Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
J Adolesc Health. 2020 Jan;66(1S):S9-S16. doi: 10.1016/j.jadohealth.2019.09.007.
Body image-related norms can be imposed by parents and can shape adolescents' body satisfaction in consequential ways, yet evidence on long-term effects is scarce. Longitudinal data from a country with strong body image focus provided a unique opportunity to investigate long-term influences of normative parent-related perceptions.
Multinomial logistic regression was used on data from a 1993 birth cohort in Brazil to investigate the association of normal-body mass index (BMI) adolescents' perception of their parent's opinion of their weight at age 11 years with their weight control attempts at 18 years, testing a mediating role for body dissatisfaction at age 15 years. All models controlled for body dissatisfaction at age 11 years and BMI change between ages 11 and 15 years.
A total of 1150 boys and 1336 girls were included. Girls were more likely than boys to diet without nutritionist advice to lose weight (51.5% vs. 34.3% among boys) and use medication to gain weight (12.7% vs. 4.2%). Normal-BMI adolescents who reported at age 11 years that their parents thought they were thin had higher odds of feeling thinner than ideal at age 15 years (odds ratio 2.8, 95% confidence interval 1.8-3.2; and odds ratio 2.0, 95% confidence interval 1.5-2.7) among boys and girls, respectively). Feeling thinner than ideal at age 15 years was associated among girls with higher odds of weight gain attempts at age 18 years. Similar patterns appeared among girls reporting that their parents thought they were fat at age 11 years, feeling fatter than ideal at age 15 years and having higher odds of weight loss attempts at age 18 years. Body dissatisfaction was a statistically significant mediator among girls but not boys.
A long-term influence of parent-related perceptions via a likely trajectory of body dissatisfaction is evident among girls.
父母强加的身体意象相关规范会以重要的方式塑造青少年的身体满意度，但长期影响的证据很少。来自一个非常关注身体意象的国家的纵向数据提供了一个独特的机会来研究规范的父母相关认知的长期影响。
利用巴西一项 1993 年出生队列的纵向数据，采用多项逻辑回归分析方法，研究正常体重指数（BMI）青少年在 11 岁时对父母对其体重看法的感知与其在 18 岁时控制体重的尝试之间的关联，同时检验了 15 岁时身体不满感的中介作用。所有模型都控制了 11 岁时的身体不满感和 11 岁至 15 岁之间 BMI 的变化。
共纳入 1150 名男孩和 1336 名女孩。与男孩相比，女孩更有可能未经营养师建议节食减肥（女孩中 51.5%，男孩中 34.3%），并且更有可能使用药物增重（女孩中 12.7%，男孩中 4.2%）。11 岁时报告父母认为自己瘦的正常 BMI 青少年，15 岁时感觉比理想体重更瘦的可能性更高（男孩和女孩分别为优势比 2.8，95%置信区间 1.8-3.2；和优势比 2.0，95%置信区间 1.5-2.7）。15 岁时感觉比理想体重更瘦的女孩，18 岁时增重尝试的可能性更高。在报告父母认为自己 11 岁时肥胖的女孩中，也出现了类似的模式，她们在 15 岁时感觉比理想体重更胖，18 岁时减肥尝试的可能性更高。在女孩中，身体不满感是一个统计学上显著的中介因素，但在男孩中则不然。
通过身体不满感的可能轨迹，父母相关认知对女孩有长期影响。
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