Body dissatisfaction from adolescence to young adulthood: Findings from a 10-year longitudinal study
Highlights
► We present results of a 10-year study of changes in body dissatisfaction through young adulthood. ► Participants’ body dissatisfaction increased between middle school and young adulthood. ► Increases in body dissatisfaction were associated with increases in BMI over time.
Introduction
Body dissatisfaction has emerged as a predictor of a broad range of disordered eating and weight-related outcomes, including frequent dieting (e.g., Ackard et al., 2002, Neumark-Sztainer et al., 2006a), bulimic symptoms and dietary restraint (e.g., Cooley and Toray, 2001, Neumark-Sztainer et al., 2006b), and weight gain (van den Berg & Neumark-Sztainer, 2007). In addition, body dissatisfaction has been identified as a risk factor in the development of related psychopathology, including symptoms of depression (e.g., Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006), and as a mediator of the relationship between body mass index (BMI) and psychological health outcomes, including self-esteem (e.g., Mond et al., 2011, Wertheim et al., 2001) and depressive mood (Mond et al., 2011).Given its negative health outcomes, it is important to know whether body dissatisfaction tends to dissipate over time, as adolescents transition into young adulthood, or whether body dissatisfaction in fact remains high. Longitudinal examinations are needed to more comprehensively track the course of adolescents’ body dissatisfaction over time.
Gender differences in the development of body dissatisfaction are well-established in the literature, with female youth reporting greater dissatisfaction than males, both in cross-sectional examinations (e.g., Lawler and Nixon, 2011, Meland et al., 2007) and over the course of adolescence (e.g., Eisenberg et al., 2006, Gardner et al., 2000, Holsen et al., 2001, Jones, 2004, Rauste-von Wright, 1989, Rosenblum and Lewis, 1999, von Soest and Wichstrom, 2009). Less is known, however, regarding the unique trajectories of female and male adolescents’ body dissatisfaction development across adolescence into young adulthood.
Despite a growing body of work examining changes in body dissatisfaction among adolescents, a clear picture of the unique trajectories of female and male adolescents’ body dissatisfaction over time has not yet emerged. Evidence largely has supported the notion that, among girls, body dissatisfaction increases through middle adolescence (Bearman et al., 2006, Holsen et al., 2001, Gardner et al., 2000, Jones, 2004, Meland et al., 2007, Eisenberg et al., 2006, Rauste-von Wright, 1989, Rosenblum and Lewis, 1999, Tiggemann, 2005), with notable exceptions citing either no change (von Soest & Wichstrom, 2009) or decreases (Ohring, Graber, & Brooks-Gunn, 2002) over time. However, findings are more mixed regarding patterns of body image development across the transition to young adulthood, with studies yielding varying evidence of further increased dissatisfaction (e.g., Bearman et al., 2006, Gardner et al., 2000, Rosenblum and Lewis, 1999, Tiggemann, 2005), stable levels of dissatisfaction (von Soest & Wichstrom, 2009), or decreased dissatisfaction (e.g., Eisenberg et al., 2006, Holsen et al., 2001, Rauste-von Wright, 1989) from middle adolescence to early young adulthood.
Among boys, disparate patterns of body image development are evident from early adolescence. Whereas results of some studies indicate a pattern of decreased body dissatisfaction over time (Holsen et al., 2001, Rosenblum and Lewis, 1999), others suggest no significant change (Bearman et al., 2006, Gardner et al., 2000, von Soest and Wichstrom, 2009), and still others point to increases in dissatisfaction from early to middle adolescence (Eisenberg et al., 2006, Rauste-von Wright, 1989) and to decreases in dissatisfaction later, during the transition to early young adulthood (Rauste-von Wright, 1989).
An important factor to consider in any examination of body image is BMI, as one's weight status provides a dynamic physical marker which an individual may use to form and develop self-appraisals over time. Whereas evidence seems to point to BMI as a consistent predictor of girls’ body dissatisfaction (Barker and Galambos, 2003, Jones, 2004, Lawler and Nixon, 2011, Presnell et al., 2004, Rosenblum and Lewis, 1999, Tiggemann, 2005), results of several studies suggest that BMI also predicts boys’ body dissatisfaction (Field et al., 2001, Lawler and Nixon, 2011). However, in one longitudinal study of adolescent boys and girls, the BMI–body dissatisfaction relationship did not bear out among either group (Bearman et al., 2006).
One prior examination of changes in adolescents’ body dissatisfaction was conducted over a 5-year period, utilizing the same data set as that being used in the current study, and was comprised of two cohorts of students in middle school and high school, respectively, at baseline. Results of that study revealed that body dissatisfaction tended to increase among participants, although some differences were noted across age transitions and gender (Eisenberg et al., 2006). This increase in dissatisfaction was most pronounced among younger males during the transition from early to middle adolescence, a period during which the ideal male body type shifts toward increased muscularity. Conversely, in the same study, body dissatisfaction among older adolescent females actually decreased slightly through adolescence (Eisenberg et al., 2006)—a finding which also may reflect a shift in the body type idealized at this transitional period, as prior research suggests (Cooley & Toray, 2001). It was concluded that the variation in body dissatisfaction observed at developmental transition periods within the sample illuminates opportunities for targeted prevention efforts that may be relevant at different stages of adolescence. The authors noted, however, that the inclusion of an additional point of assessment would provide a more nuanced exploration into the process of body dissatisfaction change. Thus, the current study builds upon this previous work to examine trajectories of adolescents’ body dissatisfaction into young adulthood—10 years later.
Most longitudinal studies examining trends in body dissatisfaction have relied for the most part on predominantly White samples (Bearman et al., 2006, Gardner et al., 2000, Jones, 2004, Ohring et al., 2002, Rosenblum and Lewis, 1999, Tiggemann, 2005, von Soest and Wichstrom, 2009), and many either have not included the key transitional period that occurs as adolescents reach age 18 (e.g., Bearman et al., 2006, Holsen et al., 2001, Jones, 2004, Rauste-von Wright, 1989, Rosenblum and Lewis, 1999, Tiggemann, 2005) or have not included transitional periods at all (e.g., Gardner et al., 2000, Ohring et al., 2002). A clear understanding of the trajectories of body dissatisfaction among diverse female and male youth will inform prevention efforts aimed at intervening in these trajectories and mitigating harmful outcomes and be suitable for more diverse populations than have been previously studied. Additionally, given the lack of clear evidence regarding the course of body dissatisfaction into and through young adulthood, further examination of key transitional periods across adolescence and emerging adulthood are needed to better inform intervention efforts. The present study, therefore, uses longitudinal data to examine changes in body dissatisfaction among diverse male and female adolescents at baseline and 10-year follow-up, spanning transitional periods between adolescence and young adulthood.
It is hypothesized that: (a) consistent with prior findings, body dissatisfaction will be higher overall among females than among males; (b) although evidence is somewhat mixed, body dissatisfaction will increase from adolescence to early young adulthood for females and males, leveling off as participants transition to adulthood, as suggested by the majority of prior findings; and (c) body dissatisfaction will be associated with BMI for females and males, such that increases in BMI over time will be associated with increases in body dissatisfaction. The present study addresses the need for clear evidence regarding the course of body dissatisfaction across key transitional periods into and through young adulthood.
Section snippets
Participants and Procedure
Data for this analysis were drawn from Project EAT-III, the third wave of a 10-year longitudinal study designed to examine dietary intake, physical activity, weight control behaviors, weight status, and factors associated with these outcomes among young people. The analytic sample includes 1902 young adults who responded at all three time points. In Project EAT-I, middle school and high school students at 31 public schools in the Minneapolis/St. Paul metropolitan area of Minnesota completed
Results
Slope estimates of change in body dissatisfaction within gender group and age cohort are presented in Fig. 1, Fig. 2. Among female participants, a significant upward linear trend across the three time points was evident in both the younger, b (SE) = 3.79 (0.62), p < .001, and older, b (SE) = 2.20 (0.39), p < .001, cohorts. Linear trends for the two age cohorts of females differed significantly (p = .031), with the younger cohort exhibiting a relatively steady increase in body dissatisfaction over time,
Discussion
Results of the current study indicate that diverse male and female participants became progressively more dissatisfied with their bodies over a 10-year period. Specifically, body dissatisfaction increased between middle school and high school, and increased further during the transition to young adulthood. Importantly, this trend was associated with similar increases in BMI over time such that, when the trajectories of body dissatisfaction were recalculated, adjusting for BMI, no significant
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