Examining the factor structure, sex invariance, and psychometric properties of the Body Image Acceptance and Action Questionnaire and the Functionality Appreciation Scale

Gender Differences in the Association between Body Shame and Binge Eating: Body Image Flexibility as a Moderator in Women

BACKGROUND

Body shame is an established antecedent and maintaining factor of binge eating, beyond global negative affect and body weight, and partly through the effects of dietary restriction. These associations have mainly been established in women and are understudied in men. Body image flexibility, a concept from Acceptance and Commitment Therapy, may be a protective psychological process against the effects of negative body image on binge eating.

METHODS

Using structural equation modeling and a non-clinical sample of 244 women and 185 men, this cross-sectional study tested an integrated model of the association between body shame and binge eating, mediated by dietary restriction and moderated by body image flexibility, controlling for depressive symptoms and BMI.

RESULTS

Body shame predicted binge eating in women but not in men, whereas depressive symptoms predicted binge eating in men but not in women. Body image flexibility moderated the association between body shame and binge eating in women.

CONCLUSIONS

These findings highlight the importance of considering gender-specific conceptualizations of binge eating and the role of body image flexibility in attenuating the influence of body shame on binge eating in women.

Reciprocal longitudinal associations between positive body image and wellbeing among early-adult women

This longitudinal study examined the prospective associations between body appreciation and wellbeing (i.e., self-esteem, depression, and emotional wellbeing) as well as body image flexibility and wellbeing among 490 women between 18-35 years of age (M = 28.63; SD = 4.27) residing in the United States. Women were contacted in three waves, each two months apart, and completed measures relating to each construct online. As a prerequisite of longitudinal analyses, this study found evidence of configural, metric, scalar, and strict invariance over time for each relevant measure. Cross-lagged panel modeling evidenced bidirectional associations between body appreciation and self-esteem between all waves and unidirectional associations between body appreciation and subsequent depression (negative) and body appreciation and subsequent emotional wellbeing (positive). Results showed bidirectional associations between body image flexibility, self-esteem, depression, and emotional wellbeing, although these bidirectional associations never occurred during the same interval between waves. This study evidences that higher body appreciation and body image flexibility are prospectively associated with increases in self-esteem, emotional wellbeing and decreases in depression, and also shows scenarios where the inverse associations also hold true. We also describe how this study complements existing cross-sectional research and the need to examine associations among more diverse participant groups.

Psychometric properties of the Spanish version of the functionality appreciation scale

BACKGROUND

The Functionality Appreciation Scale is a 7-item measure of an individual's appreciation of his or her body for what it can do and is capable of doing. While this instrument has been increasingly used in intervention-based research, its psychometric properties have not been extensively studied in non-English-speaking populations. The psychometric properties of a novel Spanish translation of the FAS were examined.

METHODS

An online sample of 838 Spanish adults (mean age = 31.79 ± 11.95 years, 50.48% men) completed the Spanish FAS and validated measures of body appreciation, eating disorder symptomatology, intuitive eating, and life satisfaction.

RESULTS

Exploratory factor analysis supported a 1-dimensional factor structure of the FAS, which was further supported by confirmatory factor analysis (SBχ²(14) = 83.82, SBχ²normed = 1.48, robust RMSEA = 0.094 (90% CI = 0.074, 0.115), SRMR = 0.040, robust CFI = 0.946, robust TLI = 0.924). Invariance across genders was shown, and there were no significant differences according to gender (t(417) = 0.77, p =.444, d = 0.07). Construct validity was also supported through significant associations with the other measures of the study. Incremental validity was established in women. Thus, appreciation of functionality predicted life satisfaction over and above the variance accounted for by other body image and eating disorder-related measures (F(4, 399) = 18.86, p <.001, ΔR2 = 0.03).

CONCLUSIONS

These results support the psychometric properties of the Spanish FAS and demonstrate the importance of the appreciation of functionality in relation to a healthier body image and psychological wellbeing.

Psychometric properties of a Spanish translation of the Functionality Appreciation Scale (FAS) in adults from Colombia

The 7-item Functionality Appreciation Scale (FAS) measures the extent of an individual's appreciation of their body for what it can do and is capable of doing. Although the FAS has been widely used in diverse linguistic contexts, it has not been previously translated into Spanish. Here, we examined the psychometric properties of a novel Spanish translation of the FAS in Colombian adults. A total of 1420 university students from Colombia (804 women, 616 men) completed the FAS, as well as additional validated measures. Exploratory and confirmatory factor analyses in separate subsamples supported a unidimensional model of FAS scores. The FAS evidenced scalar invariance across gender identity, with men having significantly higher FAS scores than women (Cohen's d = 0.18). FAS scores were also found to have adequate composite reliability, as well as adequate convergent (significant associations with body appreciation, appearance evaluation, and eating disorder psychopathology) and concurrent validity (significant associations with self-esteem, life satisfaction, and gratitude). Functionality appreciation incrementally predicted life satisfaction in women, but not in men. Overall, these results suggest that the Spanish FAS is a psychometrically valid and reliable tool for the assessment of functionality appreciation in university-aged populations from Colombia.

Psychometric properties of a Dutch translation of the Functionality Appreciation Scale (FAS) among adults in the Netherlands

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures functionality appreciation, the extent to which people appreciate their body for what it is able to do. We translated the FAS to Dutch and evaluated its factor structure and psychometric properties among 471 native Dutch speakers in the Netherlands (255 cisgender women, 204 cisgender men, 8 nonbinary, 1 "other," 3 "rather not say") who were between 18 and 85 years old. Participants completed the Dutch translation of the FAS, followed by questionnaires to assess additional variables of interest (body appreciation, appearance satisfaction, self-esteem, and gratitude). Exploratory factor analysis showed that Dutch FAS scores demonstrated a unidimensional factor structure. Dutch FAS scores demonstrated acceptable internal consistency and construct validity via their positive associations with the additional variables of interest. Dutch FAS scores also demonstrated gender invariance, and women reported higher functionality appreciation than men. Dutch FAS scores evidenced incremental validity for gratitude (but not self-esteem), and were inversely correlated with age and body mass index. Last, 2-week test-retest reliability of the Dutch FAS scores was supported. Overall, these findings provide support that the Dutch FAS is a psychometrically sound instrument to assess functionality appreciation among Dutch speaking adults in the Netherlands.

Longitudinal association between self-compassion and intuitive eating: Testing emotion regulation and body image flexibility as mediating variables

OBJECTIVES

Growing evidence suggests that intuitive eating is associated with numerous positive mental health and well-being constructs. Understanding factors that predict intuitive eating is necessary for identifying practical targets to enhance this style of eating, yet research identifying such predictors is scarce. Self-compassion is one variable that could enhance intuitive eating because it involves the practice of healthy emotion regulation skills that may disrupt the tendency to turn to food to cope during distressing situations. The present study tested for a longitudinal association between self-compassion and intuitive eating. We also tested whether this association was mediated by indices of emotion regulation (i.e., global emotion regulation skill scores and body image flexibility).

METHOD

Adult women (n = 3039) were invited to completed study measures at baseline (T1), 4-month follow-up (T2), and 8-month follow-up (T3). Path analyses were computed to test hypothesized indirect effects.

RESULTS

A direct path from T1 self-compassion to T3 intuitive eating emerged, such that higher self-compassion levels predicted increased intuitive eating over time. However, this association was not mediated by T2 emotion regulation skills nor body image flexibility.

CONCLUSION

Findings suggest that self-compassion may facilitate an intuitive eating style, which does not appear to be explained by certain emotion regulation skills.

Finding functionality: Rasch analysis of the Functionality Appreciation Scale in community-dwelling adults in the US

Introduction

The Functionality Appreciation Scale (FAS) measures an individual's appreciation for the functions their body can perform, regardless of the individual's physical limitations. Prior studies reported on internal consistency, test-retest reliability, convergent validity, and exploratory or confirmatory factor analyses, but Rasch analysis has not yet been performed to evaluate the structural validity of the FAS.

Methods

We recruited community-dwelling adults at the Minnesota State Fair and through contact lists of participants identifying interest in research done in the Brain Body Mind Lab (University of Minnesota). Community-dwelling adults with spinal cord injury (SCI) completed the FAS over Zoom. We analyzed the FAS using Rasch Measurement Theory, which produced the following outputs: item, and person fit, targeting, unidimensionality, person separation reliability (PSR), local item dependence (LID), principal component analysis of residuals (PCAR), and differential item functioning (DIF).

Results

We recruited 567 participants (average age 52.15 ± 17.5 years, 63.84% women), among which 14 adults with SCI. After rescoring 3 items and deleting 1 item, the FAS had good person and item fit (except item 4). The PCAR and subsequent paired t-tests (3.53%) confirmed the unidimensionality of the scale. There was no DIF and only one item pair had LID (item 5-6). PSR was 0.75, reflecting a capacity to differentiate groups of people with high or low functionality appreciation levels. However, there was a significant ceiling effect (28.04%) and the person mean location was 3.06 ± 2.07 logits, indicating the FAS is too easy for community-dwelling adults in the US.

Discussion

The 6-item Rasch-based FAS demonstrated unidimensionality, good item fit (except item 4) and person fit, but the FAS will require more difficult items to be added to improve the targeting of the scale, and better reliability.

The Chinese version of the Functionality Appreciation Scale: Psychometric properties and measurement invariance across gender and age

BACKGROUND

Functionality appreciation, as an important aspect of positive image, is associated with fewer body image disturbances, fewer disordered eating behaviors, and improved psychological well-being. However, it has been under-researched in Asian countries. The current work aimed to examine the psychometric properties of the Functionality Appreciation Scale (FAS) among four Chinese samples of different ages, and further examine measurement invariance and differences of the FAS across gender and age groups.

METHODS

Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to examine the factorial structure of the FAS among four Chinese samples of different ages, including middle school adolescents (n = 894, M_age = 12.17 years), high school adolescents (n = 1347, M_age = 15.07 years), young adults (n = 473, M_age = 21.95 years), and older adults (n = 313, M_age = 67.90 years). The measurement invariance of the FAS across gender and age was examined. Internal consistency reliability and construct validity were evaluated.

RESULTS

The FAS had a unidimensional structure and was invariant across gender and age groups. The FAS presented sound psychometric properties in all age groups by gender, with good internal consistency reliability [e.g., high Cronbach's α values (.91 ~ .97)] and good construct validity (e.g., significant associations with body appreciation, body dissatisfaction, and disordered eating). Moreover, group comparisons showed minimal gender differences in functionality appreciation. However, significant age differences were found in functionality appreciation, with older ages generally associated with higher functionality appreciation.

CONCLUSION

Overall, findings suggest that the FAS is a sound instrument to be used in the Chinese context. Furthermore, functionality appreciation was found to be higher in older adults than adolescents or young adults, suggesting the potential important role of aging in functionality appreciation.

Functionality appreciation and its correlates: Systematic review and meta-analysis

Functionality appreciation is a component of positive body image that refers to respecting and honoring the body for what it is capable of doing. A growing number of studies have investigated the features, correlates, and outcomes of functionality appreciation, yet a synthesis of this literature is missing. We conducted a systematic review and meta-analysis of research on functionality appreciation. Fifty-six studies were included (85 % cross-sectional). Random effects meta-analyses were performed on 21 cross-sectional correlates and on seven randomized trials of psychological interventions that assessed functionality appreciation as an outcome. Meta-analyses showed that functionality appreciation was consistently associated with fewer body image problems, lower levels of eating disorder symptoms, and better mental health and wellbeing. Functionality appreciation was unrelated to age and gender, but weakly (and negatively) related to body mass index. Preliminary evidence from prospective designs suggests that the appreciation of body functionality may promote adaptive eating patterns and prevent maladaptive eating and body image patterns over time. Psychological interventions designed to cultivate functionality appreciation in full or in part produced greater improvements in this construct than control conditions. Findings confirm that functionality appreciation is associated with numerous wellbeing constructs and could serve as a potentially useful target for intervention.

Psychometric properties of a Greek translation of the Functionality Appreciation Scale (FAS) in adults from the Republic of Cyprus

The Functionality Appreciation Scale is a widely used instrument for the measurement of an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). In the present study, we examined the psychometric properties of a novel Greek translation of the FAS in Cypriot adults. A total of 448 women and 345 men from the Republic of Cyprus completed the FAS, as well as validated measures of body appreciation, appearance evaluation, and symptoms of disordered eating, and self-esteem. Exploratory and confirmatory factor analyses supported a unidimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, with the gender difference in FAS scores not reaching significance. FAS scores were also found to have adequate composite reliability and convergent (significant associations with body appreciation, appearance evaluation, and symptoms of disordered eating) and concurrent validity (significant associations with self-esteem). Finally, functionality appreciation predicted self-esteem once the effects of all other variables had been accounted for, supporting incremental validity. Overall, these results suggest that the Greek FAS is a psychometrically valid tool for the assessment of functionality appreciation in adults from Cyprus.

Understanding the role of positive body image during digital interventions for eating disorders: Secondary analyses of a randomized controlled trial

Despite growing interest in the possible link between positive body image and eating disorder (ED) symptoms, little is known about what role this adaptive construct plays in ED treatment. This study investigated whether: (1) interventions principally designed to target ED psychopathology also lead to improvements in positive body image indices (i.e., body appreciation, functionality appreciation, and body image flexibility); (2) changes in ED symptoms correlate with changes in positive body image, both concurrently and prospectively; and (3) baseline positive body image levels moderate the degree of symptom improvement. Secondary analyses from a randomized controlled trial on digital interventions for EDs (n=600) were conducted. Intervention participants reported greater increases in the three positive body image constructs than the control group (ds=0.15-0.41). Greater pre-post reductions in ED psychopathology and binge eating were associated with greater pre-post improvements in positive body image indices. However, earlier reductions in ED psychopathology and binge eating did not predict later improvements in positive body image at follow-up. None of the positive body image constructs at baseline moderated degree of symptom change. Standard ED interventions can cultivate a more positive body image, although this is not explained by earlier symptom reduction. Understanding the mechanisms through which ED interventions enhance positive body image is needed.

Enriching sociocultural perspectives on the effects of idealized body norms: Integrating shame, positive body image, and self-compassion

Body image is an integral aspect of the psychology of the self. Idealized body images are ubiquitous in both traditional media forms (e.g., magazines, television) and social media (e.g., Facebook, Instagram). The classic sociocultural model of body image (i.e., the Tripartite Influence Model) emphasizes pathways between idealized body norms, appearance comparisons, internalization of body ideals, and body dissatisfaction and its outcomes. We summarize the model and identify some issues to be addressed in future work, particularly in light of the immense popularity of social media. We review three topics that are not included in the sociocultural model but that provide a more complete picture of the influence of societal body norms on body image: (1) body shame, (2) positive body image, and (3) self-compassion. Research on the nature, assessment, and relevance of these constructs is reviewed in detail. In terms of clinical applications of these areas of research for individuals at risk of body dissatisfaction, we suggest assessing for and targeting body shame, cultivating facets of positive body image, and teaching strategies for developing self-compassion.

Psychometric properties of an Arabic translation of the Functionality Appreciation Scale (FAS) in Lebanese adults

The Functionality Appreciation Scale is a widely used instrument for the measurement of an 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 Arabic translation of the FAS. A sample of 826 Lebanese adults completed the FAS, as well as previously validated measures of body appreciation, disordered eating attitudes, orthorexia, and self-esteem. Exploratory and confirmatory factor analyses supported a unidimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, with women reporting significantly greater functionality appreciation than men. FAS scores were found to have adequate composite reliability and adequate patterns of convergent and criterion-related validity. Additionally, functionality appreciation predicted self-esteem once the effects of all other variables had been accounted for, supporting incremental validity. Overall, these results suggest that the Arabic FAS is a psychometrically valid tool for the assessment of functionality appreciation. The availability of the Arabic FAS should facilitate improved understanding of the effectiveness of existing interventions designed to promote greater physical activity in the Lebanese context.

Psychometric properties of a Farsi translation of the Functionality Appreciation Scale (FAS) in Iranian adolescents

The 7-item Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). However, few studies have assessed the psychometric properties of the FAS in non-English speaking populations and in younger age groups. Here, we examined the psychometric properties of a novel Farsi translation of the FAS in Iranian adolescent girls and boys. A sample of 828 Iranian adolescents completed the FAS alongside the Rosenberg Self-Esteem Scale and the Beck Depression Inventory-II. Participants were randomly split into a first split-half for exploratory factor analysis (EFA) or a second split-half for confirmatory factor analysis (CFA). The EFA broadly supported a 1-dimensional model of FAS scores, although one item had low item-factor loadings. The CFA indicated that both the 6- and 7-item models had adequate fit. In further analyses, we found that the 7-item unidimensional model was invariant across gender and that higher FAS scores were significantly associated with higher self-esteem and lower depressive symptoms, indicative of convergent validity. These results provide evidence that the Farsi translation of the FAS is reliable and valid for use in Iranian adolescent girls and boys.

Short forms of the Body Appreciation Scale-2 (BAS-2SF): Item selection and psychometric evaluation

The 10-item Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015) is a widely used contemporary measure of positive body image that assesses one's love for, acceptance and appreciation of, and respect for their body. Given the need for abbreviated measures to reduce participant burden and study cost, we aimed to generate a short form of the BAS-2 (BAS-2SF). Two versions of the BAS-2SF emerged: a 3-item version derived deductively from theory (items selected based on their unique contribution to the body appreciation construct), and a 2-item version generated empirically (items selected based on a genetic algorithm approach). Psychometric evidence was garnered across five studies, totaling 3114 participants. Both BAS-2SF versions correlated highly (rs = .93-.97) with the original 10-item BAS-2 and demonstrated internally consistent and stable scores. Factor analyses revealed high item-factor loadings, unidimensionality, and gender invariance of the 3-item BAS-2SF. Correlations with construct validity measures, as well as model pathways, were similar between both BAS-2SF versions and the 10-item BAS-2. BAS-2SF versions also evidenced incremental validity. Both BAS-2SF versions retain the psychometric integrity of the BAS-2 and are recommended for use; however, the 3-item BAS-2SF is an ideal option for researchers who wish to estimate a body appreciation latent factor.

Measurement invariance and psychometric properties of three positive body image measures among cisgender sexual minority and heterosexual women

Positive body image is a multidimensional construct consisting of various facets including body appreciation, body image flexibility, and functionality appreciation measured via the Body Appreciation Scale-2 (BAS-2), Body Image-Acceptance and Action Questionnaire-5 (BI-AAQ-5), and Functionality Appreciation Scale (FAS), respectively. Research has supported the unidimensional factor structure of these measures; however, invariance testing based on sexual identity has yet to be conducted. The study's primary aim was to assess the measurement invariance of the BAS-2, BI-AAQ-5, and FAS between sexual minority and heterosexual women. The secondary aim was to assess the psychometric properties of each positive body image measure among each sample. Participants were predominantly White, cisgender women who identified as a sexual minority (n = 310) or heterosexual (n = 360) and completed online questionnaires of positive body image, eating behaviors, and mental and physical health. Results supported invariance with no differences in BAS-2 or BI-AAQ-5 scores. A significant difference with a small effect size was found in FAS scores, with sexual minority women reporting lower FAS scores. Findings supported the BI-AAQ-5 and FAS's incremental validity on perceived mental health. Overall, results suggest that the BAS-2, BI-AAQ-5, and FAS scores can be compared among women of varying sexual identities.

Psychometric validation of the Japanese version of the Functionality Appreciation Scale (FAS)

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a widely adopted measure to assess appreciation for one's body and its capacity. In this study, we performed a psychometric validation of the Japanese translation of the FAS. Participants included an online sample of 750 Japanese individuals (20-70 years old), who completed the FAS and other previously validated measures of body appreciation, intuitive eating, gratitude, self-esteem, and life satisfaction. Moreover, the survey was conducted twice, 3 weeks apart, to determine test-retest reliability. Exploratory factor analyses replicated the unidimensional factor structure of the FAS, which was also verified by the confirmatory factor analysis. FAS scores had gender invariance, and demonstrated good internal consistency and test-retest reliability over the 3-week period. In addition, further analyzes indicated adequate construct, and incremental validity. These findings indicate that the Japanese version of FAS demonstrates good psychometric properties, and can be used to examine the importance of functionality appreciation for enhancing positive body image and healthy eating.

Positive body image, intuitive eating, and self-compassion protect against the onset of the core symptoms of eating disorders: A prospective study

OBJECTIVE

Establishing factors that protect against the onset of eating disorder symptoms is needed to identify critical intervention targets to inform the design of more potent prevention programs. Knowledge of robust protective factors is lacking, which might account for the limited effectiveness of existing prevention programs. As positive body image, intuitive eating, and self-compassion show protective potential, the present study tested whether these factors protect against the onset of a range of different eating disorder symptoms.

METHOD

Data were analyzed from 1,270 women who completed study measures at baseline and 8 months. Logistic regressions tested whether, among initially asymptomatic women, baseline and changes in positive body image components (body appreciation, body image flexibility, and functionality appreciation), intuitive eating, and self-compassion predicted the continued absence versus onset of seven core eating disorder symptoms at follow-up.

RESULTS

Each of the five factors at baseline was associated with a lower odds of symptom onset for each outcome in univariate analyses. Baseline body appreciation and intuitive eating scores remained consistent, unique predictors of a lower odds of experiencing symptom onset in multivariate models. Greater increases in intuitive eating and body appreciation over time were the two factors consistently associated with a lower odds of symptom onset across several outcomes.

DISCUSSION

This study provides strong evidence for the protective influence of positive body image components, intuitive eating, and self-compassion against several eating disorder symptoms. Building these factors within established prevention programs may, in the longer term, help reduce the incidence of eating disorder syndromes and symptoms.

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.

Psychometric properties of a Romanian translation of the Functionality Appreciation Scale (FAS)

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a 7-item measure of an individual's appreciation of their body for what it can do and is capable of doing. Although the instrument is increasingly used in interventionist studies, its psychometric properties have been infrequently investigated outside Anglophone populations. Here, we examined psychometric properties of a novel Romanian translation of the FAS. An online sample of 959 Romanian adults (18-73 years old) completed the Romanian FAS, and validated measures of positive body image (body appreciation), negative body image (weight discrepancy in women, drive for muscularity in men), eating disorder symptomatology, and psychological well-being (self-esteem, gratitude). Exploratory factor analyses led to the extraction of a 1-dimensional model of FAS scores, which we confirmed using confirmatory factor analysis. FAS scores achieved scalar invariance across sex, but the sex difference in latent FAS scores did not reach significance (d = 0.15). FAS scores had adequate internal consistency and test-retest reliability up to four weeks, and further analyses provided evidence of convergent, construct, and incremental validity. These results support the psychometric properties of the Romanian FAS and present evidence of the importance of functionality appreciation in relation to healthier body image and psychological well-being.

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.

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.