Predicting Exercise and Eating Behaviors From Appearance ...

Sport, Exercise, and Performance Psychology 2012, Vol. 1, No. 3, 145–157

© 2012 American Psychological Association 2157-3905/12/$12.00 DOI: 10.1037/a0026892

Predicting Exercise and Eating Behaviors From Appearance Evaluation and Two Types of Investment Larkin Lamarche

Kimberley L. Gammage

University of Toronto

Brock University

This study examined whether appearance evaluation (self-ideal discrepancy) and appearance investment (self-evaluative and motivational salience of appearance) contributed uniquely to the prediction of dietary restraint, exercise dependence, and physical activity behavior in college women. Participants (N ⫽ 231) completed measures of appearance evaluation and investment, dietary restraint, exercise dependence symptoms, and leisure-time physical activity. Regression analyses showed both selfevaluative and motivational salience were positively related to dietary restraint. In addition, self-evaluative salience was significantly positively related to symptoms of exercise dependence. Finally, greater self-ideal discrepancy was related to lower levels of leisure-time physical activity. The results indicate that both appearance evaluation and type of investment are important to consider when investigating health behaviors. Keywords: body image, appearance importance, dietary restraint, physical activity, exercise dependence

Body image is a person’s internal representation of his or her outer body (Cash & Pruzinsky, 1990, 2002). Cash and Pruzinsky (2002) distinguished between body image attitudes (cognitions, affect, and behaviors) and perceptions. Both evaluation of (e.g., self-ideal discrepancy, satisfaction/dissatisfaction with the body) and investment in (importance placed on appearance) appearance are distinct attitudinal constructs (Cash, 2005). Much body image research has focused on self-evaluations of one’s appearance. This line of research has shown that negative appearance evaluation (e.g., body dissatisfaction) is related to a number of healthrelated outcomes including lower self-esteem, increased risk of depression, and anxiety (Kostanski & Gullone, 1998; McCauley, Mintz, & Glenn, 1988). In addition to psychological outcomes, there is evidence that appearance evaluation is related This article was published Online First January 16, 2012. Larkin Lamarche, Graduate Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada; Kimberley L. Gammage, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada. Correspondence concerning this article should be addressed to Kimberley L. Gammage, Department of Kinesiology, Brock University, 500 Glenridge Avenue, St. Catharines ON L2S 3A1, Canada. E-mail: kgammage@ brocku.ca

to behavioral outcomes such as eating pathologies and exercise (Anton, Perri, & Riley, 2000; Kruger, Lee, Ainsworth, & Macera, 2008; Stice, 2002). In general, negative appearance evaluation has been associated with less physical activity and greater dietary restraint and eating disorder symptoms (Anton et al., 2000; Brannan & Petrie, 2008; Kruger et al., 2008; Tiggemann & Williamson, 2000). For instance, Anton et al. (2000) found that greater discrepancy between perceptions of current weight and shape and ideal weight and shape were associated with greater dietary restraint, binge eating, and preoccupation with food, and less leisure-time physical activity in college women. Similarly, body dissatisfaction has been associated with dieting to lose weight (Millstein et al., 2008) and lower levels of physical activity (Kruger et al., 2008; Tiggemann & Williamson, 2000). In addition to eating behaviors and leisure-time physical activity, the relationship between exercise dependence and appearance evaluation has been investigated. Exercise dependence is a maladaptive pattern of exercise leading to significant impairment in social, occupational, or leisure aspects of life, and is associated with symptoms such as tolerance, withdrawal, and excessive time spent on exercise (Hausenblas & Symons Downs, 2002a). However, exercise dependence symptoms only weakly predicted

145

146

LAMARCHE AND GAMMAGE

body satisfaction in women (Hausenblas & Fallon, 2002). In comparison with research on the evaluation component of body image, research on investment in physical appearance has been largely ignored (Cash & Pruzinsky, 1990, 2002; Cash & Szymanski, 1995; Ip & Jarry, 2008). Research has indicated that the level of appearance investment (or orientation) is associated with outcomes such as disordered eating symptoms, body dissatisfaction, heightened sensitivity to the nature of social interactions (i.e., perceived positivity or negativity of interaction), body dysphoria, perfectionism, social anxiety, and depression (Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002; Cash & Szymanski, 1995; Cash, Theriault, & Annis, 2004; Forand, Gunthert, German, & Wenze, 2010; Spoor, Bekker, Van Heck, Croon, & Van Strien, 2005). Importantly, two types of appearance investment have been identified in research— self-evaluative salience (of appearance) and motivational salience (of appearance; Cash, Melnyk, & Hrabosky, 2004). Self-evaluative salience refers to deriving one’s sense of selfworth from physical appearance. It is considered a maladaptive form of investment. By contrast, motivational salience refers to efforts or desires to maintain or improve one’s appearance. It is considered to be less dysfunctional than self-evaluative salience (Cash, Melnyk, et al., 2004). Self-evaluative salience has been associated with more psychosocial and body image pathology than motivational salience. For instance, relative to motivational salience, researchers have shown that self-evaluative salience is related to greater internalization of societal/media ideals of appearance and greater responsiveness to such images in the media (Cash, Melnyk, et al., 2004; Ip & Jarry, 2008). It is also associated with greater social selfpresentational perfectionism, more negative appearance evaluation and global self-esteem, as well as more eating disorder symptomatology (Cash, Melnyk, et al., 2004). In addition, selfevaluative salience is more strongly negatively correlated to overall body image quality of life, which reflects the positive and negative impact of body image on one’s psychosocial quality of life (Cash, Jakatdar, & Williams, 2004), relative to motivational salience (Cash, Jakatdar, et al., 2004; Cash, Melnyk, et al., 2004; Cash, Santos, & Williams, 2005; Ip & Jarry, 2008). Finally,

findings have shown that self-evaluative salience (but not motivational salience) is related to more negative fluctuations of day-to-day body satisfaction (Melnyk, Cash, & Janda, 2004; Rudiger, Cash, Roehrig, & Thompson, 2007). On the other hand, motivational salience is unrelated to body image quality of life, selfesteem, avoidance-based coping strategies, and fluctuations of day-to-day body satisfaction (Cash, Jakatdar, et al., 2004; Cash, Melnyk, et al., 2004; Cash et al., 2005; Melnyk et al., 2004; Rudiger et al., 2007). Therefore, valuing and attending to one’s appearance by engaging in appearance-related behaviors to appear or feel attractive is not inherently negative. Of the little research on appearance investment, it appears that the nature of the relationship between appearance investment and healthrelated outcomes may depend, in part, on the type of investment, although more research is necessary to support this contention. These findings emphasize the importance of investigating psychosocial and behavioral outcomes of different types of appearance investment, rather than just global indicators of investment or importance placed on physical appearance. While much of the research investigating this type of investment has focused primarily on its relationship to psychological outcomes, less research has investigated its relationship to behaviors. Appearance investment has been associated with clothing choices (Tiggemann & Lacey, 2009). Specifically, these authors found that only self-evaluative salience was associated with using clothing to camouflage appearance problems, while both forms of investment were associated with using clothing to increase one’s confidence and fashion. Prichard and Tiggemann (2011) also found in a sample of bridesto-be that only motivational (and not selfevaluative) salience predicted intentions to engage in prewedding exercise and eating behaviors, as well as appearance-related behaviors (e.g., tanning, facials, manicures). These findings provide preliminary evidence that both types of investment may be associated with appearance-related behaviors, but that the type of investment is an important consideration. In the present study, we specifically examined two types of behaviors that may be related to appearance investment and evaluation: eating

APPEARANCE EVALUATION AND INVESTMENT

and physical activity. In particular, we investigated relationships between appearance evaluation and both types of appearance investment to dietary restraint, exercise dependence, and physical activity. These behaviors were chosen for several reasons. First, appearance investment may be particularly related to eating behaviors. While appearance investment has been associated with disordered eating symptoms (Cash, Melnyk, et al., 2004; Cash & Szymanski, 1995; Petrie, Greenleaf, Reel, & Carter, 2009), we propose that it may also be related to less severe eating behaviors such as cognitive dietary restraint. Dietary restraint is a type of eating behavior that is governed by cognitive, rather than physiological, cues (i.e., hunger, satiety) to lose or maintain weight (Herman & Mack, 1975). Those higher in restraint are conscious about the amount and type of calories they consume. While women who restrain consume fewer calories per day on average and tend to report healthier diets, they also report higher body mass indices (BMIs) and weight (e.g., Klesges, Isbell, & Klesges, 1992; Mulvihill, Davies, & Rogers, 2002). Given the extent to which those high in dietary restraint go to in order to maintain or improve (reduce) their weight, it is likely that they value their appearance. However, this contention has yet to be examined in college women. Further, given that dietary restraint has both positive (e.g., healthier diets) and negative (higher BMI) outcomes, it is unclear whether dietary restraint is related to a more functional or dysfunctional type of investment. In addition to diet, we propose that appearance investment is related to exercise, as it is a behavior commonly used to achieve a more ideal appearance. In the present study, we measured two exercise-related outcomes: exercise dependence symptoms and leisure-time physical activity. Exercise is associated with a number of physical and psychological health benefits (see Bouchard, Shephard, & Stephens, 1994 for review), including a positive influence on appearance through controlling weight and increasing muscle tone. Just as healthy eating may be related to some level of concern with appearance (Hayes & Ross, 1987), it is also likely that some investment in appearance is associated with healthy physical activity behavior. That is, leisure-time exercise could be related to motivational salience.

147

However, at an extreme, excessive exercise is potentially harmful to health. Exercise dependence is characterized by symptoms of tolerance and withdrawal, significant time spent on activities related to exercise, conflict with other important aspects of life, a loss of control over exercise behavior, and continued exercise despite known problems (Hausenblas & SymonsDowns, 2002a). It has been linked to negative health-related outcomes such as depression, disordered eating symptoms, poor body image, and lower self-esteem (e.g., Chan & Grossman, 1988; Diehl, Johnson, Rogers, & Petrie, 1998; Szabo, 2000). It could also be related to appearance investment, and specifically self-evaluative salience. For example, White and Halliwell (2010) found in a sample of adolescent girls that higher appearance investment was associated with a need for exercise, although they did not examine type of investment. While both appearance evaluation and investment are related to eating and exercise behaviors, less research has investigated the relative importance of these two constructs. As noted by others, they likely have different antecedents and consequences (Cash, Melnyk, et al., 2004; Tiggemann, 2004). There is preliminary evidence to suggest that they may contribute differently to eating and exercise behaviors. For instance, in a sample of preadolescent girls, both body dissatisfaction and concern with weight and shape were predictors of dietary restraint (Allen, Byrne, McLean, & Davis, 2008). In a small sample of adult women attending commercial weight loss programs, Lattimore and Hutchinson (2010) showed that weight and shape dissatisfaction and self-evaluative salience, but not motivational salience, were positively related to dietary restraint. However, these authors examined bivariate correlations, and did not investigate whether appearance evaluation and investment uniquely predicted dietary restraint. Finally, White and Halliwell (2010) found that in female adolescents, body dissatisfaction was negatively correlated with a focus on exercise (defined as importance, frequency, and duration of exercise), while investment was not. Conversely, they found that a compulsive need for exercise was positively related to investment, but unrelated to dissatisfaction. Together, these findings suggest that appearance evaluation and both types of investment may be differentially related to eating and exercise

148


behaviors, albeit in younger samples and in women trying to lose weight. Purpose and Hypotheses Relative to appearance evaluation, little is known about appearance investment, and even less is known about how these two variables may differentially be related to eating and particularly exercise behaviors. Importantly, most of the current research has examined only one of these variables, or has looked at only simple bivariate correlations. However, this approach fails to take into account how evaluation and investment are related to behaviors relative to one another. Further, the relationship between the type of investment and health-related outcomes, such as diet and exercise, is relatively unknown. Therefore, the purpose of this study was to examine the unique contributions of appearance evaluation (self-ideal discrepancy) and two types of appearance investment (motivational salience and self-evaluative salience) to predict dietary restraint, exercise dependence, and physical activity in college women. It was hypothesized that a poorer appearance evaluation (i.e., larger self-ideal discrepancy) and higher levels of both types of appearance investment (i.e., self-evaluative and motivational salience) would be positively related to dietary restraint, with self-evaluative salience (which is considered more maladaptive) more strongly associated than motivational salience. Second, it was hypothesized that only selfevaluative salience would be positively related to exercise dependence symptoms. Finally, it was hypothesized that poorer appearance evaluation (i.e., larger self-ideal discrepancy) would be related to less moderate-vigorous intensity leisure-time physical activity, while motivational salience would be positively associated with moderate-vigorous intensity leisure-time physical activity. Methods Participants and Procedures The sample consisted of 231 college women recruited from undergraduate classes at a university campus. The sample had a mean age of 20.92 (SD ⫽ 2.62) years, mean weight of 141.32 (SD ⫽ 23.84) lbs., and mean height

of 65.77 (SD ⫽ 2.83) in. The mean BMI was 22.98 (SD ⫽ 3.54). It is important to note that the majority of the sample (75.3%) fell within the normal weight BMI range for health risk classification (18.5–24.9; Health Canada, 2003). Of the remaining participants, 2.2% were classified as underweight, 19% as overweight, and 3.4% as obese. Participants reported engaging in a wide variety of physical activities. Upon university ethics clearance, participants were recruited through posters placed around the university campus and announcements made in undergraduate classes to participate in a study of body attitudes and behaviors. Interested participants contacted the research team, and a mutually convenient time for participation was set. Upon arrival at the laboratory, participants provided informed consent prior to the completion of demographic information (age, height, weight, and type of physical activities normally engaged in) and a series of questionnaires which were counterbalanced to avoid order effects (see Measures section below for description). Completion of questionnaires was conducted in private and took approximately 20 min. Measures Appearance Schemas Inventory-Revised (ASI-R; Cash, Melnyk, et al., 2004). Participants completed the 20-item ASI-R because it has been found to be more psychometrically sound than the original version (Cash, Melnyk, et al., 2004). This questionnaire assesses participants’ investment with regard to beliefs or assumptions about the importance, meaning, and influence of physical appearance in one’s life. The measure has two subscales: Self-Evaluation Salience (of Appearance), reflecting self-worth derived from appearance (e.g., “by controlling my appearance, I can control many social and emotional events in my life”), and Motivational Salience (of Appearance), reflecting a general desire to maintain or improve one’s appearance (e.g., “I often check my appearance in a mirror just to make sure I look okay”). Items were rated on a 5-point scale ranging from 1 ⫽ strongly disagree to 5 ⫽ strongly agree. This questionnaire has demonstrated adequate reliability and validity in college women (Cash, Melnyk, et al., 2004). Internal consistency for the self-evaluative salience and motivational sa-


lience subscales in the present study were satisfactory (␣ ⫽ .86 and .77, respectively). Body-image Ideals Questionnaire (BIQ; Szymanski & Cash, 1995). This measure of appearance evaluation is based on self-discrepancy frameworks, with appearance evaluations defined as the difference between an individual’s perceived physical characteristics and her ideals (Cash, Jakatdar, et al., 2004; McGee, Hewitt, Sherry, Parkin, & Flett, 2005; Muth & Cash, 1997). Only the discrepancy subscale was calculated and used in the present study. This subscale consists of 11 items (e.g., weight, overall physical appearance, facial features) asking participants to rate how well their ideal body compared with their current body. Each item is rated on a 4-point scale ranging from 0 ⫽ exactly as I am to 3 ⫽ very unlike me. For participants who select 0 (representing no discrepancy between the current and ideal), this score is recoded as –1, such that higher scores represent greater self-ideal discrepancy. This questionnaire has demonstrated adequate psychometric properties in college women (Szymanski & Cash, 1995). In the present study, internal consistency was satisfactory (␣ ⫽ .75). Three Factor Eating Questionnaire (TFEQ; Stunkard & Messick, 1985). This 51-item questionnaire assesses cognitive and behavioral components of eating. The first 36 items are yes/no questions (e.g., “I deliberately take small helpings as a means of controlling my weight”) with the remaining items rated on a scale from 1 to 4 (e.g., “While on a diet, if I eat food that is not allowed, I consciously eat less for a period of time to make up for it”). Only one subscale (21 items) was used for this study (Cognitive Restraint), which assesses the use of cognitive cues to control eating behaviors to lose or maintain weight. Scores can range from 0 to 21, with higher scores indicating higher cognitive restraint. This subscale has been widely used to examine eating behaviors as they relate to dietary restraint (Gorman & Allison, 1995). The TFEQ has demonstrated reliability and validity in college women (Stunkard & Messick, 1985). In the present study, internal consistency was satisfactory (␣ ⫽ .88). Exercise Dependence Scale (EDS; Hausenblas & Symons Downs, 2002b). This 21item questionnaire assesses maladaptive patterns of exercise leading to clinically significant

149

impairment or distress. Participants indicated to what extent each item reflects their current exercise beliefs and behaviors that have occurred in the past 3 months on a scale of 1 ⫽ never to 5 ⫽ always (e.g., “I am unable to reduce how long I exercise”). A total score across all items was calculated. Scores can range from 21 to 105, with higher scores representing greater symptoms of exercise dependence. The EDS has demonstrated adequate reliability and validity (Hausenblas & Symons Downs, 2002b). Internal consistency in the present study was satisfactory (␣ ⫽ .93). Godin Leisure-Time Physical Activity Questionnaire (GLTPAQ; Godin & Shephard, 1985). This questionnaire assesses the frequency of strenuous, moderate, and mild activity engaged in for at least 15 min during participants’ free-time. Because physical activity recommendations from the American College of Sports Medicine and American Heart Association focus on moderate and vigorous physical activity (Haskell et al., 2007), only moderate and vigorous activity scores were used. Weekly frequencies of vigorous and moderate activities were multiplied by 9 and 5, respectively and then summed to yield a weekly score in metabolic equivalents. Higher scores on the GLTPAQ indicate greater amounts of leisure-time physical activity. Evidence of the validity and reliability of the GLPAQ has been provided and is similar to other self-report measures (Jacobs, Ainsworth, Hartman, & Leon, 1993). Results Means and standard deviations for study variables are presented in Table 1. Prior to our main analyses, assumptions of the analyses were assessed. All variables were normally distributed. We assessed multicollinearity by examining tolerance and variance inflation factor (VIF) values. As suggested by Hutcheson and Sofroniou (1999), tolerance values less than 0.2 and VIF values greater than 5 indicate multicollinearity. In the present study, all tolerance and VIF values were found to be within acceptable limits. Prior to examining the multivariate relationships between appearance evaluation, both types of appearance investment, dietary restraint and exercise behavior through regression analyses, simple correlations among study vari-

150


Table 1 Bivariate Correlations, Means, and Standard Deviations for Study Variables Variable

1

2

3

4

5

1. BMI 2. SES 3. MS 4. Discrepancy 5. DR 6. ED 7. M-V LTPA Mean Standard deviation

—

.12 —

⫺.13 .58ⴱⴱ —

.22ⴱⴱ .52ⴱⴱ .21ⴱⴱ —

.14ⴱ .45ⴱⴱ .41ⴱⴱ .24ⴱⴱ —

22.98 3.54

3.10 .65

3.59 .60

.73 .58

8.25 4.97

6 .07 .26ⴱⴱ .17ⴱⴱ .14ⴱ .44ⴱⴱ — 50.51 14.14

7 ⫺.08 .02 .12 ⫺.19ⴱⴱ .20ⴱⴱ .53ⴱⴱ — 43.55 20.67

Note. Pearson correlations are for the sample (N ⫽ 231) presented above the diagonal. Means and standards deviations are presented in the horizontal rows. SES ⫽ self-evaluative salience; MS ⫽ motivational salience; self-evaluative and motivational salience range from 1 to 5; Discrepancy ⫽ current-ideal discrepancy, ranges –1 to 3; DR ⫽ dietary restraint, ranges from 0 to 21; ED ⫽ exercise dependence, ranges from 21 to 105. M-V LTPA ⫽ moderate-vigorous leisure-time physical activity; ranges from 12 to 146 metabolic equivalent of task. ⴱ p ⬍ .05. ⴱⴱ p ⬍ .01.

ables were investigated. Bivariate correlations indicated a moderate positive correlation between motivational salience and self-evaluative salience (r ⫽ .58, p ⬍ .01). The magnitude of the correlation between current-ideal discrepancy and self-evaluative salience (r ⫽ .52, p ⬍ .001) was larger than the correlation between current-ideal discrepancy and motivational salience (r ⫽ .21, p ⬍ .01). With respect to both types of investment, small to moderate positive correlations were found with dietary restraint and exercise dependence, while both types of investment were unrelated to moderate-vigorous leisure-time physical activity. Further, selfideal discrepancy was positively related to dietary restraint and exercise dependence, and negatively related to moderate-vigorous leisuretime physical activity (see Table 1 for all relationships). It is important to note that BMI was significantly related to dietary restraint (r ⫽ .14, p ⬍ .05), but unrelated to exercise dependence or moderate-vigorous leisure-time physical activity. To investigate the unique relationships between appearance evaluation and investment and diet and exercise behaviors, a series of hierarchical regressions were conducted with dietary restraint, exercise dependence, and moderate-vigorous leisure-time physical activity as the dependent variables. Because we were interested in the unique contribution of appearance investment over and above that of appearance evaluation, current-ideal discrepancy was entered as the independent variable on the first

step, and the two types of investment were entered simultaneously on the next step. Because of the significant correlation between BMI and dietary restraint, for the regression predicting dietary restraint, BMI was entered on the first step, followed by current-ideal discrepancy on the second step, and selfevaluative and motivational salience of physical appearance simultaneously on the third step. The overall regression on the final step was significant, F(4, 226) ⫽ 19.32, p ⬍ .001, R2adj ⫽ .24. In the final model, BMI, self-evaluative salience, and motivational salience were all significant positive predictors of dietary restraint. Together, self-evaluative salience and motivational salience accounted for approximately 19% of the variance in dietary restraint over and above BMI and self-ideal discrepancy. A summary of the regressions is presented in Table 2. BMI was not used in the regression to predict exercise dependence because the two variables were not significantly related (r ⫽ .07, p ⫽ .27). To predict exercise dependence, current-ideal discrepancy was entered first, with both motivational and self-evaluative salience entered simultaneously on the second step. The overall prediction was significant, F(3, 223) ⫽ 5.60, p ⫽ .001, R2adj ⫽ .06. Self-evaluative salience was significantly positively related to exercise dependence, accounting for approximately 5% of the variance over and above self-ideal discrepancy (see Table 2). BMI was not used in the regression to predict moderate-vigorous leisure-time physical activ-


151

Table 2 Summary of Hierarchical Regressions Predicting Dietary Restraint, Exercise Dependence, and ModerateVigorous Leisure-Time Physical Activity Dietary Restraint Predictors Step 1 BMI Step 2 BMI Discrepancy Step 3 BMI Discrepancy SES MS

␤ .14ⴱ .09 .22ⴱⴱ ⴱ

Adj R

2

.02

Exercise Dependence ⌬R

2

.02ⴱ

.06ⴱⴱⴱ

.05ⴱⴱⴱ

ⴱⴱⴱ

ⴱⴱⴱ

.24

.14 .01 .28ⴱⴱ .26ⴱⴱⴱ

␤ — — .14ⴱ

.19

⌬R

␤

Adj R2

⌬R2

—

—

—

—

—

.02ⴱ

.02ⴱ

.03ⴱⴱ

.03ⴱⴱ

.05ⴱⴱ

.03ⴱ

ⴱⴱⴱ

.06 — .01 .24ⴱⴱ .04

Physical Activity

Adj R

2

2

ⴱⴱ

— ⫺.19ⴱⴱ

.05

— ⫺.26ⴱⴱⴱ .08 .12

Note. Discrepancy ⫽ self-ideal discrepancy; SES ⫽ self-evaluative salience; MS ⫽ motivational salience. p ⬍ .05. ⴱⴱ p ⬍ .01. ⴱⴱⴱ p ⬍ .001.

ⴱ

ity because the two variables were not significantly related (r ⫽ –.08, p ⫽ .24). To predict leisure-time physical activity, self-ideal discrepancy was entered on the first step, and selfevaluative and motivational salience of physical appearance were entered simultaneously on the second step. The final overall prediction was significant, F(3, 225) ⫽ 5.19, p ⫽ .002, R2adj ⫽ .05. Only self-ideal discrepancy was significantly related to moderate-vigorous physical activity, accounting for approximately 3% of the variance, with greater discrepancy associated with less physical activity (see Table 2). Discussion The purpose of this study was to examine the unique contributions of appearance evaluation and two types of appearance investment to predict dietary restraint, exercise dependence, and physical activity. It was hypothesized that larger self-ideal discrepancies and both types of investment would be positively related to dietary restraint, self-evaluative salience would be positively related to exercise dependence symptoms, and greater self-ideal discrepancy would be related to less moderate-vigorous leisuretime physical activity, while motivational salience would be positively associated with moderate-vigorous leisure-time physical activity. In general, these hypotheses were supported. In our regression analyses, both adaptive (motivational) and maladaptive (self-evaluative) investment in physical appearance were

positively related to dietary restraint (supporting our hypothesis), while appearance evaluation was not (inconsistent with our hypothesis). Unexpectedly, the strength of the prediction for both types of investment was similar in magnitude. Previous research has found both appearance evaluation and investment to be related to dietary restraint (Allen et al., 2008; Lattimore & Hutchinson, 2010). However, Allen et al. (2008) examined these variables in preadolescent girls, and they did not examine specific types of investment, but rather a general concern with weight and shape. It is possible that as women move through adolescence, the importance they place on their physical appearance becomes more influential on their behaviors than their perceived discrepancy from the ideal. Second, Lattimore and Hutchinson (2010) examined only bivariate correlations between dissatisfaction and both types of investment and dietary restraint in a small group (N ⫽ 46) of women who were trying to lose weight. Over 75% of their sample were overweight and were on average 16 years older than our sample. It is possible that these characteristics of the sample may have contributed to the differences in our findings. For example, as women get older, investment in appearance decreases (Tiggemann, 2004), perhaps making it relatively less influential on appearance-related behaviors. Further, in the present study, bivariate relationships between dietary restraint and both appearance evaluation and investment were also significant. The present study emphasizes the importance of

152


investigating both evaluation and investment simultaneously in relation to potential associated behaviors. Dietary restraint is associated with a healthier diet (e.g., fewer calories, greater intake of fruits and vegetables; Klesges et al., 1992; Mulvihill et al., 2002), which women, regardless of the type of investment, likely associate with a healthier body weight and more attractive appearance. Therefore, those higher in appearance investment (motivational or self-evaluative) may consider this dietary pattern a good way to maintain or improve their appearance. Further, these findings are consistent with research showing women higher in dietary restraint report concern over weight and shape (Allen et al., 2008; Hawks, Madanat, & Christley, 2008) and have higher levels of body focus (Davis, Durnin, Gurevich, Le Marie, & Dionne, 1993; Davis, Shapiro, Stuart, & Dionne, 1993), which occurs regardless of type of investment. The present findings suggest that both types of investment may be relevant when examining dietary restraint, given that the strength of their prediction was similar in magnitude. It also suggests that dietary restraint may not be an entirely unhealthy behavior; the significant relationship with both types of investment (adaptive and maladaptive) supports this contention. Further, dietary restraint is also associated with healthier diets (Klesges et al., 1992; Mulvihill et al., 2002). However, the relative magnitude of the two types of investment may be more important to extreme eating patterns such as those that occur with eating disorders. Findings from past research have shown a stronger positive relationship between eating disorder symptoms and self-evaluative salience of physical appearance than with motivational salience of physical appearance (Cash, Melnyk, et al., 2004). As hypothesized, only self-evaluative salience was significantly related to exercise dependence in our regression analysis. Thus, women who derive their self-worth from physical appearance reported having higher symptoms of exercise dependence and may be at a higher risk of displaying uncontrollable exercise patterns associated with negative physiological and psychological symptoms (i.e., depression, disordered eating symptoms, poor body image, and lower self-esteem; Chan & Grossman, 1988; Diehl et al., 1998; Szabo, 2000). This finding is consistent with White and

Halliwell (2010) who found that a compulsive need for exercise was positively related to investment, but not dissatisfaction in adolescent females. Women high in self-evaluative (maladaptive) appearance investment may go to extreme lengths to achieve their appearance goals, and therefore, would likely report higher levels of exercise dependence symptoms. For these women, diet in addition to extreme exercise behaviors may be the only way they perceive they can realize their physical appearance goals. Our finding that motivational salience of physical appearance was unrelated to exercise dependence in our regression analysis may be attributed to the negative connotations associated with such exercise patterns. For example, findings from several studies have shown that although young adults generally perceive exercisers more positively than nonexercisers, excessive exercisers are often rated the same or more negatively than controls or regular exercisers on numerous psychological variables, such as vanity, egocentrism, and pretentiousness (Lindwall & Martin Ginis, 2006; Martin Ginis, Latimer, & Jung, 2003). These potentially negative associations with excessive exercise may lead women who value physical appearance, but who do not derive their sense of self from their appearance, to avoid exhibiting such behaviors, while women greater in selfevaluative salience may be willing to be perceived negatively by others in order to attain their ideal physical appearance, given its importance to their self-concept. However, it is important to note that we did find a small positive correlation between motivational salience and exercise dependence (r ⫽ .17, p ⬍ .01). Conducting simple bivariate relationships may miss important information about the relative influence of motivational and self-evaluative salience. Appearance investment was unrelated to physical activity in both our regression and correlational analyses, while greater self-ideal discrepancy (negative appearance evaluation) was associated with less physical activity. This finding is consistent with previous research showing a negative relationship between appearance evaluation and physical activity (Anton et al., 2000; Kruger et al., 2008; Tiggemann & Williamson, 2000). It is likely that individuals who believe they are further from the ideal are un-


willing to put themselves in situations in which their bodies are on display to others, such as occurs in exercise (Leary, 1992). It may also be that they believe that they are unable to be physically active if they are far from the ideal. Unexpectedly, appearance investment was not related to moderate-vigorous leisure-time physical activity. It is possible that women who are highly invested in their appearance will be more likely to look for short-term ways to improve their appearance. Physical activity, although it has been identified by college women as a way to improve appearance in the long-run (Lamarche, Kerr, Faulkner, Gammage, & Klentrou, 2011), is unlikely to lead to immediate changes in weight or shape or other aspects of appearance. Thus, for those high in investment, they may choose other appearance-related behaviors such as clothing or make-up that will yield immediate benefits, rather than choose more long-term behaviors such as exercise (Kowalski, Mack, Crocker, Niefer, & Fleming, 2006; Sabiston, Sedgwick, Crocker, Kowalski, & Mack, 2007). For example, Kowalski et al. (2006) found that short-term appearance management techniques (such as make-up or clothing) were more commonly reported by adolescent girls as a way to cope with evaluations by others of their bodies than exercise or diet (40% vs. 9% and 11%, respectively). Adolescent girls appear to consider these “appearance-fixing” approaches to be short-term fixes to concerns with their appearance and bodies (Sabiston et al., 2007). Further, engaging in regular physical activity is motivated by factors other than appearance (e.g., health, social interaction, challenge; Markland & Hardy, 1993; Markland & Ingledew, 1997). Thus, it is unlikely that appearance investment alone is likely to motivate women to engage in regular physical activity. It should be noted that investment accounted for a much greater amount of variance in dietary restraint (approximately 19%) than in either exercise behavior (5% and 3% of exercise dependence and moderate-vigorous leisure-time physical activity, respectively). Although the amount of variance accounted for in exercise dependence and moderate-vigorous leisure-time physical activity is small, these percentages are consistent with past research examining relationships between appearance investment and physical activity-related outcomes (Hausenblas & Symons Downs, 2002a; Prichard & Tigge-

153

mann, 2011). Similarly, the amount of variance accounted for by appearance investment in dietary restraint in the present study is similar to past research investigating the relationship between type of appearance investment and eating-related variables (i.e., Cash, Melnyk, et al., 2004). The difference in the amount of variance accounted for by appearance investment in the present study may reflect the fact that women are more likely to use diet rather than exercise as a way to control their weight (McCracken, Jiles, & Blanck, 2007; McElhone, Kearney, Giachetti, Zunft, & Martinez, 1999). For those women who believe it is important to maintain or improve their appearance, or for those who derive their sense of self from their appearance, it is likely that they will choose diet as a way to achieve this goal. It may be interesting to see if men, who are more likely to use exercise, or a combination of both exercise and diet rather than diet alone to control appearance (McElhone et al., 1999; Millstein et al., 2008) report similar relationships. It is also important to note that appearance evaluation was more closely associated with healthy behavior (i.e., moderate-vigorous physical activity), while investment, and particularly self-evaluative salience, was more strongly associated with (potentially) unhealthy and extreme behaviors (dietary restraint, exercise dependence). In fact, in the regression predicting dietary restraint, current-ideal discrepancy (appearance evaluation) was no longer a significant predictor once self-evaluative and motivational salience (appearance investment) were added into the model. This difference is important, because it may help us identify who is at a greater risk of engaging in dietary restraint and extreme exercise participation, as well as other unhealthy behaviors related to appearance. It appears that high levels of investment may be an indicator that women could be at risk for unhealthy appearance-related behaviors. It also suggests that programs to help increase healthy behaviors, such as exercise, may need to target different factors than those designed to prevent, or reduce, unhealthy ones. There are some limitations to this study that should be noted. First, results can only be generalized to college women with healthy BMIs, as the majority of our sample were classified as having normal BMIs. Further, this sample reported moderate levels of appearance evalua-

154


tion and investment (both self-evaluative and motivational salience of physical appearance) as evidenced by the means for these variables, which fell around the midpoint of the scales (see Table 1). Results may not be the same for individuals of different ages such as older adults (who place relatively higher value on functioning compared with appearance; see Tiggemann, 2004), men, or individuals who do not value physical appearance or, on the other hand, who place an extremely high level of value on weight and physical appearance (e.g., athletes of sports that require a specific lean body type, those with an eating disorder). Further, because of the correlational nature of the present study, causality cannot be determined; we are unable to assess whether greater appearance evaluation or investment leads to these behaviors (i.e., dietary restraint, exercise dependence, leisuretime physical activity), or whether engaging in these behaviors leads to changes in the evaluation of and importance placed on appearance. Finally, the current study investigated only investment based on physical appearance. Other aspects of body image (e.g., fitness, functioning) may further our understanding of the relationship between appearance evaluation and investment and health-related behaviors. Researchers should examine the relationship between appearance evaluation and investment, exercise, and dietary restraint in other populations with varying levels of investment in physical appearance, as well as its relationship to other potentially health-damaging behaviors as they relate to body image. For instance, elective cosmetic surgery, diet pill or steroid use, tanning, and smoking may also be related to appearance investment. Also, longitudinal research tracking the course of appearance investment from childhood through older adulthood may provide insight into how investment may change over the life span, and its relationship with health behaviors. Finally, our findings highlight the need for future research to examine the relative importance of these variables and not just simple bivariate relationships. Such correlations may miss important information, especially given the small to moderate relationship between self-discrepancy and motivational and self-evaluative salience. Because appearance investment is associated with potentially health-damaging behavior as supported by the present findings, it is important

to examine interventions designed to lower the importance placed on one’s physical appearance and in particular self-evaluative salience. Interventions may be designed to redirect individuals’ attention from physical appearance to other aspects of body image (i.e., health or function) in order to decrease the risk of engaging in health risk behavior to improve physical appearance. However, it should also be noted that investment in physical appearance is not entirely negative by definition. It has been shown that motivational salience is unrelated to body image quality of life, self-esteem, or avoidance-based coping strategies for men or women (Cash, Jakatdar, et al., 2004; Cash, Melnyk, et al., 2004; Cash et al., 2005). It is possible that adaptive appearance investment may be associated with healthy behaviors, such as healthy eating. Second, interventions designed to reduce current-ideal discrepancy should be investigated as a way to increase physical activity behavior. Also, future research should include indicators of positive body image (i.e., body pride, body esteem) to examine the relationship between motivational salience and positive body image. Much of the existing research investigating the type of investment and its relationship to body image variables has focused on negative indicators of body image. The findings of the present study indicate that it is important to consider both appearance evaluation and investment when investigating their relationship to health-related behaviors. In addition, we provide evidence that the type of appearance investment is also important. More negative appearance evaluation was associated with lower levels of moderate-vigorous physical activity. Further, when investment in appearance influences how people feel about themselves as a person (self-evaluative salience), it has the potential to become maladaptive, and may be associated with unhealthy levels of exercise (i.e., exercise dependence). However, for some health-related behaviors (dietary restraint), the level of appearance investment in addition to the type of investment may be influential. Therefore, when investigating health behaviors, it is important to consider both appearance evaluation and investment. As well, the level of the specific type of investment rather than just the overall general concern for weight and shape should be considered, in order to gain a better understanding of factors related


to the performance of healthy and unhealthy behaviors.

References Allen, K. L., Byrne, S. M., McLean, N. J., & Davis, E. A. (2008). Overconcern with weight and shape is not the same as body dissatisfaction: Evidence from a prospective study of pre-adolescent boys and girls. Body Image, 5, 261–270. doi:10.1016/ j.bodyim.2008.03.005 Anton, S. D., Perri, M. G., & Riley, J. R. (2000). Discrepancy between actual and ideal body images: Impact on eating and exercise behaviors. Eating Behaviors, 1, 153–160. doi:10.1016/S14710153(00)00015-5 Bouchard, C., Shephard, R. J., & Stephens, T. (1994). Physical activity, fitness and health: International proceedings and consensus statement. Champaign, IL: Human Kinetics. Brannan, M. E., & Petrie, T. A. (2008). Moderators of the body dissatisfaction-eating disorder symptomatology relationship: Replication and extension. Journal of Counseling Psychology, 55, 263– 275. doi:10.1037/0022-0167.55.2.263 Cash, T. F., Fleming, E. C., Alindogan, J., Steadman, L., & Whitehead, A. (2002). Beyond body image as a trait: The development and validation of the Body Image States Scale. Eating Disorders: The Journal of Treatment & Prevention, 10, 103–113. doi:10.1080/10640260290081678 Cash, T. F., Jakatdar, T. A., & Williams, E. F. (2004). The Body Image Quality of Life Inventory: Further validation with college men and women. Body Image, 1, 279 –287. doi:10.1016/S1740-1445(03) 00023-8 Cash, T. F., Melnyk, S. E., & Hrabosky, J. I. (2004). The assessment of body image investment: An extensive revision of the Appearance Schemas Inventory. International Journal of Eating Disorders, 35, 305–316. doi:10.1002/eat.10264 Cash, T. F., & Pruzinsky, T. (1990). Body images: Development, deviance, and change. New York, NY: Guilford Press. Cash, T. F., & Pruzinsky, T. (2002). Body image: A handbook of theory, research, and clinical practice. New York, NY: Guilford Press. Cash, T. F., Santos, M. T., & Williams, E. F. (2005). Coping with body-image threats and challenges: Validation of the Body Image Coping Strategies Inventory. Journal of Psychosomatic Research, 58, 191–199. doi:10.1016/j.jpsychores .2004.07.008 Cash, T. F., & Szymanski, M. L. (1995). The development and validation of the Body-Image Ideals Questionnaire. Journal of Personality Assess-

155

ment, 64, 466 – 477. doi:10.1207/s15327752jpa 6403_6 Cash, T. F., Theriault, J. E., & Annis, N. M. (2004). Body image in an interpersonal context: Adult attachment, fear of intimacy, and social anxiety. Journal of Social & Clinical Psychology, 23, 89 – 103. doi:10.1521/jscp.23.1.89.26987 Cash, T. F. (2005). The influence of sociocultural factors on body image: Searching for constructs. Clinical Psychological Science & Practice, 12, 438 – 442. doi:10.1093/clipsy.bpi055 Chan, C. S., & Grossman, H. Y. (1988). Psychological effects of running loss on consistent runners. Perceptual & Motor Skills, 66, 875– 883. doi: 10.2466/pms.1988.66.3.875 Davis, C., Durnin, J. V. G. A., Gurevich, M., Le Maire, A., & Dionne, M. (1993). Body composition correlates of weight dissatisfaction and dietary restraint in young women. Appetite, 20, 197–207. doi:10.1006/appe.1993.1020 Davis, C., Shapiro, C. M., Stuart, E., & Dionne, M. (1993). Personality and other correlates of dietary restraint: An age by sex comparison. Personality & Individual Differences, 14, 297–305. doi:10.1016/ 0191-8869(93)90127-O Diehl, N. S., Johnson, C. E., Rogers, R. L., & Petrie, T. A. (1998). Social physique anxiety and disordered eating: What’s the connection? Addictive Behaviors, 23, 1– 6. doi:10.1016/S0306-4603 (97)00003-8 Forand, N. R., Gunthert, K. C., German, R. E., & Wenze, S. J. (2010). Appearance investment and everyday interpersonal functioning: An experience sampling study. Psychology of Women Quarterly, 34, 380 –393. doi:10.1111/j.1471-6402 .2010.01583.x Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences, 10, 141–146. Gorman, B. S., & Allison, D. B. (1995). Measures of restrained eating. In D. A. Allison (Ed.), Handbook of assessment methods of eating behaviors and weight-related problems: Measures, theory, and research (pp. 149 –194). Thousand Oaks, CA: Sage. Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., . . . Bauman, A. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116, 1081–1093. doi:10.1161/CIRCULATIONAHA.107.185649 Hausenblas, H. A., & Fallon, E. A. (2002). Relationship among body image, exercise behavior, and exercise dependence symptoms. International Journal of Eating Disorders, 32, 179 –185. doi: 10.1002/eat.10071

156


Hausenblas, H. A., & Symons Downs, D. (2002a). Exercise dependence: A systematic review. Psychology of Sport & Exercise, 3, 89 –123. doi: 10.1016/S1469-0292(00)00015-7 Hausenblas, H. A., & Symons Downs, D. (2002b). How much is too much? The development and validation of the Exercise Dependence Scale. Psychology & Health, 17, 387– 404. doi:10 .1080/0887044022000004894 Hawks, S. R., Madanat, H. N., & Christley, H. S. (2008). Psychosocial associations of dietary restraint: Implications for healthy weight promotion. Ecology of Food & Nutrition, 47, 450 – 483. doi: 10.1080/03670240701821527 Hayes, D., & Ross, C. E. (1987). Concern with appearance, health beliefs, and eating habits. Journal of Health & Social Behavior, 28, 120 –130. doi: 10.2307/2137126 Health Canada. (2003). Canadian guidelines for body weight classification in adults. Retrieved from http:// www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/ guide-ld-adult/bmi_chart_java-graph_imc_javaeng.php Herman, C., & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43, 647– 660. doi:10.1111/j.1467-6494.1975 .tb00727.x Hutcheson, G., & Sofroniou, N. (1999). The multivariate social scientist: Introductory statistics using generalized linear models. Thousand Oakes, CA: Sage. Ip, K., & Jarry, J. L. (2008). Investment in body image for self-definition results in greater vulnerability to the thin media than does investment in appearance management. Body Image, 5, 59 – 69. doi:10.1016/j.bodyim.2007.08.002 Jacobs, D. R., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine & Science in Sports & Exercise, 25, 81–91. doi:10.1249/00005768199301000-00012 Klesges, R. C., Isbell, T. R., & Klesges, L. M. (1992). Relationship between dietary restraint, energy intake, physical activity, and body weight: A prospective analysis. Journal of Abnormal Psychology, 101, 668 – 674. doi:10.1037/0021-843X .101.4.668 Kostanski, M., & Gullone, E. (1998). Adolescent body image dissatisfaction: Relationships with self-esteem, anxiety, and depression controlling for body mass. Journal of Child Psychology & Psychiatry, 39, 255–262. doi:10.1017/ S0021963097001807 Kowalski, K. C., Mack, D. E., Crocker, P. R. E., Niefer, C. B., & Fleming, T. (2006). Coping with social physique anxiety. Journal of Adolescent

Health, 39, 275.e9 –275e.16. doi:10.1016/j.jadohealth .2005.12.015 Kruger, J., Lee, C., Ainsworth, B. E., & Macera, C. A. (2008). Body size satisfaction and physical activity levels among men and women. Obesity, 16, 1976 –1979. doi:10.1038/oby.2008.311 Lamarche, L., Kerr, G., Faulkner, G., Gammage, K. L., & Klentrou, P. (2011, November). A qualitative examination of body image threats using Social Self-Preservation Theory. Body Image. doi: 10.1016/j.bodyim.2011.10.004 Lattimore, P., & Hutchinson, R. (2010). Perceived calorie intake and state body-image satisfaction in women attempting weight loss: A preliminary investigation. Body Image, 7, 15–21. doi:10.1016/ j.bodyim.2009.08.002 Leary, M. R. (1992). Self-presentational processes in exercise and sport. Journal of Sport & Exercise Psychology, 14, 339 –351. Lindwall, M., & Martin Ginis, K. A. (2006). Moving towards a favourable image: The self-presentational benefits of exercise and physical activity. Scandinavian Journal of Psychology, 47, 209 – 217. doi:10.1111/j.1467-9450.2006.00509.x Markland, D., & Hardy, L. (1993). The Exercise Motivations Inventory: Preliminary development and validity of a measure of individuals’ reasons for participation in regular physical exercise. Personality and Individual Differences, 15, 289 –296. doi:10.1016/0191-8869(93)90219-S Markland, D., & Ingledew, D. K. (1997). The measurement of exercise motives: Factorial validity and invariance across gender of a revised Exercise Motivations Inventory. British Journal of Health Psychology, 2, 361–376. doi:10.1111/j.20448287.1997.tb00549.x Martin Ginis, K. A., Latimer, A. E., & Jung, M. E. (2003). No pain no gain? Examining the generalizability of the exerciser stereotype to moderately active and excessively active targets. Social Behavior & Personality, 31, 283–290. doi:10.2224/ sbp.2003.31.3.283 McCauley, M., Mintz, L., & Glenn, A. A. (1988). Body image, self-esteem, and depression-proneness: Closing the gap. Sex Roles, 18, 381–391. doi:10.1007/BF00288390 McCracken, M., Jiles, R., & Blanck, H. M. (2007). Health behaviors of the young adults U.S. Population: Behavioral risk factor surveillance system, 2003. Preventing Chronic Disease, 4, 1–15. McElhone, S., Kearney, J. M., Giachetti, I., Zunft, H. F., & Martinez, J. A. (1999). Body image perception in relation to recent weight changes and strategies for weight loss in a nationally representative sample in the European Union. Public Health Nutrition, 21, 143–151. McGee, B. J., Hewitt, P. L., Sherry, S. B., Parkin, M., & Flett, G. L. (2005). Perfectionistic self-


presentation, body image, and eating disorder symptoms. Body Image, 2, 29 – 40. doi:10.1016/ j.bodyim.2005.01.002 Melnyk, S. E., Cash, T. F., & Janda, L. H. (2004). Body image ups and downs: Prediction of intraindividual level and variability of women’s daily body image experiences. Body Image, 1, 225–235. doi:10.1016/j.bodyim.2004.03.003 Millstein, R. A., Carlson, S. A., Fulton, J. E., Galuska, D. A., Zhang, J., Blanck, H. M., & Ainsworth, B. E. (2008). Relationships between body size satisfaction and weight control practices among US adults. The Medscape Journal of Medicine, 10, 129. Mulvihill, C. B., Davies, G. J., & Rogers, P. J. (2002). Dietary restraint in relation to nutrient intake, physical activity and iron status in adolescent females. Journal of Human Nutrition & Dietetics, 15, 19 –31. doi:10.1046/j.1365-277X.2002 .00329.x Muth, J. L., & Cash, T. F. (1997). Body-image attitudes: What difference does gender make? Journal of Applied Social Psychology, 27, 1438 –1452. doi: 10.1111/j.1559-1816.1997.tb01607.x Petrie, T. A., Greenleaf, C., Reel, J., & Carter, J. (2009). Personality and psychological factors as predictors of disordered eating among female college athletes. Eating Disorders, 17, 302–312. doi: 10.1080/10640260902991160 Prichard, I., & Tiggemann, M. (2011). Appearance investment in Australian brides-to-be. Body Image, 8, 282–286. doi:10.1016/j.bodyim.2011.03 .001 Rudiger, J. A., Cash, T. F., Roehrig, M., & Thompson, J. K. (2007). Day-to-day body-image states: Prospective predictors of intra-individual level and variability. Body Image, 4, 1–9. doi:10.1016/ j.bodyim.2006.11.004 Sabiston, C. M., Sedgwick, W. A., Crocker, P. R. E., Kowalski, K. C., & Mack, D. E. (2007). Social physique anxiety in adolescence: An exploration of influences, coping strategies, and health behaviors. Journal of Adolescent Research, 22, 78 –101. doi:10.1177/0743558406294628

157

Spoor, S. T. P., Bekker, M. H. J., Van Heck, G. L., Croon, M. A., & Van Strien, T. (2005). Inner body and outward appearance: The relationships between appearance orientation, eating disorder symptoms, and internal body awareness. Eating Disorders, 13, 479 – 490. doi:10.1080/ 10640260500297267 Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825– 848. doi:10.1037/00332909.128.5.825 Stunkard, A. J., & Messick, S. (1985). The threefactor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research, 29, 71– 83. doi:10.1016/ 0022-3999(85)90010-8 Szabo, A. (2000). Physical activity as a source of psychological dysfunction. In S. J. Biddle, K. R. Fox, & S. H. Boutcher (Eds.), Physical activity and psychological well-being (pp. 130 –153). London, England: Routledge. Szymanski, M. L., & Cash, T. F. (1995). Body image disturbances and self-discrepancy theory: Expansion of the Body-Image Ideals Questionnaire. Journal of Social & Clinical Psychology, 14, 134 – 146. doi:10.1521/jscp.1995.14.2.134 Tiggemann, M., & Lacey, C. (2009). Shopping for clothes: Body satisfaction, appearance investment, and functions of clothing among female shoppers. Body Image, 6, 285–291. doi:10.1016/ j.bodyim.2009.07.002 Tiggemann, M., & Williamson, S. (2000). The effect of exercise on body satisfaction and self-esteem as a function of gender and age. Sex Roles, 43, 119 – 127. doi:10.1023/A:1007095830095 Tiggemann, M. (2004). Body image across the adult life span: Stability and change. Body Image, 1, 29 – 41. doi:10.1016/S1740-1445(03)00002-0 White, J., & Halliwell, E. (2010). Examination of a sociocultural model of excessive exercise among male and female adolescents. Body Image, 7, 227– 233. doi:10.1016/j.bodyim.2010.02.002 Received August 26, 2011 Revision received November 28, 2011 Accepted November 29, 2011 䡲