Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T02:27:04.492Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender Differences in Risk Factors for Stice’s Bulimia in a Non-Clinical Sample

Published online by Cambridge University Press:  21 September 2015

Pablo Ruisoto ,
Raúl Cacho ,
José J. López-Goñi ,
Eulogio Real Deus ,
Silvia Vaca  and
Paula Mayoral
Pablo Ruisoto*
Affiliation:
Universidad de Salamanca (Spain)
Raúl Cacho
Affiliation:
Universidad Pública de Navarra (Spain)
José J. López-Goñi
Affiliation:
Universidad Pública de Navarra (Spain)
Eulogio Real Deus
Affiliation:
Universidad de Santiago de Compostela (Spain)
Silvia Vaca
Affiliation:
Universidad Técnica Particular de Loja (Ecuador)
Paula Mayoral
Affiliation:
Universidad de Salamanca (Spain)
*
*Correspondence concerning this article should be addressed to Pablo Ruisoto. Department of Basic Psychology. Psychobiology and Methodology of Behavioral Sciences. Faculty of Psychology. Universidad de Salamanca. Avda. de la Merced, 109–131. 37007 Salamanca (Spain). Email. [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Some females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p < .05), but no gender differences were found in their degree of body thin internalization (p > .05), a key predictor of body dissatisfaction (r = .33; p < .01). Participants with higher BMI reported greater social pressure to be thin than those with lower BMI (p < .05). However, females engaged in dietary restraint, the main risk factor for eating disorders, regardless of their BMI (p > .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed.

Keywords

bulimia nervosadietingbody dissatisfactionStice
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 18 , 2015 , E72
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th Ed., Text Rev.). Washington, DC: Author Google Scholar
Andrés, A., & Saldaña, C. (2014). Body dissatisfaction and dietary restraint influence binge eating behavior. Nutrition Research, 34, 944–950. http://dx.doi.org/10.1016/j.nutres.2014.09.003 CrossRefGoogle ScholarPubMed
Batterink, L., Yokim, S., & Stice, E. (2010). Body mass correlates inversely with inhibitory control in response to food among adolescent girls: An fMRI study. Neuroimage, 52, 1696–1703. http://dx.doi.org/10.1016/j.neuroimage.2010.05.059 CrossRefGoogle ScholarPubMed
Bauer, S., Papezova, H., Chereches, R., Caselli, G., McLoughlin, O., Szumska, I.,... Moessner, M. (2013). Advances in the prevention and early intervention of eating disorders: The potential of Internet-delivered approaches. Mental Health & Prevention, 1, 26–32. http://dx.doi.org/10.1016/j.mhp.2013.10.003 CrossRefGoogle Scholar
Bohon, C., Stice, E., & Spoor, S. (2009). Female emotional eaters show abnormalities in consummatory and anticipatory food reward: A functional magnetic resonance imaging study. International Journal of Eating Disorders, 42, 210–221. http://dx.doi.org/10.1002/eat.20615 CrossRefGoogle ScholarPubMed
Brennan, M. A., Lalonde, C. E., & Bain, J. L. (2010). Body image perceptions: Do gender differences exist? Psi Chi Journal of Undergraduate Research, 15, 1089–4136.Google Scholar
Brumberg, J. J. (1997). The body project: An intimate history of American girls. New York, NY: Random House.Google Scholar
Brunson, J. A., Overup, C. S., Nguyen, M. L., Novak, S. A., & Smith, C. V. (2014). Good intentions gone awrey? Effects of weight-related social control on health and well being. Body Image, 11, 1–10. http://dx.doi.org/10.1016/j.bodyim.2013.08.003 CrossRefGoogle Scholar
Burger, K. S., & Stice, E. (2011). Relation of dietary restraint scores to activation of reward-related brain regions in response to food intake, anticipated intake, and food pictures. Neuroimage, 55, 233–239. http://dx.doi.org/10.1016/j.neuroimage.2010.12.009 CrossRefGoogle ScholarPubMed
Burger, K. S., & Stice, E. (2013). Elevated energy intake is correlated with hyperresponsivity in attentional, gustatory, and reward brain regions while anticipating palatable food receipt. The American Journal of Clinical Nutrition, 97, 1188–1194. http://dx.doi.org/10.3945/ajcn.112.055285 CrossRefGoogle ScholarPubMed
Burton, E., & Stice, E. (2006). Evaluation of a healthy-weight treatment program for bulimia nervosa: A preliminary randomized trial. Behaviour Research & Therapy, 44, 1727–1738. http://dx.doi.org/10.1016/j.brat.2005.12.008 CrossRefGoogle ScholarPubMed
Cash, T. F., Edwin, A., & Deagle, E. A. (1997). The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: A meta-analysis. International Journal of Eating Disorders, 22, 107–126. http://dx.doi.org/10.1002/(SICI)1098-108X(199709)22:2<107::AID-EAT1>3.0.CO;2-J 3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Cash, T. F., Winstead, B. A., & Janda, L. H. (1986). The great American shape-up; we're healthier than ever, fitter than ever … but less satisfied with how we look. Psychology Today, 20, 30–37.Google Scholar
Cogan, J. C., & Ernsberger, P. (1999). Dieting, weight, and health: Reconceptualizing research and policy. Journal of Social Issues, 55, 187–205. http://dx.doi.org/10.1111/0022-4537.00112 CrossRefGoogle Scholar
Cohane, G. H., & Pope, H. G. (2001). Body image in boys: A review of the literature. International Journal of Eating Disorders, 29, 373–379. http://dx.doi.org/10.1002/eat.1033 CrossRefGoogle Scholar
Collier, D. A., & Treasure, J. L. (2004). The etiology of eating disorders. The British Journal of Psychiatry, 185, 363–365. http://dx.doi.org/10.1192/bjp.185.5.363 CrossRefGoogle ScholarPubMed
Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The development and validation of the Body Shape Questionnaire. International Journal of Eating Disorders, 6, 485–494. http://dx.doi.org/10.1002/1098-108X(198707)6:4%3C485::AID-EAT2260060405%3E3.0.CO;2-O 3.0.CO;2-O>CrossRefGoogle Scholar
Drewnowski, A., & Yee, D. K. (1987). Men and body image: Are males satisfied with their body weight?. Psychosomatic Medicine, 49, 545–634. http://dx.doi.org/10.1097/00006842-198711000-00008 CrossRefGoogle ScholarPubMed
Fairburn, C. G., Agras, W. S., Walsh, B. T., Wilson, T., & Stice, E. (2004). Early change in treatment predicts outcome in bulimia nervosa. American Journal of Psychiatry, 161, 2322–2324. http://dx.doi.org/10.1176/appi.ajp.161.12.2322 CrossRefGoogle ScholarPubMed
Faravelli, C., Ravaldi, C., Truglia, E., Zucchi, T., Cosci, F., & Ricca, V. (2006). Clinical epidemiology of eating disorders: Results from the Sesto Fiorentino Study. Psychotherapy and Psychosomatics, 75, 376–383. http://dx.doi.org/10.1159/000095444 CrossRefGoogle ScholarPubMed
Fernández-Aranda, F., Dahme, B., & Meerman, R. (1999). Body image in eating disorders and analysis of its relevance: A preliminary study. Journal of psychosomatic research, 47, 419–428.CrossRefGoogle ScholarPubMed
Garner, D. M., Garfinkel, P. E., Schwartz, D., & Thompson, M. (1980). Cultural expectations of thinness in women. Psychological Reports, 47, 483–491. http://dx.doi.org/10.2466/pr0.1980.47.2.483 CrossRefGoogle ScholarPubMed
Gleaves, D. H., Brown, J. D., & Warren, C. S. (2004). The continuity/discontinuity models of eating disorders: A review of the literature and implications for assessment, treatment, and prevention. Behavior Modification, 28, 739–762. http://dx.doi.org/10.1177/0145445503259859 CrossRefGoogle ScholarPubMed
Goldfield, G. S., Blouin, A. G., & Woodside, D. B. (2006). Body image, binge eating, and bulimia nervosa in male bodybuilders. Canadian Journal of Psychiatry, 51, 160–168.CrossRefGoogle ScholarPubMed
Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders, 31(1), 1–16. http://dx.doi.org/10.1002/eat.10005 CrossRefGoogle ScholarPubMed
Halliwell, E., & Harvey, M. (2006). Examination of a sociocultural model of disordered eating among male and female adolescents. British Journal of Health Psychology, 11, 235–248. http://dx.doi.org/10.1348/135910705X39214 CrossRefGoogle ScholarPubMed
Keeton, W. P., Cash, T. F., & Brown, T. A. (1990). Body image or body images? Comparative, multidimensional assessment among college students. Journal of personality assessment. 54, 213–230. http://dx.doi.org/10.1207/s15327752jpa5401&2_21 CrossRefGoogle ScholarPubMed
Keys, A. (1950). The biology of human starvation. (Vol 1). Minneapolis, MN: University of Minnesota Press.CrossRefGoogle Scholar
Kim, S. F. (2012). Animal models of eating disorders. Neuroscience, 211, 2–12. http://dx.doi.org/10.1016/j.neuroscience.2012.03.024 CrossRefGoogle ScholarPubMed
Kostanski, M., & Gullone, E. (1998). Adolescent body image dissatisfaction: Relationship with self esteem, anxiety, and depression controlling for body mass. Journal of Child Psychology and Psychiatry, 39, 255–262. http://dx.doi.org/10.1111/1469-7610.00319 Google ScholarPubMed
Lavin, M. A., & Cash, T. F. (2000). Effects of exposure to information about appearance stereotyping and discrimination on women´s body images. International Journal of Eating Disorders, 29, 51–58.3.0.CO;2-Q>CrossRefGoogle Scholar
Lawler, M., & Nixon, E. (2011). Body dissatisfaction among adolescent boys and girls: The effects of body mass, peer appearance culture and internalization of appearance ideals. Journal of Youth Adolescence, 40(1), 59–71. http://dx.doi.org/10.1007/s10964-009-9500-2 CrossRefGoogle ScholarPubMed
Lunner, K., Wertherm, E. H., Thompson, J. K., Paxton, S. J., McDonald, S. J., & Halvaarson, K. S. (2000). A cross-cultural examination of weight-related teasing, body image, and eating disturbance in Swedish and Australian samples. International Journal of Eating Disorders, 28, 430–435. http://dx.doi.org/10.1002/1098-108X(200012)28:4%3C430::AID-EAT11%3E3.0.CO;2-Y 3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Mendes, V., Araújo, J., Lopes, C., & Ramos, E. (2014). Determinants of weight loss dieting among adolescents: A longitudinal analysis. Journal of Adolescent Health, 54, 360–363. http://dx.doi.org/10.1016/j.jadohealth.2013.12.003 CrossRefGoogle ScholarPubMed
Ng, J., Stice, E., Yokum, S., & Bohon, C. (2011). An fMRI study of obesity, food reward, and perceived caloric density. Does a low-fat label make food less appealing? Appetite, 57, 65–72. http://dx.doi.org/10.1016/j.appet.2011.03.017 CrossRefGoogle ScholarPubMed
Ouwens, M. A., van Strien, T., van Leeuwe, J. F. J., & van der Staak, C. P. F. (2009). The dual pathway model of overeating. Replication and extension with actual food consumption. Appetite, 52, 234–237. http://dx.doi.org/10.1016/j.appet.2008.07.010 CrossRefGoogle ScholarPubMed
Paxton, S. (1996). Friendship, body image and dieting in teenage girls: A research report. national eating disorder information centre. Toronto. Canada: National Eating Disorder Information Centre. Retrieved from http://nedic.ca/sites/default/files/friendship-body-image-dieting-teenage-girls-research-report.pdf Google Scholar
Presnell, K., & Stice, E. (2003). An experimental test of the effect of weight-loss dieting on bulimic pathology: Tipping the scales in a different direction. Journal of Abnormal Psychology, 112, 166–170.CrossRefGoogle Scholar
Presnell, K., Stice, E., & Tristan, J. (2008). An experimental investigation of the effects of naturalistic dieting on bulimic symptoms: Moderating effects of depressive symptoms. Appetite, 50, 91–101. http://dx.doi.org/10.1016/j.appet.2007.06.002 CrossRefGoogle ScholarPubMed
Raech, R., Mora, M., Soler, A., Ávila, C., Clos, I., & Zapater, L. (1996). Adaptación de un instrumento de evaluación de la insatisfacción corporal [Adaptation of a body image assessment instrument]. Clínica y Salud, 7, 51–66.Google Scholar
Rodin, J., Silberstein, L., & Striegel-Moore, R. (1985). Women and weight: A normative discontent. In Sonderegger, T. T. (Ed.), Psychology and gender: 1984 Nebraska Symposium Motivation (267–308). Lincoln, NE: University of Nebraska Press.Google Scholar
Sánchez-Carracedo, D., López-Guimerá, G., Fauquet, J., Barrada, J. R., Pámias, M., Puntí, J. … Trepat, E. (2013). A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary school adolescents: The MABOC study protocol. BMC Public Health, 13, 955.CrossRefGoogle ScholarPubMed
Shaw, H., Stice, E., & Becker, C. B. (2009). Preventing eating disorders. Child and Adolescent Psychiatric Clinics of North America, 18, 199–207. http://dx.doi.org/10.1016/j.chc.2008.07.012 CrossRefGoogle ScholarPubMed
Shepherd, H., & Ricciardelli, L. A. (1998). Test of Stice´s dual pathway model: Dietary restraint and negative affect as mediators of bulimic behavior. Behaviour Research and Therapy, 36, 345–352.CrossRefGoogle Scholar
Shroff, H., & Thompson, J. K. (2006). Peer influences, body-image dissatisfaction, eating dysfunction and self-esteem in adolescent girls. Journal of Health Psychology, 11, 533–551. http://dx.doi.org/10.1177/1359105306065015 CrossRefGoogle ScholarPubMed
Skrzypek, S., Wehmeier, P. M., & Remschmidt, H. (2001). Body image assessment using body size estimation in recent studies on anorexia nervosa. A brief review. European Child & Adolescent Psychiatry, 10, 215–221. http://dx.doi.org/10.1007/s007870170010 CrossRefGoogle ScholarPubMed
Slevec, J. H., & Tiggemann, M. (2011). Predictors of body dissatisfaction and disordered eating in middle-age women. Clinical Psychology Review, 31, 515–524. http://dx.doi.org/10.1016/j.cpr.2010.12.002 CrossRefGoogle Scholar
Stice, E. (1994). A review of the evidence for a sociocultural model of bulimia nervosa and a exploration of mechanisms of action. Clinical Psychology Review, 14, 633–661. http://dx.doi.org/10.1016/0272-7358(94)90002-7 CrossRefGoogle Scholar
Stice, E. (1998). Relations of restraint and negative affect to bulimic pathology: A longitudinal test of three competing models. International Journal of Eating Disorders, 23, 243–260. http://dx.doi.org/10.1002/(SICI)1098-108X(199804)23:3%3C243::AID-EAT2%3E3.0.CO;2-J 3.0.CO;2-J>CrossRefGoogle Scholar
Stice, E. (2001). A prospective test of the dual-pathway model of bulimic pathology: Mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124–135. http://dx.doi.org/10.1037/0021-843X.110.1.124 CrossRefGoogle ScholarPubMed
Stice, E., & Agras, W. S. (1998). Prospective relation of dieting behaviors to weight change in a community sample of adolescents. Behavior Therapy, 29, 277–276. http://dx.doi.org/10.1016/S0005-7894(98)80007-5 CrossRefGoogle Scholar
Stice, E., & Bearman, S. K. (2001). Body image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: A growth curve analysis. Developmental Psychology, 37, 597–607. http://dx.doi.org/10.1037//0012-1649.37.5.597 CrossRefGoogle ScholarPubMed
Stice, E., Becker, C., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. The International Journal of Eating Disorders, 46, 478–485. http://dx.doi.org/10.1002/eat.22105 CrossRefGoogle ScholarPubMed
Stice, E., Bohon, C., Marti, C. N., & Fischer, K. (2008). Subtyping women with bulimia nervosa along dietary and negative affect dimensions: Further evidence of reliability and validity. Journal of Consulting and Clinical Psychology, 76, 1022–1033. http://dx.doi.org/10.1037/a0013887 CrossRefGoogle ScholarPubMed
Stice, E., Burger, K., & Yokum, S. (2013). Caloric deprivation increases responsivity of attention and reward brain regions to intake, anticipated intake, and images of palatable foods. Neuroimage, 67, 322–330. http://dx.doi.org/10.1016/j.neuroimage.2012.11.028 CrossRefGoogle ScholarPubMed
Stice, E., Bytryn, M. L., Rohde, P., Shaw, H., & Marti, C. N. (2013). An effectiveness trial of a new enhanced dissonance eating disorder prevention program among female college students. Behavior Research and Therapy, 51, 862–871. http://dx.doi.org/10.1016/j.brat.2013.10.003 CrossRefGoogle ScholarPubMed
Stice, E., Davis, K., Miller, N. P., & Marti, C. N. (2008). Fasting increases risk for onset of binge eating and bulimic pathology: A 5-year prospective study. Journal of Abnormal Psychology, 117, 941–946. http://dx.doi.org/10.1037/a0013644 CrossRefGoogle Scholar
Stice, E., Durant, S., Burger, K. S., & Schoeller, D. A. (2011). Weight suppression and risk for future increases in body mass: Effects of suppressed resting metabolic rate and energy expenditure. American Journal of Clinical Nutrition, 94, 7–11. http://dx.doi.org/10.3945/ajcn.110.010025 CrossRefGoogle ScholarPubMed
Stice, E., & Fairburn, C. G. (2003). Dietary and dietary-depressive subtypes of bulimia nervosa show differential symptom presentation, social impairment, comorbidity, and course of illness. Journal of Consulting and Clinical Psychology, 71, 1090–1094. http://dx.doi.org/10.1037/0022-006X.71.6.1090 CrossRefGoogle ScholarPubMed
Stice, E., Marti, C. N., Shaw, H., & Jaconis, M. (2009). An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. Journal of Abnormal Psychology, 118, 587–597. http://dx.doi.org/10.1037/a0016481 CrossRefGoogle ScholarPubMed
Stice, E., Martinez, E., Presnell, K., & Groesz, L. (2006). Relation of successful dietary restriction to bulimic pathology: A prospective community-based study. Health Psychology, 25, 274–281.CrossRefGoogle Scholar
Stice, E., Maxfield, J., & Wells, T. (2003). Adverse effects of social pressure to be thin on young women: An experimental investigation of the effects of “fat talk”. International Journal of Eating Disorders, 34(1), 108–117. http://dx.doi.org/10.1002/eat.10171 CrossRefGoogle Scholar
Stice, E., & Presnell, K. (2007). The body project: promoting body acceptance and preventing eating disorders, facilitators guide. New York, NY: Oxford University Press.Google Scholar
Stice, E., Presnell, K., Groesz, L., & Shaw, H. (2005). Effects of a weight maintenance diet on bulimic pathology: An experimental test of the dietary restraint theory. Health Psychology, 24, 402–412.CrossRefGoogle Scholar
Stice, E., Pressnell, K., & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation. Health Psychology, 21, 131–138. http://dx.doi.org/10.1037/0278-6133.21.2.131 CrossRefGoogle ScholarPubMed
Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3, 207–231. http://dx.doi.org/10.1146/annurev.clinpsy.3.022806.091447 CrossRefGoogle ScholarPubMed
Stice, E., Spoor, S., Bohon, C., Veldhuizen, M. G., & Small, D. M. (2008). Relation of reward from food intake and anticipated intake to obesity: A functional magnetic resonance imaging study. Journal of Abnormal Psychology, 117, 924–935. http://dx.doi.org/10.1037/a0013600 CrossRefGoogle ScholarPubMed
Stice, E., Spoor, S., Ng, J., & Zald, D. H. (2009). Relation of obesity to consummatory and anticipatory food reward. Physiology and Behavior. 97, 551–560. http://dx.doi.org/10.1016/j.physbeh.2009.03.020 CrossRefGoogle ScholarPubMed
Stice, E., & Whitenton, K. (2002). Risk factors for body dissatisfaction in adolescent girls: A longitudinal investigation. Developmental Psychology, 38, 669–678. http://dx.doi.org/10.1037/0012-1649.38.5.669 CrossRefGoogle ScholarPubMed
Stice, E., Yokum, S., Blum, K., & Bohon, C. (2010). Weight gain associated with reduced striatal response to palatable food. Journal of Neuroscience, 30, 13105–13109. http://dx.doi.org/10.1523/JNEUROSCI.2105-10.2010 CrossRefGoogle ScholarPubMed
Stice, E., Yokum, S., Bohon, C., Marti, N., & Smolen, A. (2010). Reward circuitry responsivity predicts future increases in body mass: Moderating effects of DRD2 and DRD4. NeuroImage, 50, 1618–1625. http://dx.doi.org/10.1016/j.neuroimage.2010.01.081 CrossRefGoogle ScholarPubMed
Stice, E., Yokum, S., Burger, K. S., Epstein, L. H., & Small, D. M. (2011). Youth at risk for obesity show greater activation of striatal and somatosensory regions to food. Journal of Neuroscience, 31, 4360–4366. http://dx.doi.org/10.1523/JNEUROSCI.6604-10.2011 CrossRefGoogle ScholarPubMed
Tiggemann, M. (2000). Dieting and cognitive style. The role of current and past dieting behavior and cognitions. Journal of Health Psychology, 5(1), 17–24. http://dx.doi.org/10.1177/135910530000500106 CrossRefGoogle ScholarPubMed
Urquhart, C. S., & Mihalynuk, T. V. (2011). Disordered eating in women: implications for the obesity pandemy. Canadian Journal of Dietetic Practice and Research, 72(1), e115–e125. http://dx.doi.org/10.3148/72.1.2011.50 CrossRefGoogle Scholar
van Strien, T. (1996). On the relationship between dieting and "obese" and bulimic eating patterns. International Journal of Eating Disorders, 19(1), 83–92. http://dx.doi.org/10.1002/(SICI)1098-108X(199601)19:1<83::AID-EAT10>3.0.CO;2-R 3.0.CO;2-R>CrossRefGoogle ScholarPubMed
van Strien, T., Engels, R. C. M. E., van Leeuwe, J., & Snoek, H. M. (2005). The Stice model of overeating: Tests in clinical and non-clinical samples. Appetite, 45, 205–213. http://dx.doi.org/10.1016/j.appet.2005.08.004 CrossRefGoogle ScholarPubMed
Varsou, E. (2010). Eating disorders: A serious problem of mental health seeks solution. Pschiatrike, 21, 189–194.Google ScholarPubMed
WHO (n.d.) Body mass index – BMI. Copenhagen, Denmark: WHO. Retrieved from http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi Google Scholar
Yokum, S., Ng, J., & Stice, E. (2011). Attentional bias for food images associated with elevated weight and future weight gain: An fMRI study. Obesity, 19, 1775–1783. http://dx.doi.org/10.1038/oby.2011.168 CrossRefGoogle ScholarPubMed
Zaccagni, L., Masotti, S., Donati, R., Mazzoni, G., & Gualdi-Russo, E. (2014). Body image and weight perceptions in relation to actual measurements by means of a new index and level of physical activity in Italian university students. Journal of Translational Medicine, 12, 1–8. http://dx.doi.org/10.1186/1479-5876-12-42 CrossRefGoogle ScholarPubMed