Fat distribution, site-specific body dissatisfaction, and perceived difficulty in regional weight loss as risk factors for disordered eating behavior and body image disturbances

This study investigated the association of fat distribution and related body image variables with eating attitudes and body size dissatisfaction in a nonclinical sample of 125 male and 125 female volunteers from the Baltimore Longitudinal Study of Aging. The body image variables included site-specific body dissatisfaction and perceived difficulty in regional weight loss. Results showed that, in women, a greater dissatisfaction with the lower body than with the upper body was associated with higher levels of general body dissatisfaction. Additionally, a perception of greater difficulty in reducing weight from the hips rather than from the waist was also associated with greater body dissatisfaction. In men, a lower fat distribution and the perception of greater difficulty in losing weight from the hips were both associated with more abnormal eating attitudes. This investigation also reports the development and validation of a new and improved body image assessment tool, the Contour Drawing Rating Scale, consisting of nine male and nine female contour drawings. The drawings were designed with detailed features, are of precisely graduated sizes, and are easily split at the waist for accurate upper and lower body comparisons. The scale's demonstrated reliability and validity support its use as a measure of body size perception and dissatisfaction. Additional analyses indicated that: (1) when used together, the body image variables were more closely associated with waist-to-hip ratio and differences in body dissatisfaction in women than when these variables were analyzed separately, (2) the perception of difficulty in losing weight in either the waist or the hips could not be verified by actual differences between groups in change in waist-hip ratio with change in weight over a 10 year period, and (3) in contrast to much of the previous literature, figure selections from the Contour Drawing Rating Scale indicated that men and women did not differ in degree of body dissatisfaction. However, men were more likely than women to desire weight gain.