Modification of the cognitive model for bulimia via path analysis on a Brazilian adolescent sample

Eating disturbances in middle-class Brazilian adolescents attending three high schools (one Military, two Private schools) were investigated. Participants from both Private schools were similar to U.S. samples on the EAT-26. Path analysis on the Private schools revealed the following. Higher body weight leads to weight concerns most strongly through greater discrepancy from the ideal, but it also leads directly to weight concern. Thus, both the reality of being heavier and the perception that one is larger than ideal (which could be due to being heavier and/or having a thin ideal) contribute to weight concern. Greater weight concern is associated most directly with lower self-esteem, which in turn is associated with endorsing greater importance of weight and shape. Importance of weight and shape contributes most powerfully to eating pathology through dieting, but this variable has a modest direct effect as well. These paths were not significant for the Military school sample in which participants reported lower levels of weight concern, dieting, body dissatisfaction, and a larger ideal figure. However, the Military sample rated importance of weight and shape as high as did Private-school participants. The results provide support for variables identified as important in the cognitive model of bulimia and suggest the model may be enhanced by including body weight and one's perceived ideal body shape as additional variables.