THE ROLE OF SOCIAL PHYSIQUE ANXIETY IN THE DEVELOPMENT OF DISORDERED EATING ATTITUDES AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY
Yıl 2024,
Cilt: 10 Sayı: 1, 237 - 255, 15.05.2024
Ersin Uskun
,
Kıymet Batmaz
,
Mustafa Develi
,
Özgür Önal
,
Ahmet Nesimi Kişioğlu
Öz
Amidst the growing prevalence of disordered eating attitudes among young adults, the impact of social physique anxiety on such behaviors has garnered increasing attention. The aim of this study is to determine the prevalence of disordered eating attitudes and to investigate the effect of social physical anxiety on disordered eating attitudes among students of a university located in the Mediterranean Region of Turkey. The population of this cross-sectional study consists of the students of the central campus of a university located in Mediterranean Region of Turkey (N: 33216). The sample size was 768. The Social Physique Anxiety Inventory and Eating Attitude Test-26 questionnaires were used for data collection in the study, with the Chi-square test, Mann-Whitney-U test, and logistic regression analyses used for statistical analysis. The rate of eating attitude disorder is 15.2 in the study population. Increasing social physique anxiety increases eating attitude disorder as a predictor (β=1.15; p<.001). The prevalence of eating attitude disorder determined in this study is relatively lower than in the literature. Study findings highlight the significant role that social physique anxiety plays in the development of disordered eating attitudes and emphasize the importance of exploring prevention strategies to promote healthier eating habits and a positive body image.
Destekleyen Kurum
The authors received no financial support for the research, authorship, and/or publication of this article.
Teşekkür
The authors would like to thank all participants for their help in the study.
Kaynakça
- 1. Becker AE, Grinspoon SK, Klibanski A, Herzog DB. Eating disorders. N Engl J Med. 1999;340:1092-1098. (PMID: 10194240)
- 2. Pritts SD, Susman J. Diagnosis of eating disorders in primary care. Am Fam Physician. 2003;67:297-304. (PMID: 12562151)
- 3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA, US: American Psychiatric Publishing, Inc., 2013.
- 4. van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021 Nov 1;34:515-524. (PMID: 34419970)
- 5. Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9:273-279. (PMID: 472072)
- 6. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12:871-8. (PMID: 6961471)
- 7. Savasir I, Erol N. Eating attitude test: Index of symptoms of anorexia nervosa (in Turkish). Turk J Psychol. 1989;7:19-25.
- 8. Erguney-Okumus FE, Sertel-Berk HO. The Psychometric properties of The Eating Attitudes Test Short Form (EAT-26) in a college sample (in Turkish). Studies in Psychology 2020;40:57-78.
- 9. Hart EA, Leary MR, Rejeski WJ. Tie Measurement of Social Physique Anxiety. J Sport Exerc Psychol. 1989;11:94-104.
- 10. Lantz C, Hardy C, Ainsworth B. Social Physique Anxiety and Perceived Exercise Behaviour. J Sport Behav. 1997;20: 83–93.
- 11. Linardon J, Braithwaite R, Cousins R, Brennan L. Appearance-based rejection sensitivity as a mediator of the relationship between symptoms of social anxiety and disordered eating cognitions and behaviors. Eat Behav. 2017;27:27-32. (PMID: 29112884)
- 12. Tayhan Kartal F, Kabakuş Aykut M. Üniversite öğrencilerinde sosyal fizik kaygısı ve depresyonun yeme bozukluğu riski ile ilişkisi. Beslenme ve Diyet Dergisi. 2019; 47: 20-29.
- 13. Bundros J, Clifford D, Silliman K, Neyman Morris M. Prevalence of Orthorexia nervosa among college students based on Bratman's test and associated tendencies. Appetite 2016;101:86-94. (PMID: 26923745)
- 14. Vaquero-Cristóbal R, Alacid F, Muyor JM, López-Miñarro PÁ. Body image; literature review. Nutr Hosp. 2013;28:27-35. (PMID: 23808427)
- 15. Alsheweir A, Goyder E, Alnooh G, Caton SJ. Prevalence of Eating Disorders and Disordered Eating Behaviours amongst Adolescents and Young Adults in Saudi Arabia: A Systematic Review. Nutrients. 2023;15:4643. (PMID: 37960296)
- 16. Azzeh M, Peachey G, Loney T. Prevalence of High-Risk Disordered Eating Amongst Adolescents and Young Adults in the Middle East: A Scoping Review. Int J Environ Res Public Health. 2022;19:5234. (PMID: 35564636)
- 17. El Shikieri AB. The prevalence and nutritional status of adolescent Saudi girls with disordered eating. J Nutr Sci. 2022;11:e71. (PMID: 36106089)
- 18. Loni SB, Sami W, Abd-Elhaleem ZA, Ejiel MMNI, Gadir GAGMA, Khan MO. Prevalence of Eating Disorders among Students of Health Science Colleges in Majamaah University, Saudi Arabia. Pak J Med Health Sci. 2022;16:1323-1328.
- 19. Budhiwianto S, Bennett CJ, Bristow CA, Dart J. Global Prevalence of Eating Disorders in Nutrition and Dietetic University Students: A Systematic Scoping Review. Nutrients. 2023;15:2317. (PMID: 37242199)
- 20. Parker SC, Lyons J, Bonner J. Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool. J Am Coll Health. 2005;54:103-107. (PMID: 16255322)
- 21. Lanfranchi MC, Maïano C, Morin AJ, Therme P. Social physique anxiety and disturbed eating attitudes and behaviors in adolescents: moderating effects of sport, sport-related characteristics, and gender. Int J Behav Med. 2015;22:149-160. (PMID: 24683055)
- 22. Levinson CA, Rodebaugh TL. Social anxiety and eating disorder comorbidity: the role of negative social evaluation fears. Eat Behav. 2012;13:27-35. (PMID: 22177392)
- 23. Dean A, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health. Version 2.3.1., 2013.
- 24. World Health Organization. A healthy lifestyle - WHO recommendations. Last Modified [6 May 2010]. Accessed date: [27 October 2022]. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendation
- 25. Mulazimoglu Balli O, Asci FH. Sosyal Fizik Kaygı Envanteri’nin geçerlik ve güvenirlik çalışması. Spor Bilimleri Dergisi 2006;17:11-19.
- 26. Hagger MS, Aşçi FH, Lindwall M, Hein V, Mülazimoğlu-Balli O, Tarrant M, et. al. Cross-cultural validity and measurement invariance of the social physique anxiety scale in five European nations. Scand J Med Sci Sports. 2007;17:703-19. (PMID: 17346291)
27. IBM Corp Released. IBM SPSS Statistics for Windows, Version 22.0. NY: IBM Corp., 2013.
- 28. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates Publishers; 1988.
- 29. Field A. Discovering Statistics Using SPSS. 3rd ed. London: Sage Publications Ltd., 2009.
- 30. Johnston R, Jones K, Manley D. Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual Quant. 2018;52:1957-1976. (PMID: 29937587)
- 31. Hayran M, Hayran M. Basic statistics for health research. 3rd ed. Ankara: Omega Research Organization Education Consultancy, 2020.
- 32. Jahrami H, Sater M, Abdulla A, Faris MA, AlAnsari A. Eating disorders risk among medical students: a global systematic review and meta-analysis. Eat Weight Disord. 2019;24:397-410. (PMID: 29785631)
- 33. Trindade AP, Appolinario JC, Mattos P, Treasure J, Nazar BP. Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis. Braz J Psychiatry. 2019;41:179-187. (PMID: 30328965)
- 34. Caferoglu Z, Toklu H. Intuitive eating: associations with body weight status and eating attitudes in dietetic majors. Eat Weight Disord. 2022;27:683-692. (PMID: 33978953)
- 35. Ayran G, Süleyman Z, Avcı Ü, Arık U. The effect of Internet addiction on eating attitude and body image in university students. J Child Adolesc Psychiatr Nurs. 2021;34:199-205. (PMID: 33949745)
- 36. Sanlier N, Navruz Varli S, Macit MS, Mortas H, Tatar T. Evaluation of disordered eating tendencies in young adults. Eat Weight Disord. 2017 Dec;22:623-631. (PMID: 28871480)
37. Baş M, Karabudak E, Kiziltan G. Vegetarianism a
nd eating disorders: association between eating attitudes and other psychological factors among Turkish adolescents. Appetite. 2005;44:309-315. (PMID: 15927731)
- 38. Gargari BP, Khadem-Haghighian M, Taklifi E, Hamed-Behzad M, Shahraki M. Eating attitudes, self-esteem and social physique anxiety among Iranian females who participate in fitness programs. J Sports Med Phys Fitness. 2010;50:79-84. (PMID: 20308977)
- 39. Haase AM, Prapavessis H. Social physique anxiety and eating attitudes in female athletic and non-athletic groups. J Sci Med Sport. 2001;4:396-405. (PMID: 11905934)
- 40. Poínhos R, Oliveira BM, Correia F. Eating behavior in Portuguese higher education students: the effect of social desirability. Nutrition. 2015;31:310-314. (PMID: 25592009)
- 41. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17:941-964. (PMID: 19165161)
- 42. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100:1019-1028. (PMID: 20075322)
- 43. Kass AE, Jones M, Kolko RP, Altman M, Fitzsimmons-Craft EE, Eichen DM, et. al. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses. Eat Behav. 2017;25:74-80. (PMID: 27090854)
- 44. Lipson SK, Sonneville KR. Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities. Eat Behav. 2017;24:81-88. (PMID: 28040637)
- 45. Rouzitalab T, Pourghassem Gargari B, Amirsasan R, Asghari Jafarabadi M, Farsad Naeimi A, Sanoobar M. The Relationship of Disordered Eating Attitudes With Body Composition and Anthropometric Indices in Physical Education Students. Iran Red Crescent Med J. 2015;17:e20727. (PMID: 26734482)
- 46. Thielemann D, Richter F, Strauss B, Braehler E, Altmann U, Berger U. Differential item functioning in brief instruments of disordered eating. Eur J Psychol Assess. 2019;35:823-833.
- 47. Desai MN, Miller WC, Staples B, Bravender T. Risk factors associated with overweight and obesity in college students. J Am Coll Health. 2008;57:109-114. (PMID: 18682353)
- 48. Mason TB, Smith KE, Crosby RD, Engel SG, Wonderlich SA. Examination of momentary maintenance factors and eating disorder behaviors and cognitions using ecological momentary assessment. Eat Disord. 2021;29:42-55. (PMID: 31081472)
- 49. Sharpe H, Griffiths S, Choo TH, Eisenberg ME, Mitchison D, Wall M, et al. The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. Int J Eat Disord. 2018;51:1168-1175. (PMID: 30194690)
- 50. Jones N, Rogers PJ. Preoccupation, food, and failure: an investigation of cognitive performance deficits in dieters. Int J Eat Disord. 2003;33:185-92. (PMID: 12616585)
- 51. Zmijewski CF, Howard MO. Exercise dependence and attitudes toward eating among young adults. Eat Behav. 2003;4:181-195. (PMID: 15000981)
- 52. Thome J, Espelage DL. Relations among exercise, coping, disordered eating, and psychological health among college students. Eat Behav. 2004;5:337-351. (PMID: 15488448)
ÜNİVERSİTE ÖĞRENCİLERİNDE BOZUK YEMEK TUTUMUNUN GELİŞİMİNDE SOSYAL FİZİK KAYGININ ROLÜ: KESİTSEL BİR ÇALIŞMA
Yıl 2024,
Cilt: 10 Sayı: 1, 237 - 255, 15.05.2024
Ersin Uskun
,
Kıymet Batmaz
,
Mustafa Develi
,
Özgür Önal
,
Ahmet Nesimi Kişioğlu
Öz
Genç yetişkinler arasında düzensiz yeme tutumlarının artan yaygınlığı ve sosyal fiziksel kaygının bu tür davranışlar üzerindeki etkisi artan bir ilgi toplamıştır. Bu çalışmanın amacı, Türkiye'nin Akdeniz Bölgesinde bulunan bir üniversitenin öğrencilerinde düzensiz yeme tutumu prevalansını belirlemek ve sosyal fiziksel kaygının düzensiz yeme tutumu üzerindeki etkisini incelemektir. Kesitsel tipteki bu araştırmanın evrenini üniversitenin merkez yerleşkesindeki öğrenciler oluşturmaktadır (N: 33216). Hesaplanan örneklem büyüklüğü 768'dir. Araştırmada veri toplama aracı olarak Sosyal Fizik Kaygı Envanteri ve Yeme Tutumu Testi-26 anketi, istatistiksel analiz için Ki-kare testi, Mann-Whitney-U testi ve lojistik regresyon analizleri kullanılmıştır. Çalışma popülasyonunda yeme tutum bozukluğu prevlanası %15.2'dir. Artan sosyal fizik kaygı, yeme tutum bozukluğunun yordayıcısıdır ve yeme tutum bozukluğunu artırıcı etki göstermektedir (β=1.15; p<0.001). Bu çalışmada belirlenen yeme tutum bozukluğunun yaygınlığı literatüre göre görece daha düşüktür. Çalışma bulguları, sosyal fiziksel kaygının düzensiz yeme tutumunun gelişiminde oynadığı önemli rolü vurgulamaktadır ve daha sağlıklı beslenme alışkanlıklarını ve olumlu bir vücut imajını teşvik etmek için önleme stratejilerini keşfetmenin önemini ortaya çıkmıştır.
Kaynakça
- 1. Becker AE, Grinspoon SK, Klibanski A, Herzog DB. Eating disorders. N Engl J Med. 1999;340:1092-1098. (PMID: 10194240)
- 2. Pritts SD, Susman J. Diagnosis of eating disorders in primary care. Am Fam Physician. 2003;67:297-304. (PMID: 12562151)
- 3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA, US: American Psychiatric Publishing, Inc., 2013.
- 4. van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021 Nov 1;34:515-524. (PMID: 34419970)
- 5. Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9:273-279. (PMID: 472072)
- 6. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12:871-8. (PMID: 6961471)
- 7. Savasir I, Erol N. Eating attitude test: Index of symptoms of anorexia nervosa (in Turkish). Turk J Psychol. 1989;7:19-25.
- 8. Erguney-Okumus FE, Sertel-Berk HO. The Psychometric properties of The Eating Attitudes Test Short Form (EAT-26) in a college sample (in Turkish). Studies in Psychology 2020;40:57-78.
- 9. Hart EA, Leary MR, Rejeski WJ. Tie Measurement of Social Physique Anxiety. J Sport Exerc Psychol. 1989;11:94-104.
- 10. Lantz C, Hardy C, Ainsworth B. Social Physique Anxiety and Perceived Exercise Behaviour. J Sport Behav. 1997;20: 83–93.
- 11. Linardon J, Braithwaite R, Cousins R, Brennan L. Appearance-based rejection sensitivity as a mediator of the relationship between symptoms of social anxiety and disordered eating cognitions and behaviors. Eat Behav. 2017;27:27-32. (PMID: 29112884)
- 12. Tayhan Kartal F, Kabakuş Aykut M. Üniversite öğrencilerinde sosyal fizik kaygısı ve depresyonun yeme bozukluğu riski ile ilişkisi. Beslenme ve Diyet Dergisi. 2019; 47: 20-29.
- 13. Bundros J, Clifford D, Silliman K, Neyman Morris M. Prevalence of Orthorexia nervosa among college students based on Bratman's test and associated tendencies. Appetite 2016;101:86-94. (PMID: 26923745)
- 14. Vaquero-Cristóbal R, Alacid F, Muyor JM, López-Miñarro PÁ. Body image; literature review. Nutr Hosp. 2013;28:27-35. (PMID: 23808427)
- 15. Alsheweir A, Goyder E, Alnooh G, Caton SJ. Prevalence of Eating Disorders and Disordered Eating Behaviours amongst Adolescents and Young Adults in Saudi Arabia: A Systematic Review. Nutrients. 2023;15:4643. (PMID: 37960296)
- 16. Azzeh M, Peachey G, Loney T. Prevalence of High-Risk Disordered Eating Amongst Adolescents and Young Adults in the Middle East: A Scoping Review. Int J Environ Res Public Health. 2022;19:5234. (PMID: 35564636)
- 17. El Shikieri AB. The prevalence and nutritional status of adolescent Saudi girls with disordered eating. J Nutr Sci. 2022;11:e71. (PMID: 36106089)
- 18. Loni SB, Sami W, Abd-Elhaleem ZA, Ejiel MMNI, Gadir GAGMA, Khan MO. Prevalence of Eating Disorders among Students of Health Science Colleges in Majamaah University, Saudi Arabia. Pak J Med Health Sci. 2022;16:1323-1328.
- 19. Budhiwianto S, Bennett CJ, Bristow CA, Dart J. Global Prevalence of Eating Disorders in Nutrition and Dietetic University Students: A Systematic Scoping Review. Nutrients. 2023;15:2317. (PMID: 37242199)
- 20. Parker SC, Lyons J, Bonner J. Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool. J Am Coll Health. 2005;54:103-107. (PMID: 16255322)
- 21. Lanfranchi MC, Maïano C, Morin AJ, Therme P. Social physique anxiety and disturbed eating attitudes and behaviors in adolescents: moderating effects of sport, sport-related characteristics, and gender. Int J Behav Med. 2015;22:149-160. (PMID: 24683055)
- 22. Levinson CA, Rodebaugh TL. Social anxiety and eating disorder comorbidity: the role of negative social evaluation fears. Eat Behav. 2012;13:27-35. (PMID: 22177392)
- 23. Dean A, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health. Version 2.3.1., 2013.
- 24. World Health Organization. A healthy lifestyle - WHO recommendations. Last Modified [6 May 2010]. Accessed date: [27 October 2022]. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendation
- 25. Mulazimoglu Balli O, Asci FH. Sosyal Fizik Kaygı Envanteri’nin geçerlik ve güvenirlik çalışması. Spor Bilimleri Dergisi 2006;17:11-19.
- 26. Hagger MS, Aşçi FH, Lindwall M, Hein V, Mülazimoğlu-Balli O, Tarrant M, et. al. Cross-cultural validity and measurement invariance of the social physique anxiety scale in five European nations. Scand J Med Sci Sports. 2007;17:703-19. (PMID: 17346291)
27. IBM Corp Released. IBM SPSS Statistics for Windows, Version 22.0. NY: IBM Corp., 2013.
- 28. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates Publishers; 1988.
- 29. Field A. Discovering Statistics Using SPSS. 3rd ed. London: Sage Publications Ltd., 2009.
- 30. Johnston R, Jones K, Manley D. Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual Quant. 2018;52:1957-1976. (PMID: 29937587)
- 31. Hayran M, Hayran M. Basic statistics for health research. 3rd ed. Ankara: Omega Research Organization Education Consultancy, 2020.
- 32. Jahrami H, Sater M, Abdulla A, Faris MA, AlAnsari A. Eating disorders risk among medical students: a global systematic review and meta-analysis. Eat Weight Disord. 2019;24:397-410. (PMID: 29785631)
- 33. Trindade AP, Appolinario JC, Mattos P, Treasure J, Nazar BP. Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis. Braz J Psychiatry. 2019;41:179-187. (PMID: 30328965)
- 34. Caferoglu Z, Toklu H. Intuitive eating: associations with body weight status and eating attitudes in dietetic majors. Eat Weight Disord. 2022;27:683-692. (PMID: 33978953)
- 35. Ayran G, Süleyman Z, Avcı Ü, Arık U. The effect of Internet addiction on eating attitude and body image in university students. J Child Adolesc Psychiatr Nurs. 2021;34:199-205. (PMID: 33949745)
- 36. Sanlier N, Navruz Varli S, Macit MS, Mortas H, Tatar T. Evaluation of disordered eating tendencies in young adults. Eat Weight Disord. 2017 Dec;22:623-631. (PMID: 28871480)
37. Baş M, Karabudak E, Kiziltan G. Vegetarianism a
nd eating disorders: association between eating attitudes and other psychological factors among Turkish adolescents. Appetite. 2005;44:309-315. (PMID: 15927731)
- 38. Gargari BP, Khadem-Haghighian M, Taklifi E, Hamed-Behzad M, Shahraki M. Eating attitudes, self-esteem and social physique anxiety among Iranian females who participate in fitness programs. J Sports Med Phys Fitness. 2010;50:79-84. (PMID: 20308977)
- 39. Haase AM, Prapavessis H. Social physique anxiety and eating attitudes in female athletic and non-athletic groups. J Sci Med Sport. 2001;4:396-405. (PMID: 11905934)
- 40. Poínhos R, Oliveira BM, Correia F. Eating behavior in Portuguese higher education students: the effect of social desirability. Nutrition. 2015;31:310-314. (PMID: 25592009)
- 41. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17:941-964. (PMID: 19165161)
- 42. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100:1019-1028. (PMID: 20075322)
- 43. Kass AE, Jones M, Kolko RP, Altman M, Fitzsimmons-Craft EE, Eichen DM, et. al. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses. Eat Behav. 2017;25:74-80. (PMID: 27090854)
- 44. Lipson SK, Sonneville KR. Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities. Eat Behav. 2017;24:81-88. (PMID: 28040637)
- 45. Rouzitalab T, Pourghassem Gargari B, Amirsasan R, Asghari Jafarabadi M, Farsad Naeimi A, Sanoobar M. The Relationship of Disordered Eating Attitudes With Body Composition and Anthropometric Indices in Physical Education Students. Iran Red Crescent Med J. 2015;17:e20727. (PMID: 26734482)
- 46. Thielemann D, Richter F, Strauss B, Braehler E, Altmann U, Berger U. Differential item functioning in brief instruments of disordered eating. Eur J Psychol Assess. 2019;35:823-833.
- 47. Desai MN, Miller WC, Staples B, Bravender T. Risk factors associated with overweight and obesity in college students. J Am Coll Health. 2008;57:109-114. (PMID: 18682353)
- 48. Mason TB, Smith KE, Crosby RD, Engel SG, Wonderlich SA. Examination of momentary maintenance factors and eating disorder behaviors and cognitions using ecological momentary assessment. Eat Disord. 2021;29:42-55. (PMID: 31081472)
- 49. Sharpe H, Griffiths S, Choo TH, Eisenberg ME, Mitchison D, Wall M, et al. The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. Int J Eat Disord. 2018;51:1168-1175. (PMID: 30194690)
- 50. Jones N, Rogers PJ. Preoccupation, food, and failure: an investigation of cognitive performance deficits in dieters. Int J Eat Disord. 2003;33:185-92. (PMID: 12616585)
- 51. Zmijewski CF, Howard MO. Exercise dependence and attitudes toward eating among young adults. Eat Behav. 2003;4:181-195. (PMID: 15000981)
- 52. Thome J, Espelage DL. Relations among exercise, coping, disordered eating, and psychological health among college students. Eat Behav. 2004;5:337-351. (PMID: 15488448)