socw 6446

O R I G I N A L P A P E R

Parental Influences on Elite Aesthetic Athletes’ Body Image Dissatisfaction and Disordered Eating

Rita Francisco • Isabel Narciso • Madalena Alarcão

Published online: 10 October 2012

� Springer Science+Business Media New York 2012

Abstract Although different forms of parental influences

on adolescents’ body image and eating disturbances have

been studied, this relationship is nearly uninvestigated

within the population of aesthetic athletes, a risk group for

the development of eating disorders. The present study

examined the role of specific family variables on the body

image dissatisfaction (BID) and disordered eating (DE) of

elite aesthetic athletes (n = 85) and controls (n = 142).

Adolescents (M = 14.87 years, SD = 2.22) completed

measures of direct influences (concern with thinness and

weight teasing by parents), perceived quality of relation-

ship with each parent and the overall family environment,

BID and DE. Participants’ parents (223 mothers and 198

fathers) also completed measures of BID and DE. In gen-

eral, parents of athletes do not present higher levels of BID

or DE than do controls’ parents. Interesting differences

were found between athletes’ and controls’ BID and DE

predictors. Among athletes, direct parental influences are

the only significant predictive family variable, which can

reinforce the pressure to be thin found within elite-aesthetic

contexts. The study’s findings highlight not only the

importance of critical parental comments in athletes’

expression of BID and DE, but also of maternal modeling

among adolescents in the general population. Such parental

behavior may be an appropriate target in different pre-

vention efforts.

Keywords Aesthetic athletes � Parental influences � Body image dissatisfaction � Disordered eating � Predictors

Introduction

The impact of family influence on the development of body

image and eating disturbances has been identified by several

studies with patients diagnosed with eating disorders (e.g.,

Latzer et al. 2002; Minuchin et al. 1978) as well as with the

general adolescent and young adult population (Vincent and

McCabe 2000; Yanez et al. 2007). The only literature review

to date about parental influence merely includes studies in

the general population (Rodgers and Chabrol 2009) because,

in clinical samples, parents’ behaviors and attitudes regard-

ing weight, eating and body image can be influenced by their

child’s diagnosis or therapeutic interventions. Most of these

studies have been conducted exclusively with female ado-

lescents and their mothers; however, data suggest that both

mothers and fathers are important sources of influence for

their child’s body image and eating habits, regardless of that

child’s gender. Furthermore, this influence may take place

via different mechanisms.

The first mechanism, which has received much atten-

tion, concerns the direct transmission of weight-related

attitudes and opinions from parent to child. Both cross-

sectional and longitudinal studies conducted with preado-

lescents and adolescents show that critical negative com-

ments about eating and weight are predictors of body

image dissatisfaction, weight concerns and disordered

eating (Ata et al. 2007; Kluck 2010; Pike and Rodin 1991;

Smolak et al. 1999; Wertheim et al. 2002). Conversely,

studies have also demonstrated that lower levels of disor-

dered eating are associated with the perception of more

positive messages regarding eating and weight (Gross and

R. Francisco (&) � I. Narciso Faculty of Psychology, University of Lisbon,

Alameda da Universidade, 1649-013 Lisbon, Portugal

e-mail: [email protected]

M. Alarcão

Faculty of Psychology and Education Sciences,

University of Coimbra, Coimbra, Portugal

123

J Child Fam Stud (2013) 22:1082–1091

DOI 10.1007/s10826-012-9670-5

Nelson 2000; Kichler and Crowther 2009). In fact, this

influence can have several long-term effects, not only on

body dissatisfaction and disordered eating but also on self-

esteem and depressive symptoms. These effects have been

shown by some retrospective studies in which undergrad-

uate students reported their experiences about parental

weight-related teasing in childhood and adolescence

(Benas and Gibb 2008; Taylor et al. 2006). Vincent and

McCabe (2000) revealed some specific features of the

influence of each parent on his or her children’s disordered

eating. Specifically, discussion with both parents on topics

related to weight or diet and parental encouragement of

weight loss proved to be predictors of disordered eating

among girls; however, for boys, only maternal encour-

agement predicted weight loss behaviors and binge eating.

Given these differences, future research should include the

participation of both mothers and fathers.

Another important mechanism of parental influence is

modeling of dysfunctional eating attitudes and behaviors.

Several studies with adolescent girls and their parents have

shown significant associations between abnormal eating

attitudes of mothers and daughters (Pike and Rodin 1991;

Vincent and McCabe 2000); however, the same association

does not exist with fathers when they are included (Keel

et al. 1997; Yanez et al. 2007). As it is still unclear whether

parental eating behaviors are associated with dysfunctional

eating behaviors in adolescent boys (Keery et al. 2006;

Vincent and McCabe 2000), the influence of parent gender

on problem eating behaviors needs to be clarified among

both boys and girls.

The final form of parental influence referred to in

existing literature is the quality of family relationships,

primarily overall family environment and relationships

with parents. Family connectedness has been associated

with higher body satisfaction in both boys and girls

(Boutelle et al. 2009; Crespo et al. 2010). Additionally,

several specific aspects of the relationships that adolescents

have with each parent have proven to be rather important.

May et al. (2006) identified different dimensions of

maternal relationships, such as decreased intimacy and

knowledge of children’s daily experiences, as predictors of

weight concerns in young girls. However, the authors

suggested that parent–adolescent conflict is the most

important relationship-quality factor linked to adolescent

weight concerns. Additionally, other studies conducted

only with girls have shown that perceptions of negative

parental relationships are associated with less healthy

dieting and body image, thus highlighting the role of

relationships with both mothers and fathers in the devel-

opment of healthy or disordered eating of adolescent girls

(Archibald et al. 1999; Swarr and Richards 1996).

The world of aesthetic sports—‘‘sports usually thought of

as ‘appearance’ sports in which the sport participant’s

appearance as well as her sport performance is being judged’’

(R. Thompson and Sherman 2010, p. 211), such as dance,

figure skating or gymnastics—is considered a high risk

context for the development of eating disorders among

adolescents (e.g., Byrne and McLean 2002; Francisco et al.

2012; Sundgot-Borgen and Torstveit 2004). The adolescents

who practice elite aesthetic sports are subject to additional

pressures from coaches and are frequent targets of critical

comments pressuring them to be thin and to control weight

and body shape to achieve excellence in performance (Kerr

et al. 2006; Muscat and Long 2008). In fact, many studies

suggest that coaches have a major influence on the body

image and eating behaviors of athletes (Byrne and McLean

2002; Toro et al. 2009). However, the influence of parents on

the body dissatisfaction and disordered eating of their aes-

thetic-athlete children remains unknown. In 2001 (Klump,

Ringham, Marcus, and Kaye), a study on female ballet

dancers showed that dancers had significantly higher levels

of family history of eating disorders than participants in a

control group, reinforcing the need to conduct studies with

athletes that include family variables, as pointed by some

authors (Ringham et al. 2006; Thomas et al. 2005).

To our knowledge, only two other studies examine the

families of athletes in non-aesthetic sports. Of these, only

one evaluated the relationship between eating behaviors of

mothers and athlete daughters, which was conducted with

competitive (but not elite) tennis players and did not show an

association between the eating behaviors of mothers and

their athlete daughters (Harris and Foltz 1999). The other,

more recent study found greater body image disturbance and

higher levels of disturbed eating attitudes among female and

male college athletes who reported family climates with low

perceived support and autonomy (Blackmer et al. 2011).

In a previous study about individual and relational risk

factors (e.g., self-esteem, social pressure for thinness), we

found direct parental influences (e.g., weight teasing) on

disordered eating among elite aesthetic athletes but not on

that of non-elite aesthetic athletes or participants in the

control group (Francisco et al. 2012). Furthermore, we posit

that the quality of family relations, as well as the way ath-

letes’ parents deal with their own body image and eating,

may influence athletes’ perception of messages transmitted

in these high-risk contexts, and the impact of these mes-

sages on body image dissatisfaction and eating behaviors.

The purpose of the present study was to explore the role of

specific family variables in elite aesthetic athletes’ body

image dissatisfaction and disordered eating. We evaluate

body image dissatisfaction and disordered eating patterns of

each parent as well as the adolescent. We also assess ado-

lescents’ perceptions of other family variables: parent con-

cern with their child’s thinness and parental weight teasing,

the perceived quality of maternal/paternal relationships, and

the perceived quality of family environment. Because

J Child Fam Stud (2013) 22:1082–1091 1083

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previous research was mainly developed with adolescents

from the general population, four different objectives were

identified within this study: (1) to examine differences

between elite aesthetic athletes and controls in body image

dissatisfaction, disordered eating and family variables; (2) to

examine the correlations between parental and adolescents

variables in populations of elite aesthetic athletes and control

participants; (3) to investigate different possible family-

oriented predictors of body image dissatisfaction and dis-

ordered eating for elite aesthetic athletes and controls; and

(4) to examine differences in family characteristics of both

the elite aesthetic athletes and controls, with and without

clinical indication of disordered eating.

Method

Participants

The study involves 227 adolescents of both sexes—85 ath-

letes (M = 15.35 years, SD = 2.73; 70.6 % females) and

142 controls (M = 14.58 years, SD = 1.81; 57.7 %

females)—and their parents (223 mothers, M = 44.71 years,

SD = 5.34; 198 fathers, M = 47.25 years, SD = 6.43). The

elite aesthetic athletes are gymnasts participating in interna-

tional competitions (n = 44; 63.6 % females) and profes-

sional dance students (n = 41; 78 % females).

The majority of participants (79.3 %) come from intact

nuclear families, 11.1 % from single-parent families and

the remainder from other family configurations. The par-

ticipants live in various regions in Portugal, including the

center (48 %), the Lisbon metropolitan area (47.6 %), the

north (3.5 %) and the south (0.9 %). The participants

represent part of a sample from a previous study on pre-

dictive risk factors of disordered eating (Francisco et al.

2012), specifically participants whose parents returned

parent self-report questionnaires (elite athletes’ parents’

response rate 65 %; controls’ parents’ response rate 30 %).

Measures

Measures Completed by Adolescents

McKnight Risk Factor Survey-IV (MRFS-IV; The

McKnight Investigators 2003) The MRFS-IV is a self-

report questionnaire that assesses potential risk factors for

the development of eating disorders. The Portuguese version

(Francisco et al. 2011) used in the present study consists of 82

items (most of them rated on a 5-point Likert scale, from

‘‘Never’’ to ‘‘Always’’), organized into eight indicators and

nine factors. The ‘‘Parental Influences’’ factor (the only one

of MRFS-IV related to family influences), consisting of four

items—‘‘In the past year, how often has your father (mother)

made a comment to you about your weight or your eating that

made you feel bad?’’ and ‘‘In the past year, how important

has it been to your father (mother) that you be thin?’’—is

used to evaluate the influence of parent concern with thinness

and weight teasing by parents (a = .72).

Perception of Parent–Child Relationships Quality and of

Family Environment Through three items rated on a

5-point Likert scale (from ‘‘Very bad’’ to ‘‘Very well/

good’’), adolescents are questioned about their perception

of the quality of their relationship with each parent—’’How

is your relationship with your father (mother)?’’—and the

quality of their family environment—’’How is your family

environment?’’.

Measures Completed by Both Adolescents and Parents

Contour Drawing Rating Scale (CDRS, Thompson and

Gray 1995) Body image dissatisfaction (BID) was

assessed by the Portuguese version of CDRS (Francisco

et al., in press), consisting of a sequence of nine silhouettes

ordered from the thinnest to the largest. The participants

choose silhouettes that represent their current and ideal

body size. The discrepancy between these two is an indi-

cator of BID. The CDRS has good test–retest reliability

(r = .91) and construct validity (r = .65 with weight;

r = .72 with BMI) among both adolescents and adults.

Eating Disorder Examination-Questionnaire (EDE-Q,

Fairburn and Beglin 1994) The level of disordered eating

(DE), understood in a continuum, was evaluated using the

Portuguese version of the 5th edition of EDE-Q (Machado

and Martins 2010). This is a self-report questionnaire of 28

items grouped into four subscales (‘‘Restraint’’, a = .87; ‘‘Shape Concern’’, a = .91; ‘‘Eating Concern’’, a = .86; and ‘‘Weight Concern’’, a = .82), the average of which constitutes a global score (a = .95). The items are rated on a 7-point Likert scale (from ‘‘None’’/’’Nothing’’ to ‘‘Every-

day’’/’’Extremely’’). In the current study, the EDE-Q showed

good psychometric properties with greater internal consis-

tency values in the sample of adolescents than in the sample

of parents [Global Score (adolescents a = .92; parents a = .83), Restraint (adolescents a = .81; parents a = .75), Shape Concern (adolescents a = .91; parents a = .86), Eating Concern (adolescents a = .77; parents a = .68) and Weight Concern (adolescents a = .84; parents a = .75)].

Procedure

All participants completed an informed consent process

before answering the surveys. In order for adolescents to

participate, authorization was sought from their parents/

guardians. The main researcher delivered athlete surveys to

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the dance teachers/gymnastics coaches, who in turn handed

the surveys to their students/gymnasts. Most athletes

completed the surveys at home. The surveys were later

returned in sealed envelopes with no identifying informa-

tion, thus preserving anonymity. All adolescents in the

control group completed the surveys during normal classes

at their schools in the presence of the main researcher. All

parents received their surveys (with a code matching that of

their child) via their children, who, in turn, returned them

to the research group a week later in a sealed envelope.

Permission to conduct the study was provided by the

Ministries of Science (FCT) and of Education.

Statistical Analyses

Statistical analyses were conducted using SPSS 18.0. We

used the Kruskal–Wallis test to compare athletes and

controls on all study variables, given the small sample size

of male athletes (n \ 30). Chi-square test examined cate- gorical frequencies, and the relationships between the

variables were investigated using Spearman correlations.

Separate multiple regressions were used to investigate

which parental and family variables predict adolescents’

BID and DE for athletes and controls. For each of the

dependent variables (BID and DE), we previously con-

ducted three separate analyses for each set of variables

(mother, father, and family) to better select the predictors to

include in the final models and to assure at least 10 par-

ticipants per predictor (Field 2009). In all three sets, ado-

lescent individual variables—sex and BMI—were included

in Step 1 given the strong relationships established between

females and DE and between high BMI and DE in existing

literature (e.g., Field et al. 2001). The first set included mothers’

BID and EDE-Q subscales; the second included fathers’

BID and EDE-Q subscales; and the last included parental

influences, perception of paternal relationship, of maternal

relationship, and of the family environment. Those predic-

tors which were significant (p \ .05) or near significant (p \ .10) for each dependent variable of athletes or controls were then culled from these preliminary regressions and

used in the final multivariate models.

Results

Descriptive Statistics and Differences Between Athletes

and Controls

Table 1 presents the descriptive statistics of all variables

and the results of mean comparisons between athletes and

controls (separated by sex) and between respective parents.

Male athletes and controls showed no significant differ-

ences in any of the variables. Female athletes reported lower

BMI and higher levels of restraint and eating concern (two

subscales of EDE-Q) than did controls. Regarding adoles-

cents’ parents, there were no significant differences in any

variable between the mothers of athletes and controls,

regardless of gender, or between the fathers of female ath-

letes and the fathers of female controls. However, there were

some differences between fathers of male athletes versus

controls: the fathers of male athletes reported significantly

higher BMI than did those of controls as well as higher levels

of BID, shape concern and EDE-Q global score.

Correlations

Table 2 presents correlations between the variables

answered by adolescents, separated by athletes and con-

trols. In addition to the expected moderate-to-strong cor-

relations between BID and DE, where the correlations were

stronger for athletes than for controls, there were important

family-variable correlations to note. While there was no

significant correlation between parental influences and

BMI of athlete participants, there was a significant rela-

tionship between these variables for the controls. However,

parental influences were more strongly correlated to the

BID and DE of athletes than to those of controls. With

regard to athletes’ perception of family relationships, the

maternal relationship did not present significant correla-

tions with the BID or DE of either athletes or controls;

interestingly, the paternal relationship presented a weak but

significant correlation with the DE of both groups of ado-

lescents. Finally, the quality of family environment was

associated with parental influences reported by athletes but

not with those reported by the controls. However, the

reverse was true for DE such that the perception of family

environment significantly correlated with the DE of con-

trols only but not with athletes’ DE.

Parental influences reported by children (athletes or

controls) did not correlated with any of the parental vari-

ables indicative of BID or DE (Table 3). All significant

correlations of adolescents’ BID and DE with parental

variables were weak (r \ .30). Among the athletes, fathers’ eating concern alone was significantly correlated with

children’s DE. Among the controls, only maternal variables

were correlated with the BID and DE of their children—

shape concern, weight concern and EDE-Q global score—

with correlation with DE being stronger than with BID.

Body Image Dissatisfaction and Disordered Eating

Family Predictors

Tables 4 and 5 show the final regression models in both

samples, for BID and DE, respectively. Regarding athletes’

BID, sex, BMI and parental influences were significant pre-

dictors, accounting for 41 % of the variance; maternal

J Child Fam Stud (2013) 22:1082–1091 1085

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variables were not significant predictors. For controls’ BID,

only sex and BMI were significant contributors, explaining

merely 26 % of the variance. For athletes’ DE, sex, BMI and

parental influences were the only predictors, accounting for

42 % of the variance. In the controls’ DE model, the variables

significant in the athletes’ model, as well as perceived family

environment, mothers’ eating concern and mothers’ weight

concern, in total explained 49 % of the variance in DE.

Family Characteristics of the Group with Clinical

Indication of DE

Taking into account the clinical indication of DE (EDE-Q

subscales or global score C3.5; Machado and Martins

2010), we compared the family variables’ scores of those

adolescents who score above the EDE-Q cut-off (n = 37;

17 athletes and 20 controls) with those of sub-cut-off

adolescents. Because these adolescents included only six

males, and given that the clinical indication of DE has not

proven to be associated with belonging to the athletes or

control group [v2(1) = 1.46, p = .265], we aggregated all participants with EDE-Q scores above the clinical cut-off,

regardless of sex or study condition, and compared their

analyses with all other adolescents who scored below

EDE-Q cut-off.

Adolescents with a clinical indication of DE reported

significantly higher levels of parental influences (M = 1.64,

SD = 0.67 vs. M = 1.19, SD = 0.38; U = 1796.00,

Table 1 Descriptive statistics and mean comparisons (N = 227)

Range Girls (n = 142) Boys (n = 85)

Athletes

(n = 60)

Controls

(n = 82)

U p Athletes

(n = 25)

Controls

(n = 60)

U p

Adolescents

Age (years) 15.05 (2.40) 14.51 (1.81) 2193.50 – 16.08 (3.33) 14.68 (1.81) 596.00 –

BMI 18.66 (2.17) 19.79 (2.62) 1925.50 \.05 20.96 (3.21) 20.54 (3.42) 634.00 – Parental influences 1 to 5 1.42 (0.59) 1.21 (0.41) 2068.50 – 1.16 (0.36) 1.18 (0.34) 641.50 –

Maternal relationship 1 to 5 4.63 (0.54) 4.66 (0.62) 2234.50 – 4.71 (0.47) 4.56 (0.74) 707.50 –

Paternal relationship 1 to 5 4.50 (0.65) 4.34 (0.88) 2232.00 – 4.64 (0.63) 4.37 (0.73) 628.50 –

Family environment 1 to 5 4.47 (0.60) 4.38 (0.72) 2356.50 – 4.50 (0.86) 4.24 (0.80) 712.50 –

Body image

dissatisfaction

-8 to 8 -0.55 (1.25) -0.61 (1.34) 2425.50 – -0.21 (0.89) -0.07 (1.17) 729.00 –

Restraint 0 to 7 1.33 (1.33) 0.78 (1.18) 1861.50 \.01 0.47 (0.67) 0.36 (0.83) 626.50 – Shape concern 0 to 7 1.81 (1.65) 1.46 (1.36) 2365.50 – 0.67 (0.98) 0.77 (1.05) 729.50 –

Eating concern 0 to 7 0.97 (1.24) 0.46 (0.68) 2042.00 \.05 0.13 (0.23) 0.25 (0.48) 742.50 – Weight concern 0 to 7 1.97 (1.80) 1.59 (1.56) 2264.50 – 0.45 (0.81) 0.59 (0.95) 743.50 –

EDE-Q global score 0 to 7 1.52 (1.41) 1.07 (1.09) 2135.50 – 0.43 (0.56) 0.49 (0.73) 721.50 –

Mothers

BMI 23.27 (3.68) 23.94 (3.84) 1893.50 – 24.78 (7.14) 24.53 (4.45) 525.50 –

Body image

dissatisfaction

-8 to 8 -1.50 (1.31) -1.14 (1.34) 2015.00 – -1.64 (2.02) -1.49 (1.40) 557.50 –

Restraint 0 to 7 0.54 (0.92) 0.73 (0.97) 2154.50 – 0.96 (1.60) 1.05 (1.43) 624.50 –

Shape concern 0 to 7 1.16 (1.24) 1.22 (1.12) 2044.50 – 1.25 (1.87) 1.24 (1.39) 667.00 –

Eating concern 0 to 7 0.26 (0.61) 0.22 (0.50) 2291.00 – 0.46 (1.04) 0.13 (0.37) 623.50 –

Weight concern 0 to 7 1.22 (1.32) 1.15 (1.14) 2004.50 – 1.30 (1.79) 1.26 (1.33) 666.00 –

EDE-Q global score 0 to 7 0.79 (0.89) 0.83 (0.78) 1909.00 – 0.99 (1.49) 0.92 (1.01) 657.50 –

Fathers

BMI 26.58 (3.83) 26.76 (3.38) 1705.50 – 28.28 (4.38) 26.80 (4.12) 339.50 \.05 Body image

dissatisfaction

-8 to 8 -1.24 (0.94) -0.83 (1.11) 1654.00 – -1.50 (1.09) -0.93 (0.91) 362.00 \.05

Restraint 0 to 7 0.67 (0.98) 0.61 (1.17) 1844.50 – 0.54 (1.02) 0.37 (0.75) 462.00 –

Shape concern 0 to 7 1.06 (1.25) 0.71 (1.13) 1676.00 – 0.96 (0.94) 0.58 (0.97) 377.50 \.05 Eating concern 0 to 7 0.24 (0.43) 0.23 (0.65) 1932.00 – 0.10 (0.28) 0.07 (0.21) 526.00 –

Weight concern 0 to 7 1.09 (1.40) 0.89 (1.41) 1841.00 – 0.93 (0.94) 0.67 (1.04) 381.00 –

EDE-Q global score 0 to 7 0.76 (0.86) 0.61 (0.94) 1733.00 – 0.63 (0.53) 0.42 (0.65) 305.00 \.01

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p \ .001), perceived lower quality in their paternal rela- tionship (M = 3.86, SD = 0.99 vs. M = 4.51, SD = 0.68;

U = 2357.00, p \ .01), lower quality in their maternal

relationship (M = 4.14, SD = 0.94 vs. M = 4.70, SD =

0.52; U = 2583.50, p \ .01) and lower quality in family environment (M = 3.82, SD = 1.01 vs. M = 4.44,

Table 2 Spearman correlations between adolescent variables, for athletes and controls

Athletes (n = 85) Controls (n = 142)

1 2 3 4 5 6 7 8

Sex a

– -.17* .08 .03 -.07 .10 -.13 .37**

BMI -.23* – .28** -.03 -.12 -.24** -.48** .24**

Parental influences .08 .00 – .52** -.14 -.13 -.22* .37**

Maternal relationship -.01 -.22 -.12 – .51** .52** -.01 -.14

Paternal relationship -.14 -.17 -.20 .68** – .63** .07 -.25**

Family environment .03 -.30** -.24* .62** .55** – .10 -.25**

Body image dissatisfaction -.18 -.50** -.24* .07 .19 .14 – -.44**

Disordered eating .35** .26* .45** -.13 -.25* -.21 -.69** –

Athletes’ correlations appear below the diagonal, and controls’ correlations appear above the diagonal; a

sex of adolescent (boys = 0, girls = 1);

** p \ .01; * p \ .05

Table 3 Spearman correlations between parental (BID and EDE-Q subscales) and athletes and controls’ variables (parental influences, BID and DE)

Variables Athletes (n = 85) Controls (n = 142)

Parental influences BID DE Parental influences BID DE

Mother’s BID .07 .10 -.06 -.07 .04 -.04

Mother’s restraint .09 -.03 -.03 .13 -.04 .09

Mother’s shape concern .06 .02 -.01 .08 -.19* .27**

Mother’s eating concern .01 .10 -.02 .12 -.02 .13

Mother’s weight concern .14 -.04 .05 .05 -.20* .26*

Mother’s EDE-Q global score .05 .01 -.00 .10 -.17* .29**

Father’s BID -.03 .22 -.07 -.09 .03 -.02

Father’s restraint -.07 -.21 .20 .14 -.10 .12

Father’s shape concern -.01 -.20 .12 .09 .03 .11

Father’s eating concern -.00 -.15 .25* -.04 .03 .09

Father’s weight concern -.05 -.20 .16 -.03 .02 .09

Father’s EDE-Q global score -.06 -.23 .17 .02 -.02 .11

BID body image dissatisfaction, DE disordered eating; * p \ .05; ** p \ .01

Table 4 Summary of multiple linear regression analyses for variables predicting athletes’ and controls’ body image dissatisfaction

Variable Athletes Controls

B SE B b B SE B b

Sex a

-0.86 0.27 -.33** -0.57 0.21 -.22**

BMI -0.28 0.05 -.61*** -0.18 0.04 -.41***

Parental influences -0.44 0.20 -.22* -0.24 0.24 -.08

Mother’ body image dissatisfaction -0.03 0.10 -.03 -0.15 0.09 -.17

Mother’ restraint -0.27 0.14 -.25 0.04 0.11 .04

Mother’ weight concern 0.18 0.12 .21 -0.21 0.12 -.20

R 2

.41 .26

F 7.64*** 7.01***

a Sex of adolescent (boys = 0, girls = 1); *** p \ .001; ** p \ .01; * p \ .05

J Child Fam Stud (2013) 22:1082–1091 1087

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SD = 0.64; U = 2664.00, p \ .01). Additionally, the par- ents of these adolescents revealed some differences on their

own EDE-Q scores when compared with the parents of the

adolescents below clinical levels of DE symptoms. Mothers

were more concerned about their own body shape

(M = 1.65, SD = 1.19 vs. M = 1.17, SD = 1.29; U =

2368.50, p \ .05) and weight (M = 1.53, SD = 1.23 vs. M = 1.15, SD = 1.28; U = 2606.00, p \ .05), while fathers had higher levels of restraint (M = 0.99, SD = 1.27

vs. M = 0.48, SD = 0.95; U = 1883.00, p \ .01), weight concern (M = 1.48, SD = 1.70 vs. M = 0.75, SD = 1.16;

U = 1736.50, p \ .05) and EDE-Q global score (M = 0.95, SD = 1.05 vs. M = 0.52, SD = 0.76; U = 1655.00,

p \ .05).

Discussion

Our study sought to focus on the influences of several

family variables—particularly related to the mothers and

fathers of adolescents—in the body image dissatisfaction

and disordered eating of elite aesthetic athletes, compared

with a control group of non-athlete adolescents and their

parents.

Related to the first objective of our study, adolescents’

individual variables showed the expected differences

according to the literature (e.g., Byrne and McLean 2002),

with female athletes presenting lower BMI and higher

levels of two indicators of disordered eating (restraint and

eating concern) compared with the controls. However, we

also expected to find global levels of disordered eating that

were significantly higher, as demonstrated in a previous

study in which these same adolescents participated (Fran-

cisco et al. 2012). Because the mean values of disordered

eating are lower than expected in this study, we propose

two possible explanations for this fact: (1) adolescents with

higher levels of disordered eating may have been less ready

to seek cooperation from parents to participate in the study

because the subject of the investigation could trigger

weight- and/or eating-related conversations with their

parents (a behavior that the literature shows people with

disordered eating generally avoid); or (2) parents of ado-

lescents with higher levels of disordered eating may have

refused to participate, possibly because they also had

unhealthy eating behaviors and attitudes. However, the

absence of significant differences in body image dissatis-

faction and disordered eating indicators of the mothers of

participants of either gender and the fathers of female

participants do not support the results of the only known

study comparing aesthetic athletes with the controls

(Klump et al. 2001). Given that different measures were

used by Klump et al. (2001), future studies should be

conducted to clarify whether there are significant differ-

ences between parents of elite aesthetic athletes and those

of adolescents in general. For variables concerning family

relationships, there were no significant differences between

athletes and controls (either for boys or girls). Thus, we can

assume that the quality of family environment and parental

relationships, as well as parental influences on weight and

body image, are perceived similarly by athlete and control

adolescents.

Nevertheless, in the context of our second objective for

this study, we found different associations between family

variables and body image dissatisfaction and disordered

eating for athletes than we did for the controls. The sig-

nificant correlation between parental influences and BMI

among controls, but not in the athletes, reinforces the idea

that the critical comments received by elite athletes do not

depend on their BMI, as well as social influence in general

(Francisco et al. 2012). Instead, the critical comments

received by elite aesthetic athletes are an element of the

aesthetic sports subculture, and the parents also seem to

follow this same subculture. The strength of the correla-

tions between parental influences and body image dissat-

isfaction and disordered eating in athletes (more so than for

controls) points to the importance of studying the family

Table 5 Summary of multiple linear regression analyses for variables predicting athletes’ and controls’ disordered eating

Variable Athletes Controls

B SE B b B SE B b

Sex a

1.07 0.28 .38*** 0.82 0.14 .38***

BMI 0.17 0.05 .34** 0.06 0.02 .16*

Parental influences 1.01 0.22 .43*** 0.97 0.16 .42***

Family environment -0.13 0.20 -.07 -0.25 0.09 -.18**

Mother’ eating concern -0.05 0.26 -.02 -0.53 0.18 -.24**

Mother’ weight concern -0.05 0.12 -.05 0.26 0.07 .31***

R 2

.42 .49

F 7.97*** 20.57***

a Sex of adolescent (boys = 0, girls = 1); *** p \ .001; ** p \ .01; * p \ .05

1088 J Child Fam Stud (2013) 22:1082–1091

123

contexts of aesthetic elite athletes, who are already a group

at increased risk for the development of body image and

eating disturbances. Moreover, given the absence of sig-

nificant correlations between parental influences and par-

ents’ body image dissatisfaction or disordered eating, we

suggest that perhaps parents are not motivated by their own

personal concerns. Rather, we believe that parental influ-

ences may be a reflection of socio-cultural pressures: par-

ents are simply a conduit for reinforcing thinness as the

standard of beauty.

To address to our third objective, we examined multiple

regression models for both athletes and the controls. Dif-

ferent family factors predicted body image dissatisfaction

and disordered eating for athletes and the controls. As

expected, based on existing literature (e.g., Field et al.

2001; Francisco et al. 2012), adolescents’ sex and BMI

were significant predictors of either body image dissatis-

faction or disordered eating for both athletes and the con-

trols. In addition to these two individual predictors,

parental influences emerged as the only family variable that

predicted athletes’ body image dissatisfaction and disor-

dered eating, especially for disordered eating. We believe it

is necessary to alert parents in the elite aesthetic sports

community to the influence of their comments and values

on their athlete children because these comments can

strengthen the concerns of adolescents and others in the

social contexts of the adolescent’s sport (i.e., peers and

coaches). Ideally, parents would be integrated into pre-

ventive actions within the context and communities of

aesthetic elite sports. It is essential that the family system

provides conditions that balance the demands of thinness

within the community of these sports. In relation to control

adolescents, parental influences were not predictive of

body image dissatisfaction or any other family variable.

However, for disordered eating in the control group, a

larger number of family variables emerged as predictors.

Apart from parental influences, consistent with Field et al.

study (2001), eating and weight concern of mothers–con-

firming the influence of maternal modeling pointed by

other authors (e.g., Pike and Rodin 1991)–and the negative

perception of the quality of family environment proved to

be important predictors, as opposed to the quality of the

specific relationship with each parent. Thus, family envi-

ronment should be taken into account in the future to

explore the specific features that make this variable a

predictor of disordered or healthy eating behaviors.

Finally, our fourth objective has led us to investigate the

differences on family variables between adolescents who

scored above and below the EDE-Q cut-off. Our results

agree with the literature that investigates family charac-

teristics associated with disordered eating: adolescents at

higher clinical risk did perceive lower quality in their

relationships with both parents, as well as within the family

environment overall (Archibald et al. 1999; Blackmer et al.

2011; Crespo et al. 2010), and their parents endorsed more

weight teasing and concern with their child’s thinness (Ata

et al. 2007; Smolak et al. 1999). In addition, the differences

between in parent–child relationships coincides with the

findings of Pike and Rodin (1991), who found associations

between mothers’ and daughters’ disordered eating

behaviors, but not between those of father and daughter

(Keel et al. 1997; Yanez et al. 2007). Our data, when

considered in the context of existing literature, suggest the

need to continue studying fathers and their eating behavior,

a theme often neglected in other studies.

In conclusion, as was found by Wertheim et al. (2002),

our data seem to indicate that parental influences have

greater influence when it presents in the form of parent

concern with child thinness and weight teasing rather than

as parental modeling of dieting or body concerns, espe-

cially among athletes. Exposure to many other social

models of eating behavior—from peers, television and, in

the specific case of athletes, coaches—can diminish the

contribution of parents. However, among adolescents in the

general population, maternal modeling still seems to have a

major impact on disordered eating. This finding should be

taken into account in preventive actions, particularly

because healthy food models can also predict healthy eat-

ing behaviors in adolescents.

The present study has several limitations that should be

taken into consideration when interpreting our results.

First, the relatively small sample size of adolescent athletes

presents challenges, especially for carrying out multiple

regressions. These regressions are potentially unstable and

thus preliminary, offered as indicators for future research,

which should also seek to test these models in different

samples of male and female athletes. The cross-sectional

design represents another limitation because it does not

allow for causal inferences to be made with regard to the

influence of family variables in the development of ado-

lescents’ body image dissatisfaction and disordered eating.

Longitudinal studies are needed for a proper exploration of

this influence. Despite these limitations, this study has

strengths and makes important contributions to the litera-

ture. To our knowledge, it is the first time a characteriza-

tion of the family influences on body image dissatisfaction

and disordered eating has been conducted with both female

and male aesthetic athletes, also including both mothers

and fathers. Thus, being considered an exploratory study,

this study has enabled the identification of several specific

and relevant aspects of elite aesthetic athletes’ families to

be considered more rigorously in future studies.

Acknowledgments This work was funded by a Ph.D. Grant awar- ded to the first author by the Fundação para a Ciência e a Tecnologia,

Portugal (SFRH/BD/27472/2006). The authors would like to thank all

J Child Fam Stud (2013) 22:1082–1091 1089

123

the adolescents, parents and heads of school who participated in the

study.

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