Body Checking and Body Image Avoidance as Partial Mediators of the Relationship between Internalized Weight Bias and Body Dissatisfaction

Longer-term consequences of increased body checking in women at risk for eating disorders-a naturalistic experimental online study

Body checking is a common behavior in both the general population and individuals with body image disturbances. Cognitive-behavioral theories postulate that body checking reduces negative emotions in the short term, but over time contributes to the development and maintenance of eating disorder pathology. So far, few experimental studies have assessed these longer-term consequences, mostly under laboratory conditions, yielding inconsistent findings, and without considering individual vulnerability and specific personality traits. In a naturalistic experimental cross-over design, women with low (n = 76) vs. high (n = 103) body concern completed an online survey on trait characteristics (e.g., intolerance of uncertainty). After a two-day baseline to assess the daily amount of habitual body checking, participants underwent two three-day experimental conditions in randomized order, in which they were asked to exhibit typical vs. threefold increased body checking. Before and after conditions, participants completed state measures of eating disorder symptoms, body dissatisfaction, affect, and general pathology online. In women with high body concern, body image-related symptoms (i.e., drive for thinness, body dissatisfaction) and negative affect worsened in the increased body checking condition, whereas in the typical body checking condition, positive affect increased and no negative impact emerged. Conversely, women with low body concern remained unaffected, except for higher drive for thinness following the increased condition. Bulimic and depressive symptoms did not change in either group. The inclusion of intolerance of uncertainty from an exploratory perspective generally did not impact the results. Our findings regarding the high-risk group underscore the potential etiological relevance of body checking for body image disturbances and eating disorders. For individuals at risk and those already affected by eating disorders, it seems important to address individual body checking as early as possible within psychoeducation to prevent a presumably harmful increase in this behavior. Personality factors influencing vulnerability to body checking need to be further examined.

Body Positivity, Physical Health, and Emotional Well-Being Discourse on Social Media: Content Analysis of Lizzo's Instagram

BACKGROUND

Weight stigma is a fundamental cause of health inequality. Body positivity may be a counterbalance to weight stigma. Social media is replete with weight-stigmatizing content and is a driver of poor mental health outcomes; however, there remains a gap in understanding its potential to mitigate the prevalence and impact of harmful messaging and to promote positive effects on a large scale.

OBJECTIVE

We selected musical artist Lizzo, whose brand emphasizes body positivity and empowerment, for an instrumental case study on the discourse on social media and specifically Instagram. We focused on 3 domains, including body positivity, physical health, and emotional well-being. These domains challenge social norms around weight and body size and have the potential to positively affect the physical and psychological health of people with diverse body sizes.

METHODS

We evaluated posts by Lizzo, comments from Instagram users, and replies to comments over a 2-month period (October 11 to December 12, 2019). Two coders rated Lizzo's posts and Instagram users' comments for their sentiments on the 3 domains. Replies to Instagram users' comments were assessed for their reactions to comments (ie, did they oppose or argue against the comment or did they support or bolster the comment). Engagement metrics, including the number of "likes," were also collected.

RESULTS

The final sample included 50 original posts by Lizzo, 250 comments from Instagram users, and 1099 replies to comments. A proportion of Lizzo's content included body positive sentiments (34%) and emotional well-being (18%); no posts dealt explicitly with physical health. A substantial amount Instagram users' comments and replies contained stigmatizing content including the use of nauseated and vomiting emojis, implications that Lizzo's body was shameful and should be hidden away, accusations that she was promoting obesity, and impeachments of Lizzo's health. In spite of the stigmatizing content, we also discovered content highlighting the beneficial nature of having positive representation of a Black woman living in a larger body who is thriving. Moreover, analysis of the discourse between users illustrated that stigmatizing expressions are being combated online, at least to some degree.

CONCLUSIONS

This study demonstrates that Lizzo has exposed millions of social media users to messages about body positivity and provided more visibility for conversations about weight and shape. Future research should examine the extent to which body positive messages can lead to greater acceptance of individuals living in larger bodies. Instagram and other social media platforms should consider ways to reduce body-shaming content while finding ways to promote content that features diverse bodies. Shifting the landscape of social media could decrease stereotypes about weight and shape while increasing dialog about the need for greater acceptance and inclusion of people with diverse bodies.

A systematic review of weight stigma and disordered eating cognitions and behaviors

Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.

Cognitive Defusion and Psychological Flexibility Predict Negative Body Image in the Chinese College Students: Evidence from Acceptance and Commitment Therapy

Body dissatisfaction is a global phenomenon. Despite the significant cultural difference, most research on negative body image was conducted in Western countries. How do cognitive fusion and psychological flexibility relate to negative body image in the Chinese population? In the present study, this question was investigated through the intervention technique, Acceptance and Commitment Therapy (ACT). Here, 86 young Chinese university students with high negative physical self were invited, in which 42 students received 10 sessions of group-based ACT intervention in a clinical setting while the remained acted as the control group with no intervention. Pretests showed no statistical differences in negative body image between these two groups, while both cognitive fusion and psychological flexibility predicted negative body image. Post-pre tests showed no change in the control group, while enhanced cognitive defusion and psychological flexibility in the ACT group. Individual differences in psychological flexibility and cognitive defusion enhancement predicted improved body image. A strong association of implicit body image with Fatness and Shortness changes suggested that although with individual differences, those components could be internalized during the intervention in the College students.

The Role of Body Shame and Age on Appearance-Based Exercise and Positive Body Image in Women from Poland: Preliminary Results of a Cluster Analysis

The aim of this study has been to analyse whether body shame and age may play a role in appearance-based exercise and positive body image in Women from Poland. It was assumed that women with high body shame and at the stage of young adulthood have significantly greater levels of appearance-based exercise and lower positive body image than those with a low level of body shame and at the stage of middle adulthood. The final sample included 234 Polish women (age: M = 31.58, SD = 13.93; body mass index: M = 23.45, SD = 4.72). Participants completed: the Objectified Body Consciousness Scale (OBCS), the Exercise Appearance Motivations Scale (EAMS), the Body Appreciation Scale-2 (BAS-2) and a socio-demographic survey. The cluster analysis technique indicated four distinct clusters: (a) Cluster 1 (N = 83): high body shame and young adulthood; (b) Cluster 2 (N = 29): high body shame and middle adulthood; (c) Cluster 3 (N = 88): low body shame and young adulthood; (d) Cluster 4 (N = 34): low body shame and middle adulthood. The outcomes partially support the hypothesis, as higher levels of almost all subscales related to appearance-based exercise (EAMS: "muscularity", "societal pressures", "shape/weight concerns", "avoidance/shame") and lower positive body image (BAS-2) were observed in women with high body shame and at the stage of young adulthood compared with women with a low level of body shame and at the stage of middle adulthood. These results indicate that both body shame and age may contribute to the intensity of appearance-based exercise and positive body image deterioration. Clarity on this issue is essential to ensure that an appropriate preventive activity and interventions are made which will be able to take into account the specific sociocultural context in Poland.