in the way women deal with pressures from society regarding the attributes and characteristics of an ideal woman. It appears that all 89 women in this study were striving to be that ideal woman, but it could be speculated that some of the women might have believed that they already had the traits of an ideal woman. These women might have been satisfied with their body weights, had a positive self-esteem and might not have felt a need to change their eating behaviors to attain the attributes of the ideal woman. Steiner-Adair suggested, that "Wise Women" (body satisfied/unrestrained eaters) are aware of the pressures on women and realize the effects, but have made a conscious effort not to succumb to these unrealistic societal pressures. However, it is possible that the real reason they do not succumb to the societal pressures is that there is no need to do so. Perhaps these women have already attained many of the attributes and characteristics they believe are important traits of an ideal woman, especially thinness. Selected Behaviors related to Weight Control Although there were no significant differences between groups in the frequency of weighing, it was interesting that the dissatisfied/restrained women tended to weigh themselves more frequently than the satisfied/unrestrained. The trends in weighing frequency indicated that the dissatisfied/restrained women were possibly more concerned about their weight and frequently monitored weight gains or losses more often than the satisfied/unrestrained women. Dwyer et al. (1969) reported weighing frequencies of 90 adolescents and found no significant differences in frequency of weighing according to body weight, but again overweight subjects tended to weigh themselves frequently. It has been reported that women in attempts to lose weight have engaged in unsafe dieting practices such as vomiting and bingeing (Garner et al., 1986; Miller, 1980; Moore, 1988; Moses et al., 1989). Some women in this current study also engaged in these abnormal eating behaviors. Forty percent of the body dissatisfied/restrained group reported vomiting at least once after a meal. This figure is high according to other reports of the prevalence of self-induced vomiting in the literature from 3% (Cooper and Fairburn, 1983) to 12% (Halmi et al., 1981). However in this current study, subjects were asked if vomiting had ”ever" occurred and results might not indicate attempts for longterm weight control behavior. Binge eating was prevalent in both groups of dissatisfied women, but was slightly more prevalent in the body dissatisfied/restrained women. This is understandable because dietary restraint has been suggested to be a main factor in the prevalence of bingeing (Kirkley et al., 1988; Laessle et al., 1989; Polivy and Herman, 1985). It is important to note that 34% of the satisfied/unrestrained women reported binge eating which most likely is not related to deprivation, as in restrained eaters, because the body satisfied women were unrestrained eaters. 91 The restrained groups of women had the highest mean BMI values, higher than either of the unrestrained groups. These results are in agreement with studies (Laessle et al. 1989; Tuschl et al. 1990) in which the authors found significantly higher maximal BMI values in restrained eaters than in unrestrained eaters. Garner et al. (1984) also found similar weight trends in weight-preoccupied and not- weight-preoccupied women. The weight-preoccupied women had both higher maximal and minimal percent average weights in comparison to not-weight-preoccupied women. The higher maximal BMI values might have predisposed the restrained eaters and weight-preoccupied women to attempt to decrease their higher body weights. Smoking was included in this study because there are data indicating that smoking is related to weight status (Albanes et al., 1987; Larkin et al., 1990). However, the prevalence of smoking in this study was relatively low and there was no significant difference in smoking frequency between the groups of women. Weight perceptions The discrepancies between actual weight and perceived weight for most women in this study have been documented in other studies as well (Gray 1977; Desmond et al., 1986; Harmatz, 1987; Kaplan et al., 1988). It is reported that women perceive themselves to be heavier than they really are. Therefore, women perceive a need to lose more weight 92 than is really necessary for good health. Discrepancy between actual and perceived weight is the second component of body image disturbance (Garner et al., 1981). This discrepancy is important because women engage in weight loss practices, when they perceive themselves to be overweight even if in reality, they are not. This desire of most women to weigh less than they do might be explained by societal pressures. When self-reported weights of individuals and actual weights are compared, women frequently underreport weight (Stewart et al. 1987). This finding was documented in this study also. Sixty-five percent of the women reported their body weight to be less than (13 lb) their actual body weight. Possible explanations for differences in reported and actual weights include that individuals might not be aware of their body weight and therefore guess. Another explanation might be that societal pressures for thinness led some people to underreport their body weight or report desirable weights rather than actual weights. Implications Contrary to the hypotheses of this study in which the body satisfied/unrestrained women were targeted and compared to other groups of women, findings focus more on the body dissatisfied/restrained women. This latter group had distinctive characteristics of interest. The 93 dissatisfied/restrained women reported consuming less meat, fewer high fat and calorie dense foods, had higher BMI's, lower self-esteem and self-induced vomiting more frequently after eating. Despite this focal shift, a main goal of this study was still accomplished. That is to provide information regarding potential protective factors against body dissatisfaction and dieting for women. Lifestyle characteristics of women with body satisfaction and unrestrained eating were also described. Findings from this study indicate that weight loss diets are a bad prescription for women who have an inaccurate perception of their bodies, for whatever reason. These dissatisfied/restrained women are already depriving themselves of food, have mean weekly servings below recommendations from the Basic Four Food Groups and have irregular eating patterns. They do not always consistently consume lunch and supper. Therefore, it seems illogical to deprive these women by further restricting calories. They are already dieting, although they might be periodically bingeing. Further recommendations and encouragement by professionals for these women to restrict caloric intake might inadvertently promote serious eating disorders. The need for weight loss should be evaluated by medical standards for weight, weight history and likelihood of success and maintenance, not by societal standards. From 94 the results of this study, it might be beneficial in a program addressing body dissatisfaction and restrained eating to emphasize positive self-esteem and valuing of self as a person. Exercises to help women accurately perceive their bodies would also be beneficial as would the incorporation of a regular aerobic exercise program for these dissatisfied/restrained women. Exercise is an important component of energy expenditure and has been reported in the literature as important for improving cardiovascular fitness (Powell et al. 1987). Dietary intake and eating patterns should provide a regular pattern of nutrient dense calories to reduce subjects' risk of developing bingeing behaviors. That is, these women should be encouraged not to skip meals and to distribute calories evenly throughout the day. Addressing and changing the sociocultural pressures of thinness for women most likely would be the best way to decrease the prevalence of body dissatisfaction, restrained eating and eating disorders. However, this is a big accomplishment due to large industry that makes money through attempted weight loss and the frequent weight fluctuations of individuals who diet. Addressing the mass media regarding the standards of thinness and beauty portrayed for women might also be a key challenge in combating the sociocultural pressures on women. .95 Limitations and Strengths This study has limitations that should be considered in evaluation of the data and results. The sampling procedure for this study was based on the availability of individuals in Management 302. The results obtained from this convenience sample are generalizable only to other groups with similar characteristics, because subjects were not selected by random or systematic sampling techniques. However, this type of sample is appropriate for an exploratory study in which new information is obtained. The subjects who participated in this study were assumed to be similar to the population of college students, in general, at MSU and at other universities. Another limitation of this study is that subjects self- reported the information in the questionnaire. Subjects were informed that they would not be identified in any way. Therefore, they should have no reason to report inaccurate information and were assumed to have answered all questions honestly. Still their recall or perceptions of behaviors might not be accurate as was evidenced by their reported weights. Limitations of the food frequency questionnaire also need to be addressed. Based on the standard portion sizes in the food frequency questionnaire, there might have been errors in food intake estimates and the women with higher BMI values might have underreported their food intakes. The 96 food frequency questionnaire also does not detect bingeing behavior which might effect BMI values. Breakfast skipping percentages might have been elevated due to the fact that some subjects might arise late in the morning and not consume breakfast. Time subjects typically arose in the morning would have been an important question to include in the questionnaire. This study might also have been strengthened by assessing the percent fat intake of subjects and their waist/hip ratios. Maximum oxygen uptake during exercise might also have added more strength to this study. Strengths of this study include that actual heights and weights of all subjects were measured and that the response rate of the sample was very high. The pilot study also provided time for valuable evaluation of the questionnaire administration and of the questionnaire itself. This study did not, in any way, attempt to diagnose women with any eating disorder by classification in to the group with which they were identified. CONCLUS I ONS This study provided evidence that there are college- aged women who actually have unrestrained eating behaviors and who are satisfied with their bodies. This is true despite reports of high prevalence of body dissatisfaction, restrained eating, and eating disorders in young women. When three different groups of women based on restrained eating and body satisfaction were compared, the body satisfied/unrestrained group had unique characteristics. Low body weight and high self-esteem along with greater self-reported consumption of food, characterized the body satisfied/unrestrained women. The satisfied/unrestrained women also consumed lunch and supper more frequently than any other group of women. There were no significant differences in activity patterns; most subjects were moderately active. Attitudes regarding an ideal woman did not significantly differ between groups. All groups perceived both traditional and modern roles of women as important and necessary characteristics for women today. Programs for college-aged women addressing body dissatisfaction and restrained eating should probably focus on the promotion of a positive self-esteem, and the accurate 97 perception of body weight and shape. Regularity of food intake should be emphasized as well as the incorporation of a regular aerobic exercise program to promote a healthy lifestyle. Recommendations for weight and caloric reductions are not advisable unless careful evaluation regarding weight history, weight-for-height and age, likelihood of success and tendency toward bingeing and vomiting are made. Because eating disorders are so prevalent, recommendations by professionals for women to further restrict caloric intake might inadvertently promote and perpetuate serious eating disorders. Future research in the determination of basal metabolic rates of body satisfied/unrestrained women versus other groups of women would be valuable information to obtain as well as indepth interviews regarding the body satisfied/unrestrained women's perception of an ideal woman. Determining if women exercise for the sole purpose of weight control would also be beneficial to provide information in the prevention and education for women who are body dissatisfied and restrained eaters. 98 APPENDI CES APPENDI X A APPENDIX A MICHIGAN STATE UNIVERSITY DEPARTMENT Of I'OOD SCIENCE AND HUMAN NUTllrn0N EAST LANSING . MICHIGAN . «IN-ll“ June 21, 1990 John Wagner, Ph.D. Associate Professor Department of Management College of Business Michigan State University Dear Dr. Wagner: We want to thank you for allowing us to use the students in Management 302 as subjects for the master's thesis research project on eating habits and body satisfaction in college women. It was a great way to obtain subjects that were motivated to complete the questionnaire. Approximately 390 students participated Spring term and the data collection went very smoothly. It was useful to be able to do the pilot study on the same class during Winter term, also. The students did not appear to have any problems with attending the sessions outside of lecture and some students expressed interest in obtaining results of the study. Thank you again for allowing us to use the students in your class! It all worked out well. Sincerely, ‘Egkp-~élfiifi7*~ Gail Moore Dr. Sharon Hoerr "SI ' h on ”fin-aim Ania-M Main Inuit- Ho- 99 APPENDIX B APPENDIX B MICHIGAN STATE UNIVERSITY UNIVERSITY couumtn 0N RESEARCH INVOLVING EAST LANSING . MICHIGAN . «mam HUMAN SUBJECTS (UCIIIIS) zoo Simr HALL (m) ”3.913: February 2|, I990 IRB# 90-078 Gail Moore, RD 204 Food Science Bldg. Dear Ms. Moore: FIE: "A'ITITUDES AND HEALTH BEHAVIORS OF COLLEGE WOMEN CLASSIFIED ACCORDING TO BODY SATISFACTION AND RESTRAINED EATING IRB# 90-078” The above project is exempt from full UCRIHS review. I have reviewed the proposed research protocol and find that the rights and welfare of human subjects appear to be protected. You have approval to conduct the research. You are reminded that UCRIHS approval is valid for one calendar year. If you plan to continue this project beyond one year, please make provisions for obtaining appropriate UCRIHS approval one month prior to February 2|, l991. Any changes in procedures involving human subjects must be reviewed by UCRIHS prior to initiation of the change. UCRIHS must also be notified promptly of any problems (unexpected side effects, complaints, etc.) involving human subjects during the course of the work. Thank you for bringing this project to our attention. If we can be of any future help, please do not hesitate to let us know. Sincerely, ‘K John” K. Hudzik, Ph. D. Chair UCRIHS JKH/sar cc: 3. Hoerr M H -' in an A/fimuinv Adina/[wall Opportunity I-uimu‘mu 100 APPENDI X C APPENDIX C INFORMED CONSENT FORM You are being asked to participate in a study being conducted by Gail Moore, RD and Sharon Hoerr, RD, PhD from the Department of Food Science and Human Nutrition at Michigan State University. The purpose of this study is to describe attitudes and health behaviors, such as eating and activity patterns and body perceptions, in a sample of college students. Please answer as completely as you can the following questions in this questionnaire. You and your responses will not be identified in any way. All answers will remain anonymous. Following completion of the questionnaire, your height and weight will be measured in private. Total time for completion of this survey will be approximately 30-40 minutes. If you decide to participate, you may refuse to answer any questions and you are free to withdraw consent and discontinue participation at any time. However, if you decide to do so, you will not receive the 10 points. You indicate your voluntary agreement to participate by completing and returning this questionnaire. If you would like a copy of this consent form, one will be provided for you. If you have any questions regarding this study, you may call 353-3106 or 887-2552. THANK YOU!!! DATE Please print your name Please sign your name MGT 302 section number Teaching assistant's name Investigator's signature 101 APPENDI X D APPENDIX 0 PHYSICAL ACTIVITY Instructions: This set of questions asks about your leisure time physical activity. Please respond to each question by placing a mark on the appropriate line. 1) Do a) b) C) d) e) you participate in one of the following activities? Jog or run? Yes No _day If Y_§. how many times? time(s) week month Each time (typically) for minutes Ride a bike or exercise bike? Yes No ___daY If Yes. how many times? time(s) week month Each time (typically) for minutes Swim? Yes No day If Yes. how many times? time(s) week month Each time (typically) for minutes Do aerobics or aerobic dancing? Yes No day If Yes ow man times? _____time(s) week month Each time (typically) for - minutes Do other dancing? Yes No day If Yes. how manvitimgél _____time(s) week ___month Each time (typically) for minutes 102 2) 3) f) 9) 103 Do calisthenics or exercises? Yes No . day If Ygg. how many times time(s) week . . month Each time (typically) for minutes Lift weights? Yes No _day If Yes. how many times? time(s) week . month Each time (typically) for minutes In the past month, did you walk a mile or more at a time without stopping? Yes No day If Yes. how many times: time(s) week month Each time (typically) for minutes In the past month, have you done any other exercises, sports or physically active hobbies not mentioned yet? 4) Yes No If yes, what was it? _day How many times? time(s) week month Each time (typically) for minutes Any other activities? During the past month, were you more active, less active, or about the same compared to your phySical actiVity for the past 12 months? more active? less active? about the same? don't know 104 5) Compared to most people your age and sex would you say that you are more active, less active or about the same? more active less active about the same don't know SELF-ESTEEM Instructions: Please answer these questions according to the way you usually feel. answer. Place a mark after the response which best indicates your Strongly Strongly Agree Agree Disagree Disagree 1) I feel that I'm a person of worth, at least on an equal basis with others. 2) I feel that I have a number of good qualities. 3) All in all, I am inclined to feel that I am a failure. 4) I am able to do things as well as most people. 5) I feel I do not have much to be proud of. 6) I take a positive attitude toward myself. _____ ____ 7) On the whole, I am satisfied with myself. ____ ____ 8) I wish I could have more respect for myself. 9) I certainly feel useless at times. ____ ____ 10) At times I think I am no good at all. ____ ____ 105 VIEWS OF WOMEN Instructions: These questions pertain to perceptions of women in society and Place a check mark after the response which best indicates your beliefs. your perception of the ideal woman in society. A) 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) What traits do you believe SOCIETY values in women today? Success in careers Nurturance Physical appearance Child rearing Intelligence Ability to attract men Education Thinness Gentleness Independence/autonomy Ability to relate to others Strongly Agree Feeling good about themselves Agree Disagree Strongly Disagree 106 B) Which of the following traits correspond to YOUR OWN image of 1) 2) 3) 4) . 5) 6) 7) 8) 9) 10) 11) 12) an ideal woman? Success in careers Nurturance Physical appearance Child rearing Intelligence Ability to attract men Education Thinness Gentleness Independence/autonomy Ability to relate to others Feeling good about themselves Strongly Agree Agree Disagree Strongly Disagree 107 BODY SATISFACTION Instructions: This is a scale which measures your attitudes and feelings regarding your body. There are no right or wrong answers. Read each question and place an (X) on the line which best applies to you. Please answer each question very carefully. ‘g A h v \ A is e" e“ o at" e e 8 of once/day 2 Daily 3 Sev. time/wk 4 Once/wk 5 Sev. time/mo 6 Once/mos. 7 Never 8 Other 5/3 BINGE Have you binged é Yes No 5/5 BINGEPER Freq. of bingeing 1 not in 3 mo 2 Monthly 3 Weekly 4 Daily 5/7-8 BINGETIM Number of times 3 times 5/10-11 BINGEMAX Maximum I of binges I 5/13 VOMIT Have you vomited 1 yes 2 No Fre . of vomiting 1 not in 3 mo 5/15 VOMITPER q 2 Monthly 3 Weekly 4 Daily - OMITIM Number of times I times 2:20-22 beITMAx Maximum I of vomits I 5/23 5/25 5/27 5/29 5/31-33 5/35 5/37-38 5/40-43 5/45-48 5/50-53 5/55-58 5/60-63 5/65-68 AGE YRSCMOOL LIVE ETHNIC GPA SMOKE CIGS 131 DEMOGRAPHIC INFORMATION Age Yr. in school Where live Race or ethnic group Overall college GPA Smoke cigarettes How many per week FOOD INTAKE INFORMATION FFMCMALT FFMCMILK FFMCWMIL FFMCICEC FFMCCHEE FFMCMWCM Milkshake or malt Lowfat milk Whole milk Ice cream Cheese Meals with cheese 'NI—I -O‘U'IIBUNH GUI-DWNH CIU’IIbUNH IDOQUIUIILUNH Freshman Sophomore Junior Senior Graduate Other Res. Hall Off-campus Sor/Frat COOP Univ. apts. other White, nonh Black Hispanic Asian Indian Other Yes No 5/70-73 5/75-78 6/1-3 6/5-8 6/10-13 6/15-18 6/20-23 6/25-28 6/30-33 6/35-38 6/40-43 6/45-48 6/50-53 6/55-58 6/60-63 6/65-68 6/70-73 6/75-78 7/1-3 7/5-8 7/10-13 7/15-18 7/20-23 7/25-28 7/30-33 7/35-38 7/40-43 7/45-48 7/50-53 7/55-58 7/60-63 7/65-68 7/70-73 7/75-78 8/1-3 8/5-8 8/10-13 8/15-18 8/20-23 8/25-28 8/30-33 8/35-38 8/40-43 8/45-48 8/50-53 FFFVORJU FFFVORAN FFFVGRFT FFFVTOMA FFFVCANT FFFVBROC FFFVGREE FFFVCARR FFFVSOUP FFFVSWEE FFFVFFPO FFFVPOTA FFFVCORN FFFVSALA FFFVCOLE FFFVAPPS FFFVAPPL FFFVBANA FFFVGRAP FFFVOFRU FFFVOVEG FFMPPEAB FFMPBURG FFMPBEEF FFMPPORK FFMPHAM FFMPCMIX FFMPFISM FFMPDOGS FFMPBACO FFMPEGGS FFBCNOOD FFBCBREA FFBCBUNS FFBCBAGE FFBCCRX FFBCRICE FFBCMUFF FFBCTORT FFBCCERE FFOFRPOP FFOFDPOP FFOFMCAN FFOFCMOC FFOFCHIP 132 Orange juice Orange Grapefruit Tomato Cantelope Broccoli Spinach, greens Carrots Vegie or tomato soup Sweet potatoes French fries Potatoes Corn Green salad Coleslaw Applesauce Apple Banana Grape Other fruit Other vegetable Peanut butter Burgers, meatloaf Other beef Pork chops and roast Ham Fried chicken Fried fish Hot dogs, lunch meat Bacon, sausage Eggs Spaghetti, noodles Bread Burger or dog buns Bagels Crackers Rice Muffin, biscuits Tortilla Cereal Regular pop Diet pop Hard candy Chocolate Chips, popcorn ll'lriIT‘ 133 8/55-58 FFOFDOUG Doughnuts, pastry 8/60-63 FFOFPIE Pie, cake 8/65-68 FFOFCOOK Cookies 8/70-73 FFOFMARG Margarine or butter HEIGHT AND WEIGHT MEASUREMENTS 8/75-78 HEIGHTl First ht. measurement 9/1-3 HEIGHT2 Second ht. measurement 9/5-8 WEIGHTl First wt. measurement 9/10-13 WEIGHTZ Second wt. measurement MISSING DATA CODE:-9 APPENDIX G Appendix G Table 7.1 Correlation matrix of key study variables. l 2 3 4 5 6 7 a 1) BMI 1.00 b 2) BD .51** 1.00 c 3) EST .15 -.40** 1.00 d 4) BR -.16 .15 .05 1.00 e i 5) RE .19* -.24** .13 .07 1.00 f 6) FAT .00 -.02 -.02 -.03 -.17 1.00 9 7) CAL .00 .02 .02 -.05 -.27** .74** 1.00 a Body Mass Index values b Body Dissatisfaction c Self-Esteem d Frequency of skipping breakfast e Restrained Eating f High fat foods 9 Calorie dense snacks * p<.01 ** p<.001 134 APPENDIX I-I Appendix H Psychosocial variables: Behavioral Variables: Sociocultural views of women Physical activity Body weight perceptions Food group intakes Perceived roles of women Eating patterns Self-esteem Vomiting & bingeing ‘ Weighing frequency ‘ 4? Smoking In r= -.40** BMI r=.27** —.19* r=.51** \i' r= -.24** I Body Dissatisfaction (L. :3.Unrestrained eating Figure 7.1 Strength of relations between variables in Conceptual Model. * (p<.01), **(p<.001). 135 LIST OF REFERENCES REFERENCES Albanes, D., Jones, D., Micozzi, M., Mattson, M., Associations between smoking and body weight in the U.S. population:Analysis of NHANES II. American Journal of Public Health, 77:439-441, 1987. Allon, N., Self-perceptions of the stigma of overweight in relationship to weight losing patterns. American Journal of Clinical Nutrition, 32:470-480, 1979. Axelon J., Repeated measurements in evaluation. Journal of Nutrition Education, 16:12-14, 1984. Bailey, 8. and Goldberg, J., Eating patterns and weight concerns of college women. Journal of the American Dietetic Association, 89:95-96, 1989. Bandini, L., Schoeller, D., Cyr, H., Dietz, W., Validity of reported energy intake in obese and nonobese adolescents. 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