The Reliability and Validity of the Turkish Body Mass Anxiety Scale: A Methodological Study

Abstract

Objective: This research aims to translate the Body Mass Anxiety Scale (BMAS) into Turkish and evaluate its reliability and validity. Methods: Data from 647 adult volunteers in Türkiye were gathered online for this methodological study. Two forms, the demographic information form (7 items) and the Body Mass Anxiety Scale (20 items), were used in the study. A reliability analysis was conducted, along with confirmatory factor analysis, to assess the scale's construct validity. The research was completed with the stages: The Body Mass Anxiety Scale is translated into Turkish and then back into English, a team of experts tests its content validity, and psychometric analysis (item-total correlation, validity coefficient, and factor analysis) is performed. Results: Factor analyses revealed that the scale has a two-factor structure: weight gain and loss anxiety. The scale was deemed highly reliable with a Cronbach's alpha internal consistency coefficient of 0.92. Conclusion: This study demonstrates the validity and reliability of the Turkish version of the Body Mass Anxiety Scale (BMAS), a novel instrument with a two-factor structure to assess body mass anxiety.

Keywords

• Body mass anxiety
• validity
• reliability
• Turkish adaptation

References

1. Anderson, K. (2023). Popular fad diets: An evidence-based perspective. Progress in Cardiovascular Diseases, 77, 78-85. https://doi.org/10.1016/j.pcad.2023.02.001
2. Bölükbaş, N., & Göl, G. (2021). Surgical Anxiety Questionnaire: Turkish validity and reliability. Psychology Health & Medicine, 29(9), 1-12.
3. Bonett, D.G., & Wright, T.A. (2015). Cronbach's alpha reliability: Interval estimation, hypothesis testing, and sample size planning. Journal of Organizational Behavior, 36(1), 3-15.
4. Çakmak, T., Öztürk, G.Z., & Aksu, S.B. (2024). Exploring the relationship between obesity and social anxiety disorder: A Cross-sectional study on quality of life impacts in adults aged 18-45. European Archives Medical Research, 40(1), 19-24.
5. Çapık, C. (2014). Geçerlik ve güvenirlik çalışmalarında doğrulayıcı faktör analizinin kullanımı. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 17(3), 196-205.
6. Gruszka, W., Owczarek, A.J., Glinianowicz, M., Bąk-Sosnowska, M., Chudek, J., & Olszanecka-Glinianowicz, M. (2022). Perception of body size and body dissatisfaction in adults. Scientific Reports, 12(1), 1159. https://doi.org/10.1038/s41598-021-04706-6
7. Conceição, I.S.R., Garcia-Burgos, D., de Macêdo, P.F.C., Nepomuceno, C.M.M., Pereira, E.M., Cunha, C.M., Ribeiro, C.D.F., & de Santana, M.L.P. (2023). Habits and Persistent Food Restriction In Patients With Anorexia Nervosa: A scoping review. Behavioral Sciences (Basel. Switzerland), 13(11), 883. https://doi.org/10.3390/bs13110883
8. Crocq, M.A. (2015). A history of anxiety: from Hippocrates to DSM. Dialogues in Clinical Neuroscience, 17(3), 319–325. https://doi.org/10.31887/DCNS.2015.17.3/macrocq

9. Esin, M. (2014). Data collection methods and tools & reliability and validity of data collection tools. Research Process in Nursing Application and Critical, İstanbul. Turkey: Nobel Medicine Book Houses. 193-233.
10. Gorwood, P., Blanchet-Collet, C., Chartrel, N., Duclos, J., Dechelotte, P., Hanachi, M., Fetissov, S., Godart, N., Melchior, J.C., Ramoz, N., Rovere-Jovene. C., Tolle, V., Viltart, O., & Epelbaum, J. (2016). New insights in anorexia nervosa. Frontiers in Neuroscience, 10, 256. https://doi.org/10.3389/fnins.2016.00256
11. Grammer, A.C., Tanofsky-Kraff, M., Burke, N.L., Byrne, M.E., Mi, S.J., Jaramillo, M., Shank, L.M., Kelly, N.R., Stojek, M. M., Schvey, N.A., Broadney, M.M., Brady, S.M., Yanovski, S.Z., & Yanovski, J.A. (2018). An examination of the associations between pediatric loss of control eating. anxiety and body composition in children and adolescents. Eating Behaviors, 30, 109–114. https://doi.org/10.1016/j.eatbeh.2018.06.007.
12. Griffiths, S., Hay, P., Mitchison, D., Mond, J.M., McLean, S.A., Rodgers, B., Massey, R., & Paxton, S.J. (2016). Sex differences in the relationships between body dissatisfaction. quality of life and psychological distress. Australian and New Zealand Journal of Public Health, 40(6), 518–522. https://doi.org/10.1111/1753-6405.12538
13. Haddad, C., Zakhour, M., Sacre, H., Eid, N., Wehbé, G., Farha, J., Azar, J., Obeid, S., & Hallit, S. (2021). Variation of psychological and anthropometrics measures before and after dieting and factors associated with body dissatisfaction and quality of life in a Lebanese clinical sample. BMC Psychology, 9(1), 189. https://doi.org/10.1186/s40359-021-00691-7.
14. Heale, R., & Twycross, A. (2015). Validity and reliability in quantitative studies. Evidence-Based Nursing, 18(3), 66–67. https://doi.org/10.1136/eb-2015-102129
15. Jackson, S.E., Steptoe, A., Beeken, R.J., Kivimaki, M., & Wardle, J. (2014). Psychological changes following weight loss in overweight and obese adults: a prospective cohort study. PloS One, 9(8), e104552. https://doi.org/10.1371/journal.pone.0104552.
16. Jiotsa, B., Naccache, B., Duval, M., Rocher, B., & Grall-Bronnec, M. (2021). Social media use and body image disorders: association between frequency of comparing one's own physical appearance to that of people being followed on social media and body dissatisfaction and drive for thinness. International Journal of Environmental Research and Public Health, 18(6), 2880. https://doi.org/10.3390/ijerph18062880
17. Karakoç, F.Y., & Dönmez, L. (2014). Ölçek geliştirme çalışmalarında temel ilkeler. Tıp Eğitimi Dünyası, 13(40). 39-49.
18. Kılıç, A., & Koyuncu, İ. (2017). Ölçek uyarlama çalışmalarının yapı geçerliği açısından incelenmesi. Ö. Demirel, S. Dinçer (Ed.), Küreselleşen Dünyada Eğitim (s. 415-438). Pegem Akademi.
19. Kyriazos, T.A., & Stalikas, A. (2018). Applied psychometrics: The steps of scale development and standardization process. Psychology, 9(11), 2531-2560.
20. Levinson, C.A., Zerwas, S., Calebs, B., Forbush, K., Kordy, H., Watson, H., Hofmeier, S., Levine, M., Crosby, R.D., Peat, C., Runfola, C.D., Zimmer, B., Moesner, M.. Marcus, M. D., & Bulik, C. M. (2017). The core symptoms of bulimia nervosa. anxiety. and depression: A network analysis. Journal of Abnormal Psychology, 126(3), 340–354. https://doi.org/10.1037/abn0000254
21. Lewandowska, K., Klinkosz, W., Styk, W., & Kowalczyk, M. (2023). Diversity of binge-eating disorder symptoms is associated with anxiety about getting fat rather than body image: a clinical study of women in Poland. Nutrients, 15(21), 4572.
22. Liyanage, G., Karunainathan, T., Jeyarajah, L., Thevatheepan, P., Thavendra, M., & Seneviwickrama, M. (2021). Body image dissatisfaction and its determinants in urban Sri Lankan adolescents. The Ceylon Medical Journal, 66(4), 185–190. https://doi.org/10.4038/cmj.v66i4.9509
23. Lloyd, E.C., Haase, A.M., Zerwas, S., & Micali, N. (2020). Anxiety disorders predict fasting to control weight: A longitudinal large cohort study of adolescents. European Eating Disorders Review : The Journal Of The Eating Disorders Association, 28(3), 269–281. https://doi.org/10.1002/erv.2714
24. Lox, C.L., Osborn, M.C., & Pellett, T.L. (1998). Body image and affective experiences of subjectively underweight females: implications for exercise behavior. Journal of Applied Biobehavioral Research, 3(2), 110-118. https://doi.org/https://doi.org/10.1111/j.1751-9861.1998.tb00048.x
25. Major, B., Hunger, J.M., Bunyan, D.P., & Miller, C.T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51, 74-80. https://doi.org/https://doi.org/10.1016/j.jesp.2013.11.009
26. Narulita, S., Yuria, M., & Istianah, I. (2018). Body mass ındex and anxiety in postpartum period. Malahayati International Journal of Nursing and Health Science, 1(2), 42-46.
27. Özdamar, K. (2016). Scale and test development structural equation modeling in education. health and behavioral sciences: IBM SPSS. IBM SPSS AMOS and MINITAB applied. Eskisehir: Nisan Bookstore.
28. Smith, A., Emerson, D., Winkelmann, Z., Potter, D., & Torres-McGehee, T. (2020). Prevalence of eating disorder risk and body image dissatisfaction among ROTC Cadets. International Journal of Environmental Research and Public Health, 17(21), 8137. https://doi.org/10.3390/ijerph17218137
29. Staiano, A.E., Marker, A.M., Martin, C.K., & Katzmarzyk, P.T. (2016). Physical activity. mental health. and weight gain in a longitudinal observational cohort of nonobese young adults. Obesity (Silver Spring. Md.), 24(9), 1969–1975. https://doi.org/10.1002/oby.21567
30. Stice, E., & Shaw, H.E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. Journal of Psychosomatic Research, 53(5), 985–993. https://doi.org/10.1016/s0022-3999(02)00488-9
31. Styk, W., Wojtowicz, E., & Zmorzynski, S. (2023). I don't want to be thin! fear of weight change is not just a fear of obesity: research on the Body Mass Anxiety Scale. International Journal of Environmental Research and Public Health, 20(4), 2888. https://doi.org/10.3390/ijerph20042888
32. Tabachnick, B.G., Fidell, L.S., & Ullman, J.B. (2013). Using multivariate statistics (Vol. 6. pp. 497-516). Boston. MA: Pearson.
33. Tantleff-Dunn, S., Hayes, S., & Braun, C.P. (2009). How did you get so thin? The effect of attribution on perceptions of underweight females. Eating and Weight Disorders : EWD, 14(1), 38–44. ttps://doi.org/10.1007/BF03327793
34. Tavşancıl, E. (2014). Measurement of attitudes and data analysis with SPSS. Ankara: Nobel Yayın.
35. Vuong, A.T., Jarman, H.K., Doley, J.R., & McLean, S.A. (2021). Social media use and body dissatisfaction in adolescents: the moderating role of thin- and muscular-ideal internalisation. International journal of Environmental Research and Public Health, 18(24), 13222. https://doi.org/10.3390/ijerph182413222
36. Yeşilyurt, İ., & Kendirkıran, G. (2024). The effect of social appearance anxiety and body perception on the quality of life in burn patients. International Wound Journal, 21(2), e14720. ttps://doi.org/10.1111/iwj.14720
37. Yılmaz, M., Dişsiz, G., Demir, F., Irız, S., & Alacacioglu, A. (2017). Reliability and validity study of a tool to measure cancer stigma: patient version. Asia-Pacific Journal of Oncology Nursing, 4(2),155–161. https://doi.org/10.4103/apjon.apjon_10_17
38. Yiu, A., Murray, S.M., Arlt, J.M., Eneva, K.T., & Chen, E.Y. (2017). The importance of body image concerns in overweight and normal weight individuals with binge eating disorder. Body Image, 22, 6–12. https://doi.org/10.1016/j.bodyim.2017.04.005
39. Yu, U.J., & Jung, J., (2018). Effects of self‐discrepancy and self‐schema on young women's body image and self‐esteem after media image exposure. Family and Consumer Sciences Research Journal, 47(2), 142-160.
40. Zhou, X., Rao, L., Yang, D., Wang, T., Li, H., & Liu, Z. (2023). Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study. BMC Pregnancy And Childbirth, 23(1), 188. https://doi.org/10.1186/s12884-023-05502-y