The development of a body comparison measure: the CoSS

Shifting the Focus: A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE.

Experimental analysis of the impact of body comparison on non-clinical women

BACKGROUND AND OBJECTIVES

Two experimental studies examined the impact that body comparison has on women's body satisfaction and self-esteem. The two studies differed in the use of a human comparator or an avatar (non-human) comparator. The independent variables were the type of body comparison (upward, downward and neutral) and the perceived personality of the comparator.

METHODS

Each study used a within-participant design. Participants compared themselves to images of women or avatars (previously rated as 'attractive', 'neutral' or 'unattractive'), with an accompanying 'positive' or negative' personality descriptor. Participants rated their body satisfaction and self-esteem after each image.

RESULTS

Upward comparison resulted in negative effects for the participant compared to downward and neutral conditions, but downward comparison's impact was only found for human images. The described personality of the image had a more complex impact when using human images, but was still relevant for avatars.

LIMITATIONS

The sample for this study was lacking in diversity. Compliance within the experimental tasks was not strictly monitored. The use of a within-subject design might have allowed some participants to deduce the nature of the study.

CONCLUSIONS

These findings provide causal evidence for the theorised effects of body comparison on body satisfaction self-esteem. Upward comparison has especially problematic outcomes, even causing negative effects when comparing to a non-human avatar. Downward comparison had positive effects, but only for human images. Furthermore, personality played some moderating role in these outcomes. Social comparison theory needs to be reviewed in light of these findings, and practical implications are discussed.

Does comparison of self with others influence body image among adult women? An experimental study in naturalistic settings

BACKGROUND AND OBJECTIVES

It has been suggested that body comparison is a safety behavior in eating disorders. This experimental study investigates the causal impact of upward and downward body comparison on body image, eating pathology, self-esteem, anxiety and mood. It also considers whether trait body comparison and eating pathology are associated with responsiveness to upward and downward comparison.

METHODS

Thirty-nine women participated. Each completed trait comparison and eating pathology measures. Following this, each participant spent an hour (on different days) making an upward, downward or neutral comparison in a naturalistic setting. After each condition, the participant completed measures of body satisfaction, self-esteem, anxiety, depression and eating pathology.

RESULTS

Participants were significantly less satisfied with their bodies following upward comparison. Both upward and downward comparison were associated with particularly negative effects if an individual had greater trait eating concerns. The effects of downward comparison were correlated with increased anxiety.

LIMITATIONS

The sample was lacking in diversity. Compliance with the experimental tasks was not strictly monitored.

CONCLUSIONS

Upward comparison resulted in lower body satisfaction, but downward comparison did not result in positive effects. However, trait eating concerns and comparison influenced the impact of both forms of comparison. Body comparison should be a target for treatment in CBT for eating disorders, particularly where the individual has a strong tendency to make comparisons with other people.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Evaluating associations between fitspiration and thinspiration content on Instagram and disordered-eating behaviors using ecological momentary assessment: A registered report

INTRODUCTION

Greater use of appearance-focused social media, such as Instagram, is associated with increased body dissatisfaction and eating disorder (ED) symptoms; however, questions remain about the mechanism connecting social media use to disordered-eating behaviors (DEBs). The proposed study evaluates how and for whom exposure to fitspiration or thinspiration on Instagram is associated with DEBs.

METHODS

We will evaluate a hypothesized pathway from Instagram use to disordered-eating mediated by negative affect. We will test how individual differences in internalized weight stigma, trait self-esteem, and trait self-comparison moderate the pathway from social media use to negative affect. We will recruit 175 undergraduate women who report engaging in DEBs on average at least once per week over the past 3 months. Participants will complete a 7-day ecological momentary assessment protocol, during which they will report their Instagram use, affect, and engagement in DEBs.

RESULTS

Multi-level modeling will be used to assess moderated mediation. Results from this study will provide increased specificity about how Instagram usage is linked to eating pathology and who may be most vulnerable to experiencing distress.

DISCUSSION

Information about negative affect from Instagram and engagement in DEBs could contribute to the development of Just-In-Time Interventions for problematic social media use.