Embrace Kids – Evidence-based claims 

The research and evidence we use is primarily drawn from peer-reviewed journal articles outlining high quality research conducted at Universities wherever possible. 

We are not always able to list the source for each statement we make (though we do try!)- please find some of the key references for the statistics we use and statements we make below. 

Skip to references for: 

• The scope of the problem
• Weight stigma and health 
• Embrace Magazine References 
• Embrace Kids Classroom Program 
• Body Blocks References 
• Activate by Embrace Kids References 

The scope of the problem

The majority of adolescents and adults want to change something about their body or appearance, and this has a significant impact on their physical and mental health behaviours and outcomes. 

• 77% of Australian adolescents report body image distress (Milton et al., 2021)
• 33% of adolescent girls meet the criteria for an eating disorder (Mitchison et al., 2020)
• Children as young as 3 have already internalised ideas about bodies and appearance (Spiel, Paxton, Yager, 2013)

Body dissatisfaction leads to:

• 24 x more likely to develop depression (Bornioli et al., 2021)
• Increased risk of eating disorders (Bucchianeri et al., 2013; Stice et al., 2019)
• Self-harm (Bornioli et al., 2019; Muhlenkamp et al., 2012) 
• Increased suicide intentions and ideation (Fan et al., 2022; Grunewald et al., 2021) 
• Lower diet quality (Bucchianeri et al., 2013)
• Less likely to engage in physical activity (Bucchianeri et al., 2013; Neumark-Sztainer et al., 2006)
• High-risk drinking behaviours (Bornioli et al., 2021)
• Recreational drug use (Bornioli et al., 2021; Kanayama et al., 2006)
• Smoking (Amos & Bostock, 2007; Bornioli et al., 2019; Stice & Shaw, 2003)
• Use of steroids and weight gain supplements (Kanayama et al., 2006; Yager & McLean, 2020)
• Lower academic engagement (Atkinson & Diedrichs, 2021)
• Loss of productivity and engagement in the workforce (Dove Real Cost of Beauty Ideals report)

Eating Disorders

• Body dissatisfaction is recognised as a key risk factor for eating disorders (Bucchianeri et al., 2013; Stice et al., 2019), but there are also genetic, personality, and other environmental factors (Barakat et al., 2023).
• Eating disorders have doubled since 2019, especially among 5-9 year olds (Morris et al., 2022).
• 25% of Australian adolescents meet the criteria for an eating disorder, including 33% of girls and 12% of boys (Mitchison et al., 2020).
• There are 1.1 Million people living with an eating disorder in Australia (Butterfly Paying the Price report ) 
• In 2023, 1273 people died from an eating disorder in Australia, more than the National road toll. (Butterfly Paying the Price report ) 
• Eating disorders cost the Australian economy $67 billion annually. (Butterfly Paying the Price report ) 

Amos, A., & Bostock, Y. (2007). Young people, smoking and gender—a qualitative exploration. Health Education Research, 22(6), 770-781.

Atkinson, M. J., & Diedrichs, P. C. (2021). Assessing the impact of body image concerns on functioning across life domains: Development and validation of the Body Image Life Disengagement Questionnaire (BILD-Q) among British adolescents. Body Image, 37, 63-73.

Barakat, S., McLean, S. A., Bryant, E., Le, A., Marks, P., Touyz, S., & Maguire, S. (2023). Risk factors for eating disorders: findings from a rapid review. Journal of eating disorders, 11(1), 8

Bornioli, A., Lewis-Smith, H., Smith, A., Slater, A., & Bray, I. (2019). Adolescent body dissatisfaction and disordered eating: Predictors of later risky health behaviours. Social Science & Medicine, 238, 112458.

Bornioli, A., Lewis-Smith, H., Slater, A., & Bray, I. (2021). Body dissatisfaction predicts the onset of depression among adolescent females and males: a prospective study. J Epidemiol Community Health, 75(4), 343-348.

Bucchianeri, M. M., Arikian, A. J., Hannan, P. J., Eisenberg, M. E., & Neumark-Sztainer, D. (2013). Body dissatisfaction from adolescence to young adulthood: Findings from a 10-year longitudinal study. Body Image, 10(1), 1-7.

Fan, Q., Li, Y., Gao, Y., Nazari, N., & Griffiths, M. D. (2022). Self-compassion moderates the association between body dissatisfaction and suicidal ideation in adolescents: A cross-sectional study. International journal of mental health and addiction, 1-18.

Grunewald, W., Calzo, J. P., Brown, T. A., Pennesi, J. L., Jun, H. J., Corliss, H. L., & Blashill, A. J. (2021). Appearance-ideal internalization, body dissatisfaction, and suicidality among sexual minority men. Body Image, 38, 289-294.

Kanayama, G., Barry, S., Hudson, J. I., & Pope Jr, MD, MPH, H. G. (2006). Body image and attitudes toward male roles in anabolic-androgenic steroid users. American Journal of Psychiatry, 163(4), 697-703.

Kvalem, I. L., von Soest, T., Træen, B., & Singsaas, K. (2011). Body evaluation and coital onset: A population-based longitudinal study. Body Image, 8(2), 110-118.

Mitchison, D., Mond, J., Bussey, K., Griffiths, S., Trompeter, N., Lonergan, A., … & Hay, P.(2020). DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance. Psychological medicine, 50(6), 981-990.

Morris, A., Elliott, E., & Madden, S. (2022). Early‐onset eating disorders in Australian children: A national surveillance study showing increased incidence. International Journal of Eating Disorders, 55(12), 1838-1842.

Muehlenkamp, J. J., & Brausch, A. M. (2012). Body image as a mediator of non-suicidal self-injury in adolescents. Journal of Adolescence, 35(1), 1-9.

Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39(2), 244-251.

Spiel, E. C., Paxton, S. J., & Yager, Z. (2012). Weight attitudes in 3-to 5-year-old children: Age differences and cross-sectional predictors. Body image, 9(4), 524-527.

Stice, E., & Shaw, H. (2003). Prospective relations of body image, eating, and affective disturbances to smoking onset in adolescent girls: How Virginia slims. Journal of Consulting and Clinical Psychology, 71(1), 129

Stice, E., & Van Ryzin, M. J. (2019). A prospective test of the temporal sequencing of risk factor emergence in the dual pathway model of eating disorders. Journal of Abnormal Psychology, 128(2), 119.

Yager, Z., & McLean, S. (2020). Muscle building supplement use in Australian adolescent boys: relationships with body image, weight lifting, and sports engagement. BMC Pediatrics, 20(1), 1-9.

Weight Stigma and Health 

The past 20 years of health promotion messaging has exacerbated body image concerns, weight stigma and eating disorders (Bristow et al., 2020; Rathbone et al., 2021). Increasing evidence suggests that body shame, weight bias, discrimination and stigma have a significant negative impact on physical and psychological health (Emmer et al., 2020; Wu &Berry, 2018;  Zhu et al., 2022). Eating disorders affect an estimated 22% of adolescents, 13% of boys and 33% of girls (Mitchison et al., 2020), and have significant economic implications and the highest mortality rate of any mental illness (Santomauro et al., 2021).

Promoting body appreciation and reducing weight stigma offers an opportunity to improve protective factors for positive mental and physical health outcomes at any age and promote wellbeing for all (Hunger et al., 2020).

Bristow, C., Allen, K. A., Simmonds, J., Snell, T., & McLean, L. (2022). Anti-obesity public health advertisements increase risk factors for the development of eating disorders. Health Promotion International, 37(2), daab107.

Emmer, C., Bosnjak, M., & Mata, J. (2020). The association between weight stigma and mental health: A meta‐analysis. Obesity Reviews, 21(1), e12935.

Hunger, J. M., Smith, J. P., & Tomiyama, A. J. (2020). An evidence‐based rationale for adopting weight‐inclusive health policy. Social Issues and Policy Review, 14(1), 73-107.

Rathbone, Joanne Ashley (2021). Weight stigma and discrimination: psychological and social determinants and the implications for behaviour and health. PhD Thesis, School of Psychology, The University of Queensland.https://doi.org/10.14264/64e6eb9.

Santomauro, D. F., Melen, S., Mitchison, D., Vos, T., Whiteford, H., & Ferrari, A. J. (2021). The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. The Lancet Psychiatry, 8(4), 320-328.

Wu, Y. K., & Berry, D. C. (2018). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of advanced nursing, 74(5), 1030-1042

Zhu, X., Smith, R. A., & Buteau, E. (2022). A meta-analysis of weight stigma and health behaviors. Stigma and Health, 7(1), 1.

Embrace Magazine References 

Issue 1: 

BYE BYE BMI (page 16): On admission for eating disorder treatment, 14% of young people specifically mentioned food and nutrition lessons in health education as a contributing factor to the development of their eating disorder.

Chen, A., & Couturier, J. (2019). Triggers for children and adolescents with anorexia nervosa: a retrospective chart review. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 28(3), 134. 

Lin, J. A., Jhe, G., Adhikari, R., Vitagliano, J. A., Rose, K. L., Freizinger, M., & Richmond, T. K. (2023). Triggers for eating disorder onset in youth with anorexia nervosa across the weight spectrum. Eating Disorders, 31(6), 553-572. doi: 10.1080/10640266.2023.2201988

FIRST NATIONS (page 29) 

Prevalence of eating disorders among First Nations Australians. 

Burt, A., Mannan, H., Touyz, S., & Hay, P. (2020). Prevalence of DSM-5 diagnostic threshold eating disorders and features amongst Aboriginal and Torres Strait islander peoples (First Australians). BMC psychiatry, 20, 1-8.

Indigenous wellbeing framework: 

Gee, Dudgeon, Shultz, Hart and Kelly 2013 cited in Dudgeon, Milroy, Walker, 2014. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice: 2nd Edition, Edited Book, viewed 28 May 2024, https://www.nintione.com.au/?p=3787 

Embrace Kids Classroom Program References 

1. Milton, A., Hambleton, A., Roberts, A., Davenport, T., Flego, A., Burns, J., & Hickie, I. (2021). Body Image Distress and Its Associations From an International Sample of Men and Women Across the Adult Life Span: Web-Based Survey Study. JMIR Formative Research, 5(11), e25329.
2. McLean, S. A., Rodgers, R. F., Slater, A., Jarman, H. K., Gordon, C. S., & Paxton, S. J. (2021). Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls. European Child & Adolescent Psychiatry, 1-12.
3. Mission Australia Youth Survey. (2020). https://www.missionaustralia.com.au/what-we-do/research-impact-policy-advocacy/youth-survey
4. Bornioli, A., Lewis-Smith, H., Slater, A., & Bray, I. (2021). Body dissatisfaction predicts the onset of depression among adolescent females and males: a prospective study. Journal of Epidemiology and Community Health, 75(4), 343-348.
5. Bucchianeri, M. M., Arikian, A. J., Hannan, P. J., Eisenberg, M. E., & Neumark-Sztainer, D. (2013). Body dissatisfaction from adolescence to young adulthood: Findings from a 10-year longitudinal study. Body Image, 10(1), 1-7.
6. Stice, E., & Van Ryzin, M. J. (2019). A prospective test of the temporal sequencing of risk factor emergence in the dual pathway model of eating disorders. Journal of Abnormal Psychology, 128(2), 119.
7. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39(2), 244-251.
8. Kanayama, G., Barry, S., Hudson, J. I., & Pope Jr, MD, MPH, H. G. (2006). Body image and attitudes toward male roles in anabolic-androgenic steroid users. American Journal of Psychiatry, 163(4), 697-703.
9. Amos, A., & Bostock, Y. (2007). Young people, smoking and gender—a qualitative exploration. Health Education Research, 22(6), 770-781.
10. Bornioli, A., Lewis-Smith, H., Smith, A., Slater, A., & Bray, I. (2019). Adolescent body dissatisfaction and disordered eating: Predictors of later risky health behaviours. Social Science & Medicine, 238, 112458.
11. Stice, E., & Shaw, H. (2003). Prospective relations of body image, eating, and affective disturbances to smoking onset in adolescent girls: How Virginia slims. Journal of Consulting and Clinical Psychology, 71(1), 129.

12.. Yager, Z., & McLean, S. (2020). Muscle building supplement use in Australian adolescent boys: relationships with body image, weight lifting, and sports engagement. BMC Pediatrics, 20(1), 1-9.

13. Kvalem, I. L., von Soest, T., Træen, B., & Singsaas, K. (2011). Body evaluation and coital onset: A population-based longitudinal study. Body Image, 8(2), 110-118.
14. Muehlenkamp, J. J., & Brausch, A. M. (2012). Body image as a mediator of non-suicidal self-injury in adolescents. Journal of Adolescence, 35(1), 1-9.
15. Atkinson, M. J., & Diedrichs, P. C. (2021). Assessing the impact of body image concerns on functioning across life domains: Development and validation of the Body Image Life Disengagement Questionnaire (BILD-Q) among British adolescents. Body Image, 37, 63-73.
16. Devoe, D., Han, A., Anderson, A., Katzman, D. K., Patten, S. B., Soumbasis, A., … & Dimitropoulos, G. (2022). The impact of the COVID-19 pandemic on eating disorders: A systematic review. International Journal of Eating Disorders.
17. World Health Organisation. (2021). Health Promoting Schools. https://www.who.int/health-topics/health-promoting-schools#tab=tab_1
18. Mann, T., & Burgard, D. (1998). Eating disorder prevention programs: What we don’t know can hurt us. Eating Disorders, 6(2), 101-103.
19. Yager, Z., Diedrichs, P. C., Ricciardelli, L. A., & Halliwell, E. (2013). What works in secondary schools? A systematic review of classroom-based body image programs. Body Image, 10(3), 271-281.
20. Linardon, J., Gleeson, J., Yap, K., Murphy, K., & Brennan, L. (2019). Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention. Cognitive Behaviour Therapy, 48(1), 15-38.
21. MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545-552.
22. Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455-1473.
23. Linardon, J., Gleeson, J., Yap, K., Murphy, K., & Brennan, L. (2019). Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention. Cognitive Behaviour Therapy, 48(1), 15-38.
24. Seekis, V., Farrell, L., & Zimmer-Gembeck, M. (2022). A Classroom-Based Pilot of a Self-Compassion Intervention to Increase Wellbeing in Early adolescents. EXPLORE.
25. Alleva, J. M., & Tylka, T. L. (2021). Body functionality: A review of the literature. Body Image, 36, 149-171.
26. Alleva, J. M., Martijn, C., Van Breukelen, G. J., Jansen, A., & Karos, K. (2015). Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 15, 81-89.

Body Blocks References 

Body Blocks is informed by the latest research and evidence, including the research that informed the Confident Body Confident Child program: 

Hart, L. M., Damiano, S. R., Cornell, C., & Paxton, S. J. (2015). What parents know and want to learn about healthy eating and body image in preschool children: a triangulated qualitative study with parents and Early Childhood Professionals. BMC public health, 15(1), 1-13.

Hart, L. M., Damiano, S. R., Chittleborough, P., Paxton, S. J., & Jorm, A. F. (2014). Parenting to prevent body dissatisfaction and unhealthy eating patterns in preschool children: a Delphi consensus study. Body Image, 11(4), 418-425.

Module 1– We are more likely to be physically active if it’s fun (Creighton et al., 2022). 

Module 2- “37% of 3 year olds want a different body” (Spiel, 2013)

Module 6- “Parent criticism leads to ED later in life” (Dahill et al., 2021; Haines et al., 2006)

Creighton, R. M., Paradis, K. F., Blackburn, N. E., & Tully, M. A. (2022). Group-based physical activity interventions targeting enjoyment in older adults: a systematic review. Journal of Ageing and Longevity, 2(2), 113-129.

Dahill, L. M., Touyz, S., Morrison, N. M., & Hay, P. (2021). Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health, 21, 1-13.

Haines, J., Neumark-Sztainer, D., Eisenberg, M. E., & Hannan, P. J. (2006). Weight teasing and disordered eating behaviors in adolescents: longitudinal findings from Project EAT (Eating Among Teens). Pediatrics, 117(2), e209-e215.

Spiel, E. (2013). Sociocultural and individual predictors of children’s body size stereotypes, body size ideals, and dieting awareness from 3 to 4-years-old: A longitudinal investigation (Doctoral dissertation, La Trobe).

Activate

Engagement in physical activity offers a powerful opportunity to enhance the health and wellbeing of girls and women, yet many report avoidance or drop out from sport because of the judgment and pressure they feel about their appearance. (Biddle et al., 2014; Daniels et al., 2020; Koulanova et al., 2021; Sabiston et al ., 2019; Slater & Tiggemann, 2011; Vani et al., 2021).

• Almost 77% of Australian adolescents indicate that they experience body image distress (Milton et al., 2021), and pressure around appearance can be exacerbated in sporting clubs, cultures, and environments (Sabiston et al., 2019; Daniels et al., 2020).

• 70% of girls report avoidance or drop out from sport because of the judgment and pressure they feel about their appearance. (Sport England)

• How girls and women feel about their bodies has been identified as a critical factor in their engagement in sport and physical activity (Schneider et al., 2023; Slater & Tiggemann, 2011). 

• Moving our bodies is such a powerful way to improve the way we feel about our bodies (Sabiston et al., 2019; Matheson et al., 2023).

• Research has found that physical activity can improve body image- even after one, 20-minute session. It’s not because anything has changed about your body, it’s because we realise how powerful our bodies are, because we feel more connected with our bodies, and focus on things other than our appearance (Campbell & Hausenblas, 2009; Ginis et al., 2012). 

• Coaches are typically aware that body image pressures exist, particularly for girls and women, but are not confident in addressing these issues (Sabiston et al., 2020).

 

• Negative body commentary is common from athletes, parents, and coaches (Lucibello et al., 2021).

Biddle, S. J., Braithwaite, R., & Pearson, N. (2014). The effectiveness of interventions to increase physical activity among young girls: a meta-analysis. Preventive medicine, 62, 119-131.

Campbell, A., & Hausenblas, H. A. (2009). Effects of exercise interventions on body image: A meta-analysis. Journal of health psychology, 14(6), 780-793.

Daniels, E. A., Zurbriggen, E. L., & Ward, L. M. (2020). Becoming an object: A review of self-objectification in girls. Body Image, 33, 278-299.

Ginis, K. M., Bassett-Gunter, R. L., & Conlin, C. (2012). Body image and exercise. Oxford handbook of exercise psychology, 55-75.

Koulanova, A., Sabiston, C. M., Pila, E., Brunet, J., Sylvester, B., Sandmeyer-Graves, A., & Maginn, D. (2021). Ideas for action: Exploring strategies to address body image concerns for adolescent girls involved in sport. Psychology of Sport and Exercise, 56, 102017.

Lucibello, K. M., Koulanova, A., Pila, E., Brunet, J., & Sabiston, C. M. (2021). Exploring adolescent girls’ experiences of body talk in non-aesthetic sport. Journal of Adolescence, 89, 63-73.

Matheson, E. L., Schneider, J., Tinoco, A., Silva-Breen, H., LaVoi, N. M., & Diedrichs, P. C. (2023). How can we help you? A global investigation into girls’ body image experiences in sport and intervention preferences. Body Image, 46, 265-279.

Matheson, E. L., Schneider, J., Gentili, C., Tinoco, A., Silva-Breen, H., White, P., … & Diedrichs, P. C. (2023). A systematic review and meta-analysis of interventions that target the intersection of body image and movement among girls and women. International Review of Sport and Exercise Psychology, 1-36.

Murray, R. M., Lucibello, K. M., Pila, E., Maginn, D., Sandmeyer-Graves, A., & Sabiston, C. M. (2022). “Go after the fatty”: The problematic body commentary referees hear—and experience—in adolescent girls’ sport. Sport, Exercise, and Performance Psychology, 11(1), 1.

Sabiston, C. M., Pila, E., Vani, M., & Thogersen-Ntoumani, C. (2019). Body image, physical activity, and sport: A scoping review. Psychology of sport and exercise, 42, 48-57

Sabiston, C. M., Lucibello, K. M., Kuzmochka-Wilks, D., Koulanova, A., Pila, E., Sandmeyer-Graves, A., & Maginn, D. (2020). What’s a coach to do? Exploring coaches’ perspectives of body image in girls sport. Psychology of Sport and Exercise, 48, 101669..

Schneider, J., Matheson, E. L., Tinoco, A., Silva-Breen, H., Diedrichs, P. C., & LaVoi, N. M. (2023). A six-country study of coaches’ perspectives of girls’ body image concerns in sport and intervention preferences: Template analysis of survey and focus group data. Body Image, 46, 300-312.

Slater, A., & Tiggemann, M. (2011). Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. Journal of adolescence, 34(3), 455-463.

Sport England (2022). Reframing Sport for Teenage Girls: Tackling teenage disengagement. Research Report. Available at: https://womeninsport.org/resource/reframing-sport-for-teenage-girls-tackling-teenage-disengagement/ 

Vani, M. F., Pila, E., deJonge, M., Solomon-Krakus, S., & Sabiston, C. M. (2021). ‘Can you move your fat ass off the baseline?’Exploring the sport experiences of adolescent girls with body image concerns. Qualitative Research in Sport, Exercise and Health, 13(4), 671-689.