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Prior research has documented an association between conformity to masculine gender norms and muscle dysmorphia symptomatology. However, much of this research has been limited to samples of men. To address this important gap in the research, the aim of this study was to determine the association between conformity to masculine gender norms and muscle dysmorphia symptomatology among a gender-diverse sample of Canadian adolescents and young adults. Data from the Canadian Study of Adolescent Health Behaviors (N = 2,719) were analyzed. Regression analyses were used to estimate the association between conformity to masculine gender norms and muscle dysmorphia symptomatology, clinical risk for muscle dysmorphia, and lifetime anabolic-androgenic steroid (AAS) use, among the overall sample and stratified by gender. Conformity to masculine gender norms was positively associated with muscle dysmorphia symptomatology, clinical risk for muscle dysmorphia, and lifetime AAS use among the sample. Moreover, findings were similar among boys and young men, girls and young women, and transgender/gender-expansive participants. Findings underscore the relevance of masculine gender norms in relation to the pursuit of muscularity among adolescents and young adults. Future research is needed to explore the specific mechanisms underlying the link between conformity to masculine gender norms and muscle dysmorphia symptomatology across genders. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) disproportionately affect sexual and gender minorities, with majority of research conducted among samples in the United States. The purpose of this study was to examine ED psychopathology among adolescents and young adults in Canada with diverse gender and sexual identities. Method: Data were collected from 2,714 Canadians, aged 16–30 years old, via an online survey at the end of 2021 during the COVID‐19 pandemic. Participants responded to sociodemographic questions (including history of EDs) and reported on eating attitudes and behaviors. Descriptive statistics and multiple modified Poisson and linear regressions were conducted. Results: Over half the sample was heterosexual, 35% were sexual minority cisgender men and women, and 6.5% were transgender and gender non‐conforming (TGNC) people. The sample overall reported elevated ED psychopathology based on their eating attitudes and behaviors. TGNC participants reported the most severe ED psychopathology. Generally, sexual minority cisgender women and cisgender men had elevated ED psychopathology compared to their heterosexual counterparts. Regression analyses revealed all gender and sexual minorities reported greater ED psychopathology compared to heterosexual cisgender men. Discussion: The Canadian sample reported elevated ED psychopathology compared to previous studies among various populations. Additional investigations are now needed to observe how ED psychopathology continues to change after the onset of the pandemic. Further research is needed among cisgender men, TGNC people, and sexual minorities to understand the unique stressors they face that lead to high ED psychopathology, and develop appropriate prevention and treatment tools. Public significance: EDs affect people of all gender and sexual identities. People who identify as a gender and/or sexual minority often experience problematic eating attitudes and behaviors, particularly transgender and gender non‐conforming people of all sexual identities. More research attention is needed among these populations, especially due to a paucity of research among Canadians, to develop effective diagnostic tools, prevention efforts, and treatment programs specific to gender and sexual identities. [ABSTRACT FROM AUTHOR]

Background: "Cheat meals", described as brief eating episodes that depart from established dietary practices to consume prohibited foods, represent a novel and increasingly common eating behavior with particular salience in adolescence and young adulthood. However, knowledge gaps remain regarding the frequency and characterization of foods and calories consumed during cheat meals, and their associations with eating disorder behaviors and psychopathology. Thus, the aims of this study were to delineate engagement in cheat meals among a large, national sample of Canadian adolescents and young adults. Methods: Participants (N = 2,717) were from the Canadian Study of Adolescent Health Behaviors. Frequencies of engagement in cheat meals, and associated foods and calories consumed, in the past 12 months and 30 days were determined. The associations between engagement in cheat meals and eating disorder behaviors and psychopathology were determined using modified Poisson regression analyses. Results: Engagement in cheat meals in the past 12 months was highest among men (60.9%) compared to women (53.7%) and transgender/gender non-conforming (TGNC; 52.5%) participants. Cheat meals consisting between 1,000 and 1,499 cal were those most frequently reported among all participants. Mean number of cheat meals in the past 12 months was equivalent to > 1 per week, which was similar to engagement in the past 30 days. Finally, engagement in cheat meals in the past 12 months and 30 days was associated with patterns of eating disorder behaviors and psychopathology among all participants, including binge-eating-related behaviors. Conclusions: This study further characterized and extended knowledge of cheat meal engagement across genders, aligning with prior research by demonstrating that engagement is associated with greater eating disorder psychopathology. Plain english summary: Findings from this study add to the growing characterization of the novel behavioral phenomenon of cheat meals. Specifically, over half of adolescents and young adults across all 13 provinces and territories in Canada reported engaging in > 1 cal dense cheat meal per week, over the past 12 months. Despite the normalization and promotion of cheat meal engagement among the general public and unique fitness communities, engagement in this behavior is linked to greater eating disorder behaviors and psychopathology, including binge-eating episodes. Our findings emphasize the need for further research, public awareness, and clinical interventions aimed at addressing this potentially harmful eating behavior. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and correlates of weight gain attempts in a pooled sample of adults aged 18 and older from Canada, Australia, the United Kingdom, the United States, and Mexico. Method: Data collected during 2 years (2018 and 2019) of the International Food Policy Study (N = 42,108) were analyzed. Unadjusted 12‐month prevalence of weight gain attempts was estimated based on body mass index (BMI; kg/m2), weight perception, country, survey year, and sex. Logistic regression analyses were estimated to determine the sociodemographic correlates (age, race/ethnicity, education, BMI, weight perception, weight perception accuracy, and self‐rated mental health) of weight gain attempts among the pooled sample stratified by sex. Results: Men (10.4%) were significantly more likely than women (5.4%) to report weight gain attempts (p <.001). Nearly one in five (17.1%) men with a BMI in the "normal" range (≥18.5 to <25.0) reported weight gain attempts. Among both men and women, minority group identity was associated with higher odds, while older age and higher BMI category were associated with lower odds, of reporting weight gain attempts. Country differences over the two survey years showed the prevalence of weight gain attempts in 2019 (vs. 2018) was higher among women in Australia (p <.05) and men in the United States (p <.01). Discussion: Weight gain attempts are more common among men, compared to women, across five countries, potentially reflecting the global salience of the pursuit of a muscular body. [ABSTRACT FROM AUTHOR]

Objective: To prospectively explore the relationship between exposure to potentially distressing news content and disordered eating. Method: Within 2 weeks of the March 3, 2011 Japan earthquake, an online survey was conducted among non-Japanese adults in distant countries ( N = 698) assessing time spent on TV and the internet watching the news as well as peritraumatic reactions to the news and sleep disturbance. Participants were invited to complete a followup survey two months later [ n = 113, mean age (SD) = 38.8 (11.91), 73% female] reporting on eating disorder symptoms. Results: Exposure to TV and, to a lesser extent, internet coverage of the Japan disaster were associated with disordered eating, in particular dieting and oral control, as measured by the eating attitudes test. Peritraumatic reactions and sleep disturbance displayed specific patterns of association with disordered eating. Discussion: Exposure to media coverage of distant disasters may be associated with increased disordered eating. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012;45:845-849) [ABSTRACT FROM AUTHOR]

It has been documented in the literature that the use of photo filters to alter one's appearance may negatively impact body image and increase the risk for thinness-oriented disordered eating behaviors. However, the prior research has neglected to investigate the association between use of photo filters and muscle dysmorphia symptomatology, which was the aim of this study. Data from the Canadian Study of Adolescent Health Behaviors (2022; N = 912), a national study of adolescents and young adults in Canada, were analyzed. Linear regression analyses revealed that the use of photo filters was associated with greater muscle dysmorphia symptomatology, including total symptomatology and Appearance Intolerance, among the overall sample. Gender significantly moderated the association between photo filter use and muscle dysmorphia symptomatology, whereby boys and young men, compared to girls and young women, who reported photo filter use had greater Drive for Size and Functional Impairment symptomatology. Findings expand prior research by emphasizing that photo filter use is related to muscularity-oriented body image concerns and behaviors. Future research is needed to elucidate the mechanisms that underpin this association., Competing Interests: Declaration of Competing Interest All authors report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Unique risk factors for the development of muscle dissatisfaction and engagement in muscle-building behaviors have been described by theoretical frameworks and supported by empirical research. What remains unknown are the unique processes, including catalysts and facilitators, which underpin engagement in muscle-building behaviors. Therefore, this study used a grounded theory methodology to elucidate the process of engagement in muscle-building behaviors. Thirty-three individual semi-structured interviews with Canadian adolescents and young adults ages 16-30 years were conducted. Transcripts were analyzed using initial and focused coding to identify themes that explained the grounded theory. The core theme underpinning the grounded theory was balancing aesthetic, health, and functional goals in relation to participants' engagement in muscle-building behaviors. Participants described experiences that encompassed several unique phases of muscle-building engagement, including the initiation phase, beginner phase, preservation phase, and intensification phase. Participants also described unique methods of gathering information on muscle-building behaviors, and their own analysis and decision-making processes driving their behaviors. Findings from this study extend prior theory and research by conceptualizing a novel process theory of engagement in muscle-building behaviors among adolescent and young adults, resulting in important implications for research and practice., Competing Interests: Declaration of Competing Interest All authors report no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The aim of this study was to investigate the association between lifetime sex work involvement and muscle dysmorphia symptomatology., Methods: Data from the Canadian Study of Adolescent Health Behaviours (N =912) were analysed. Multiple adjusted linear regression models were estimated with lifetime sex work involvement as the independent variable and muscle dysmorphia symptomatology, measured using the Muscle Dysmorphic Disorder Inventory, as the dependent variable., Results: Among the sample, 3.7% of participants reported engaging in lifetime sex work. Significant associations were found between self-reported lifetime sex work and greater total muscle dysmorphia symptomatology (B =5.03, 95% CI 1.80, 8.26), greater Drive for Size symptomatology (B =2.36, 95% CI 0.74-3.97), and greater Functional Impairment symptomatology (B =2.11, 95% CI 0.54, 3.67), while adjusting for relevant sociodemographic variables., Conclusions: Findings from this study expand prior research that has documented poor mental health among individuals involved in sex work. Clinical and community health professionals should consider screening for muscle dysmorphia symptomatology among young people who have been involved in sex work.

This study aimed to determine the associations between violent victimization and symptoms of muscle dysmorphia (MD) among a sample of Canadian adolescents and young adults. Data from 2538 adolescents and young adults (16-30 years) from the Canadian Study of Adolescent Health Behaviors were analyzed. Violent victimization assessed included experiences of rape, sexual assault, emotional abuse, and physical abuse occurring in the past 12 months. A violent victimization sum score was also created. Symptoms of MD were assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Linear regression analyses were conducted, stratified by gender, to determine the associations between violent victimization and MDDI total score and subscale scores. Among women and men, experiencing sexual assault, physical abuse, and emotional abuse in the past 12 months were significantly associated with a higher MDDI total score. Additionally, as the number of forms of violent victimization experienced increased, the likelihood of a higher MDDI total score also increased, with the strongest association among women and men who reported experiencing three or more victimizations. Findings expand the limited prior research suggesting associations between violent victimization and MD by assessing these associations via multiple forms of victimization and amongst a sample of Canadian adolescents and young adults., Competing Interests: Declaration of Competing Interest All authors declare no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of this study was to describe muscle dysmorphia (MD) symptomatology among a large, diverse, and national sample of adolescents and young adults in Canada. Data from the Canadian Study of Adolescent Health Behaviors (N = 2256) were analyzed. MD symptomatology was assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Men (mean [M] = 33.9, standard deviation [SD] = 8.6) reported significantly greater overall MD symptomatology compared to women (M = 30.1, SD = 7.3) and transgender/gender non-conforming (TGNC; M = 31.5, SD = 7.6) participants. Similarly, the prevalence of clinical MD risk was also highest among men (25.7 %). In regression analyses, participants who identified as South Asian (B 1.97, 95 % confidence interval [CI] 0.41, 3.52) or Middle Eastern (B 2.92, 95 % CI 0.50,5.35), compared to White participants, or identified as gay or lesbian (B 2.65, 95 % CI 1.19, 4.10), compared to heterosexual participants, had greater MD symptomatology. Findings are the first to describe the MD symptomatology among Canadian adolescents and young adults. Health care and public health professionals should be aware of the overall high occurrence of MD symptomatology in this sample, and future research is needed to continue to describe MD among Canadian young people., Competing Interests: Conflicts of interests All authors report no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: Screen time has been previously linked to body dissatisfaction and eating disorder behaviors. However, less is known about whether use of common forms of screen technology is associated with symptoms of muscle dysmorphia (MD), which was the aim of this study., Methods: Data from the Canadian Study of Adolescent Health Behaviors (N = 2538) were analyzed. Associations between hours of use of six contemporary forms of recreational screen time, as well as total screen time, and symptoms of MD were determined using multiple linear regression models, stratified by gender, and adjusting for potential confounders., Results: Among both men and women, greater total screen time and texting were associated with greater symptoms of MD; however, differences emerged across the screen time modalities by gender. Among women, video chatting was most strongly associated with symptoms of MD, while social media use was most strongly associated with symptoms of MD among men., Conclusion: Findings add to the growing literature documenting the potentially harmful correlates of screen time by including MD symptomatology. Findings have important implications for health care, public health, and policymaking professionals., Level of Evidence: Level V, cross-sectional descriptive study., (© 2023. The Author(s).)

Purpose: First, to characterize the prevalence and incidence of "bulk" and "cut" cycles among Canadian adolescents and young adults. Second, to determine the associations between bulk and cut cycle engagement and drive for muscularity and eating disorder and muscle dysmorphia psychopathology., Methods: Data were from the Canadian Study of Adolescent Health Behaviors (2021; N = 2762), a national study of Canadian adolescents and young adults aged 16-30 years (M = 22.9, SD = 3.9). Prevalence and mean incidence of bulk and cut cycles in both the past 12 months and 30 days were estimated. Modified Poisson regressions were estimated to determine the associations between bulk and cut cycle engagement and levels of drive for muscularity and eating disorder and muscle dysmorphia psychopathology., Results: The sample comprised of 53.5% women, 38.4% men, and 8.1% transgender/gender non-conforming (TGNC) individuals. Nearly half (48.9%) of men and one in five women (21.2%) and TGNC (21.9%) participants reported bulk and cut cycles in the past 12 months. TGNC participants and women reported a greater mean number of bulk and cut cycles completed compared to men. Engagement in bulk and cut cycles was associated with stronger drive for muscularity across the sample, and more severe eating disorder and muscle dysmorphia psychopathology among men and women., Conclusion: Findings underscore the common incidence and accompanying psychopathology of bulk and cut cycles among a community sample of adolescents and young adults in Canada, indicating the need for future research, as well as clinical and public health efforts., Level of Evidence: Level V, cross-sectional descriptive study., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The aim of the current study was to examine the psychometric properties of two well-established measures of sociocultural influence and internalization of the thin/low body fat ideal and muscular ideal. Data from 6272 emerging adults (68.9 % female), aged 18-30 years from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. were included in this study. Participants completed measures of pressure from mother, fathers, peers, and media, to both increase muscles and lose weight, as well as internalization of the thin/low body fat ideal and muscular ideal. Overall, support for partial invariance was found across the scales. In addition, group level differences were found between countries as well as along demographic factors including gender, age, body mass index, and socioeconomic status. These findings make an important contribution by identifying these scales as useful tools that will support future cross-country and cross-cultural examinations of explanatory models of the development of body image and eating concerns grounded within sociocultural theories., (Copyright © 2020. Published by Elsevier Ltd.)

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures., Competing Interests: Declaration of Competing Interest The authors reported no declarations of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; M age = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)