Body Image 7 (2010) 814

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Body Image
journal homepage: www.elsevier.com/locate/bodyimage

Family inuence on disordered eating: The role of body image dissatisfaction

Annette S. Kluck *
Psychology MS 2051, Texas Tech University, Lubbock, TX 79409, United States

A R T I C L E I N F O A B S T R A C T

Article history: Research has linked an appearance-focused family culture (including parental commentary about
Received 20 May 2009 weight/size) with increased disordered eating and body image dissatisfaction in daughters. Since body
Received in revised form 4 September 2009 image dissatisfaction is also a risk factor for disordered eating, body image dissatisfaction may
Accepted 30 September 2009
contribute to the link between family focus on appearance and disordered eating. This correlational
study included a sample of 268 college women who completed the Family Inuence Scale, Bulimia Test
Keywords: Revised, Body Shape Questionnaire, and a series of items about their parents comments about their
Disordered eating
weight/size. Both family appearance focus and daughters body image dissatisfaction predicted
Body image dissatisfaction
Parental behavior
increased disordered eating in daughters. Additionally, body image dissatisfaction partially mediated
the inuence of family appearance focus on daughters disordered eating. No specic type of parental
comments regarding weight/size emerged as a superior predictor of eating disturbance, but
encouragement to control weight/size was a stronger predictor of body dissatisfaction than other
types of parental comments.
2009 Elsevier Ltd. All rights reserved.

Introduction in the development of disordered eating (e.g., Kluck, 2008;

The family represents an important social institution through
which values, behaviors, and attitudes are transmitted over time
(Parke & Buriel, 2008). According to learning theorists (e.g.,
Bandura & McDonald, 1963), adults, including family members,
can inuence childrens behavior through modeling and con-
tingencies placed upon behavior via rewards and punishments. In
addition, research suggests that those closest to an individual may
have a particularly powerful inuence on what the individual
perceives as normative (see Killeya-Jones, Costanzo, Malone,
Quinlan, & Miller-Johnson, 2007), making behaviors of others to
whom one is close, such as parents, particularly important in
development. The inuence of ones family and the role that
parents play in development extends into the adolescent and early
adult years (e.g., Aquilino & Supple, 2001). Not surprisingly,
researchers have explored various mechanisms through which
family experiences might place some young women at risk for
eating disorders. Although some studies link family dynamics (e.g.,
Minuchin, Rosman, & Baker, 1978) with disordered eating, the
culture of a family with regard to emphasis on appearance,
thinness, eating, and weight may play a particularly important role
This research was completed as part of fulllment of the requirement for the
doctoral dissertation.
* Correspondence address: Special Education, Rehabilitation, & Counseling,
School Psychology, 2084 Haley Center, Auburn University, Auburn, AL 36849,
United States. Tel.: +1 334 844 2553; fax: +1 334 844 7677.
E-mail address: ask0002@auburn.edu.
Wertheim, Martin, Prior, Sanson, & Smart, 2002).
Family behavior, disordered eating, and body image dissatisfaction
Research suggests that various aspects of family behavior
related to food and weight (e.g., expressed attitudes towards
appearance, comments about body size) are associated with
increased rates of problematic eating in children (for a review, see
Golan & Crow, 2004). A general tendency for a family to focus on
appearance and attractiveness is related to greater difculties with
disordered eating and weight concerns among daughters (e.g.,
Davis, Shuster, Blackmore, & Fox, 2004; Field, Camargo, Taylor,
Berkey, Roberts, & Colditz, 2001; Laliberte, Boland, & Leichner,
1999).
In the quest to identify risk factors for disordered eating,
researchers have also explored specic behaviors that family
members may exhibit such as parents modeling of dieting and
their own disordered eating behaviors (e.g., Keel, Heatherton,
Harnden, & Hornig, 1997; Kichler & Crowther, 2001; Stice, Agras, &
Hammer, 1999). Included in this group of family behaviors that
may create an appearance-focused culture are verbal comments
parents make about their daughters body size or appearance
which may increase or decrease the likelihood of the daughter
engaging in a certain behavior. For example, mother and (less
strongly) father teasing (MacBrayer, Smith, McCarthy, Demos, &
Simmons, 2001), negative comments, and criticism about appear-
ance or weight (Baker, Whisman, & Brownell, 2000; Smolak,
Levine, & Schermer, 1999; Vincent & McCabe, 2000) are linked with

1740-1445/$ see front matter 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.bodyim.2009.09.009
 A.S. Kluck / Body Image 7 (2010) 814
increased disordered eating in daughters. Similarly, encourage-
ment to diet and lose weight from both mothers and (less
consistently) fathers is associated with daughters disordered
eating (e.g., Benedikt, Wertheim, & Love, 1998; Keel et al., 1997;
Vincent & McCabe, 2000; Wertheim et al., 2002). What is
particularly concerning about the link between encouragement
to diet and disordered eating is that parents may perceive verbal
encouragement to diet and lose weight as a caring behavior and
they may view teasing about weight and size as neutral comments
made during family bonding. Yet, both parental encouragement to
diet and lose weight and parental teasing have been linked with
negative consequences for daughters (i.e., development of
disordered eating).
There is little research on the specic mechanisms through
which a family appearance-focused environment (i.e., emphasis on
appearance and thinness) works to place some individuals at risk
for eating disorders. Research exploring specic pathways through
which parental behaviors operate could help clarify why some
young women in appearance-focused families develop disordered
eating while others do not.
Body image dissatisfaction may be one of several mechanisms
through which a familys emphasis on thinness leads to eating
disorders and related concerns. Body image dissatisfaction, a
subjective negative self-evaluation about ones body (Cash &
Pruzinsky, 2002), is common among women (see Thompson,
Heinberg, Altabe, & Tantleff-Dunn, 1999). Studies suggest that high
levels of body image dissatisfaction place individuals at risk for
subclinical disordered eating and development of a clinically
diagnosable eating disorder (e.g., Mora-Giral, Raich-Escursell,
Segues, Torras-Claraso, & Huon, 2004; Shaw, Stice, & Springer,
2004).
It stands to reason that daughters raised in families that are
more appearance-focused may be simultaneously more cognizant
and concerned about their own physical appearance and how that
appearance ts with familial and societal standards. Parents may
focus on appearance due to their own body image dissatisfaction
and may send messages to their daughters that they value
thinness, such as when a parent encourages a child to diet.
Research has linked body image dissatisfaction and history of
maladaptive eating attitudes among mothers with increased body
image dissatisfaction in daughters (Kichler & Crowther, 2001;
Sanftner, Crowther, Crawford, & Watts, 1996; Smolak et al., 1999).
This is consistent with the idea that mothers focus on physical
appearance may have negative consequences for daughters. In
addition, mothers disapproval of daughters gures and encour-
agement to diet from mothers (Benedikt et al., 1998), have been
linked with increased body image dissatisfaction in daughters even
after controlling for body size. Teasing and negative feedback
about appearance from fathers and mothers were also associated
with increased body image dissatisfaction in daughters (Schwartz,
Phares, Tantleff-Dunn, & Thompson, 1999). Thus, there appears to
be a link between maternal and, to a lesser extent, paternal
behaviors suggestive of a family appearance-focused culture and
increased body image dissatisfaction in daughters.
The present study
Research linking specic parental behaviors (i.e., emphasis on
appearance, commentary about body size and appearance) with
body image dissatisfaction (Sanftner et al., 1996; Smolak et al.,
1999) and disordered eating (e.g., Davis et al., 2004; Field et al.,
2001; Laliberte et al., 1999) suggests that a family culture that
emphasizes appearance and thinness might be associated with
both increased disordered eating and body image dissatisfaction.
In addition to the direct effect of family focus on appearance on the
development of disordered eating, an indirect effect may occur as
9
family focus on appearance and thinness inuences body image
dissatisfaction, which subsequently increases risk for disordered
eating. As such, it was expected that in addition to the inuence
that family focus on appearance and thinness/attractiveness has on
the development of disordered eating behaviors, an appearance-
focused family culture would indirectly effect disordered eating
through increased body image dissatisfaction.
In addition, some types of parental comments, one aspect of the
family culture, related to daughters weight may have particularly
problematic effects. Some types of parental comments about
daughters body size and appearance have been linked with body
image dissatisfaction and disordered eating (e.g., Keel et al., 1997;
Schwartz et al., 1999; Vincent & McCabe, 2000). Research
evaluating the relative contributions of these different types of
comments from parents on the development of disordered eating
in daughters is lacking. Thus, a secondary aim of the study was to
explore the relative strength of the relationship between specic
types of parental comments with problems linked to eating
disorders concerns among daughters (e.g., disordered eating, body
image dissatisfaction) in previous research. Without research
regarding the potential intentions of various types of appearance
commentary, one can only speculate about intentions and the
effects of such commentary. Criticism may reect more distant and
less supportive relationships (research links family dynamics with
disordered eating, see Minuchin et al., 1978). Therefore, one might
expect perceived criticism to be the best predictor of disordered
eating and body image dissatisfaction among various types of
parental commentary. It is possible that encouragement to diet and
control weight reects a focus upon health and a desire to be
helpful if parents are concerned about their childs weight and
health (research indicates that mothers become concerned if they
believe their daughters are gaining weight, see McCabe, Ricciar-
delli, Stanford, Holt, Keegan, & Miller, 2007). As such, perceived
encouragement to control weight was expected to be a weaker
predictor, compared to parental criticism and teasing, of dis-
ordered eating and body image dissatisfaction.
Method
Participants
A sample of 268 never-married college women, ranging in age
from 16 to 24 (M = 18.83; SD = 1.21), enrolled in introductory
psychology courses, was recruited to participate in part of a larger
study in exchange for class credit (Kluck, 2008). Participants mean
weight (136.57 lbs; SD = 22.73) and height (65.32 in., approxi-
mately 50 500 ; SD = 2.96) resulted in a mean body mass index (BMI)
of 22.50 (SD = 3.73). Participants predominantly self-identied as
Caucasian (82.8%), with 6.3% identifying as Hispanic, 4.9%
identifying as African American, 2.6% identifying as Asian
American, and 3% identifying with other racial backgrounds. The
majority of participants (85.0%) came from households in which
their biological parents were married or in which one or both
parents were remarried. In addition, the average age at which
participants reported having last lived with their parents was
18.06 (SD = 0.68) which means that participants had, on average,
last lived with their parents less than one-year prior to the study.
Measures
The Body Shape Questionnaire (BSQ; Cooper, Taylor, Cooper, &
Fairburn, 1987) is a 34-item self-report measure designed to assess
an individuals level of dissatisfaction with weight and shape, fear
of gaining weight, and desire to lose weight (e.g., I would prefer
for my legs to be thinner than they currently are, Has being with
thin women made you feel self-conscious about your shape?). The
10 A.S. Kluck / Body Image 7 (2010) 814

BSQ is constructed along a 5-point scale ranging from 1 (strongly
agree) to 5 (strongly disagree) with lower scores indicating more
dissatisfaction. Young, McFatter, and Clopton (2001) developed a
16-item modication of the BSQ eliminating items that assessed
bulimic behaviors and added items on dissatisfaction with specic
body parts. Thus, Young et al. (2001) reduced the item overlap
between their short form of the BSQ and measures of bulimic
symptomology. This change in item content is necessary to avoid
arbitrarily high correlations between the related constructs of
body image dissatisfaction and bulimic symptomology, which by
denition includes over-valuation of body shape (American
Psychiatric Association, 2000). Internal consistency of this
modied version was reported to be .97 (Young et al., 2001).
The present study used this modied version and reverse scoring
so that higher scores indicated greater dissatisfaction. The
Cronbachs alpha for the present study was .95.
The Family Inuence Scale (FIS; Young, Clopton, & Bleckly,
2004) is a 12-item measure designed to assess family attitudes
toward appearance or family focus on appearance and attractive-
ness (e.g., I have noticed a strong message from my family to have
a thin body, In my family, people make favorable comments
about the slender gures of other women). The FIS is constructed
along a 5-point scale ranging from 1 (strongly agree) to 5 (strongly
disagree). Reverse scoring was used for the present study so that
higher scores represent more problematic family attitudes. Young
et al. (2004) reported an internal consistency value of .89. The
Cronbachs alpha for the current study was .88 (as previously
reported in Kluck, 2008).
Given the lack of valid measures to assess for the presence of
specic parental comments about an individuals weight and size,
a set of six items specically related to negative parental
comments were developed for a larger study (Kluck, 2006,
2008) from which these data were obtained (see Appendix A).
Participants rated how frequently each parent (separately)
criticized their weight/size, teased them about their weight/size,
and encouraged them to control their weight/size through dieting,
exercise and other behaviors while growing up. Participants rated
the frequency of the verbal messages using a Likert-type scale
ranging from 1 (never) to 5 (all the time). Thus, participants rated
how frequently their mother criticized them about their weight/
size, teased them about their weight/size, and encouraged them to
control their weight/size. They then rated the frequency with
which their father displayed the same behaviors. Combining all six
items into a scale produced a Cronbachs alpha of .82. The one- to
three-week testretest reliabilities for subscales of negative
maternal commentary and negative paternal commentary (of
which these items are a part) were .82 and .86, respectively, in an
unpublished study on 24 undergraduate women (Kluck et al.,
2009).
Table 1
Means (standard deviations) and intercorrelations for types of parental commentary, FIS, BSQ, and BULIT-R.
The Bulimia Test Revised (BULIT-R; Thelen, Farmer, Won-
derlich, & Smith, 1991) is a 34-item measure used to assess
symptomology associated with bulimia nervosa (e.g., Do you feel
you have control over the amount of food you consume? How
often do you intentionally vomit after eating?) and was used as a
measure of disordered eating in the present study. The BULIT-R
uses a 5-point scale, with higher scores indicating more sympto-
matic behaviors. Thelen, Mintz, and Vander Wal (1996) demon-
strated that the BULIT-R has adequate validity, as well as
sensitivity and selectivity for detecting individuals meeting the
diagnostic criteria for bulimia nervosa. The internal consistency
score was .98 for the standardization sample and a two-month
testretest reliability was reported to be .95 (Thelen et al., 1991).
The Cronbachs alpha in the present study was .93 (as reported in
Kluck, 2008).
Procedure
After receiving approval from the Institutional Review Board,
participants were recruited via a participant pool for under-
graduate introductory psychology courses at a large southwestern
university. For participants under the age of 18, parents were
mailed a consent form that participants brought to the study. After
giving informed consent (or assent with documented parental
consent), groups of participants completed a study packet
containing a demographic information sheet (to collect descriptive
data for the sample as well as self-reported height and weight) and
several questionnaires. Participants were provided with a debrief-
ing form that described the studys purpose and included a list of
local mental health care providers upon completion of their
participation. All responses were obtained and recorded anon-
ymously.
Results
Effect of family appearance-focus on body image dissatisfaction and
disordered eating
Table 1 contains means, standard deviations, and intercorrela-
tions for measures and items used to evaluate the hypotheses.
Mothers made critical comments and encouraged weight control
through dieting, exercise or other weight control behaviors
signicantly more often than fathers. Mothers and fathers did not
signicantly differ in the frequency of teasing comments. As would
be expected, all six indicators of parental comments (e.g., mother
criticism, father teasing) were related to the broader indicator of
family appearance focus (FIS scores). In addition, parental comments
and family appearance focus were signicantly associated with body
image dissatisfaction and bulimic symptomology with more

Measured variable Mean (SD) 2 3 4 5 6 BSQ BULIT-R FIS

1 Mother criticism 1.91 (1.07)a .63** .59** .40** .33** .33** .30** .35** .59**
2 Mother teasing 1.62 (0.92) .46** .28** .40** .25*** .26** .37** .47**
3 Mother encouragement 2.34 (1.25)b .38** .29*** .55** .47**c .41**d .58**
4 Father criticism 1.62 (0.97)a .78** .57** .29** .26** .43**
5 Father teasing 1.56 (0.94) .46** .19* .26** .38**
6 Father encouragement 2.02 (1.24)b .32**c .27**d .49**
BSQ 46.68 (15.59) .60** .49**
BULIT-R 52.56 (17.45)^ .47**^
FIS 30.55 (10.33)^

Note: BSQ is the Body Satisfaction Questionnaire; BULIT-R is the Bulimia Test Revised; FIS is the Family Inuence Scale. Criticism, teasing, and encouragement refer to types
of commentary about weight or size.
^
Statistic reported previously in Kluck (2008).
Superscript letters denote signicant differences between the means (p < .001) or correlation coefcients (p < .01) for matched types of commentary for mother and father.
*
p < .01.
**
p < .001.
 A.S. Kluck / Body Image 7 (2010) 814
frequent comments predicting greater difculties in daughters.
When comparing the correlations between parents comments and
daughters eating disorder-related variables (i.e., body image
dissatisfaction and bulimic symptomology), only encouragement
to diet, exercise, or control weight/size showed a signicant
difference with mothers encouragement being a stronger predictor
of daughters difculties than fathers encouragement. Consistent
with past research, body image satisfaction signicantly predicted
disordered eating with higher levels of body image dissatisfaction
associated with greater levels of bulimic symptomology among
daughters (b = .60, p < .01).
Two simple regression analyses with the FIS (i.e., independent
variable) predicting the BSQ (i.e., mediator variable) and the BULIT-
R (i.e., outcome variable) were used to evaluate the hypotheses
that family focus on appearance would be associated with
increases in body image dissatisfaction and bulimic symptomol-
ogy. FIS scores were signicantly associated BSQ scores with
increased family focus on attractiveness and appearance predict-
ing increased body image dissatisfaction, b = .49, p < .01 (although
reduced, this relationship held after controlling for BMI, b = .40,
p < .01). As reported in Kluck (2008), FIS scores signicantly
predicted BULIT-R scores, b = .47, p < .01 (after controlling for BMI,
b = .44, p < .01). The signicant positive beta weights indicate that
increased family focus on appearance was associated with
increased body image dissatisfaction and bulimic symptomology.
Testing for partial mediation
After demonstrating that the independent variable predicts the
mediator and criterion variables, the next step in testing for
mediation is testing the relationship between the mediator and
criterion (Baron & Kenny, 1986). Since the rst three steps in the
causal model for mediation were conrmed with the simple
regression analyses, a multiple regression analysis predicting
bulimic symptomology with family attractiveness/appearance
focus and body image dissatisfaction was conducted. The model
signicantly predicted BULIT-R scores (r = .63, F(2, 256) = 83.56,
p < .01). Although the beta value for the inuence of FIS scores on
BULIT-R scores was reduced (b = .23, p < .01), the inuence of the
predictor variable remained signicant. Thus, full mediation was
not present. A Sobel test using the Aroian test statistic was
conducted, as recommended by Preacher and Hayes (2004), to
determine if the indirect effect was signicant. The Sobel test
produced a value of 6.22 (p < .01), supporting the hypothesis that a
signicant indirect effect existed. In addition to the Sobel test
statistic, one can compute the percentage of the total effect that
occurred through mediation (see Dudley & Benuzillo, 2002;
Dudley, Benuzillo, & Carrico, 2004). Of the total effect, 50.07%
was mediated by body image dissatisfaction, indicating that body
image dissatisfaction partially mediated the inuence of family
attractiveness/appearance focus on bulimic symptomology. Fol-
lowing the guidelines from Li, Bienias, and Bennett (2007) for
different methods of testing mediation with control variables to
avoid biased estimates, the Sobel test statistic when controlling for
BMI was 6.05 (p < .01). The beta value for the inuence of FIS
scores on BULIT-R scores when the mediator was added to the
model and confounding effects of BMI were controlled for was .24
(p < .01). Thus, the nding that body image dissatisfaction
partially mediates the relationship between family focus upon
appearance and attractiveness and bulimic symptomology was not
an artifact of BMI.
Testing the relative importance of types of parental commentary
Using combinations (i.e., the mother and father pair for each
type of comment) of individual items developed to explore the
11
Table 2
Regression statistics for types of mother and father comments predicting body
image dissatisfaction and disordered eating.
Types of parental comment R
BSQ
Criticism about weight/size .34**
Teasing about weight/size .27**
Encouragement to control weight/size .47**
BULIT-R
Criticism about weight/size .37**
Teasing about weight/size .36**
Encouragement to control weight/size .40**
Note: For each type of parental comment, the perception of frequency of the
comment for mother and for father were entered as predictor variables (rather than
summed to create one variable) such that there are two predictors (the separate
ratings for mother and father for the particular type of comment) represented by
the R value.
BSQ is the Body Shape Questionnaire. BULIT-R is the Bulimia Test Revised. Values
collapse across ratings for mothers and fathers with separate regressions for each
type of comment on the BSQ and BULIT-R.
**
p < .001.
inuence of types of comments from parents, the relative
importance of parental criticism, teasing about weight/shape,
and encouragement to control weight through dieting, exercise,
and other weight control behaviors in predicting disordered eating
variables was explored. A total of six multiple linear regression
analyses were conducted to evaluate the predictive ability of each
form of commentary on body image dissatisfaction and bulimic
symptomology as measured by the BSQ and BULIT-R, respectively.
Table 2 reveals that each type of parental comment signicantly
predicted both body image dissatisfaction and bulimic sympto-
mology. The R values indicate that parental criticism and teasing
accounted for less variance than did encouragement to control
weight/size in both body image dissatisfaction and bulimic
symptomology.
Due to error variance, one cannot simply conclude that the
predictor set with the larger R value is signicantly better than
another predictor set with a smaller R value. To empirically test the
expectation that parental criticism would be most powerful
predictor of (accounting for the most variance in) problems of
body image dissatisfaction and bulimic symptomology, the
procedures outlined by Tabachnick and Fidell (2001, pp. 145
147) for comparing sets of predictors were followed. First, z scores
were computed for each set of predictors (e.g., one set would be
mother criticism and father criticism) on each dependent variable.
When testing the signicance of the difference in the predictive
power of parental criticism and parental teasing using BSQ scores
as a criterion, the resulting z score for the z test of the difference
between the two sets of predictors was 1.61. Since this value did
not exceed the cutoff of the critical value for a two-tailed test (with
alpha level of .05) of 1.96, the predictive powers of parental
criticism and teasing for body image dissatisfaction as measured by
the BSQ did not differ signicantly. In contrast, parental encourage-
ment to control weight through diet, exercise, or other behaviors for
health reasons was a signicantly better predictor of body image
dissatisfaction than both parental criticism (z = 2.57, p < .05) and
parental teasing (z = 3.50, p < .05). Results obtained when using
participants BULIT-R scores as a measure of bulimic symptomology
revealed that the predictive power of parental criticism did not differ
signicantly from the predictive power of parental teasing (z = .49, ns)
or encouragement to control weight (z = .93, ns). Finally, the
relationships between BULIT-R scores and parental teasing did not
signicantly differ from the relationship between BULIT-R scores and
encouragement to control weight (z = 1.18, ns).
Inspection of the bivariate correlates (Table 1) for each mother
and father variable and the outcome variables reveal that there is
more variability in the relationship between types of commentary
12 A.S. Kluck / Body Image 7 (2010) 814
and body image dissatisfaction than compared to the relationship
between types of commentary and bulimic symptomology. In
particular, the relationship between mothers encouragement to
control weight/size through dieting, exercise, and other weight
control behaviors and body image dissatisfaction (r = .47) was
stronger (accounting for more than twice the amount of variance)
than the relationship between any other type of commentary and
body image dissatisfaction (r ranged from .19 to .32). It is this
relationship that appears to account for the greater predictive
power of encouragement to control ones weight or size through
dieting, exercise and other weight control behaviors when
predicting body image dissatisfaction.
Discussion
This study sought to examine one mechanism through which
the family environment may relate to disordered eating symp-
toms. More specically, it was hypothesized that body image
dissatisfaction would partially mediate the relationship between a
family culture that emphasizes thinness and appearance and
bulimic symptomology. A secondary purpose of the study was to
examine whether some types of comments from parents related to
weight and size are more problematic than others. Criticism was
expected to better predict body image dissatisfaction and bulimic
symptomology compared to teasing and encouragement to control
weight (with encouragement to control weight expected to be the
least detrimental).
The ndings support the notion that the inuence of the family
on development may extend to disturbed eating. In this study,
family focus on appearance and specic types of comments parents
make about weight and size were associated with increased
difculties with behaviors associated with a diagnosis of bulimia
nervosa in a nonclinical sample. More specically, a little over 20%
of the variance in bulimic symptomology was explained by an
appearance-focused family culture. The results also demonstrated
that the relationship between family appearance focus and bulimic
symptomology may be partially mediated by body image
dissatisfaction such that body image dissatisfaction accounted
for half of the variance in bulimic symptomology explained by
family focus on appearance. In other words, study results were
consistent with previous research linking a weight-centric family
environment with disordered eating. In addition, these ndings
extend previous research by identifying one potential mechanism,
body image dissatisfaction, through which the inuence of the
family environment operates to place some individuals at risk for
developing eating disturbances.
In addition to the ndings that family attitudes towards
appearance may have both direct and indirect effects on the
development of bulimic eating behavior, the results also add to our
understanding of the relationship between parental commentary
(a specic type of parental appearance-related behavior) and
eating disorder-related experiences in daughters. In contrast to
expectations that encouragement to control ones weight and size
through diet or exercise would be signicantly less associated with
body image and bulimic eating problems compared to criticism or
teasing, the results indicated that even comments daughters
perceived as encouragement were linked to increased body image
dissatisfaction and bulimic symptomology. Although a link
between disordered eating and parental encouragement to diet
is not new (see Wertheim et al., 2002), this nding is particularly
important since well-meaning parents might believe such com-
ments are helpful. In fact, all types of comments about weight and
size were signicant predictors of increased body image dis-
satisfaction and bulimic symptomology. Parental teasing and
criticism may communicate to the daughter that her body is
unattractive while encouragement to control her weight/size may
be seen as a sign of genuine concern. At the same time, this
encouragement could indirectly, and perhaps unintentionally,
communicate that the daughters present physical appearance is
unacceptable and requires her to take action to change her body. In
other words, encouragement to use dieting, exercise, and other
weight control behaviors gives a daughter specic directives she
should take to change. One might liken this to media messages that
imply the thin-ideal is achievable with a particular product, such
that it is a womans fault if she does not attain the thin-ideal
(Trottier, Polivy, & Herman, 2005).
Findings from this study were consistent with past research in
which the strongest and most consistent associations between
appearance and size comments from parents and eating disorder-
related difculties among daughters involved comments from
mothers (e.g., Baker et al., 2000; Wertheim et al., 2002). In the
present study, differences between mothers and fathers inuence
were only signicant for one type of comment (i.e., encouragement
to control weight/size). However, the pattern of relationships
across all types of comments ts well with conclusions drawn by
other researchers that mothers comments are more inuential
than fathers with regard to daughters body image dissatisfaction
and disordered eating (e.g., Wertheim et al., 2002). One potential
explanation for this pattern is that children are more inuenced by
same-gendered parents. However, in some cases mothers
behaviors have been shown to be as good or better predictors of
disordered eating in sons than fathers behaviors (e.g., Baker et al.,
2000; Wertheim et al., 2002). Alternatively, it may be that the
greater inuence from mothers reects sociocultural differences in
weight control practices such that father comments might be
better predictors when examining body image concerns and body
size control behaviors (such as increasing muscle mass) more
commonly reported among men (Wertheim et al., 2002).
Strengths and implications
The present study explored a more complex theoretical model
of the relationship between parental behaviors (i.e., focus on
appearance) and disordered eating in a nonclinical sample. The
results provide a greater understanding of the potential etiological
relationship between family behaviors and eating disorders. The
ndings that various types of comments about weight and size,
including encouragement to control ones size, were associated
with increased body image dissatisfaction and bulimic sympto-
mology provide further evidence of the important role that
families play with regard to eating disorder-related problems.
This study has important implications for mental health
providers. A thorough history of family background and perceptions
of parental attitudes about weight and body size may be warranted,
even when treating a college student seeking help for disordered
eating or body image dissatisfaction. The current study suggests that
excessive familial focus on thin appearances might require attention
in the course of treatment. If in fact the young adult is experiencing
familial pressure around weight and size, the failure to address this
pressure may lead to continued exposure to a weight-centric family
environment. If the family environment has played a signicant role
in the development of the individuals disordered eating or body
image dissatisfaction, the young woman may continue to struggle
with body image dissatisfaction despite the use of treatment
interventions that otherwise would reduce symptoms associated
with body image dissatisfaction and eating disturbances. In such a
case, treatment may require the therapist to help a young women
who reports an appearance-focused family culture deal with the
potential effects of that environment in much the same way that
treatment of eating disorders has done with the media-portrayed
thin-ideal where young women are taught to carefully examine
messages in the mass media (e.g., Coughlin & Kalodner, 2006).
 A.S. Kluck / Body Image 7 (2010) 814
Study results also support the inclusion of the family therapy in
the arsenal of treatments for eating disorders (Vandereycken,
1987). In such cases, recovery could serve as a common goal among
parents and daughters such that parental behaviors that interfere
with the recovery process (e.g., comments) could be addressed
(Zucker, Ferriter, Best, & Brantley, 2005). In treatment, parents may
feel more competent to help daughters if they receive psychoe-
ducation and skill building around basic issues in disordered eating
and recovery (Holtkamp, Herpertz-Dahlmann, Vloet, & Hagenah,
2005; Zucker et al., 2005). One such method for family involve-
ment in treatment is the Maudsley Method, which builds upon the
family strengths to assist in the re-feeding process among
adolescents with anorexia (Dare & Eisler, 2000).
Limitations and recommendations for future research
The ndings of this study must be considered in the context of
important limitations including the use of a correlational and
retrospective design as well as the homogeneous sample.
Correlational methodology prohibits the inference of causality.
Whereas experimental designs to explore causes of eating
disorders are difcult, longitudinal designs and studies examining
perceptions of parents comments while living with parents would
add support to the hypothesis that parental behaviors play a causal
role since such a causal role requires a set temporal sequence.
Although dysfunctional eating is common among college women,
it is difcult to know how these results extend to women of other
ages and backgrounds, and to men.
The nding that perceived parental emphasis on appearance
was associated with body image dissatisfaction and bulimic
symptomology suggests a need for additional research exploring
the role of the family environment in the development of
disordered eating. Although this study focused on young adults,
body image dissatisfaction among pre-teens is a common problem
(Ricciardelli & McCabe, 2001; Smolak, 2004), supporting further
research on the age at which negative consequences (i.e.,
disordered eating and body image dissatisfaction) rst emerge
in daughters where families emphasize appearance and the extent
to which younger individuals are aware of the appearance-focused
culture within their families. The use of longitudinal designs could
help clarify the potential long-term effects of early exposure to an
appearance-focused family culture. Should such research reveal
that early exposure has particularly detrimental long-term effects,
it would be vital to develop cost-effective developmentally-
appropriate large-scale prevention programs for parents of young
children to reduce the risk of development of body image
dissatisfaction (Graber & Brooks-Gunn, 1996).
Appendix A
Parental Comment Items
Instructions: Please think about the person who t the role of mother while you were growing up and rate (using the response scale below) how often she did each of the
following
A. Never
1. Criticized your weight/size?
2. Teased you about your weight/size?
3. Encouraged you to control your weight/size through dieting,
exercise, or other weight control behaviors?
Instructions: Please think about the person who t the role of father while you were growing up and rate how often (using the same response scale) he did each of the
following.
A. Never
1. Criticized your weight/size?
2. Teased you about your weight/size?
3. Encouraged you to control your weight/size through dieting,
exercise, or other weight control behaviors?
Note: Items are taken from the Family Experiences Related to Food Questionnaire (Kluck, 2006).
13
Should additional research continue to link certain parental
behaviors with problematic eating and body image difculties,
efforts targeted at helping families avoid or change an overemphasis
on weight and appearance might be needed and should be tested
using experimental research designs. The use of multiple informants
might help inform efforts targeted at reducing the extent to which
families emphasize appearance, since the approach may need to
differ depending upon whether parents hold the same perceptions
as their daughters with regard to the emphasis on appearance.
Large-scale intervention programs might help parents address their
own eating and weight issues as well as providing psychoeducation
regarding the negative consequences of body image dissatisfaction
for young women (e.g., depression, low self-esteem; Sarwer,
Wadden, & Foster, 1998). The nding that encouragement to diet
was as strongly associated with body image dissatisfaction and
disordered eating as other forms of comments means that
researchers need to identify ways parents can encourage their
children to make healthy choices that lead to desired behaviors (i.e.,
behaviors that will increase the physical and mental health of the
child). One place to start may be in exploring whether shared family
activities (e.g., family meals, recreational activities involving all
family members) would lead to less problematic outcomes (i.e., are
not associated with body image dissatisfaction and disordered
eating) or serve as protective factors. In addition, research exploring
the potential for a family culture that de-emphasizes appearance to
be protective against other risk factors (e.g., peer culture that
emphasizes appearance and thinness) is needed.
Future research should also test the effectiveness of therapeutic
interventions specically targeted toward reducing the impact of
perceived parental messages on body image. Such research might
involve empirical comparisons of techniques like assertiveness
training (Shiina et al., 2005), cognitive behavioral interventions that
increase the cognitive dissonance a young woman feels towards the
thin-ideal (Stice, Chase, Stormer, & Appel, 2001), and psychoeduca-
tion (Graber & Brooks-Gunn, 1996) for addressing an appearance-
focused family culture in treatment. In essence, research is needed to
better understand how difculties with disordered eating or body
image dissatisfaction can be prevented or ameliorated when a young
woman has grown up in a family with an appearance-focused culture.
Acknowledgments
The author acknowledges her dissertation chair, Dr. Sheila
Garos, and dissertation committee members (Dr. Jim Clopton, Dr.
Darcy Reich, and Dr. Erin Hardin) for their assistance. In addition,
she acknowledges Megan Cobb and Sophie Ahmad for their
assistance with manuscript editing.
B. Rarely C. Sometimes D. Often E. All the time
B. Rarely C. Sometimes D. Often E. All the time
14 A.S. Kluck / Body Image 7 (2010) 814
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