Body image is a multidimensional construct that has been found to affect psychosocial functioning throughout the lifetime. Some degree of body image dissatisfaction has been found to be a common aspect of the female experience. The aim of this study is to find out if there exists a correlation between body image dissatisfaction and eating attitudes in undergraduate college girls. This topic was chosen by the researcher due to the growing concerns over body image dissatisfaction, weight pre-occupation and the ill-conceived measures taken to control weight such as crash dieting especially amongst girls in late teens. A total of 45 participants were chosen for the purpose of this study. The research instruments used are the 34-item Body Shape Questionnaire (BSQ), which is used to assess the body shape dissatisfaction and the Eating Attitudes test -26 (EAT-26), used for assessing the eating behaviour. The result of this study proves that there is an insignificant correlation between Body Image Dissatisfaction and Eating Attitudes. Nonetheless, the study shows that a disturbing trend of eating habits is evolving among the participants, which may later develop into an eating disorder. In course of answering the questionnaires, the participants became aware of their eating behaviour and body image perception, which can lead them towards healthy eating habits and body image.
Keywords : Body Image, Eating Attitudes, Undergraduate Students
CORRELATION BETWEEN BODY IMAGE DISSATISFACTION AND EATING ATTITUDES
Body image is a multidimensional construct that has been found to affect psychosocial functioning throughout the lifetime (Cash & Pruzinsky, 2002). There have been numerous studies in relation to body image and self esteem, self confidence. Although some degree of body image dissatisfaction has been found to be a common aspect of the female experience, research suggests that a disturbance in body image can result in a number of clinical complications, including the development of an eating disorder (ED; Rosen, 1990).
Body image has been defined as a person’s subjective concept of his or her physical appearance. Garner (1981) defined body image to include both a self-perceptual component of what we see or think we see in size, shape, weight, feature, movement and performance, and an attitudinal and affective component of how we feel about those attributes and how our feelings motivate certain behaviours. Cash and Pruzinsky (2002) specify the current cognitive behavioural position that body image is a multifaceted experience including three components: 1) an individual’s perceptions of her body, 2) her attitude toward those perceptions, and 3) her overt behaviour in response to those perceptions (c.f., Banfield & McCabe, 2002). Usually women are more concerned about their body image than men (Cash, Morrow, Perry, and Hrabosky, 2004). Two problem patterns are associated with body image – dissatisfaction and distortion.
Body Image as a Construct
Body image is a perception formed from experiences we have with parents, role models, and peers who give us an idea of what it is like to love and value a body. The body encompasses physical appearance, size, and shape. The image is formed by positive or negative feedback given by people whose opinions are important to us. Body image can impact the way an individual perceives their body, attitudes and feelings towards their body, and the behaviors that affect their body.
Body image is viewed as a “loose mental representation of body shape, size, and form which is influenced by a variety of historical, cultural, and social, individual, and biological factors, that operate over varying time spans” (Slade, 1994:p.497). In general, body image is one’s attitude towards one’s body, particularly size, shape, and aesthetics; it also refers to an individual’s evaluations and affective experiences regarding their physical attributes. As a result of body image being based on feelings, our behavior is directly governed by our perceptions, feelings, and beliefs and is the result of our decision-making. (Cash, 1990)
History of Body Image
Our body today is believed to be the way a woman can express who she is to the world and the way her identity is portrayed. Before the twentieth century, Girls did not organize their thinking around their bodies; but today they are worrying about the contour of their body because they believe it is the ultimate expression of themselves (Brumberg, 1997). These same women were dressing themselves in corsets as a symbol of external control over their bodies (Brumberg, 1997). Today our generation has turned the focus inward and our relationships with our bodies are the signal of how far we still have to go (Edut, 2000). Not only the way we treat our bodies, but the role of our bodies permeates our being and determines the direction of our lives.
After World War I, American culture became one of the pinnacle eras with the rise of radio, film, television, telephone, and electricity. This was the time when women sensed freedom and began to “unveil” their bodies. The cultural and psychological change from external to internal control of the body resulted from a societal transformation that moved from agrarian to industrial society and from a conservative and religious to a secular world (Brumberg, 1997).
The late twentieth century became a pop driven culture based on the fact that females’ activism was directed at our most visible “oppressors” like the media and entertainment industries (Edut, 2000). Movies and magazines began to influence a woman’s body image by creating a visual for women to model their appearance leading them to worry about the way they “looked”. Women began to use their appearance through clothing, body image, and make up top express their inner convictions, pride, affiliations, identities, insecurities, and other weaknesses (Edut, 2000). By increasing the attention to their bodies, this made the body into a project (Brumberg, 1997). The body has become a project not based on accident or curiosity; but rather, a symptom of historical changes that are only the beginning (Brumberg, 1997).
Dimensions of Body Image Disturbance
Body image can become problematic when it is inaccurate, distressing and/or disruptive to other areas of functioning (see Thompson et al., 1999 for a review). Typically referred to as a body image disturbance, such problems in all three dimensions of body image-perception, attitude, and behavior-have been investigated (Cash, 2002; Thompson et al., 1999).
Perceptual Dimension: Body Image Distortion
Disturbance in the perceptual dimension of body image typically involves overestimation of the size of the body or certain body parts (Farrell, Lee, & Shafran, 2005). However, it can also include misperception of the shape or placement of a body part, or an overestimation of the salience of some characteristic of the body or body part. For example, an individual might perceive her eyes as being abnormally far apart, or the dryness of her skin being particularly noticeable. Current research in the area of body image distortion is based on the idea that perception is influenced both by sensory input and nonsensory input (i.e., cognition and affect; Smeets, Ingleby, Hoek, & Panhuysen, 1999).
Attitudinal Dimension: Dissatisfaction and Investment
Body image dissatisfaction. Disturbance to the attitudinal dimension involves a negative evaluation of the body perception (Cash, 2002). This is often referred to as body image dissatisfaction. In this case, the individual evaluates her body as “bad” or “ugly.” An individual might experience body image dissatisfaction with respect to her overall appearance. For example an individual might express simply, “I hate the way I look.”
Body image investment. Recently, the attitudinal dimension has been expanded to include body image investment (see Cash & Labarge, 1996). Individuals with negative body image differ in the degree to which they hold these evaluations as important. From this perspective, it is not just the valence of the evaluation, but also the level of importance that causes disruption (Geller et al., 1998; Goldfein et al., 2000). This emphasis on the individual’s relationship with body image dissatisfaction parallels a broad shift in cognitive-behavioral models of anxiety and depression to emphasize individuals’ relationships to negative cognitions rather than the content, rationality, or accuracy of the cognition (e.g., Teasdale et al., 2000; Wells, 1995).
Behavioral Dimension: Body Image Avoidance
Another dimension of body image includes the overt behaviors exhibited to change, reduce or escape negative body perceptions and evaluations. Disturbance in the behavioral dimension is typically considered to include body avoidance, body grooming and body checking (Rosen, 1997). Body avoidance includes avoidance of both perceiving the body and of letting the body be perceived (Rosen, Srebnik, Saltzberg, & Wendt, 1991). For example, an individual might consistently dress in clothes that are baggy, neutrally colored, or fully covering in order to hide her body from herself and others. She also might cover mirrors and avoid reflective surfaces. Body grooming involves engaging in activities designed to improve one’s appearance (Grant & Phillips, 2005). In this case, the focus is on avoidance of a particular defect being observed. For example, an individual might engage in a particularly lengthy ritual of makeup application and hair styling. Body checking involves repeatedly examining one’s appearance in order to detect and correct perceived problems (Reas, Whisenhunt, Netmeyer, & Williamson, 2002). Some have noted that dysphoria seems to increase following most instances of body checking (Shafran et al., 2004).
Difficulties Associated with Body Image Disturbance
Associated Psychological Difficulties
Body image disturbance is associated with a range of psychological difficulties. It has been investigated most commonly in the context of body dysmorphic disorder and eating disorders.
Body dysmorphic disorder: Sometimes, body image disturbance is disruptive enough to an individual’s life, independent of other psychological difficulties, to warrant a diagnosis of body dysmorphic diosrder (BDD; see American Psychiatric Association, 2000). BDD can involve preoccupation with any aspect of appearance, but is most commonly associated focused facial features (Phillips, 1991). Individuals diagnosed with BDD are preoccupied with a particular flaw in their appearance, sometimes allowing obsessions about the flaw to take up 3-8 hours a day (Phillips, 2004). In addition, grooming, mirror checking, camouflaging, clothes changing, and other forms of avoidance behavior related to the perceived bodily flaw are persistent and difficult to control (Phillips, 2004). The critical feature of BDD is not whether others observe the flaw in appearance, but whether the distress caused by the problem results in functional impairment.
Eating disorders: Diagnostic criteria for both anorexia nervosa and bulimia nervosa include body image disturbance (American Psychiatric Association, 2000). Individuals diagnosed with eating disorders are similar to individuals diagnosed with BDD on levels of preoccupation with appearance, dissatisfaction with appearance, and body checking (Rosen & Ramirez, 1998; c.f., Hrabosky et al., 2009). Conceptualizations of eating disorders have long pointed to body image as a primary precursor for disordered eating (e.g., Bruch, 1962; Rosen, 1992; Slade, 1982; Thompson, 1992). Meta-analytic reviews support these theories, demonstrating the important role of body image in both the development and maintenance of disordered eating (see Stice & Shaw, 2002 for a review).
Anxiety disorders: For many individuals, body image disturbance is associated with excessive anxiety. BDD is overrepresented in samples of individuals diagnosed with obsessive-compulsive disorder (Phillips & Castle, 2002; Simeon et al., 1995). Body image disturbance is also associated with social anxiety (Leary & Kolwalski, 1995). Body image disturbance is associated with social-evaluative anxiety for both sexes, and with romantic intimacy anxiety for women (Cash, Theriault & Annis, 2004). Additionally, social anxiety seems to be an important both with respect to trait-like difficulties with body image (e.g., Cash & Labarge, 1996) and with respect to temporary fluctuations in body image (Cash, Theriault, & Annis, 2004).
Mood disorders: Body image disturbance has also been found to predict depressive symptoms (e.g., Armatas et al., 2003; Downs et al., 2008; Forrest & Stuhldreher, 2007; Stice & Hayward, 2000), even when controlling for the effects of body mass and disordered eating (Denniston, Roth, & Gilroy, 1992). In addition, there is some evidence to suggest that body image disturbance contributes to depression symptoms to a greater extent than depression contributes to body image disturbance (Ebbeck, Watkins, Concepcion, Cardinal, & Hammermeister, 2009)
Personality disorders: In a small sample of individuals diagnosed with BDD, 87% met criteria for a personality disorder, and 53% met criteria for more than 1 (Cohen et al., 2000). Most of the impairments observed have been in cluster C, although much of the research has focused on comorbidity with borderline traits (Cohen et al., 2000; Phillips & McElroy, 2000). BDD may be associated with increased pathology in personality disorder samples. For example, Semiz and colleagues (2007) considered a sample of individuals with borderline personality disorder, and found that the 54.3% who also met criteria for BDD experienced higher levels of dysfunction, pathology, child sexual assault, and suicide attempts.
Substance abuse: An estimated 48.9% of individuals diagnosed with BDD met criteria for comorbid substance abuse at some point in their lives, and 35.8% met criteria for comorbid substance dependence (Grant et al., 2005). Rates of substance use disorders may be even more common among individuals suffering from muscle dysphoria (Pope et al., 2005). This may be especially attributable to the association of muscle dysmorphia with use of steroids, prohormones, and ephedrine (Cafri, van den Berg, & Thompson, 2006; see Rohman, 2009 for a review of steroid use and muscle dysmorphia).
Individuals with body image disturbance often use nicotine as a weight control strategy. A large study of high school students demonstrated that 18% of girls and 10% of boys smoked cigarettes in order to control their weight (Croll, Neumark-Sztainer, Story, and Ireland, 2002). Individuals who are alcohol dependent exhibit highly variable body image that tends to fluctuate with emotional changes (Menichetti & Primi, 2000). Body dissatisfaction among 13 year olds predicted alcohol use up to two years later, even after accounting for the impact of cigarette use (Rodriguez-Cano, Belmonte-Llario, & Pelayo-Delgado, 2005).
Suicidality: Body image disturbance is associated with elevated risk for suicidality. A history of suicidal ideation and suicide attempts is increased in adolescents with body dissatisfaction and weight-control behaviors (Crow et al., 2008). Prospective data on suicidality among individuals diagnosed with BDD suggest 57.8% one-year prevalence of suicidal ideation, 2.6% one-year prevalence of attempts, and 0.3% one-year prevalence of completed suicide (Phillips & Menard, 2006). Rates of lifetime suicidal ideation (estimated 78%) and attempts (estimated 27.5%) are also markedly elevated (Phillips et al., 2005).
Associated Social Difficulties
Body image disturbance has been associated with a range of social difficulties. Body image disturbance is related to social introversion (Archer & Cash, 1985), and reports of lifetime impairment in social functioning are nearly universal among individuals diagnosed with BDD (Phillips & Diaz, 1997). The relationship between body image and social difficulty is most likely bidirectional. For instance, adolescent girls with high levels of body dissatisfaction tend to perceive low social support (Stice & Whitenton, 2002), as well as alienation and conflict in the friendships they do have (Schutz & Paxton, 2007).
Associated Health Difficulties
Body image disturbance seems to predict engagement in a number of health-compromising behaviors in nonclinical populations. For example, body image dissatisfaction predicts unhealthy weight control behaviors, binge eating, poor diet, and low levels of physical activity in individuals without eating disorders (Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006). In addition, body image disturbance predicts a number of health-compromising behaviors that are not weight-related. For example, college students are reluctant to seek treatment for dysfunction in body parts that they associate with stigma or consider private, such as breasts and genitals (Klonoff & Landrine, 1993). In addition, body image disturbance predicts risky sexual behaviors such as inconsistent condom use, multiple sex partners, and having sex while under the influence of alcohol and drugs (Littleton, Breitkopf, & Berenson, 2005). Body image disturbance may have direct costs to physical health. For example, in a recent large representative sample of U.S. adults, body image disturbance was a better predictor of poor physical health than body mass index (Meunnig, Jia, Lee, & Lubetkin, 2008). It may be that the stress associated with obesity contributes more to disease than obesity itself.
Body Image Dissatisfaction
The term “body image dissatisfaction” was defined as the discrepancy between identification of one’s own figure (actual) and the figure one chose as the desirable self image (ideal). Whereas the term “body image distortion” was defined as the discrepancy between the figure one chose as ideal and the figure the other opposite gender found as attractive.
Women are more likely than men to describe themselves as fat, to weigh themselves often, and to diet frequently. They are also generally more dissatisfied with their physical appearance than are men (Cooper and Fairburn, 1983; Furnham and Calnan, 1998).
Women are generally dissatisfied with their physical appearance. This dissatisfaction can come from parents, schools, peers, and even the media. This has been happening over the past 30 years and is not surprising since the media has depicted thinner women (Hoyt, 2001). The media plays a significant role in how women view their bodies. Thin women are associated as healthy individuals with good looks, desirability, and happy relationships. Our bodies are represented as personal billboards providing others with first impressions (Hoyt, 2001). As women try to meet this unrealistic expectation of thinness, eating disorders can impact women who are trying to reach unrealistic goals.
There are two growing trends among females from childhood to adulthood: either to become dramatically inactive or to become more involved with extreme eating disorders and extreme exercise (Rhea, 1998). Girls who are inactive can have a low body image and eventually their self-esteem will decrease. When girls start to sense dissatisfaction and low self-esteem through their attitudes and feelings, then women turn to their body to exert these negative attitudes and feelings through negative behaviors. A negative behavior can be acted out through extreme dieting. Extreme dieting allows a female to relieve her thoughts and feelings through a temporary restricting or binging of food. Over 90% of severe eating disorder cases are currently diagnosed among adolescent and young adult white females (Barlow and Durand, 1995).
Many studies have been conducted on body dissatisfaction among college women. As body dissatisfaction becomes more and more prevalent among college females. According to Pliner, Chaiken, and Flett (1990) a majority of studies concerning weight have been drawn from student populations who are predominately white and age from late teens to early 20’s (Stevens, 1998). It is as if this is the time in a female’s life where independence is gained and decisions about her body are made such as: what to eat, when to eat, when to exercise or not exercise, and how to measure what is healthy.
Body image is the single most prevalent factor in the development of eating disorders and body dissatisfaction is the most consistent predictor of eating disorders developing (Hoyt, 2001). Body dissatisfaction and the fear of being fat are on the rise with dieting being an ongoing epidemic consisting of about half of adolescent girls (Grigg, Bowman, & Redman, 1996) and 30 % of adult women dieting (Neumark-Sztainer, Jefferey, & French, 1997) at any given time (Biaggio & Hersen, 2000). Regarding body weight, 66 percent of women report feelings of dissatisfaction (Garner, 1997). Women are being influenced to meet certain criteria that society has established causing women to feel negative about their bodies.
There is no agreeable definition of eating attitudes but psychologists agree that screening for eating attitudes is effective. It provides as a pre-cursor for various eating disorders.
The sheer amount of reported and unreported individuals with disordered eating behavior is a cause of great concern. Although the onset of an eating disorder can occur at any age (Anorexia Nervosa and Related Eating Disorders, Inc., 2005), they typically begin during adolescence and young adulthood, between the ages of 12 and 25.8 (MHS, 2005). Of those suffering from an eating disorder, 86% reported onset by the age of 20 (MHS, 2005). About 10% of female college students suffer from an eating disorder (Anne Collins, 2005) and 25% of college-aged women engage in bingeing and purging as a way to manage their weight (MHS, 2005). Anorexia nervosa is one of the most common psychiatric diagnoses in young women (Students Against Driving Drunk [SADD], 2005) and is the third most chronic illness among adolescents (MHS, 2005; SADD, 2005). For those who do suffer from an eating disorder or from eating disturbance (those engaged in bingeing and purging), it can have grave effects upon their lives. The mortality rate associated with eating disorders is “twelve times higher than the death rate associated with all causes of death for females 15-24 years old” (MHS, 2005, SADD, 2005). For those who do suffer from an eating disorder or from eating disturbance (those engaged in bingeing and purging), it can have grave effects upon their lives. The mortality rate associated with eating disorders is “twelve times higher than the death rate associated with all causes of death for females 15-24 years old” (MHS, 2005).
The relationship between body image disturbances and the etiology and maintenance of eating pathology has been studied repeatedly. Researchers have concluded that body image disturbance is one of the most salient features of the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) (Bunnell, Cooper, Hertz, & Shenker, 1992; Garner and Garfinkel, 1981; Slade, 1985). Indeed, American Psychiatric Association (APA) definitions of these disorders included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000; ) require significant disturbance in the individual’s perception of the shape or size of his or her body, or a preoccupation with one’s body shape and weight in order to qualify for the diagnoses. Accordingly, body dissatisfaction is often recognized as the single strongest predictor of eating disorder symptomatology among women (Phelps, Johnston, & Augustyniak, 1999; Polivy & Herman, 2002).
Research regarding individuals’ perceptions and attitudes about their body shape is an ever-growing store of studies involving clinical and non-clinical populations, a variety of measures, and correlations and associations with eating disorders and other clinical diagnoses. Samples in the literature include both genders and all ages and utilize measures of body shape that yield data indicating that body image concerns may exist along a continuum from normative discontent (Rodin et al., 1984) to clinically significant body image disturbance (Cooper et al., 1987).
Body Image Concerns
In a 1966 study of teenage girls, Huenemann and colleagues found that an overwhelming majority of their participants were profoundly unhappy with their size and shape: even though only one-quarter of their sample were classified as overweight, nearly three-quarters expressed a strong desire to lose weight. Subsequent studies of adolescents in Western industrialized nations have produced similar findings (Dwyer, Feldman, & Mayer, 1967; Wardle & Beales, 1986). A self-report study of college women conducted by Mintz and Betz in 1988 concluded that the frequency of disturbed eating behaviors as a result of poor body image among college women was quite high. In this study, data from participants (n = 643) suggested that lower self-esteem, poorer body image, and greater tendency to endorse societal beliefs about the importance of female thinness and attractiveness corresponded with progression along the eating-disorders continuum.
Body dissatisfaction and concerns with body shape can be found in similarly high levels among populations of older women. For example, in a study conducted by Cooper and Fairburn (1983), although more than three-quarters of the sample of women attending a British family planning clinic were within 15 percent of average body weight, 39 percent reported that they considered themselves significantly overweight, and 60 percent reported persistently feeling fat.
With such negative opinions of one’s body shape rampant among female populations, it is quite clear that, indeed, body dissatisfaction is not unique to individuals with clinical eating disorders (Mazzeo, 1999; Striegel-Moore, Silbertstein, & Rodin, 1986). While this dissatisfaction may be common among both clinical and community populations, the disturbing fact remains that “body image dissatisfaction can lead to unhealthy eating patterns, extreme dieting behaviors, and the development of more serious eating disorders, which can have dire health consequences and long-term ramifications” (Skemp-Arlt, 2006, p. 45). Such negative consequences of serious body image concerns therefore warrant further study and concerted prevention and treatment efforts.
Body Image Concerns and Eating Disorders
Body image dissatisfaction, excessive weight concerns, and disordered eating patterns have been implicated as risk factors for the development of eating disorders (Brooks-Gunn, 1988; Herzog, Hopkins, & Burns, 1993; Killen, Hayward, et al., 1994; Killen et al., 1994; Killen et al., 1996; Rierdan, Koff, & Stubbs, 1998, Taylor et al., 1998). Specifically, body distortion and body dissatisfaction are both strong predictors of mild and severe eating disturbances (Cattarin & Thomson, 1994; Stice, 2002). Individuals who suffer from AN and BN often place an excessive emphasis on body shape and weight, and base much of their self-evaluation on these two factors. In a meta-analytic review conducted by Stice (2002), his effect size results showed that body dissatisfaction predicted increases in dieting (r = .26), negative affect (r = .14), and bulimic pathology and eating pathology (r = .13). Further, body dissatisfaction predicted maintenance of bulimic symptoms (r = .30). Statistics supported Stice’s conclusion that the body dissatisfaction variable “emerged as one of the most consistent and robust risk and maintenance factors for eating pathology” (p. 833). While this is true, the small effect sizes included above may imply that no single factor can account for a large proportion of the variance in change in eating pathology.
Weichmann (2007) demonstrated the longitudinal course of body dissatisfaction in a college sample of undergraduate females. She showed that the highest levels occurred among incoming freshmen women and steadily decreased throughout their college experience. These findings suggest a noteworthy vulnerability for women beyond typical high school age; thus, it is reasonable to conduct a study of body image concerns pertinent to eating disorders with a young adult sample of college freshmen women.
This topic was chosen by the researcher as there are growing concerns over body image dissatisfaction, weight pre-occupation and the ill-conceived measures taken to control weight such as crash dieting, extreme exercising, etc. Body dissatisfaction has been repeatedly associated with a range of problematic eating attitudes and behaviors among college students and adolescents (e.g., Johnson & Wardle, 2005; Rosen, 1990; Strachan & Cash, 2002). Body dissatisfaction has also been identified as the primary risk factor for the development of eating pathology (Polivy & Herman, 2002; Shisslak & Crago, 2001; Stice, 2002).
Today, as a young woman grows, the messages about weight control and achieving the perfect shape grow louder, amplified by unrealistic advertising that are designed to sell products rather than promote health and wellness. As adults, the quest for an ideal body has become an exercise in self-control for women.
Most research on body image dissatisfaction has been devoted to understand the relationship with self esteem and media influence. There is little research done on the above mentioned aspects especially in relation to the Indian population. In the present study, the researcher is determined to find out if there is any correlation between body image dissatisfaction and eating attitudes. The hypothesis the study is based is that there is a correlation between body image dissatisfaction and eating attitudes in female college students aged between 18years to 22years.
According to the results, concerns for eating attitudes and awareness for body image satisfaction can be raised by organising seminars for the target groups.
For the present study, 45 female college students, aged between 18 years and 22 years were chosen. Participants were mainly students of St. Francis College. The sampling techniques used were Random Sampling and Snowball sampling.
Body Shape Questionnaire. The Body Shape Questionnaire is “a self-report measure of concerns about body shape, in particular the phenomenal experience of ‘feeling fat’” (Cooper et al., 198 7, p. 490). Its 34 items were derived from formal interviews, questionnaires, and demographic information gathered from samples of patients diagnosed with bulimia nervosa, anorexia nervosa, and no clinical eating disorder. Participants respond on a five-point scale from never to always, and responses are scored such that higher scores indicated higher body image dissatisfaction. Rosen, Jones, Ramirez, and Waxman (1996) reported a test-retest reliability of 88 and a concurrent validity of .77 with the Body Dysmorphic Disorder Examination among university undergraduates. Cooper et al. (1987) reported concurrent validity of the BSQ with the Body Dissatisfaction subscale of the EDI for patients with BN to be 0.66 (p < .001). According to these researchers, the BSQ measures body image preoccupation and appears to be a relevant and practical measure of body image symptoms for persons with excessive concerns about weight or shape.
Total scores range from 34 to 204, with higher scores indicating more dissatisfaction of the individual’s appearance. Women whose total scores on the BSQ exceed 110 are considered to have body image concerns that may be clinically significant (Cooper et al., 1987).
Eating Attitudes Test-26. The EAT-26 (Garner, Olmsted, Bohr, & Garfinkel, 1982) is a 26-item measure of disordered eating behavior usually associated with anorexia nervosa. Participants respond on a six-point scale from never to always