Exploring Positive Body Image and Motives for Exercise as (PDF)

University of Wisconsin Milwaukee UWM Digital Commons Theses and Dissertations August 2018 Exploring Positive Body Image and Motives for Exercise as Predictors of Intuitive Exercise and Exercise Behavior Among Women Natalie Michelle Ramsey University of Wisconsin-Milwaukee Follow this and additional works at: https://dc.uwm.edu/etd Part of the Kinesiology Commons This Thesis is brought to you for free and open access by UWM Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UWM Digital Commons. For more information, please contact [email protected] Recommended Citation Ramsey, Natalie Michelle, "Exploring Positive Body Image and Motives for Exercise as Predictors of Intuitive Exercise and Exercise Behavior Among Women" (2018). Theses and Dissertations. 1905. https://dc.uwm.edu/etd/1905  EXPLORING POSITIVE BODY IMAGE AND MOTIVES FOR EXERCISE AS PREDICTORS OF INTUITIVE EXERCISE AND EXERCISE BEHAVIOR AMONG WOMEN by Natalie Michelle Ramsey A Thesis Submitted in Partial Fulfilment of the Requirements for the Degree of Master of Science in Kinesiology at The University of Wisconsin - Milwaukee August 2018  ii ABSTRACT EXPLORING POSITIVE BODY IMAGE AND MOTIVES FOR EXERCISE AS PREDICTORS OF INTUITIVE EXERCISE AND EXERCISE BEHAVIOR AMONG WOMEN by Natalie Michelle Ramsey The University of Wisconsin-Milwaukee, 2018 Under the Supervision of Professor Lori Klos, PhD Purpose: To explore three facets of positive body image and motives for exercise as predictors of women’s intuitive exercise and exercise behavior. Scientific significance: Positive body image has been associated with health-promoting behaviors such as utilizing sun protection techniques and intuitive eating. Despite these findings and the known benefits of exercise, there are no known published studies exploring if positive body image and exercise motivation predict intuitive exercise and exercise behavior in women. Understanding these relationships could facilitate the design of interventions targeting improvements in both psychological well-being and exercise behavior. Methodology: This cross-sectional study included 391 women (18-91 years; Mage: 49.9 ± 15.7 years; BMI: 28.2 ± 6.9 kg/m2) who completed the Body Appreciation Scale–2, Broad Conceptualization of Beauty Scale, Body Image - Acceptance and Action Questionnaire, Functions of Exercise Scale, and Intuitive Exercise Scale. Participants reported exercise behavior using a 7-day exercise log which was used to calculate exercise behavior in MET minutes per week. Pearson correlations were used to determine interrelationships between study variables; stepwise hierarchical multiple regression was used to determine if facets of positive body image  iii and motives for exercise, and the interaction between these variables, predict intuitive exercise and exercise behavior. Results: Body appreciation (r = .21), broad conceptualization of beauty (r = .15), filtering information in a body protective manner (r = .17), and weight/appearance motives for exercise (r = -.10) were significantly (p < .05) correlated with intuitive exercise. Body appreciation (r = .11), broad conceptualization of beauty (r = .13), health/enjoyment motives for exercise (r =.31), and weight/appearance motives for exercise (r = .14) were significantly (p < .05) correlated with exercise behavior. Hierarchical multiple regression revealed body appreciation (β = .16) was the only significant (p < .05) predictor of intuitive exercise. Body appreciation (β = -.18), and the interactions between broad conceptualization of beauty and weight/appearance (β = -.17) as well as health/enjoyment motives for exercise (β = .15), and the interaction between filtering information in a body protective manner and weight/appearance motives for exercise (β = -.17) significantly (p < .05) predicted exercise behavior. Conclusions: Women with a higher body appreciation are more likely to also exercise intuitively. Interventions aiming to increase intuitive exercise should aim to help women appreciate the appearance, function, and health of their body. Women engage in the highest levels of exercise when body appreciation is low, and when they have a narrow conceptualization of beauty and are highly motivated to exercise for weight/appearance-related reasons. However, interventions should be extremely cautious when promoting a narrow conceptualization of beauty and weight/appearance motives for exercise as this may lead to a maladaptive relationship with the body and exercise. To avoid a potentially harmful outcome, researchers should focus on helping women develop a more effective body image filter, perceive beauty in a variety of appearances of body sizes, and increase health/enjoyment motives for  iv exercise. Future research is needed to gain a better understanding of the interrelationships between positive body, exercise motives, intuitive exercise and exercise behavior.  v TABLE OF CONTENTS PAGE Abstract.................................................................................................................................. ii List of Figures...................................................................................................................... vii List of Tables ......................................................................................................................viii List of Abbreviations ............................................................................................................ ix CHAPTER I: Introduction ............................................................................................................................ 1 Study Purpose.................................................................................................................... 5 Specific Aims and Hypotheses.......................................................................................... 5 II: Literature Review................................................................................................................. 16 Body Image ..................................................................................................................... 16 Negative Body Image...................................................................................................... 18 Positive Body Image ....................................................................................................... 24 Holistic View of Positive Body Image..................................................................... 32 Positive Body Image and Health-Promoting Behaviors........................................... 36 Positive Body Image and Exercise Motivation. ....................................................... 41 III: Methods .............................................................................................................................. 45 Participants...................................................................................................................... 45 Procedure......................................................................................................................... 46 Measures.......................................................................................................................... 47 Positive Body Image................................................................................................... 48 Exercise Motivation.................................................................................................... 50 Intuitive Exercise........................................................................................................ 50 Exercise Behavior....................................................................................................... 51 Data Analysis .................................................................................................................. 52 IV: Results ................................................................................................................................ 55 Preliminary Analysis....................................................................................................... 56  vi Intercorrelations .............................................................................................................. 60 Hierarchical Multiple Regression.................................................................................... 63 V: Discussion........................................................................................................................... 75 Limitations and Future Directions.................................................................................... 92 Implications...................................................................................................................... 99 Conclusions.................................................................................................................... 101 References................................................................................................................................... 103 Appendices………………………...............................................................................................112 APPENDIX A: Screening Questions .................................................................................. 112 APPENDIX B: Sociodemographic Questionnaire .............................................................. 115 APPENDIX C: Body Appreciation Scale-2........................................................................ 118 APPENDIX D: Broad Conceptualization of Beauty Scale ................................................. 120 APPENDIX E: Body Image-Acceptance and Action Questionnaire .................................. 122 APPENDIX F: Functions of Exercise Scale........................................................................ 124 APPENDIX G: Intuitive Exercise Scale ............................................................................. 126 APPENDIX H: Exercise Behavior Log............................................................................... 128 APPENDIX I: MET Values Used to Calculate MET Minutes per Week........................... 130 APPENDIX J: Summary of Additional Intercorrelations ................................................... 133 APPENDIX K: Discussion of Exploratory Regression....................................................... 136 APPENDIX L: UWM IRB Approval.................................................................................. 138 APPENDIX M: Informed Consent – General ..................................................................... 140 APPENDIX N: Informed Consent – No Positive Body Image........................................... 143  vii LIST OF FIGURES Figure 1. Conceptual framework of the hypothesized relationship between body appreciation, broad conceptualization of beauty, and filtering information in a body protective manner predicting (a) intuitive exercise and (b) exercise behavior...................................................................................................7 Figure 2: Conceptual framework of the hypothesized relationship between facets of positive body image and motives for exercise as predictors of (a) intuitive exercise and (b) exercise behavior. …………………………………….……………9 Figure 3: Conceptual framework of the hypothesized interaction effects between three facets of positive body image and motives for exercise predicting (a) intuitive exercise and (b) exercise behavior...……..………………..….…………11 Figure 4. Wood-Barcalow et al.’s (2010) holistic body image model………………………......34 Figure 5. Interaction between the Broad Conceptualization of Beauty Scale, and weight and appearance-based motives for exercise, as predictors of women’s exercise behavior………………………………………..………..…….70 Figure 6. Interaction between the Broad Conceptualization of Beauty Scale, and health and enjoyment-based motives for exercise, as predictors of women’s exercise behavior………………………………………....…...………..71 Figure 7. Interaction between the Body Image - Acceptance and Action Questionnaire, and weight and appearance-based motives for exercise, as predictors of women’s exercise behavior…..…………………………………….…………..72  viii LIST OF TABLES Table 1. Order of Variable Entry for Hierarchical Multiple Regression Predicting Intuitive Exercise……………………………………………………….………...…..53 Table 2: Order of Variable Entry for Hierarchical Multiple Regression Predicting Exercise Behavior……………………………………………………………….……53 Table 3. Sociodemographic Characteristics of Participants (N = 391)……..……………...…….57 Table 4. Means, standard deviations, and correlations of study variables..……………………...61 Table 5. Hierarchical Multiple Regression Analysis Predicting Intuitive Exercise (N = 391)……………………………………………………………………………....65 Table 6. Hierarchical Multiple Regression Analysis Predicting Exercise Behavior (N = 391)………………………………………………………………………………68 Table 7. Hierarchical Multiple Regression Analysis Predicting Exercise Behavior with Sociodemographic Variables in the Final Step (N = 391)…………………….....73  ix LIST OF ABBREVIATIONS BA Body Appreciation BAS Body Appreciation Scale BAS-2 Body Appreciation Scale-2 BCB Broad Conceptualization of Beauty BCBS Broad Conceptualization of Beauty Scale BI-AAQ Body Image - Acceptance and Action Questionnaire BMI Body Mass Index FES Functions of Exercise Scale FIBPM Filtering Information in a Body Positive Manner HE Health and Enjoyment MET Metabolic Equivalent WA Weight and Appearance  1 Chapter I: Introduction Engaging in regular physical activity can lead to many physical and psychological benefits, such as decreased risk of cardiovascular disease and Type 2 Diabetes, as well as improvements in mental health and mood (Centers for Disease Control and Prevention, 2015). To achieve these health benefits, the Centers for Disease Control and Prevention recommends that adults engage in a minimum of 150 minutes of moderate, 75 minutes of vigorous intensity aerobic activity, or any combination of moderate and vigorous intensity activity equaling 150 minutes of moderate intensity activity, as well as muscle strengthening activities at least two days per week (Physical Activity Guidelines Advisory Committee, 2008). Despite these recommendations to receive health benefits, between 14 and 42% of women are inactive (Carlson, Densmore, Fulton, Yore, & Kohl III, 2009). There are several factors that influence exercise behavior participation including certain psychological factors, such as body image (Bell, Donovan, & Ramme, 2016; Dalle Grave, Calugi, & Marchesini, 2008) and motivation for exercise (Duncan, Hall, Wilson, & Jenny, 2010). A better understanding of how these psychological constructs relate to participation in exercise behavior - including exercise that demonstrates body trust, flexibility and variety, mindful exercise and the management of negative emotions can be useful in programs and interventions aiming to increase the engagement in exercise. A small, but growing number of researchers have begun exploring potential relationships between positive body image and health-promoting behaviors such as exercise. Positive body image is currently defined as the following:  2 An overarching love and respect for the body that allows individuals to (a) appreciate the unique beauty of their body and the functions that it performs for them; (b) accept and even admire their body, including those aspects that are inconsistent with idealized images; (c) feel beautiful, comfortable, confident, and happy with their body, which is often reflected as an outer radiance, or a “glow;” (d) emphasize their body’s assets rather than dwell on their imperfections; and (f) interpret incoming information in a body protective manner whereby most positive information is internalized and most negative information is rejected or reframed (Wood-Barcalow, Tylka, & Augustus-Horvath, 2010, p. 112). Evidence from qualitative studies on positive body image indicate adult women (Wood- Barcalow et al., 2010) and adolescents (Frisén & Holmqvist, 2010) with positive body image reported engaging in regular exercise as a way to care for their body. Although these qualitative findings are suggestive of a potential positive relationship between positive body image and exercise behavior, few researchers have explored this relationship quantitatively. In one study, Homan and Tylka (2014) reported that women who had the highest level of positive body image were highly active. Although the preliminary evidence is promising, more quantitative research is needed to understand the relationships between positive body image and physical activity behavior. In exploring the construct of positive body image, several studies suggest that exercise motivation also impacts exercise behavior. Two categories of exercise motivation have been utilized in previous studies about positive body image and physical activity behavior: health and enjoyment-based motives and weight appearance-based motives. In qualitative studies of adolescents (Frisén & Holmqvist, 2010) and adult women (Wood-Barcalow et al., 2010)  3 identified as having positive body image by high levels of body esteem, and high appearance evaluation, low overweight preoccupation and self-perceived positive body image, reported participating in exercise for health and enjoyment reasons such as becoming stronger and to improve what their body was capable of doing. Participants did not report engaging in exercise as a means to alter their weight or appearance (Wood-Barcalow et al., 2010). Further, among women with positive body image, those with higher levels of appearance motivation were more likely to be physically active than those with lower levels of appearance motivation (Homan & Tylka, 2014). Although women with high levels of appearance motivation engaged in higher levels of exercise, women with the high levels of exercise and women with high levels of body appreciation had the lowest levels of appearance-based motives for exercise (Homan & Tylka, 2014). While preliminary evidence suggests that health and enjoyment-based motives may be associated with higher levels of exercise in certain populations, more research is needed to elucidate these associations, as well as determine how positive body image and exercise-related motivations may relate to how often people exercise as well as how they approach exercising, such as exercising intuitively. Individuals who engage in intuitive exercise give themselves the freedom of engaging in a variety of enjoyable activities, and listen to their body to determine the duration of exercise which may help prevent injuries (Calogero & Pedrotty-Stump, 2011). Intuitive exercise is a construct that can be useful to consider when studying positive body image, and exercise motives and behavior. Intuitive exercise is the act of engaging in exercise that aligns with the physical cues of the body rather than feeling obligated to exercise (Reel & Miyairi, 2012). Specifically, individuals who intuitively exercise listen to their body to decide when to start and stop exercising and will discontinue exercising based upon their bodily cues (Reel & Miyairi, 2012).  4 Although the construct of intuitive exercise parallels the more extensively researched construct intuitive eating (Reel & Miyairi, 2012), currently there is limited available evidence regarding a relationship with positive body image. In a quantitative study of adults, Reel, Galli, Miyairi, Voelker, and Greenleaf (2016) reported that body appreciation - a facet of positive body image - was positively related to Body Trust and negatively related to Exercise Rigidity, factors of intuitive exercise; that is, men and women with higher levels of body appreciation were more likely to also report listening to their body and using a variety of exercises than individuals with lower levels of body appreciation. This relationship was also supported in the aforementioned qualitative studies of adolescents (Frisén & Holmqvist, 2010) and women (Wood-Barcalow et al., 2010). Thus, it is useful to consider exploring how positive body image, as well as motives for exercise, relate to the degree to which adults engage in intuitive exercise during an exercise session. The present study built upon the research by Homan and Tylka (2014), as well as the qualitative studies by Frisén and Holmqvist (2010) and Wood-Barcalow et al. (2010). Specifically, Homan and Tylka (2014) utilized hierarchical regression modeling to elucidate how frequency of exercise and exercise motivation predicted positive body image in women between the ages of 18 and 51. The accounts from adolescents (Frisén & Holmqvist, 2010) and women (Wood-Barcalow et al., 2010) with positive body image suggested higher levels of this construct may facilitate health and enjoyment (rather than weight and appearance) motives for exercise, and engagement in aspects of intuitive exercise, as well as higher levels of exercise in general. The current study explored how different facets of positive body image, as well as health and enjoyment-related motives and weight and appearance-related motives for exercise, predicted intuitive exercise and exercise behavior among adult women. Although body image concerns  5 have been observed among both women and men, nearly three quarters of women have been found to be dissatisfied with some aspect of their body. Further, body dissatisfaction is considered a part of the diagnostic criteria for the eating disorder anorexia nervosa (American Psychiatric Association, 2013), and women are up to three times more likely to experience an eating disorder than men during their lifetime (Hudson, Hiripi, Pope, & Kessler, 2007). Further, most of the preliminary research related to positive body image has been limited to adult women (Homan & Tylka, 2014; Tylka & Homan, 2015), therefore to facilitate hypothesis generation between the relevant constructs, the current study only included women. However, it is understood that future studies should include both men and women. Research Question Are certain facets of positive body image and motives for exercise predictors of (a) intuitive exercise and (b) exercise behavior among women? Study Purpose The purpose of this study was to extend the limited literature exploring positive body image and exercise behavior to determine if multiple facets of positive body image (i.e., body appreciation, broad conceptualization of beauty, and filtering information in a body protective manner) and motives for exercise (i.e., weight and appearance, and health and enjoyment) are predictors of intuitive exercise and exercise behavior among women. Specific Aims and Hypotheses Specific Aim 1: To determine if three facets of positive body image (i.e., body appreciation, broad conceptualization of beauty, and filtering information in a body protective manner) are predictors of (a) intuitive exercise as well as (b) exercise behavior among women.