Unpacking negative body talk: Fat talk holds stronger impact on mental health, while old talk still raises concerns

By Bhavana KunkalikarReviewed by Benedette Cuffari, M.Sc.May 22 2023

In a recent study published in the Journal of Eating Disorders, researchers examine the impact of negative body and age talk with mental health and quality of life (QoL) outcomes in men and women.

Study: Fat talk, old talk, or both? Association of negative body talk with mental health, body dissatisfaction, and quality of life in men and women. Image Credit: Alex_Maryna / Shutterstock.com

The health effects of body dissatisfaction

Adolescent boys and girls who experience body dissatisfaction are at an increased risk of developing depressive symptoms, eating disorder (ED) symptoms, low self-esteem, and suicidal ideation. Anxiety, psychological distress, depression, and ED pathology have also been correlated with body dissatisfaction in adult men. Comparatively, middle-aged women experiencing body dissatisfaction are at a greater risk of restrained eating, experiencing bulimic symptoms, thin-ideal internalization, aging anxiety, and depression.

Negative body talk, including ‘fat talk,’ has been found to significantly contribute to body dissatisfaction. Fat talk often causes the affected individual to strive for Western appearance ideals, such as a thinner or more muscular body in women and men, respectively. In addition to fat talk, the pressure for people, particularly women, to age gracefully while also maintaining a thin body can also lead to significant stress.

Collectively, negative or seemingly positive phrases on both body weight and an individual’s age-related appearance can be described as ‘negative age-related body talk.’ Several studies have investigated the relationship between both old and fat talk to health effects, with old talk significantly correlated with body image disturbances, ED pathology, and aging anxiety.

Despite these observations, researchers are still studying how old talk, fat talk, or their combination can affect body imaging, aging anxiety, ED pathology, and mental health. Furthermore, it remains unclear whether the poorer health outcomes associated with old talk can be attributed to its similarities with fat talk, or whether it is unique in its impact to both body dissatisfaction and mental health effects.

About the study

The current study included 778 adults, 288 of whom were men and 490 were women, between 18 and 91 years of age who were recruited from various sources including online social media platforms, clinics, local senior centers, coffee shops, libraries, and networks of the research team. The study participants were recruited from the United States, the United Kingdom, and other Western European countries. About 64% of the participants were White/Caucasian, 18% were Hispanic, 4.5% Asian, and 4.2% Black/African American.

An online survey distributed to the participants was used to assess how often they engaged in fat talk and old talk, levels of body dissatisfaction, depression, ED pathology, aging anxiety, QoL, general anxiety, and demographics.

The Negative Body Talk Scale (NBTS), which was used to evaluate engagement in fat talk, included 13 items that created a body concerns and body comparison subscale based on the responses. A modified 13-item NBTS was also created to assess old talk, with participants rating the frequency of saying a particular phrase on a seven-point Likert scale that ranged from "never" to "always."

The ED-15, which consists of 10 attitudinal items and five eating behavior items, was used to evaluate ED pathology based on a six-point Likert scale. Total scores were obtained by averaging the 10 attitudinal items, with a higher total score reflecting a greater degree of ED pathology.

The Body Satisfaction Questionnaire-16b is a 16-item scale that asks about an individual’s body image, negative feelings, and any actions that the individual takes to cope with these feelings. Responses were based on a six-point Likert scale, with higher scores reflecting a greater level of body dissatisfaction.

An eight-item Patient Health Questionnaire (PHQ-8), which was scored on a four-point scale, was used to assess depressive symptoms, with higher scores also indicating more severe depressive symptoms. Anxiety about Aging Scale (AAS) with a five-point Likert scale was used to measure aging anxiety, whereas the General Anxiety Scale was used to assess anxiety symptoms. The EUROHIS QOL eight-item index was used to assess the psychological, physical, social, and environmental aspects of an individual’s QoL.

Study findings

Engaging in fat talk and a higher body mass index value (BMI) was significantly associated with increased ED pathology. Notably, women more frequently engaged in both old and fat talk, both of which were associated with a greater risk of ED pathology and poorer QoL in women.

Increased fat talk was also associated with higher levels of body dissatisfaction and depressive symptoms, while older age was linked to lower levels of body dissatisfaction.

Comparatively, old talk did not affect ED pathology nor body dissatisfaction, with older age instead associated with reduced ED pathology. Old talk did not appear to impact depressive symptoms.

In men, a greater amount of old and fat talk was associated with greater general anxiety. Old talk, rather than fat talk, increased the risk of aging anxiety in women, with older age in women associated with less anxiety and a better QoL.

Conclusions

Fat talk appears to have a greater impact on mental health and QoL measures as compared to old talk; however, both types of negative body talk were significantly correlated with QoL and mental health. The extent to which these factors influence body image and mental health throughout a person's life remains unclear. A better understanding this phenomenon can help promote mental health and body image, particularly in midlife and beyond.