RUNNING HEAD:  Body Image in Older Women

 

 

 

 

Body Image, Body Dissatisfaction, and Eating Attitudes

in Mid-life and Elderly Women

 

 

Diane M. Lewis, M.A., & Fary M. Cachelin, Ph.D.

California State University, Los Angeles

 

 

 

 

This work was conducted by the first author, under the supervision of the second author, in partial fulfillment of the requirements for the Master of Arts degree.  Address all correspondence to:  Dr. Fary Cachelin, Department of Psychology, California State University at Los Angeles, 5151 State University Drive, Los Angeles, CA 90032-8227; tel:  (323) 343-5005; fax:  (323) 343-2281; email:  fcachel@calstatela.edu.

 

EATING DISORDERS:  THE JOURNAL OF TREATMENT & PREVENTION, 2001, VOL. 9, pp. 29-39
Abstract

 

            Cohort differences in body image, drive for thinness, and eating attitudes in middle-aged and elderly women were examined.  Participants were 125 women between the ages of 50 and 65 ("middle-aged" group), and 125 women 66 years old and above ("elderly" group).  Instruments used were figure ratings (Stunkard, Sorensen, & Schulsinger, 1983), and scales of the Eating Disorder Inventory (EDI; Garner, Olmstead, & Polivy, 1983).  Items were developed to assess fear of aging.  The middle-aged group, as compared to the elderly group, had more drive for thinness, disinhibited eating, and interoceptive confusion.  The elderly group reported body size preferences and levels of body dissatisfaction that were similar to the younger women.  There was a positive relationship between fear of aging and disordered eating.  Sociocultural standards of body image and pressures toward thinness affect similarly different generations of older women. 

 

 

 

 

 

 

 

Key Words:  body image, disordered eating, elderly women, middle-aged women

 

            The elderly population in the United States has been increasing steadily, and it is expected that in the next millenium, the growth of this segment of the population will exceed that of all other age groups.  The majority of the elderly population are, and will continue to be, women (U.S. Bureau of the Census, 1996).  The changes associated with the aging of the body most likely have an effect upon body image (Kreuger, 1989).  Yet, until recently, research on body image and eating disorders has focused almost exclusively on younger, adolescent and college-aged populations.

            Existing research indicates that body image disturbance, drive for thinness, and eating disorders do occur in older women (Hsu & Zimmer, 1988), and that eating disorders such as anorexia nervosa and bulimia nervosa are probably underdiagnosed in this population (Cosford & Arnold, 1991; Hall & Driscoll, 1993).  Numerous case reports of anorexia nervosa in the elderly have been reported (e.g., Cosford & Arnold, 1991; Dally, 1984; Gupta, 1990; Hall & Driscoll, 1993; Hsu & Zimmer, 1988; Killett, Trimble, & Thorley, 1976; White, Harries, & Allen, 1990).  The clinical picture of eating disorders in the elderly is similar to that seen in adolescents (Hsu & Zimmer, 1988), and there appears to be considerable continuity between midlife- and adolescent-onset anorexia nervosa (Dally, 1984).  It has been suggested that the psychological and physical changes associated with aging and menopause may parallel the changes associated with puberty and menarche, producing eating and weight-related concerns that are similar in the different age groups of women (Gupta, 1990; Kellett, Trimble, & Thorley, 1976).  It appears that concern with aging, the belief that weight loss and a slim physique result in youthful looks, and the increasing social pressures on older women to retain physical attractiveness and sexuality can contribute to the development of disordered eating (Gupta, 1990; Gupta & Schork, 1993; Hall & Driscoll, 1993; Hsu & Zimmer, 1988).

            Concerns about an aging appearance, including concerns about aging skin, can be associated with a drive for thinness and excessive dieting, factors that are key components in the development of eating disorders (Gupta, 1995).  Body dissatisfaction and drive for thinness have been demonstrated in groups of older women (Feingold & Mazzella, 1998; Hetherington & Burnett, 1994; Lamb, Jackson, Cassiday, & Priest, 1993; Rozin & Fallon, 1988; Tiggemann, 1992; Tiggemann & Stevens, 1999).  Drive for thinness and dieting found in older women are of particular concern not only because of their association with the development of eating disorders, but also because of the health consequences of dieting and low weight that occur in old age.  Dieting in the elderly may pose a significant threat to good health (see Gupta, 1990; Hetherington & Burnett, 1994).  Mortality associated with low weight increases as a function of age (Tayback, Kumanyika, & Chee, 1990), and physical complications due to nutritional deficiencies, such as osteoporosis and stress fractures, are quick to occur in the elderly (Kay, 1987).  Additionally, restrained eating is associated with slower cognitive performance in young individuals (Rogers & Green, 1993), and this cognitive impairment may be even more pronounced in the elderly who diet.

            Cohort differences have been studied in order to examine body dissatisfaction across the life span, and to investigate how society's changing beauty ideal may have affected the body image of different generations.  The majority of these studies have focused upon college-aged populations and their parents or middle-aged adults (i.e., 40-65 years old), and have found that body dissatisfaction in women remains apparent in midlife (Lamb et al., 1993; Rozin & Fallon, 1988), and may even increase as older women gain weight and move further from their ideal (Tiggemann, 1992).  We are aware of only one study to date (Hetherington & Burnett, 1994) that has examined cohort differences by comparing an elderly population of women (mean age 67.3, ranging from 60-78 years old) to young adults (18-31 years old).  These investigators included only normal-weight individuals in the study, and found that dieting restraint and eating attitudes were similar across the age groups (Hetherington & Burnett, 1994).  With such a wide age range, however, it is difficult to separate cohort influences from developmental influences (Lamb et al., 1993).

            In this study we examined cohort differences in body image, drive for thinness, and eating attitudes by comparing a middle-aged population of women to an elderly population of women.  The following questions were addressed:  1) How do the two groups of women compare on figure preferences and body dissatisfaction?  2) How do the two groups compare on eating and weight-related behaviors and attitudes?  3) What are the characteristics of those individuals who have comparatively high levels of body dissatisfaction, drive for thinness, and disordered eating?  4) Does marital status have an influence?  It has been proposed that development of disordered eating in older women may be a maladaptive solution to marital crisis (Dally, 1984), and that weight and eating may become a means of maintaining equilibrium in a marriage (Abramson, 1999).

            In order to minimize developmental differences, we compared generations that are closer in age range.  Additionally, we included individuals of all weight categories (i.e., underweight, normal weight, overweight and obese), and sampled from an elderly population that was considerably older than that represented in most previous studies. 

 

Methods

Participants

            Participants (N = 250) were 125 women between the ages of 50 and 65 ("middle-aged" group), and 125 women 66 years old and above ("elderly" group).  The majority of participants were White (231 White, 3 Black, 4 Hispanic, 9 Asian, 2 "Other," and 1 missing value).  Mean age for the total sample was 67.6, average level of education was a 2-year college degree, average household income was $30,000 - $50,000 per year, and mean Body Mass Index (BMI) was 23.3 (range 15.7 to 40.2).  Participants were generally healthy and were not cognitively or perceptually impaired.

            Participants were recruited from a large urban community.  Originally 675 surveys were distributed in residential neighborhoods, university campuses, senior centers, retirement communities, and planned communities for mature adults.  Elderly participants living in communities were individuals classified as "unassisted" and who made independent decisions about eating and meals.  A total of 257 surveys were completed and returned (38.1% response rate); seven were discarded from the final sample due to missing data.

Procedure

            Participation in the study was voluntary and no compensation was given.  The survey, entitled "Women's Health and Eating Habits," consisted of the following:

            Demographics & BMI.  Participants were asked to report their age, ethnicity, highest level of education (1 = high school, 2 = some college, 3 = 2-year college degree, 4 = 4-year college degree, 5 = graduate degree), yearly household income (1 = less than $20,000, 2 = $20,000-$30,000, 3 = $30,000-$50,000, 4 = $50,000-$70,000, 5 = $70,000 and over), marital status (living with spouse or living alone), and height and weight.  BMI (weight in kilograms/height2 in meters) was calculated based on participants’ self-reported height and weight; self-reports are highly correlated with actual heights and weights and are sufficiently valid to use in survey studies (Nieto-Garcia, Bush, & Keyl, 1990; Stewart, 1982; Stunkard & Albaum, 1981).  Based on BMI guidelines (National Heart, Lung, and Blood Institute, National Institutes of Health, 1998), participants were categorized as underweight (BMI < 20.0), normal weight (20.0 < BMI < 25.0), overweight (25.0 < BMI < 30.0), or obese (30.0 < BMI). 

            Figure Ratings.  Referring to nine female silhouettes depicting body size (Stunkard, Sorensen, & Schulsinger, 1983), ranging from severe emaciation ("1") to severe obesity ("9"), participants were asked to indicate:  "your current size and shape" (current); "the size and shape you would most like to be" (ideal); and "the size and shape you feel men in general find most attractive" (attractive).  This procedure has been used widely in similar research (e.g., Fallon & Rozin, 1985; Tiggemann, 1992).

            Eating and Weight-Related Behaviors & Attitudes.  The following scales of the Eating Disorder Inventory (EDI; Garner, Olmstead, & Polivy, 1983) were used:  Drive for Thinness, Body Dissatisfaction, Bulimia (disinhibited eating), and Interoceptive Awareness (lack of).

            Fear of Aging.  The following statements were utilized based on their face validity:  "I wish that I were younger," and "The changes caused by aging are too great."  Each item was scored as "never" (0), "rarely" (1), "sometimes" (2), "often" (3), "usually" (4), "always" (5). 

 

Results

Sample Characteristics

            An overall one-factor (age group:  middle-aged vs. elderly) Multivariate Analysis of Variance (MANOVA), with age, BMI, education and income as dependent variables, was conducted and found to be significant, Pillai Trace = .78, F(4, 245) = 222.94, p = .0001.  Planned univariate analyses indicated that the two groups were significantly different on age (Mean = 56.4 vs. 78.8 years for middle-aged and elderly group, respectively), F(1, 248) = 866.71, p = .0001, and on income, F(1, 248) = 25.22, p = .0001.1  There were no significant differences between the groups on education or BMI (Mean = 23.1 and 23.4 for middle-aged and elderly group, respectively).  Similarly, chi-square analysis demonstrated that the two groups were not significantly different in terms of weight category.

Body Image

            Paired t-tests were conducted within each age group to examine differences between current, ideal, and attractive figure ratings.  For the middle-aged group (N = 125), current figure was significantly larger than ideal figure, t(124) = 10.33, p < .0001, and attractive figure, t(121) = 9.43, p < .0001, and ideal figure was significantly larger than attractive figure, t(121) = 3.94, p = .0001.  A similar pattern was found for the elderly group (N = 125):  current figure was significantly larger than ideal figure, t(124) = 12.52, p < .0001, and attractive figure, t(120) = 10.88, p < .0001, and ideal figure was significantly larger than attractive figure, t(120) = 2.88, p = .005.  (See Table 1 for figure rating means for each age group.)

            An overall two-factor (age group X weight category) MANOVA was significant for weight category, Pillai Trace = .61, F(15, 699) = 11.87, p = .0001, but not significant for age group; there was no significant interaction.  Planned univariate tests revealed a significant main effect of weight category on current figure, F(3, 235) = 90.56, p = .0001, ideal figure, F(3, 235) = 15.57, p = .0001, attractive figure, F(3, 235) = 4.53, p = .004, and on current-vs.-ideal discrepancy, F(3, 235) = 53.53, p = .0001.  (See Table 2 for figure rating means for each weight category.)

            There was a significant main effect of age group on current-vs.-ideal discrepancy, F(1, 235) = 8.89, p = .003:  the middle-aged group displayed significantly more current-vs.-ideal discrepancy than the elderly group.  There were no significant correlations between figure ratings and fear of aging items.

Eating and Weight-related Behaviors

            An overall two-factor (age group X weight category) MANOVA conducted on the scales of the EDI was significant for age group, Pillai Trace = .07, F(4, 239) = 4.58, p = .001, and for weight category, Pillai Trace = .25, F(12, 723) = 5.54, p = .0001; there was no significant interaction.  Planned univariate tests revealed a significant main effect of age group on Drive for Thinness, F(1, 242) = 13.28, p = .0003, Bulimia, F(1, 242) = 13.44, p = .0003, and (lack of) Interoceptive Awareness, F(1, 242) = 6.51, p = .01:  the middle-aged group had significantly higher scores than the elderly group on these scales.  The two groups did not differ significantly on Body Dissatisfaction.  (See Table 3 for EDI subscale means for each age group.)  The mean EDI subscale scores for each age group were within less than one standard deviation of the normative data that have been derived primarily from the female college population (Garner, Olmstead, & Polivy, 1983).

            Planned univariate tests revealed a significant main effect of weight category on Drive for Thinness, F(3, 242) = 4.79, p = .003, Body Dissatisfaction, F(3, 242) = 14.67, p = .0001, Bulimia, F(3, 242) = 7.30, p = .0001, and (lack of) Interoceptive Awareness, F(3, 242) = 2.69, p = .047:  underweight individuals reported significantly less drive for thinness than normal weight and obese persons; underweight individuals reported significantly less body dissatisfaction than the other three groups, and normal weight individuals reported less body dissatisfaction than overweight and obese persons; the obese group had significantly higher Bulimia scores than the other groups; the underweight group had significantly less lack of interoceptive awareness than the normal weight and obese groups.  (See Table 4 for EDI subscale means for each weight category.)

            Correlational analyses revealed significant positive relationships between scales of the EDI and fear of aging.  There were significant correlations between "The changes caused by aging are too great" and Drive for Thinness (r = .30, p < .0001), Body Dissatisfaction (r = .24, p = .0002), Bulimia (r = .24, p = .0002), and (lack of) Interoceptive Awareness (r= .36, p < .0001).  "I wish that I were younger" was significantly correlated with Drive for Thinness (r = .15, p = .02).   

High Scorers on EDI Scales

            For each participant, scale scores were summed to provide an EDI total score (N = 250, Mean = 18.7, SD = 15.2).  Participants who scored more than one standard deviation above the mean (> 34) were considered "high scorers," and were compared to low scorers on the variables of interest.  Chi-square analyses indicated that high scorers (n = 44), as compared to low scorers (n = 206), were significantly more likely to be from the middle-aged group, c2(1) = 15.89, p < .0001, and were significantly more likely to belong to the obese weight category, c2(1) = 13.50, p = .004; the two groups were not different in terms of marital status.

            An overall one-factor (high scorer vs. low scorer) MANOVA conducted on the dependent variables of interest was significant for group membership, Pillai Trace = 0.27, F(10, 232) = 8.43, p = .0001.  Planned univariate tests revealed that high scorers, as compared to low scorers, were significantly younger (Mean = 61.2 vs. 69.0 years, respectively), F(1, 241) = 14.64, p = .0002, were significantly heavier (Mean BMI = 24.6 vs. 23.0, respectively), F(1, 241) = 6.61, p = .01, reported significantly larger current figures (Mean = 5.1 vs. 4.2, respectively), F(1, 241) = 22.31, p = .0001, reported significantly greater current-vs.-ideal figure discrepancy (Mean = 2.0 vs. 0.9, respectively), F(1, 241) = 48.03, p = .0001, and endorsed more strongly fear of aging on the item "The changes caused by aging are too great," (Mean = 2.5 vs. 1.8, respectively), F(1, 241) = 15.05, p = .0001.  High scorers were not significantly different from low scorers in terms of education, income, ideal or attractive figures.

Marital Status

            Preliminary chi-square analysis demonstrated that the two age groups were significantly different in terms of marital status, c2(1) = 35.43, p < .0001, with middle-aged women more likely than elderly women to be living with a spouse (71.2% vs. 33.6%), and elderly women more likely than middle-aged women to be living alone (66.4% vs. 28.8%).  Therefore, subsequent analyses were conducted within each age group. 

            For the middle-aged group, MANOVA indicated no significant effect of marital status on BMI, figure ratings, EDI scales, or fear of aging.  Likewise, for the elderly group, there was no significant effect of marital status on these variables.

           

Discussion

            The middle-aged women in our study exhibited more drive for thinness, disinhibited eating, and interoceptive confusion on the Eating Disorder Inventory (EDI; Garner, Olmstead, & Polivy, 1983) than did the elderly women.  Moreover, individuals who had particularly high scores on the scales of the EDI were more likely to be middle-aged and were younger than the rest of the sample.  Yet, the elderly group displayed similar levels of body dissatisfaction as the younger group, and chose similarly thin figures as their ideal and as attractive to men.  These findings indicate that sociocultural standards of body image and pressures toward thinness affect to a similar degree different generations of older women.  The differences between the two groups appear to be primarily motivational and behavioral; although equally dissatisfied with their bodies, elderly women are less likely than middle-aged women to report doing anything about it, such as restraining their eating or engaging in other weight-related behaviors.   

            Not surprisingly, individuals from different weight categories reported different levels of body dissatisfaction and disordered eating.  The underweight group reported less drive for thinness, body dissatisfaction (as measured by the EDI and by current versus ideal figure discrepancy), and interoceptive confusion than the normal weight, overweight and obese groups.  Importantly, the obese group reported more drive for thinness, body dissatisfaction, disinhibited eating, and lack of interoceptive awareness than the other groups; individuals who had particularly high scores on the EDI were more likely to be obese and were heavier than the rest of the sample.  These results suggest that Binge Eating Disorder (BED), which is often accompanied by obesity, may occur in older women (particularly those who are middle-aged).  The limited research to date on eating disorders in older women has focused on anorexia nervosa and bulimia nervosa.  It appears that the possibility of BED in this population should be a clinical concern and a focus of future research.   

            We did find a relationship between fear of aging and drive for thinness, body dissatisfaction, disinhibited eating and interoceptive confusion; individuals with more disordered eating reported greater fear of aging.  These results support the work of Gupta and colleagues (1990, 1993, 1995) who have argued that a concern with aging can be associated with drive for thinness and excessive dieting, and may precipitate the development of eating disorders in older women.  More research with both women and men is needed to increase our understanding of the relationship between concern with aging and disordered eating.  As the incidence of eating disorders seems to be increasing, this area of research is particularly pertinent given that eating disorders do run in families (American Psychiatric Association, 1994), and that excessive weight concern and dieting can be transmitted from mothers (or parents) to offspring.         

            We did not find a relationship between marital status and body image or disordered eating (as measured by scales of the EDI).  Other investigators (Abramson, 1999; Dally, 1984) have suggested that the development of disordered eating in older women can be a response to marital problems.  In this study, we did not gather information on the quality of the marital relationships of our sample.  Therefore, we can not rule out the possibility that a lack of relationship between these variables was due to a low rate of marital problems in our sample.  Another possibility is that the hypothesized relationship between marital difficulties and disordered eating is variable, differing between individuals and changing across time.  It might be best to study this relationship on a case-by-case basis.

            Our sample was primarily White, and nonclinical.  Therefore, findings from this study cannot be generalized to clinical populations or to different ethnicities.  Additionally, the size of our obese group was quite small, and participants self-selected by volunteering to be in the study.  Future studies are needed that include clinical populations, different ethnicities, elderly men, and large samples of individuals from different weight categories.  Limitations notwithstanding, our findings contribute to the limited research on body image and eating attitudes in two groups of older women, the middle-aged and the elderly.

            The pattern demonstrated in our study, of the relatively younger women (i.e., middle-aged) reporting greater eating and weight-related concerns than the more elderly, is consistent with other research that has investigated cohort differences by comparing college-aged to older women (Hetherington & Burnett, 1994).  It is noteworthy that the elderly women in our study, who were older than samples studied in most previous research, reported body size preferences and levels of body dissatisfaction that were similar to younger women, as well as levels of drive for thinness and other eating-related concerns that were within the normative range of that found for college women.  These findings are of particular concern given the nutritional consequences of dieting and weight control for the elderly.  Physicians and clinicians need to consider disordered eating, with accompanying body image problems and attempts at weight control, as potential health concerns in elderly women.

Footnote

 

                1Although the two groups were significantly different on income level, this difference was not large (Mean = 3.9 for middle-aged group vs. 3.1 for elderly group, indicating yearly household incomes of $50,000-$70,000 vs. $30,000-$50,000).  We did not control for income by entering it as a covariate in subsequent analyses because we felt that the difference was due to the retired status of the elderly group and did not reflect a true difference in social class, which has been hypothesized to influence body image and eating attitudes (see Striegel-Moore & Cachelin, 1999).

 

 

                  

 

References

 

            Abramson, E. E.  (1999).  To have and to hold:  How to take off the weight when marriage puts on the pounds.  New York:  Kensington Books.

            American Psychiatric Association.  (1994).  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.  Washington, DC:  Author.

            Cosford, P., & Arnold, E.  (1991).  Anorexia nervosa in the elderly.  British Journal of Psychiatry, 158, 286.

            Dally, P.  (1984).  Anorexia tardive--late onset marital anorexia nervosa.  Journal of Psychosomatic Research, 28, 423-428.

            Fallon, A. E., & Rozin, P.  (1985).  Sex differences in perceptions of desirable body shape.  Journal of Abnormal Psychology, 94, 102-105.

            Feingold, A., & Mazzella, R.  (1998).  Gender differences in body image are increasing.  Psychological Science, 9, 190-195.

            Garner, D. M., Olmstead, M. P., & Polivy, J.  (1983).  Development and validation of a multidimensional eating disorder inventory of anorexia nervosa and bulimia.  International Journal of Eating Disorders, 2, 15-34.

            Gupta, M. A.  (1990).  Fear of aging:  A precipitating factor in late onset anorexia nervosa.  International Journal of Eating Disorders, 9, 221-224.

            Gupta, M. A.  (1995).  Concerns about aging and a drive for thinness:  A factor in the biopsychosocial model of eating disorders?  International Journal of Eating Disorders, 18, 351-357.

            Gupta, M. A., & Schork, N. J.  (1993).  Aging-related concerns and body image:  Possible future implications for eating disorders.  International Journal of Eating Disorders, 14, 481-486.

            Gupta, M. A., Schork, N. J., & Dhaliwal, J. S.  (1993).  Stature, drive for thinness and body dissatisfaction:  A study of males and females from a nonclinical sample.  Canadian Journal of Psychiatry, 38, 59-61.

            Hall, P., & Driscoll, R.  (1993).  Anorexia in the elderly--an annotation.  International Journal of Eating Disorders, 14, 497-499.

            Hetherington, M. M., & Burnett, L.  (1994).  Ageing and the pursuit of slimness:  Dietary restraint and weight satisfaction in elderly women.  British Journal of Clinical Psychology, 33, 391-400.

            Hsu, L. K. G., & Zimmer, B.  (1988).  Eating disorders in old age.  International Journal of Eating Disorders, 7, 133-138.

            Kay, P. A. J.  (1987).  Clinical aspects of geriatric eating disorders.  In H. Field & B. Domangue (Eds.), Eating disorders throughout the life span (pp. 139-146).  New York:  Praeger.

            Kellett, J., Trimble, M., & Thorley, A.  (1976).  Anorexia nervosa after the menopause.  British Journal of Psychiatry, 128, 555-558.

            Kreuger, D. W.  (1989).  Body self and psychological self.  New York:  Brunner/Mazel.

            Lamb, C. S., Jackson, L. A., Cassiday, P. B., & Priest, D. J.  (1993).  Body figure preferences of men and women:  A comparison of two generations.  Sex Roles, 28, 345-358.

            National Institutes of Health; National Heart, Lung, and Blood Institute.  (1998).  First federal obesity clinical guidelines released.  [Online].  Available:  http://www.nhlbi.nih.gov/nhlbi/obesity.html.

            Nieto-Garcia, F. J., Bush, T. L., & Keyl, P. M.  (1990).  Body mass definitions of obesity:  Sensitivity and specificity using self-reported weight and height.  Epidemiology, 1, 146-152.

            Rogers, P. J., & Green, M. W.  (1993).  Dieting, dietary restraint and cognitive performance.  British Journal of Clinical Psychology, 32, 113-116.

            Rozin, P., & Fallon, A.  (1988).  Body image, attitudes to weight, and misperceptions of figure preferences of the opposite sex:  A comparison of men and women in two generations.  Journal of Abnormal Psychology, 97, 342-345.

            Stewart, A. L.  (1982).  The reliability and validity of self-reported weight and height.  Journal of Chronic Diseases, 35, 295-309.

            Striegel-Moore, R. H., & Cachelin, F. M.  (1999).  Body image concerns and disordered eating in adolescent girls:  Risk and protective factors.  In N. G. Johnson, M. C. Roberts, & J. Worell (Eds.), Beyond appearance:  A new look at adolescent girls (pp.  85-108).  Washington, DC:  American Psychological Association.

            Stunkard, A. J., & Albaum, J. M.  (1981).  The accuracy of self-reported weights.  American Journal of Clinical Nutrition, 34, 1593-1599.

            Stunkard, A. J., Sorensen, T., & Schulsinger, F.  (1983).  Use of the Danish Adoption Register for the study of obesity and thinness.  In S. S. Kety, L. P. Rowland, R. L. Sidman, & S. W. Matthysse (Eds.), Genetics of neurological and psychiatric disorders (pp.  115-120).  New York:  Raven Press.

            Tayback, M., Kumanyika, S., & Chee, E.  (1990).  Body weight as a risk factor in the elderly.  Archives of Internal Medicine, 150, 1065-1072.

            Tiggemann, M.  (1992).  Body-size dissatisfaction:  Individual differences in age and gender, and relationship with self-esteem.  Personality and Individual Differences, 13, 39-43.

            Tiggemann, M., & Stevens, C.  (1999).  Weight concern across the life-span:  Relationship to self-esteem and feminist identity.  International Journal of Eating Disorders, 26, 103-106.

            U. S. Bureau of the Census.  (1996).  Growth of the elderly population.  Current Population Reports.

            White, A., Harries, D., & Allen, S. C.  (1990).  Anorexia nervosa in the elderly:  A case report and review of the literature.  British Journal of Clinical Practice, 44, 630-631.

Table 1.  Figure rating means for each age group.

 

                                                            Middle-aged                           Elderly

                                                            (N = 125)                             (N = 125)

                                                            M            (SD)                             M            (SD)

                                                                                                                                               

Current Figure                          a4.3            (1.2)                             a4.3            (1.3)

Ideal Figure                                          b3.2            (.72)                             b3.4            (.69)

Attractive Figure                           c2.9            (.95)                             c3.0            (1.0)

                                                                                                                                               

Note.  Unadjusted groups means are shown.  Different superscripts indicate significant within-group differences at p < .005.

Table 2.  Figure rating means for each weight category.

 

                        Underweight                 Normal weight            Overweight                   Obese                          (N = 48)                      (N = 135)                    (N = 47)                      (N = 13)

                        M            (SD)                 M         (SD)                 M         (SD)                 M         (SD)

                                                                                                                                                           

Current             a3.1            (.97)                 b4.2      (.75)                 c5.4      (.88)                 d6.5      (1.1)

Ideal                 a3.0            (.73)                 a3.1      (.61)                 b3.8      (.62)                 b3.8      (.80)

Attractive         a3.2            (.73)                 b2.8      (.80)                 a3.1      (1.2)                 a3.2      (1.9)

                                                                                                                                                           

Note.  Unadjusted groups means are shown.  Different superscripts indicate significant between-group differences at p < .0001.

Table 3.  EDI subscale means for each age group.

 

                                                            Middle-aged                           Elderly

                                                            (N = 125)                             (N = 125)

                                                            M            (SD)                             M            (SD)

                                                                                                                                               

Drive for Thinness                                   5.0**            (5.3)                             2.4**            (2.8)

Body Dissatisfaction                           12.7            (9.8)                             11.8            (8.1)

Bulimia                                     2.1**            (3.1)                             0.9**            (1.6)

Interoceptive Awareness                   1.5*            (2.0)                             0.9*            (2.3)

                                                                                                                                               

Note.  Unadjusted groups means are shown.

*between-group difference at p = .01

**between-group difference at p < .001

Table 4.  EDI subscale means for each weight category.

 

                                    Underweight                 Normal weight            Overweight                   Obese                                      (N = 50)                        (N = 138)                        (N = 49)                        (N = 13)

                                    M            (SD)                 M            (SD)                 M            (SD)                 M     (SD)

                                                                                                                                                                  

Drive for Thinness               a1.8                (3.2)                        b4.4                (4.8)                        3.1                (3.6)                        b5.3   (5.0)

Body Dissatisfaction           a7.0                (7.3)                        b12.0        (8.9)                        c16.0        (8.1)                        c21.1  (6.7)

Bulimia                   a0.5          (1.6)                                a1.7          (2.7)                                a1.4          (1.7)                                b3.7    (4.1)

Interoceptive Awareness* a0.6                (1.0)                        b1.5                (2.6)                        1.0                (1.2)                        b1.8    (2.4)

                                                                                                                                                               

Note.  Unadjusted groups means are shown.  Different superscripts indicate significant between-group differences at p < .01.

*A higher score indicates greater interoceptive confusion.