What is and what is not positive body image? Conceptual foundations and construct definition

Psychometric properties of an Italian translation of the Functionality Appreciation Scale (FAS)

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a widely used instrument for the measurement of individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). Here, we examined the psychometric properties of a novel Italian translation of the FAS. A sample of 950 Italian adults completed the FAS, as well as previously validated measures of body image (body appreciation, body esteem, body surveillance), disordered eating symptoms, and psychological well-being (self-esteem, general distress). Exploratory and confirmatory factor analyses supported a 1-dimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, and the gender difference in latent FAS scores was not significant. FAS scores were found to have adequate internal consistency, test-retest reliability up to three weeks, and convergent and criterion-related validity through significant correlations with all additional constructs. However, evidence of incremental validity was weak, and likely reflected high nomological and conceptual similarity between functionality and body appreciation in this national context. Overall, these results provide strong evidence that scores on the Italian FAS are psychometrically valid, which may aid future development of interventions to promote more positive body image in Italian-speaking samples.

The Positive Body Image among Adolescents Scale (PBIAS): Conceptualization, development, and psychometric evaluation among adolescents from Belgium

In this study, we aimed to offer a conceptualization of positive body image during adolescence and psychometrically examine a new scale developed to measure this conceptualization. A literature review on positive body image and adolescence was conducted, which shaped the development of the Positive Body Image among Adolescents Scale (PBIAS). In Study 1, four focus groups (totaling 14 adolescents) from Belgium explored the content, clarity, and applicability of the PBIAS items. In Study 2, an exploratory factor analysis (N = 565; M_age = 14.9, 63.8 % girls) revealed 4 factors: body self-appreciation, body other-appreciation, resilience against media body ideals, and resilience against negative appearance feedback. This 4-factor structure was confirmed in Study 3 (N = 718; M_age = 15.2, 50.4 % girls), and gender invariance was upheld. The test-retest reliability of the PBIAS scores was partially supported in Study 4 (N = 309, M_age = 15.3, 66.3 % girls). Across studies, internal consistency was supported and construct validity (convergent and incremental) evidence was garnered. Further, the PBIAS was translated from Dutch to English to offer researchers an option for collecting data in English-speaking countries. Overall, the PBIAS is a brief measure with psychometric support that assesses four dimensions of adolescent positive body image.

"I didn't want to say something and them to go outside and tell everyone": The acceptability of a dissonance-based body image intervention among adolescent girls in the UK

Cognitive dissonance-based interventions (CDIs) have been well established as effective programs for the prevention of eating disorders. However, limited research has qualitatively explored adolescent girls experience of such interventions. The present study examined the acceptability of a cognitive dissonance-based body image intervention among adolescent girls in UK secondary schools. Adolescent girls aged 14-18 years (N = 99; M_age = 14.87, SD = 0.97) who opted to participate in the intervention were invited to provide intervention feedback via open-ended questions and small focus groups. The findings suggest that the intervention was largely acceptable among adolescent girls. Peers played an important role. Despite initial concerns about sharing within the group, the groups provided a sense of belonging and participants no longer felt alone in their experience of body dissatisfaction. Participants discussed a transition from negative to positive body image following the intervention. Although acceptability was generally high, the data provides some interesting insights into potential considerations and modifications which may be advantageous in future CDIs. These include enhancing authenticity through reduced reliance on the script, inclusion of more personal content from the peer-leaders, and more interactive activities and physical movement.

The relationship between postmenopausal women's body image and the severity of menopausal symptoms

BACKGROUND

Body image is the main element of an individual's personality that may be influenced by many factors during menopause. We aimed to assess the relationship between postmenopausal women's body image with the severity of menopausal symptoms.

METHODS

This was a cross-sectional study on 300 postmenopausal women, aged 45 to 65 years old, in Tehran, Iran. We recruited the samples using the multi-stage sampling method. Tools for data collection were: 1) the Menopausal Rating Scale (MRS), 2) the Fisher's Body Image questionnaire and 3) a socio-demographic questionnaire. We analyzed data using the independent samples t-test, Pearson correlation coefficient, Spearman's correlation coefficient, and multiple linear regression tests.

RESULTS

Three hundred women aged 55.11 ± 3.99 years old, participated in the study. Mean scores for body image and MRS were 163.07 ± 21.17 (Range: 46-230) and 16.45 ± 8.38 (Range: 0-44), respectively. About 50% of women had severe symptoms of menopause (MRS score ≥ 17). There was a negative correlation between the total score and the score of all dimensions of body image with the total score and all dimensions of MRS (P < 0.001). There were also significant relationships between women's body image with: their education (P < 0.001, r = 0.20) the spouse's education (P < 0.001, r = 0.26), adequacy of monthly household income (P < 0.001, r = 0.32), marital status (P = 0.36), their occupation (P = 0.007) and housing status (P = 0.012). There was also a significant negative correlation between women's lower body organs image with the number of children (P = 0.017, r = - 0.14). According to the multiple linear regressions model, severity of menopausal symptoms (Beta = - 0.45, P < 0.001) and adequacy of monthly household income (Beta = 0.15, P = 0.005) are the significant related factors with postmenopausal women's body image.

CONCLUSIONS

Body image is correlated with menopausal symptoms of women during menopause. Therefore, it seems that interventions aimed at relieving the annoying symptoms of menopause can help to improve their body image. Also, body image could be influenced by some socio-demographic factors which should be considered in menopause health promotion programs.

Towards a Comprehensive Understanding of Body Image: Integrating Positive Body Image, Embodiment and Self-Compassion

Body image (BI) disturbance is a relevant factor in the etiology and treatment of eating disorders (ED). Although progress has been made in recent decades in understanding BI and its relationship with ED, the efficacy of BI disturbance prevention and intervention programs is still limited. In order to reach deeper understanding of BI disturbance and clarify the interactions between some protective and risk factors related to this construct, we carried out a literature review on some specific BI-related factors that so far have been analyzed independently. We specifically examined positive and negative BI; embodiment and its role in the development of positive and negative BI; and self-compassion as a protective factor that promotes positive embodiment (vs. disembodiment) and protection against body shame. We conclude that integrating the available evidence on these factors into BI models may be used to enhance our understanding of BI and improve the efficacy of prevention and intervention programs to help fight negative BI (by reducing body shame and disembodiment) and promote positive BI (by increasing self-compassion and positive embodiment).

Examining Race and Gender Differences in Associations Among Body Appreciation, Eudaimonic Psychological Well-Being, and Intuitive Eating and Exercising

PURPOSE

The present study examined race and gender differences among positive psychological constructs, and adaptive eating and exercise behaviors.

DESIGN

Cross-sectional.

SETTING

Online.

SAMPLE

College students (N = 1,228; Mage = 22.27, SD = 5.83).

MEASURES

Participants completed measures assessing positive body image, eudaimonic psychological well-being, and health behaviors.

ANALYSES

Multi-group structural equation modeling was used to examine whether White versus Black race and, separately, woman versus man gender identity moderated associations among body appreciation, eudaimonic psychological well-being, and intuitive eating and intuitive exercising.

RESULTS

Results generally indicated that greater body appreciation was associated with greater eudaimonic psychological well-being (βs = 0.48, 0.56) and, in turn, intuitive eating (βs = -0.20, 0.25) and intuitive exercising (βs = -0.06, 0.23). However, notable variations in this pattern of results were identified based on the facet of intuitive eating and exercising under investigation, and participants' racial identities. For example, greater eudaimonic psychological well-being strictly mediated a positive association between body appreciation and reliance on hunger and satiety cues intuitive eating behaviors among participants who identified as Black (95%CI: 0.01, 0.12), but not White (95%CI: -0.08, 0.04).

CONCLUSIONS

Although the present findings warrant replication using longitudinal designs due to the cross-sectional nature of the present study, these findings suggest that increasing adults' eudaimonic psychological well-being may help improve health-promoting eating and exercise behaviors, and should be assessed as a mechanism of change in future clinical research.

Body Compassion Scale

Abstract. Background: In recent years, body image research has focused on the aspects of positive body image ( Smolak & Cash, 2011 ). This represents an important change in this area from a primary focus on negative body image to a comprehensive exploration of the body image concept. Aims: Validation of measures to help understand the positive and healthy characteristics of body image is therefore particularly important. The Body Compassion Scale (BCS; Altman, Linfield, et al., 2017 ) is a self-report scale aimed at measuring how compassionate one feels toward one’s own body. This study is a validation of BCS to confirm its factor structure and to assess its reliability and validity. Method: The 23-item scale was translated into Italian and presented to a sample of 695 Italian women. A Confirmatory Factor Analysis (CFA) was performed to examine the factor structure of the Italian version of the BCS. Results: Results were largely comparable to those obtained for the original English version of the BCS. The three-factor structure was largely replicated and expected associations with body dissatisfaction, psychological inflexibility, and psychological well-being were found. Limitations: BCS reliability was assessed only in terms of internal consistency; a longitudinal research design could be useful to assess the test-retest reliability. It would also be important for future research to study body compassion in different populations. Conclusion: This scale could be a useful measure for structured psychological interventions aimed at promoting a positive body image, but also in empirical research to obtain information on how individuals relate to their bodies.

Exceeding body composition standards is associated with a more negative body image and increased weight cycling in active duty U.S. soldiers

Negative body image is more often identified in individuals with overweight or obesity. More than 65% of U.S. soldiers have a body mass index (BMI) that classifies them with overweight or obesity. Additionally, all soldiers must meet body composition and physical fitness standards which may increase the risk of negative body image. This cross-sectional study aimed to identify associations between compliance with body composition standards, body image, and weight cycling through surveying 969 active-duty soldiers (86% male, 24.0 ± 5.5 years of age, BMI 26.0 ± 3.6 kg/m²). Compliance with body composition standards was measured by whether a soldier had ever taken and failed the circumference-based body fat assessment. Weight cycling was self-reported as ≥3 weight fluctuations of ≥5% of body weight during their military career. Multivariate linear and logistic regression models were used to examine the relationship between compliance with body composition standards, body image, weight cycling, and sociodemographic characteristics while controlling for BMI. Failing the circumference-based body fat assessment was associated with increased concern with conforming to military image. Negative body image was associated with higher odds of weight cycling. Further examination is warranted to understand the effects of body composition standards on soldiers' body image and weight cycling.

Validation of the body image dimensional assessment in adolescents from Spanish high school

INTRODUCTION

There are not many valid instruments to quickly and easily identify body dissatisfaction in adolescents. Most studies have used the Stunkard Rating Scale to assess body image. Nevertheless, this scale has been described as too abrupt and crude for adolescents.

AIM

Was to validate the body image dimensional assessment (BIDA) questionnaire in a sample of adolescents from Secondary schools of Spain.

METHOD

The BIDA consists of four items to answer with reference to a series of four silhouettes using a numeric scale that allows the quantification of the degree of body dissatisfaction (BD), sexual body dissatisfaction (SxBD), comparative body dissatisfaction (CBD) and the calculation of the final body dissatisfaction index (BDIndex). The sample included 2059 adolescents, 1132 males and 929 females aged 13.10 ± 0.89. Participants answered the BIDA and then their anthropometrics measurements were taken.

RESULTS

Reliability test, a convergent test and confirmatory factorial analysis were conducted to validate BIDA instrument. A single factor structure emerged from confirmatory factorial analysis; the BIDA demonstrated adequate internal consistency in adolescents: (CFI > 0.90, TLI > 0.90, α > 0.80). Significant correlations (p < 0.001) emerged between the BIDA indices and all the anthropometric measures.

CONCLUSIONS

The BIDA questionnaire is a valid and reliable instrument to evaluate body dissatisfaction in Spanish adolescents.

LEVEL OF EVIDENCE

Level V, descriptive study.

Princess Power: Longitudinal Associations Between Engagement With Princess Culture in Preschool and Gender Stereotypical Behavior, Body Esteem, and Hegemonic Masculinity in Early Adolescence

Princess culture is criticized for contributing to gender stereotypes and poor body esteem, however, there is little longitudinal research examining these claims. This study examines associations between engagement with princess culture during early childhood and gender stereotypes, body esteem, and adherence to hegemonic masculinity in early adolescence. Participants included 307 children (51% female, M_age  = 4.83 years, 87% White) who completed questionnaires at two time points, 5 years apart. The results indicated that early engagement with princess culture was not associated with later adherence to female gender stereotypes. However, princess engagement was associated with lower adherence to norms of hegemonic masculinity and higher body esteem. Socioeconomic status and gender moderated the results. Effect sizes were small to moderate. The changing nature of Disney princesses is discussed in the context of gender development across childhood.

Real beauty: Effects of a body-positive video on body image and capacity to mitigate exposure to social media images

OBJECTIVE

Recent industry-created social marketing campaigns have targeted positive body image; however, research investigating the effects of such social media campaigns on body image has largely neglected non-Western English-speaking groups. This study explored the effects on body image of a video produced by Dove for a Japanese audience 'Real Beauty ID', and its capacity to modify the effects of subsequent exposure to celebrity social media images of young women.

METHOD

Young women from Japan (n = 568), mean age (SD) = 25.38 (3.52) years, were randomly allocated to view either the Dove Real Beauty ID video, or a control video, followed by exposure to celebrity social media images (female celebrities or landscapes). Finally, participants reported on state and trait appearance-based comparisons, thin ideal internalization, body appreciation, and media similarity scepticism.

RESULTS

Among participants with high levels of thin ideal internalization, those who viewed the Dove Real Beauty ID video reported significantly lower satisfaction with body and facial features, as well as more negative mood (p < .05) compared with the control video. Little support emerged for the capacity of the Dove Real Beauty ID video to modify the effects of exposure to celebrity social media images, nor were these effects moderated by risk and resilience factors.

CONCLUSIONS

In sum, no usefulness emerged for the Dove Real Beauty ID video in promoting positive body image, and limited usefulness was seen in buffering the effects of exposure to celebrity social media images among Japanese young women. Given the reach of such interventions, exploring whether interventions that are culturally adapted and theoretically driven are more helpful is warranted.

On Redefining the Body Image Satisfaction Questionnaire: A Preliminary Test of Multidimensionality

The aim of the present study was to examine the Body Image Satisfaction Questionnaire (BISQ) as a multidimensional instrument, designed to measure individuals' body image satisfaction. A sample of 790 Portuguese healthy adults (female = 399; male = 391) aged 18 and 49 years old (M = 28.61, SD = 7.97) completed the BISQ. Exploratory factor analysis of the BISQ provided initial psychometric validity for a five-factor model assessing five dimensions of body image, namely, face, upper torso, lower torso, lower body, and overall body appearance. Confirmatory factor analysis supported this five-correlated model, in which a bifactor model provided the best fit to the data, defining a body image satisfaction factor and five specific factors. The BISQ clearly distinguished between various dimensions of body image satisfaction and showed satisfactory psychometric quality through factor analyses. This measure may have a broad application for research and practice, as a tool for capturing individual body image satisfaction.

Is a Picture Worth a Thousand Words? Using Photo-Elicitation to Study Body Image in Middle-to-Older Age Women With and Without Multiple Sclerosis

In this study, we explored how women with varying relationships to disability and aging used photographs to represent their body image experiences. Seven middle-aged and older adult women with and without multiple sclerosis were asked to provide up to 10 photographs that represented their body image and complete a one-on-one interview. We used reflexive thematic analysis to develop themes and interpret the findings. Overall, the women expressed not only complicated relationships with their bodies, represented through symbolism, scrutiny of body features (e.g., posture, varicose veins, and arthritis) but also deep reflection linked to positive body image and resilience. These findings revealed not only the nuanced experiences women have with aging, disability, and gender but also the commonly experienced ingrained views of body appearance as each participant illustrated a difficult negotiation with the aesthetic dimension of their body image. Finally, we provide important implications of the use of visual methods in body image research.

Disordered eating & body image of current and former athletes in a pandemic; a convergent mixed methods study - What can we learn from COVID-19 to support athletes through transitions?

BACKGROUND

The COVID-19 pandemic has seen worsened mental health as a result of lockdowns, isolation and changes to sociocultural functioning. The postponement of the Tokyo 2020 Olympics is representative of global cancellations of sporting events, reduced facility access and support restrictions that have affected both current and former athlete's psychological wellbeing. This study aimed to determine whether current (n = 93) and former (n = 111) athletes experienced worsened body image, relationship with food or eating disorder symptomatology during acute COVID-19 transitions.

METHODS

The study was a Convergent Mixed Methods design whereby qualitative content analysis was collected and analysed simultaneously with quantitative cross-sectional data using the EAT-26 and self-report COVID-19 questions. Data were collected from April until May 2020 to capture data pertaining to transitions related to the pandemic and included individuals across 41 different individual and team sports from club to international competition levels.

RESULTS

There was a surge in disordered eating in current and former athletes as a result of the early COVID-19 response. Eating disorders were suggested to occur in 21.1% of participants (18% current athletes n = 17, 25% former athletes (n = 26). There was a significant difference between males and females (p = 0.018, r = 0.17), but interestingly no differences between groups from individual vs team sports, type of sporting category (endurance, antigravitational, ball sport, power, technical and aesthetic) or level of competition (club, state, national or international). 34.8% (n = 69) self-reported worsened body image and 32.8% (n = 65) self-reported a worsened food relationship directly from COVID-19. Qualitative analysis indicated that disordered eating occurred predominantly in the form of body preoccupation, inhibitory food control, fear of body composition changes and binge eating.

CONCLUSIONS

This study indicates that transitions in COVID-19 have worsened food-body relationships in current and former athletes and must be treated as an at-risk time for eating disorder development. We suggest that resources are allocated appropriately to assist athletes to foster psychologically positive food and body relationships through COVID-19 transitions. This study makes practice suggestions in supporting athletes to manage control, seek support, adapt and accept change and promote connection and variety through athletic transitions.

Framing real beauty: A framing approach to the effects of beauty advertisements on body image and advertising effectiveness

Current literature is inconsistent about the effects of idealized (i.e., thin) vs. non-idealized (i.e., average or plus-size) models on young women's well-being. This inconsistency may be explained by different frames (i.e., passive body, active body, and subject) surrounding beauty ad models. The current experimental study among 568 women aged 18-30 years (M = 21.45, SD = 1.84) tested the effects of differently framed ads featuring idealized vs. non-idealized models on well-being and ad effectiveness while taking into account the mediating role of cognitive schemas and moderating role of thin-ideal internalization. Results showed that a passive body frame generated more appearance schemas compared to a subject frame. The effects of framing on body functionality schemas operated differently for idealized vs. non-idealized models. The passive body frame also induced inferior ad outcomes (i.e., lower attitudes to the advertisement and brand and lower purchase intent) compared to an active body frame. No other main framing effects nor moderating effects of thin-ideal internalization were found. These results for advertising outcomes can encourage beauty brands to stop using typical objectifying ads.

Body image flexibility and its correlates: A meta-analysis

Body image flexibility refers to the ability to openly experience thoughts or feelings about the body without acting on them or trying to change them. Accumulating evidence has demonstrated that body image flexibility is connected to numerous adaptive processes, and that it is sensitive to change during psychological interventions. However, a quantitative synthesis of empirical research on body image flexibility is lacking. We conducted the first meta-analysis on body image flexibility and its correlates. Sixty-two studies were included. Random effects meta-analyses were conducted on 19 psychological correlates, divided into three clusters: eating and body image disturbances, positive body-related and general psychological constructs, and general psychopathology. Meta-analyses showed inverse correlations between body image flexibility and each construct within the eating and body image disturbances cluster (rs= -.45 to -.67), and the general psychopathology cluster (rs= -.37 to -.58). Body image flexibility was positively associated with each positive psychology construct (rs = .23 - .58). Men reported higher levels of body image flexibility than women (d = 0.32). Psychological interventions were more effective than control groups at enhancing body image flexibility in randomized controlled trials (d = 0.42). Findings confirm that body image flexibility is consistently connected to indices of mental health, and that it can be enhanced during psychological interventions.

Evaluating the impact of a brief Health at Every Size®-informed health promotion activity on body positivity and internalized weight-based oppression

Weight-based oppression, including negative attitudes about body weight, and harassment, stigma, and discrimination based on body weight, is a widespread phenomenon that leads to considerable distress and poor health and wellbeing outcomes. Conversely, body positivity is a multi-faceted concept that encompasses body acceptance, body appreciation, and body love, and adaptive approaches protective of health and wellbeing. The aim of this study was to evaluate the impact of a brief health promotion activity informed by Health at Every Size® and critical health promotion principles on body positivity and internalized weight-based oppression in female students at Qatar University. A quasi-experimental mixed methods pre-post evaluation design was used, with quantitative assessment of body positivity and internalized weight-based oppression before the activity, immediately afterwards, and 10 weeks later, and qualitative assessment at the 10-week follow up. Measures used were the Body Appreciation Scale 2, Modified Weight Bias Internalization Scale, Fat Attitudes Assessment Toolkit Size Acceptance and Self Reflection on Body Acceptance subscales, and an open-ended questionnaire. Body acceptance and appreciation increased significantly after the activity. Qualitative results suggest that these improvements were sustained at follow up. Brief Health at Every Size® informed health promotion activities show potential to improve health and wellbeing.

Cultural adaptation and validation of the Body Esteem Scale for Adults and Adolescents for use in English among adolescents in urban India

Body image research is growing in India; however, there are no psychometrically valid measures to assess body image concerns among an Indian population. In this study, the Body Esteem Scale for Adults and Adolescents (BESAA) underwent adaptation and validation among urban Indian adolescents in English. Cultural adaptations were made in consultation with body image experts and acceptability interviews with adolescents in India. 1462 adolescents living in Northern India completed the adapted BESAA and measures to assess construct validity. For girls, a 15-item three-factor model provided the best fit to our data, using exploratory factor analysis, with 'Appearance-Negative', 'Appearance-Positive', and 'Weight' subscales. For boys, a 7-item two-factor model provided best fit, with 'Appearance-Negative' and 'Appearance-Positive' subscales. Models were confirmed via confirmatory factor analysis. The scales demonstrated good internal consistency and satisfactory test-retest reliability. Construct, convergent validity was supported for girls and boys through significant correlations with figure rating scales and disordered eating. Further analyses using common items across the female and male scales, produced a psychometrically sound scale that can be used comparatively across genders. This study presents a culturally adapted, shortened BESAA as a valid and reliable measure to assess body image concerns in English among urban Indian adolescents.

The effectiveness of positive appearance and functionality reflective writing tasks on state body image and response to idealised media exposure among 35-60 year-old women

Functionality and appearance-based reflective writing tasks can improve body image in young women. There is limited research investigating these tasks in mature women. This study tested (a) the effectiveness of writing tasks on women's state body image and (b) whether these tasks buffered responses to idealised media. Women (N = 240, M_age = 44.58) were randomly allocated to write about the positive aspects of their body functionality, their appearance, or their stress management techniques. They were then exposed to images of cities, or thin-ideal models presented in either posed or active ways. Body appreciation, appearance satisfaction, and functionality satisfaction were measured at pre-reflection, post-reflection, and post-image exposure. Social comparison was measured at post-image. The functionality writing task produced immediate improvements across all state measures, while the positive appearance and stress reflection tasks produced improvements in functionality satisfaction. Image exposure then produced a decrease across all measures, except for body appreciation which remained stable in women who had completed the functionality reflections. No difference in social comparison was found between reflection conditions. The active images resulted in more functionality-based comparison than posed images. These findings contribute to the literature showing benefits of writing tasks which focus on appreciating one's body functionality.

Body image profiles and exercise behaviours in early motherhood. A latent profile analysis

Early motherhood may impact body image, and its relationship to exercise, potentially affecting mother and infant wellbeing. This study examined whether duration of weekly exercise differed according to body image profile (BIP) based on relative levels of body dissatisfaction and body appreciation. Survey data from 262 women, 0-5 years postpartum, were analysed. Latent profile analysis identified "average", "dissatisfied" and "appreciative" BIPs. Significantly lower exercise was found in the dissatisfied compared to the appreciative BIP (p = 0.005), with marginally lower exercise in the dissatisfied compared to the average BIP (p = 0.029 with adjusted α = 0.02). This research has implications for designing targeted interventions supporting postpartum wellbeing.

Translation and Validation of the Brazilian Portuguese Version of the Broad Conceptualization of Beauty Scale With Brazilian Women

In many countries, women are socialized to adopt a narrow definition of beauty. Research has revealed that, in the United States and China, the ability to broadly conceptualize beauty (perceive beauty in diverse body sizes, shapes, and appearances) is linked to women’s lower anti-fat attitudes, higher body appreciation, and higher well-being. In this study, we translated an existing measure of this construct, the Broad Conceptualization of Beauty Scale (BCBS), into Brazilian Portuguese and evaluated the factor structure and reliability and validity of its scores with a diverse sample of 563 Portuguese women. Findings revealed that the Brazilian Portuguese BCBS contains two factors—external/appearance features of beauty (BCBS-E) and internal features of beauty (BCBS-I)—contrary to the unidimensional factor structure found in previous studies. Support for internal consistency and 3-week test–retest reliability was garnered. Total BCBS and BCBS-E scores evidenced convergent, discriminant, and incremental validity, whereas the BCBS-I did not accrue substantial convergent or incremental validity support beyond its inverse bivariate association with anti-fat attitudes. We recommend the use of the Brazilian Portuguese BCBS in body image research programs as well as clinical practice and prevention programs with Brazilian women seeking support for body dissatisfaction and disordered eating.

Association of work performance and interoceptive awareness of 'body trusting' in an occupational setting: a cross-sectional study

OBJECTIVES

Work performance has been known to be influenced by both psychological stress (mind) and physical conditions (body). The aim of this study was to investigate the association between work performance and 'body trusting', which is a dimension of interoceptive awareness representing mind-body interactions.

METHODS

A cross-sectional study was conducted among a sample of workers in an industrial manufacturing company in Japan. Participants were assessed with a self-reported questionnaire including evaluations of work performance, body trusting, psychological distress, pain persistence, workplace and home stressors, and workaholism. Participants' sociodemographic, health and lifestyle characteristics were collected from their annual health check data. The association between work performance and body trusting was examined using multivariable regression analyses in the overall sample and in a subsample of people with pain.

RESULTS

A total of 349 workers participated in the study. A significant association between work performance and body trusting was observed, with higher body trusting representing higher work performance. The association was significant after controlling for psychological distress, workplace and home stress, workaholism and participants' characteristics (p<0.001). Compared with people without pain (n=126, 36.1%), people with pain (n=223, 63.9%) showed less body trusting, which was associated with decreased work performance after controlling for pain-related variables (p<0.001).

CONCLUSIONS

Workers with higher body trusting showed higher work performance, even after controlling for various influencing factors. Body trusting may be an important target to promote work performance and to prevent loss of performance induced by health problems.

Examining the efficacy of video-based microinterventions for improving risk and protective factors for disordered eating among young adult women

OBJECTIVE

Brief self-guided activities designed for focused and immediate benefits, termed microinterventions, have the potential to aid reach and engagement in mental health interventions; however further validation is needed. This study evaluated effects of two microinterventions for responding to appearance-ideal media on risk and protective factors for disordered eating.

METHOD

Undergraduate women (N = 202, M_age = 19.90, SD = 2.75) were allocated quasi-randomly to one of three 15-min video-based microinterventions (mindfulness, cognitive dissonance, educational control) in the lab and assessed on state outcomes at baseline and immediate posttest. One week later, trait factors were assessed and participants underwent an appearance-ideal media exposure task.

RESULTS

Both mindfulness and dissonance groups reported significant immediate benefits to state appearance-ideal internalization, perceived sociocultural pressures and related distress, and mood, compared to educational control (Glass's Δ effect sizes = .40-.94), but not state weight or appearance satisfaction. At 1-week follow-up, mindfulness and dissonance groups demonstrated improved trait appearance-ideal internalization (Δ = .40 and .42), weight and shape concerns (Δ = .27 [ns] and .44), and body appreciation (Δ = .39 and .46) compared to the educational control. There were no effects on trait perceived pressures, negative affect, or body image psychological flexibility, and no differential changes in state outcomes from premedia to postmedia exposure.

DISCUSSION

Microinterventions using mindfulness and dissonance techniques show promise for improving some risk and potential protective factors for disordered eating in the immediate and short-term. Further research is required to substantiate their place within the spectrum of eating disorder prevention, early intervention and treatment techniques.

‘She Should Not Be a Model’: The Effect of Exposure to Plus-Size Models on Body Dissatisfaction, Mood, and Facebook Commenting Behaviour

Objectives: The present study investigated the exposure effect of plus-size models on body dissatisfaction and mood, and the nature of participants’ commenting behaviour towards images of plus-size models. Method: The study was comprised of 92 female university students who were exposed to Facebook photos of plus-size models. Participants were randomly allocated to having the exposed photo paired with positive, negative, or neutral comments, and participants were asked to leave an anonymous comment on each picture. Results: Results showed that participants had less body dissatisfaction and better mood after exposure to plus-size models regardless of the comment condition. Additionally, comment condition significantly influenced the type of comments participants contributed — in photos paired with negative comments, participants were significantly more likely to leave negative comments themselves, with 40% of participants leaving negative comments compared with 4% in the positive condition, and 12% in the neutral condition. Conclusion: This study provides evidence that the negative comments of plus-size models can encourage bystanders to contribute negative comments themselves; reinforcing the need to develop better protocols to oppose cyberbullying and encourage an online environment of positivity.

Testing modified gender-moderated exercise and self-esteem (EXSEM) model of positive body image in adolescents

The most acceptable model explaining the associations between physical exercise and self-esteem is the exercise and self-esteem model (EXSEM). The present cross-sectional study tested the mediating role of body appreciation and physical fitness perception in the associations between physical activity and self-esteem in modified EXSEM. Overall, 1412 Lithuanian adolescents (40.2% were boys, mean age 17.0 (SD = 0.5) years) completed online questionnaires. The study was implemented in 2019 from October to December. Perceived physical fitness and body appreciation mediated the associations in the EXSEM. Physical fitness perception was directly associated with the self-esteem of girls, but not boys. Gender moderated EXSEM associations in body appreciation and perceived physical fitness showed stronger mediation effects for the adolescent girls compared to boys. Increasing physical activity, positive body image and perception of physical fitness might help to foster mental health, especially in girls.

Body satisfaction of female staff members working in primary schools in Mangaung, Bloemfontein

Background

The role of psychosocial determinants of overweight and obesity is receiving attention in South African literature. South Africans tend to exhibit an inaccurate perception of their body weight.

Aims

The purpose of this study was to determine levels of body satisfaction in female staff members working in primary schools in Mangaung, Bloemfontein.

Setting

Mangaung is a peri-urban area in Bloemfontein in the Free State province of South Africa.

Methods

Female staff members over the age of 18 years were invited to participate in the study. Anthropometric measurements of weight and height were measured using standardised techniques to calculate body mass index (BMI). Waist circumference (WC) was measured as an indicator of risk for non-communicable diseases (NCDs). Weight satisfaction was measured using a structured, self-administered body satisfaction questionnaire.

Results

The majority of the staff members (71.3%) were classified as obese (BMI > 30 kg/m²); similarly a majority of them were at a high risk of NCDs according to WC. A little over a third (34.8%) of the women perceived themselves to have a normal weight. The majority of the women who had no concern with their body image were obese (59.1%) and only 8.7% of the women in this study were markedly concerned with their body image. Of the 60.9% of women who reported having attempted to lose weight, 38.6% reported using exercise and 30.0% used water as a weight loss method.

Conclusion

Women's awareness of a healthy weight should be promoted if efforts to achieve weight loss are to be effective.

Body Image and Voluntary Gaze Behaviors towards Physique-Salient Images

The purpose of this study was to explore body image correlates of voluntary consumption of physique-salient media. A secondary aim was to assess changes in affect following media consumption. Young adult men (n = 47; mean age = 20.2 years) and women (n = 87; mean age = 19.5 years) were discretely exposed to images of same-sex models with idealized- and average-physiques while completing an irrelevant computer task. Voluntary gaze at the images was covertly recorded via hidden cameras. Participants also completed measures of affect before and after the computer task. Measures of body-related envy, body appreciation, and self-perceptions of attractiveness, thinness, and physical strength were completed. Men and women did not differ in how often nor for how long they looked at the images overall, but body image variables were differentially associated with their voluntary gaze behaviors. For men, higher body-related envy and lower body appreciation were correlated with more looks at the average-physique model. Although women reported higher body-related envy than men, envy and body appreciation were not significant correlates of gaze behaviors for women. Both men and women experienced a general affective decrease over time, but only for men was the change in negative affect associated with their time spent looking at the ideal-physique image. Overall, these findings suggest that body-related envy and body appreciation influence how men choose to consume physique-salient media, and that media consumption may have negative consequences for post-exposure affect. Body image factors appear to be more strongly associated with behavior in men, perhaps because men are generally less often exposed to physique-salient media and, in particular, to average-physique images.

"I appreciate your body, because…" Does promoting positive body image to a friend affect one's own positive body image?

Research has shown that individuals with a positive body image promote positive body image to others, yet also have close others who unconditionally accept their body and feel positively about their own body, too. This mutual interdependence between the individual and the environment with respect to positive body image has been termed reciprocity. Inspired by this research, we investigated whether promoting positive body image to others leads to improvements in one's own positive body image. To do so, undergraduate women (N = 154) were randomised to write a letter to a friend, expressing either appreciation for their friend's body functionality (experimental group) or appreciation for their shared memories (control group). Participants completed pretest and posttest measures of state functionality appreciation and state body appreciation, and filler items. Unexpectedly, there were no group differences in state functionality appreciation and state body appreciation. Instead, participants within both groups experienced medium to large improvements in state functionality appreciation and state body appreciation. To our knowledge, this is the first study to test the effects of promoting positive body image to others. Future research can shed further light on the effects of promoting positive body image to others in particular, and on the phenomenon of reciprocity more broadly.

'Everybody's Different: The Appearance Game'. A randomised controlled trial evaluating an appearance-related board game intervention with children aged 9-11 years

This study evaluated the effectiveness of an educational board game aimed at increasing knowledge of appearance-related issues, positive body image, media literacy, and acceptance of appearance diversity with British school children. Two hundred and fifty-nine children, aged 9-11 (Mage = 10.26), from three primary schools in South-West England participated in a two-arm matched cluster randomised controlled trial. Outcome measures were collected pre-, post- and at two-week follow-up. Knowledge of appearance-related issues significantly increased in the intervention group, compared to the control group post-intervention, but was not maintained at follow-up. There were no significant differences between groups for body appreciation, media literacy or acceptance of visible difference. Of the intervention arm, 78 % (n=117) they would like to play again and 85.3 % (n=128) thought other children would like to play. Qualitative data suggests participants learned the key messages of the game. The findings suggest 'Everybody's Different: The Appearance Game' is an enjoyable way to increase knowledge of appearance-related issues. In future, researchers should consider how to increase body appreciation, media literacy and acceptance of appearance diversity, for example by increasing the dosage of the game or using it in conjunction with discussions and lessons surrounding appearance diversity and appearance-altering conditions.

The "Little Red Riding Hood effect:" Fitspiration is just as bad as thinspiration for women's body satisfaction

Fitspiration is a popular form of social media which outwardly promotes the pursuit of health and strength rather than of thinness. Content analyses, however, suggest that it is thematically similar to thinspiration, which is primarily associated with thinness and presents disordered eating as a lifestyle choice. Exposure to both reduces body satisfaction, but their effect has not been compared. Further, positive body image may act as a protective factor by reducing engagement in appearance comparisons. Female undergraduate students (N = 331) were randomly assigned to view fitspiration, thinspiration, or travel images, followed by measures of state body satisfaction, state appearance comparison, and positive body image. Viewing fitspiration and thinspiration resulted in lower body satisfaction than did viewing travel images. However, whereas women with higher positive body image appeared protected from thinspiration by engaging in lower appearance comparisons than did women with lower positive body image, this same effect was not observed in women who viewed fitspiration. The fact that positive body image is not protective against fitspiration suggests that fitspiration is just as harmful, if not more, than is thinspiration and highlights the need for media literacy programs targeting fitspiration and so-called "healthy living" websites.

Body acceptance by others: Refinement of the construct, and development and psychometric evaluation of a revised measure - The Body Acceptance by Others Scale-2

The Body Acceptance by Others Scale (BAOS) measures the degree to which individuals perceive body acceptance by others, but its factor structure is questionable. Here, we developed a revision of the BAOS (i.e., the BAOS-2) by designing novel items reflective of generalised perceptions of body acceptance by others. In three studies, we examined the psychometrics of the 13-item BAOS-2. Study 1, with United Kingdom adults (N = 601), led to the extraction of a unidimensional model of BAOS-2 scores and provided evidence of 4-week test-retest reliability. Study 2, with United Kingdom adults (N = 423), indicated that the unidimensional model of BAOS-2 scores had adequate fit and that scores were invariant across gender. Study 2 also provided evidence of convergent, construct, criterion, discriminant, and incremental validity. Study 3 cross-validated the fit of the unidimensional model in adults from the United State (N = 503) and provided evidence of invariance across gender and national group. Internal consistency coefficients of BAOS-2 scores were adequate across all three studies. There were no significant gender differences in BAOS-2 scores and a significant national difference had a negligible effect size. Thus, the BAOS-2 is a psychometrically-sound measure that can be utilised in future research.

Exploring the gratitude model of body appreciation and intuitive eating among Japanese women

Culture is believed to play a central role in body image and eating problems, and for this reason, it is important to conduct cross-cultural investigations of relevant theoretical models. This study involves a non-Western replication of one of the few existing models of positive body image, the gratitude model of body appreciation, which was originally developed using American women. The model postulates that a grateful attitude is associated with body appreciation and intuitive eating via reduced contingent self-worth and social comparison. The current study aims to examine the applicability of the model to Japanese women. A sample of 648 Japanese women (age range = 15-69, M = 42.1, SD = 15.7) completed online measures of gratitude, contingent self-worth, social comparison, body appreciation, and intuitive eating. In general, all paths in the original model were replicated in the current model. However, two new paths were added to achieve good fit, including a path from basing one's self-worth on others' approval to body appreciation and another path from gratitude directly to intuitive eating. These differential pathways are discussed in the context of Japanese culture that emphasizes appreciation towards foods and self-definition based on social approval. In addition, implications for intervention are described.

Body functionality: A review of the literature

Body functionality describes everything that the body is able to do, across diverse domains (e.g., bodily senses, creative endeavours). Nearly a decade ago, leading scholars identified research on body functionality as a priority for the body image field. The field has responded, as shown by the recent rise of body functionality research. We considered this an opportune time to (a) define body functionality (what it is and is not); (b) present theoretical frameworks of body functionality; (c) articulate first-generation and current measures relating to body functionality; (d) offer functionality-focused body image interventions that can improve appreciation for one's body functionality (and body image more broadly); (e) summarise additional areas of research related to body functionality and positive body image; and (f) provide considerations and directions for future research and interventions incorporating body functionality. Research has underscored body functionality as a valuable construct with respect to positive body image and well-being, particularly when individuals appreciate what their bodies can do and conceptualise their body functionality holistically. Yet, the experience of body functionality is nuanced across social identities. Overall, the field has greatly advanced knowledge about body functionality, and we are excited to see the next generation of research that emerges.

Analysis of Body Perception, Preworkout Meal Habits and Bone Resorption in Child Gymnasts

The beneficial effects of physical activity on body image perception and bone are debated among artistic gymnasts. Gymnasts seem to be at greater risk of developing body dissatisfaction, eating disorders and osteoporosis due to inadequate nutrition and attention to the appearance of the body. The objective of this work was to investigate the association between the artistic gymnast and a more favorable body image compared to their sedentary peers and if a preworkout high-carbohydrate meal (HCM; 300 kcal, 88% carbohydrates, 9% protein, 3% fat) or high-protein meal (HPM; 300 kcal, 55% carbohydrates, 31% protein, 13% fat) is able to attenuate bone resorption in young rhythmic gymnasts. Twenty-eight preadolescent female gymnasts were examined. Self-esteem tests were used to analyze body image perception. Preworkout eating habits were examined by short food frequency questions (FFQ) validated for children. The biomarker of the bone resorption C-terminal telopeptide region of collagen type 1 (CTX) was measured in the urine (fasting, postmeal and postworkout). Gymnasts reported higher satisfaction with their body appearance compared to sedentary peers. Of the gymnasts, 30% did not have a preworkout meal regularly, and the timing of the consumption was variable. Bone resorption was decreased by the HCM, consumed 90 min before the training, with respect to the HPM. The study suggests that playing artistic gymnastics is associated with a positive body self-perception in a child. The variability in preworkout meal frequency and timing need attention to prevent inadequate eating habits in light of the ability of the HCM to reduce acute bone resorption.

The Meaning and Factors That Influence the Concept of Body Image: Systematic Review and Meta-Ethnography from the Perspectives of Adolescents

Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among adolescents. This study aimed to understand the meanings and factors that influence the concept of body image through a systematic review and meta-ethnography of qualitative studies from the perspective of adolescents. Ten studies published from 2009–2019 were identified by a search of relevant systematic databases between September and December 2019. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument. The synthesis revealed six themes: self-perception of body image; opinions of friends and colleagues; opinions of family; specific features of the school environment; expectations perceived across the mass-media; and strategies, practices, and self-management of body image. An explanatory model was developed that showed adolescents’ development of body image and the path towards its establishment. In conclusion, these results should be considered to implement strategies to promote a healthy body image in adolescents by community health and mental health nurses.

Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women

BACKGROUND

Sexual self-esteem and communication on sexual issues with a partner contribute greatly to an individual's quality of sex life; however, their effects on the relationship between body image and sexual function are underexplored.

AIM

To test a serial mediating pathway of sexual self-esteem and sexual communication underlying the relationship between body image and sexual function.

METHODS

A total of 510 women aged 18-53 years (mean = 28, SD = 5.5) who were involved in an intimate relationship completed an online survey.

OUTCOMES

Women's (i) body appreciation, (ii) body image self-consciousness during sexual intimacy, (iii) sexual self-esteem, (iv) dyadic sexual communication, (v) negative disclosure apprehension, and (vi) sexual function were assessed.

RESULTS

Findings revealed that sexual self-esteem and dyadic sexual communication played a serial mediating role in the relationship between body image (body appreciation and body image self-consciousness during sexual intimacy) and sexual function, and the relationship between body image and arousal, lubrication, orgasm, satisfaction, and pain. Sexual self-esteem and negative disclosure apprehension also played a serial mediating role in the relationship between body image and sexual pain. In addition, dyadic sexual communication played a unique mediating role in the relationship between body image and sexual function, which is isolated from the effect of sexual self-esteem.

CLINICAL IMPLICATIONS

Women's sexual self-esteem and sexual communication with their partner can make beneficial contributions to the relationship between body image and sexual function. Therefore, promoting women's positive body image, sexual self-esteem, and sexual communication skills deserves attention from women themselves and clinicians.

STRENGTHS & LIMITATIONS

This study used a robust method of data analysis to test the mediating effect of sexual self-esteem and sexual communication to clarify the mechanism underlying the relationship between body image and sexual function among Chinese women; however, causal conclusions cannot be drawn. Furthermore, various demographics including participants' age, education level, sexual orientation-factors such as relationship status and length, relationship functioning, and partner-related variables-and other aspects of sexual self-concept and sexual communication should be examined in future research.

CONCLUSION

The current study indicates that women's thoughts and feelings regarding sexuality and communicating sexual issues with their partner are associated closely with their body image and sexual function. Wu T, Zheng Y. Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women. J Sex Med 2021;18:474-486.

A Systematic Review and Meta-Analysis on the Relationship between Body Dissatisfaction and Morbid Exercise Behaviour

Background: The present study aimed to quantify the relationship between body dissatisfaction and morbid exercise behaviour (MEB). Methods: The electronic databases MEDLINE, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global were searched from inception to September 2020. Pooled effect sizes corrected for sampling errors (r⁺) were computed using a bare-bones meta-analysis. The robustness of the results was examined by influence analyses. The presence of moderators was examined by inspection of the variance in r⁺ attributable to sampling errors and 80% credibility intervals, followed by subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined by visual inspection of funnel plot symmetry, cumulative meta-analysis, and Egger’s test. Results: A total of 41 effect sizes from 33 studies (n = 8747) were retrieved. Results showed a significant and near to moderate effect size (r⁺ = 0.267, 95% CI = 0.226 to 0.307), and this did not differ by gender, BMI, age, percentage of Whites, study quality, or MEB measure. Conversely, effect sizes were found to be stronger in published and more recently conducted studies. Conclusion: The findings indicate that body dissatisfaction is one of the likely causes underlying MEB. This suggests the need for further longitudinal research aimed at confirming the potential causal nature of this relationship.

The Relationship between Body Appreciation and Self-Esteem and Associated Factors among Omani University Students: An Online Cross-Sectional Survey

BACKGROUND

Given the rapid pace of globalization and the fact that the Sultanate of Oman is experiencing a significant impact of social media on specifying appearance norms among youth in the country, research into positive body images and self-esteem among young individuals has become a national priority. Whilst body image has been well studied across cultures, both positive body image and the relationship between positive body image and self-esteem among Omani youth have been neglected. The aim of the study was to investigate the relationship between positive body image and self-esteem and associated sociodemographic factors among Omani university students based on gender.

METHODS

This cross-sectional study used an online survey consisting of the two questionnaires that are Body Appreciation Scale-2 and Rosenberg's Self-Esteem Scale. A total of 237 students were recruited from Sultan Qaboos University's different colleges.

RESULTS

The results indicated that positive body image has a significant relationship with an individual's self-esteem (β = 0.122, t = 2.197, p=0.038), Cumulative Grade Point Average (cGPA) (β = 0.140, t = 2.306, p=0.022), body mass index (BMI) (β = -0.414, t = -6.930, p < 0.001), monthly household income (β = -0.129, t = 2.467, p=0.029), and the number of social media accounts (≥2, β = -0.132, t = -2.232, p=0.027). In addition, an individual's self-esteem was significantly associated with an individual's cGPA (β = 0.231, t = 3.592, p < 0.001) and mothers' educational level (β = -0.130, t = -2.065, p=0.040) besides body appreciation (β = 0.160, t = 2.491, p=0.013).

CONCLUSIONS

The findings of this study shed light on the current status of positive body image among university students of Oman. In light of the new knowledge, we propose health interventions that include strategies such as involvement of family, to maintain and/or promote positive body image perceptions among young individuals and subsequently promote healthy appreciation of the physical appearance and self-esteem.

Effectiveness of an Internet Dissonance-Based Eating Disorder Prevention Intervention Among Body-Dissatisfied Young Chinese Women

Body image disturbances are widespread in highly populated, rapidly developing Asian nations such as China, but there are severe shortages of practitioners qualified to treat these issues. In such contexts, validated online interventions offer a potentially viable approach for addressing the lack of treatment resources. In this study, we evaluated effects of the eBody Project, an online, dissonance-based eating disorder prevention program, on functioning among body-dissatisfied young Chinese women. Participating women were randomly assigned to the 6-week eBody Project intervention (n = 191) versus an education brochure control condition (n = 181). Self-report assessments of eating disorder risk factors (body dissatisfaction, thin ideal internalization, depressive symptoms, restrained eating), self-esteem, body appreciation, and disordered eating were completed at baseline, posttreatment, and a 6-month follow-up. There were no intervention differences on outcomes before treatment but eBody Project women experienced significantly larger improvements on all outcomes following treatment and/or at follow-up compared to controls; corresponding effect sizes were small to medium. Results indicated the eBody Project program is a promising intervention for young women at risk for eating disorders in China and provide foundations for broad implementation in low- and middle-income countries where resources for in-person therapy and supervision are limited or unavailable altogether.

Validation of the Intuitive Exercise Scale in Patients With Eating Disorders

Unhealthy cognitive–emotional relationships with exercise can hinder positive treatment outcomes when left unaddressed. However, clinicians lack validated tools to monitor this aspect of treatment. This study examined the 14-item Intuitive Exercise Scale with 165 patients in the United States (Mage = 26.48 years) who were receiving treatment for an eating disorder. The original factor structure was inadequate for the current sample, and exploratory factor analysis generated three factors—emotional exercise, body intuition, and exercise variety. The three-factor solution yielded strong internal consistency and partial support for the scale’s validity. Furthermore, patients scored lowest in body intuition, confirming low awareness of bodily cues common in patients with eating disorders. This study informs how clinicians may integrate and monitor patients’ cognitive–emotional relationship with exercise as part of holistic and intuitive eating disorder treatment approaches.

Cognitive Behavioral Training Using a Mobile Application Reduces Body Image-Related Symptoms in High-Risk Female University Students: A Randomized Controlled Study

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.

The role of body appreciation, weight bias internalization, and disordered eating behaviors among presurgical bariatric patients

BACKGROUND

Body appreciation and internalized weight bias have consistently been associated with eating behaviors. However, research has yet to examine the role of these variables among presurgical bariatric patients.

OBJECTIVES

The present study sought to assess the relationships between body appreciation and weight bias internalization, binge eating, disinhibited eating, and symptoms of depression and anxiety among a sample of presurgical bariatric patients. The study also sought to examine the extent to which body appreciation and weight bias internalization account for unique variance in disordered eating even when controlling for depression and anxiety.

SETTING

Academic medical center in the United States.

METHODS

Data were collected on body appreciation, weight bias internalization, eating behaviors, depression, and anxiety as part of a standard presurgical psychological evaluation for bariatric surgery (n = 319). Pearson correlations were used to assess relationships between all study variables. Multiple regressions were conducted to assess the roles of body appreciation and weight bias internalization on disordered eating.

RESULTS

Significant associations were found between low levels of body appreciation and high levels of weight bias internalization, disordered eating, and symptoms of depression and anxiety. Results indicated that body appreciation and weight bias internalization each significantly accounted for unique variance in symptoms of binge eating and disinhibited eating. Depressive symptoms were also statistically significant in all analyses.

CONCLUSION

Findings indicate the importance of conducting future positive body image research, as well as continuing to examine weight-related constructs, such as internalized weight bias, among bariatric surgery patients.

The impact of body diversity vs thin-idealistic media messaging on health outcomes: an experimental study

The recent rise in body dissatisfaction and weight bias has led to a call to the media to increase the diversity of their imagery, in efforts to challenge the thin-ideal. Therefore, this study aimed to evaluate the effects of both body diversity and thin-ideal interventions on health outcomes. Female participants (n = 160) were randomly allocated into an intervention group: body diversity; thin-ideal; control. They completed measures of body satisfaction, body compassion, internalisation of the thin-ideal, weight bias and behavioural intentions at baseline and post-intervention. The results showed significant differences between groups for weight bias and intentions to eat healthily. Specifically, those in the body diversity intervention group reported a greater reduction in weight bias compared to the other conditions. Further, those in the thin-ideal intervention group reported a greater increase in intentions to eat healthily compared to the other conditions. There were no differences between groups for body satisfaction, body compassion, internalisation of the thin-ideal and behavioural intentions to exercise and manage weight. In conclusion, exposure to body diversity images reduced weight bias whereas exposure to the thin-ideal promoted intentions towards healthy eating. These findings therefore offer empirical evidence for the impact of using different types of imagery to change different health outcomes.

The Body Acceptance by Others Scale: An assessment of its factorial validity in adults from the United Kingdom

The construct of body acceptance by others (i.e., the degree to which an individual perceives acceptance for their appearance by others) is central to conceptual models of positive body image and adaptive eating styles. It is typically measured using the 10-item Body Acceptance by Others Scale (BAOS; Avalos & Tylka, 2006), but emerging research has suggested that a unidimensional model of BAOS scores may be unstable. Here, we examined the factor structure of BAOS scores in a sample of adults from the United Kingdom (N = 1148). Exploratory factor analyses indicated that BAOS scores reduced to two dimensions in women, of which only a primary 6-item factor was stable. In men, all 10 items loaded onto a primary factor. However, the results of confirmatory factor analyses indicated that both models of BAOS scores had poor fit. Although both the unidimensional 10-item and 6-item models had adequate internal consistency, our results are suggestive of factor structure instability. We conclude by suggesting ways in which future research could revise the BAOS to improve its factorial stability and validity.

Exploring primary care providers' understandings of body image in patient care

Research has shown that healthcare providers lack confidence in having the knowledge needed to have conversations about body image with their patients. No research to date has explicitly explored how providers in primary healthcare understand body image, including its definition and how it impacts plans for care. Accordingly, the current study explored how primary healthcare providers define body image and how they see the concept of body image manifest in their practice. A total of 21 participants were interviewed, including 3 registered dietitians, 6 occupational therapists, 4 physiotherapists, 1 registered massage therapist, 1 kinesiologist, 4 family physicians, 1 nurse, and 1 social worker. Using thematic analysis, it was found that gaps in knowledge about body image were quite apparent as participants' understanding of body image was slippery (e.g., they struggled to articulate specifics about the concept within care and recognized body image is not something associated with a clinical guideline that would bring form to the concept). However, healthcare providers believed in the importance of body image in their patients' care in broad and far reaching ways. Future directions for bridging the knowledge gap with respect to body image among primary healthcare providers are discussed.

Assessing positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults: A cross-validation study across eight countries

Positive body image refers to individuals' ability to conceptualize their bodies with love, respect, and appreciation. The study of positive body image is relatively new, and instruments used to investigate this multi-faceted construct have received limited use in non-English speaking countries. Thus, the aim of this investigation is to consider four measures that are associated with positive body image across eight different countries. Participants (n = 6272) completed the Body Appreciation Scale-2, the Body Areas Satisfaction Scale, the Physical Appearance Comparison Scale, and the Weight Bias Internalization Scale. Multi-group confirmatory factor analyses (MG-CFAs) and item-response theory (IRT) models were used to examine the measurement invariance of these surveys. Our results generally suggest that positive body image, weight bias, and appearance comparison can be assessed using brief assessments and that these four instruments can be used in different countries, but care should be taken to consider individuals' gender, BMI, and socio-economic position.

Embodiment: Cultural and gender differences and associations with life satisfaction

Although cultural factors have an important impact on individuals' experiences of living in their bodies, to date no studies have examined cross-cultural or gender differences in individuals' experience of embodiment. This study compared Swedish and Canadian women's experience of embodiment (and other body image related constructs), as well as Swedish men and women's experience of embodiment. Associations between embodiment, body esteem, and life satisfaction in men and women were also examined. Participants were 302 Swedish women, 242 Swedish men, and 216 Canadian women. Results showed that Swedish women had overall more positive experience of embodiment, more positive body esteem, lower thin-ideal internalization and lower levels of disordered eating than Canadian women. In comparison to Swedish men, however, Swedish women had more negative experience of embodiment in some ways, but similar experience of embodiment in other ways. Although associations between embodiment, body esteem, and life satisfaction were strong, embodiment was a better predictor of life satisfaction than body esteem for both men and women. Results are interpreted through the lens of the developmental theory of embodiment and consider cultural differences between Sweden and Canada, as well as Swedish society's both progress and problems in promoting gender equity.

The potential benefits of death reflection for improving women's body image

This study investigated death reflection as a novel strategy to improve body image among women. Young adult women (N = 158; M_age = 21.35) completed a death reflection exercise, a death-related active control exercise (to ensure that effects were due to the manner in which women reflected on their death, rather than due to thoughts about death in general), or a non-death-related active control exercise. Participants completed measures of body image at posttest and 1-week follow-up. The women in the death reflection group, compared to the non-death-related control group, experienced higher body weight satisfaction at posttest. Among women higher in beauty orientation, those in the death reflection group experienced higher body shape satisfaction compared to women in the death-related control group. Effects were medium-to-large in magnitude. No group differences were observed for overall appearance satisfaction, appearance importance, broad conceptualisation of beauty, and endorsement of cultural appearance ideals. These findings provide preliminary support for death reflection as a technique to improve some facets of women's body image. Yet, future research is needed to test whether these effects are replicable and can be extended to other facets of body image.