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Abstract
Background
Children’s eating behaviors, body shape and body image cognition may be more susceptible to the influence of their parents, but these influences may be weakened with age. There may be different association pathways between parental pressure on children’s body image (PPCBI), body mass index (BMI), body image dissatisfaction (BID) and eating disorders (EDs) among children and adolescents at different developmental stages.
Methods
The stratified cluster sampling method (Stratified by grade, and took the classes as clusters) was used to select 486 students aged 8–15 years in two 9-year schools. Children’s body height, weight, testicular volume and breast development were measured. PPCBI, BID, and EDs were investigated using the Appearance-related Social Stress Questionnaire, Body Size Questionnaire (BID-14), and EDI-1 scale, respectively.
Results
The boys before puberty initiation had significantly higher EDs score (182.3±50.8) than girls before puberty initiation (164.1±58.1) (P<0.05). There were significant association pathways of PPCBI→BMI→BID→EDs and PPCBI→BID→EDs in boys before puberty initiation (β=0.035, P<0.01; β=0.059, P<0.01), in boys after puberty initiation (β=0.032, P<0.01; β=0.175, P<0.001), and in girls after puberty initiation (β=0.026, P<0.01; β=0.172, P<0.001). There was a positive association pathway of PPCBI→EDs in boys before puberty initiation (β=0.30, P<0.001) and PPCBI→BID→EDs in girls before puberty initiation (β=0.176, P<0.01).
Conclusion
Parental pressure on children’s body image may positively associate with children’s eating disorders through BMI and body image dissatisfaction in boys and girls after puberty initiation and directly associate with eating disorders in boys before puberty initiation; however, it may indirectly associate with eating disorders only through BID in girls before puberty initiation.
Abbreviations
PPCBI, parental pressure on children’s body image; BMI, body mass index; BID, body image dissatisfaction; EDs, eating disorders; X2/DF, chi-square/free ratio; GFI, goodness-of-fit index; AGFI, adjusted goodness-of-fit index; SRMR, standardized root mean square residual; NFI, standard fit index; TLI, Tucker-Lewis index; CFI, comparative fit index.
Data Sharing Statement
All data generated or analyzed during this study are not publicly available to maintain the privacy of the individuals’ identities. The dataset supporting the conclusions is available upon request to the corresponding author.
Ethics Approval and Consent to Participate
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Medical Research Ethics Committee of Bengbu Medical College ([2015] NO.003). Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.
Acknowledgments
We would like to thank the teachers and students who participated in this study, as well as all other members for their support during the different phases of the study.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests.