Development and validation of the sociocultural attitudes towards appearance questionnaire-4-revised (SATAQ-4R)

Behind the mirror: An exploration of the Tripartite Influence Model among Italian adolescent boys and girls

Body image concerns and eating disorder (ED) symptoms are increasingly common among adolescents, highlighting the importance of discerning their risk factors. One of the main frameworks explaining the development of body image and eating-related issues is the Tripartite Influence Model (TIM); however, adolescent research examining this model remains scarce and mainly limited to female individuals. Therefore, this study aimed to test the original TIM in a sample of 788 Italian students (59 % girls) aged 13-19 years. They completed self-report tools assessing appearance-related sociocultural pressures, general attractiveness-ideal internalization, appearance comparison frequency, body shame, and ED symptoms. Path analysis was employed to test the TIM in the overall sample, followed by a multigroup analysis by biological sex. The results showed that, in both groups, family pressure was linked to body shame directly and to ED symptoms via body shame; however, neither internalization nor appearance comparisons mediated these relations. Peer pressure was associated with body shame via appearance comparisons but not via internalization. Media pressure was related to body shame both directly and via appearance comparisons and indirectly linked to ED symptoms through body shame. In girls, significant relations between family pressure and ED symptoms, as well as between media pressure and internalization, also emerged. The practical implications are discussed, especially regarding culturally sensitive prevention programs.

The role of female family members in relation to body image and eating behaviour: A cross-national comparison between Western and Middle-Eastern cultures

While recent research has shifted toward investigating positive body image, gaps remain in our understanding beyond Western contexts. The present study investigated cross-national differences in the associations between perceived pressures from female family members (mothers and sisters) and both negative and positive body image and eating behaviour outcomes. Participants, aged 18-25, were recruited from both a Western (n = 486) and Middle-Eastern (n = 372) population, and completed an online survey measuring familial pressures and fat talk, internalisation, comparisons, body dissatisfaction, disordered eating, body appreciation and mindful eating. Overall, both mothers and sisters were found to be important sources of pressures. Results demonstrated similarities and differences in negative and positive body image and eating behaviours across cultures. However, the major finding was clear. Middle-Eastern participants, compared to Western participants, demonstrated greater levels of body appreciation and in the mindful eating behaviour of eating without distraction. Despite young Middle-Eastern women facing similar body image and eating concerns as Western women, they exhibit greater body appreciation which may mitigate these concerns. These findings extend our understanding of body image and eating behaviour across countries, and could inform the development of interventions which promote positive body image and eating behaviours within the family environment.

Italian adolescents' body image and sociocultural influences: An investigation using the Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised

Body dissatisfaction and eating disorders (EDs) are highly prevalent among adolescents, imposing a significant burden on this group. Therefore, a deeper investigation into the risk factors of these issues is urgently needed. In this regard, adopting a sociocultural framework can offer valuable insights; however, research on the assessment of appearance-related sociocultural pressures among adolescents remains limited. This study aimed to validate the Sociocultural Attitude Towards Appearance Questionnaire-4-Revised (SATAQ-4R) among Italian adolescents aged 13-17 years. A total of 692 girls (Mage = 15.5 years ± 1.16) and 450 boys (Mage = 15.2 years ± 1.21) completed the Female and Male versions of the SATAQ-4R along with other self-report tools assessing ED symptoms, body dissatisfaction, self-esteem, peer and family appearance pressure, drive for muscularity, and frequency of Instagram appearance comparisons. To investigate the SATAQ-4R factor structure, several models were tested. Measurement invariance across early and middle adolescent groups, reliability, and validity were addressed. The original 7-factor model yielded the best fit to the data for both boys and girls. This model was also invariant across age groups. Both the SATAQ-4R-Male and Female exhibited excellent psychometric properties in terms of construct and criterion validity, as well as internal consistency (McDonald's omega values ranging from .79 to .93 for the SARAQ-4R-Male and from .82 to .93 for the SATAQ-4R-Female). Therefore, the SATAQ-4R can be considered a valid and reliable tool for measuring societal influences on body image among Italian adolescents. Research and practical implications are discussed.

The Effect of Person-First Language on Obesity Stigma

PURPOSE

To test the assumption that person-first language (PFL) reduces obesity stigma, mediated by perceived personal responsibility for obesity.

DESIGN

Cross-sectional, experimental.

SETTING

Online, United States.

PARTICIPANTS

299 young adults.

MEASURES

Participants read a vignette using PFL or identity-first language (IFL) or about someone without obesity. Participants reported perceived personal responsibility for obesity, and 3 operationalizations of obesity stigma: prejudice, stereotypes, and support for punitive policies. Mediation analyses were used to test if the manipulation affected obesity stigma, through perceived personal responsibility.

RESULTS

There was no indirect effect of PFL vs IFL on the 3 outcomes (95% CIs contained zero). However, the indirect effects of PFL vs no-obesity condition were significant (prejudice: β = -0.10, SE = 0.05, 95% CI [-0.22, -0.01]; stereotypes: (β = 0.07, SE = 0.03, 95% CI [0.01, 0.14]); punitive punishment: (β = -0.06, SE = 0.04, 95% CI [-0.15, -0.01]). Also, the indirect effects of IFL vs no-obesity condition on stereotypes (β = 0.07, SE = 0.04, 95% CI [0.0003, 0.15]) and punitive punishment (β = -0.06, SE = 0.04, 95% CI [-0.15, -0.0002]) were significant.

CONCLUSION

PFL may not affect obesity stigma as it does in the context of other marginalized groups. The effect of PFL and IFL, compared to the no-obesity condition, suggests future routes for intervention.

Examining effects of race and ethnic identity on body dissatisfaction following media exposure of thin and curvy body ideals

This study examined moderating effects of race and ethnic identity on associations between thin and curvy media exposure and body dissatisfaction in a community sample of Black and white women. Participants (n = 200 white, n = 199 Black) completed a pre-exposure measure of ethnic identity and pre-post measure of body satisfaction (where lower scores indicate dissatisfaction) after randomization to thin or curvy body ideal conditions. Black women endorsed higher pre-exposure ethnic identity than white women but did not differ in level of body dissatisfaction. Moderated-moderation analysis indicated no effect of race nor a conditional effect of ethnic identity on race. Only the thin but not curvy condition was related to greater body dissatisfaction from pre-exposure (M = 3.00, SD =.78) to post-exposure (M = 2.96, SD =.79), t(199) = 2.67, p =.008, d = .19. Findings support growing research suggesting differences in body ideal pressures and associated body dissatisfaction may be less pronounced between Black and white women than in previous decades. Findings have implications for sociocultural models of body dissatisfaction across racial groups and the hypothesis that ethnic identity may prime or buffer certain body ideals.

Body image research among sexual minority men in the Mekong region: A scoping review

Body image among sexual minority men (SMM) has received increasing attention. However, the current literature has primarily focused on white SMM and body image and physical appearance concerns among SMM. In response to a call for more nuance in understanding how SMM perceive and make sense of their body image in a broader sociocultural context, we conducted a scoping review to examine the extent and nature of body image research among SMM in the Mekong region. We searched CINAHL, MEDLINE, Scopus, PsycInfo-1806 (Ovid), ProQuest Central, Social Science Premium Collection, and Web of Science and identified 25 studies that met the inclusion criteria. Overall, the findings suggest that body image research in the Mekong region is limited in the range of topics, study populations, and methods, with quantitative studies on preferences for masculine physical traits among young and well-educated Chinese SMM dominating. Furthermore, the current literature is primarily influenced by Western scholarship, which predominantly uses Western measurement and theories. We encourage scholars from other countries in the region, including Vietnam, Laos, Cambodia, Myanmar, and Thailand, to engage sociocultural approaches in research on the body image of SMM.

Death and beauty: mortality salience and creatureliness increase self-objectification not only in females but also in males

Background

Self-objectification, the tendency to perceive oneself as an object subject to external evaluation, negatively impacts wellbeing, contributing to issues such as anxiety and eating disorders. While objectification theory outlines its societal underpinnings, it provides limited insight into the psychological mechanisms that sustain its prevalence. Terror Management Theory (TMT) posits that self-objectification functions as a defense against death anxiety, operating through two pathways: cultural worldview compliance (adherence to objectifying societal norms) and suppressing the awareness of creatureliness (avoiding awareness of humans' biological vulnerability and animalistic nature). This research explores these mechanisms and their gender-specific dynamics under mortality salience (MS).

Methods

This study includes three experimental studies. The study 1 examined baseline gender differences in perceived creatureliness and adherence to objectification culture. Study 2 used a 2 (MS/control) × 2 (gender: male/female) design to investigate the effects of MS and gender on self-objectification with cultural worldview compliance as a continuous moderator. Study 3 employed a 2 (MS/control) × 2 (creatureliness: heightened/reduced) × 2 (gender: male/female) design to assess the effects of creatureliness salience on self-objectification.

Results

Study 1 revealed that women were more culturally objectified, whereas men exhibited higher perceived creatureliness. However, Study 2 and Study 3 found no significant gender-related interactions in self-objectification. Study 2 showed that MS increased self-objectification across genders, with women displaying higher self-objectification due to stronger adherence to objectification cultural norms. Study 3 demonstrated that heightened creatureliness salience amplified self-objectification under MS for both genders, highlighting the universal role of creatureliness suppression in existential defenses.

Conclusion

These findings provide evidence for dual pathways-cultural worldview compliance and creatureliness suppression-underlying self-objectification as a defense against death anxiety. However, while cultural compliance explains gender differences in self-objectification at baseline, creatureliness suppression appears to function universally across genders. This study clarifies the boundaries of gender differences, emphasizing that the observed gender differences were limited to perceptions of objectification and creatureliness, rather than self-objectification itself. These insights contribute to interventions targeting the maladaptive effects of self-objectification, advocating for gender-sensitive approaches to enhance psychological wellbeing.

Longitudinal Associations among Identity, Internalization of Appearance Ideals, Body Image, and Eating Disorder Symptoms in Community Adolescents and Emerging Adults: Adaptive and Maladaptive Pathways

Previous research examined the role of identity confusion and body dissatisfaction in eating disorder symptoms, but an integrative perspective including identity synthesis and positive body image is lacking. The current study used three-wave longitudinal data (T1: N = 403; 52.1% female; Mage = 14.85, SD = 0.89) spanning two years to examine the directionality of effects among identity, internalization of appearance ideals, body image, and eating disorder symptoms, with attention to adaptive mechanisms. Results revealed a maladaptive pathway in which internalizing appearance ideals posed a risk for body dissatisfaction and eating disorder symptoms. Conversely, an adaptive pathway highlighted the potential protective role of positive body image regarding identity formation and internalization of appearance ideals. This study provides further insight into the critical role of appearance ideal internalization in the development of eating disorders and the potential value of positive body image. Future research and prevention/intervention efforts should focus on promoting resilience to appearance ideal internalization and enhancing positive body image in the context of identity struggles and eating disorder symptoms.

The current clinical approach to feeding and eating disorders aimed to increase personalization of management

Feeding and eating disorders (FEDs) are a heterogeneous grouping of disorders at the mind-body interface, with typical onset from childhood into emerging adulthood. They occur along a spectrum of disordered eating and compensatory weight management behaviors, and from low to high body weight. Psychiatric comorbidities are the norm. In contrast to other major psychiatric disorders, first-line treatments for FEDs are mainly psychological and/or nutrition-focused, with medications playing a minor adjunctive role. Patients, carers and clinicians all have identified personalization of treatment as a priority. Yet, for all FEDs, the evidence base supporting this personalization is limited. Importantly, disordered eating and related behaviors can have serious physical consequences and may put the patient's life at risk. In these cases, immediate safety and risk management considerations may at least for a period need to be prioritized over other efforts at personalization of care. This paper systematically reviews several key domains that may be relevant to the characterization of the individual patient with a FED aimed at personalization of management. These domains include symptom profile, clinical subtypes, severity, clinical staging, physical complications and consequences, antecedent and concomitant psychiatric conditions, social functioning and quality of life, neurocognition, social cognition and emotion, dysfunctional cognitive schemata, personality traits, family history, early environmental exposures, recent environmental exposures, stigma, and protective factors. Where possible, validated assessment measures for use in clinical practice are identified. The limitations of the current evidence are pointed out, and possible directions for future research are highlighted. These also include novel and emerging approaches aimed at providing more fine-grained and sophisticated ways to personalize treatment of FEDs, such as those that utilize neurobiological markers. We additionally outline remote measurement technologies designed to delineate patients' illness and recovery trajectories and facilitate development of novel intervention approaches.

"I sometimes feel like I can't win!": An exploratory mixed-methods study of women's body image and experiences of exercising in gym settings

Despite an increase in gym memberships, women are less active than men and little is known about the barriers women face when navigating gym spaces. This study explored women's body image and experiences exercising in gyms. Two-hundred and seventy-nine women (84% current gym-goers; 68.1% White) completed an online mixed-methods survey. Thematic analysis of qualitative data produced four themes and nine subthemes: (1) "Never enough" ([perceived] judgement about appearance, [perceived] judgement about performance); (2) "Often too much" (self-criticism, clothing challenges); (3) "Always on display" (harassment and safety, fighting for space, the appearance contingency); and (4) "Sometimes empowered" (empowering places, empowering self). Qualitative and quantitative data showed that women often feel judged for their appearance and performance, leading to a persistent sense of inadequacy, as well as having to fight for space in the gym and to be taken seriously, while navigating harassment and unsolicited comments from men. Despite this, women showed signs of resistance towards gendered and appearance ideals permeating gym environments and some experienced empowerment through skill acquisition, breaking gender norms, and exercising in supportive environments. Based on our findings, we suggest a multi-level approach to tackling these barriers and creating more inclusive gym spaces for women.

Examining how sociocultural appearance pressures relate to positive and negative facets of body image and eating behaviors in adolescents: An exploratory person-centered approach

The present study explored how patterns of sociocultural appearance pressures were linked to positive and negative facets of body image and eating behaviors in an adolescent sample (N = 438). Latent profile analyses indicated three distinct subgroups of perceived sociocultural appearance-related pressures: a Generalized-Pressure profile (28.8%) (moderate pressure from mother, father, and peers, and relatively high pressure from the media), a High-Media-Pressure profile (38.8%) (low pressure from mother, father, peers, and relatively high pressure from the media), and a Low-Pressure profile (32.4%) (low pressure from all sources). Overall, adolescents in the Generalized-Pressure profile reported a less positive relationship with food and their bodies (i.e., higher internalization of the thin ideal, body dissatisfaction, and bulimia symptoms, and lower body esteem and intuitive eating) than adolescents in the High-Media-Pressure profile, who exhibited poorer outcomes than those in the Low-Pressure profile. These findings highlight the importance of exploring how sociocultural appearance pressures from various sources combine in distinct ways, and how these configurations relate to different aspects of body image and eating behaviors in adolescents.

Psychometric properties of the Chinese version of the body image life disengagement questionnaire in a sample of adolescents

BACKGROUND

The negative consequences of body image concerns manifest in ways such as negative emotional experiences, eating disorders, and problems with social life. The Body Image Life Disengagement Questionnaire (BILD-Q) is an instrument for assessing the impact of body image concerns specifically on adolescents' life disengagement. The objective of this study is to create a Chinese version of the BILD-Q and assess its validity and reliability with Chinese adolescents.

METHODS

A total of 593 adolescents were recruited, of whom 316 (Sample 1) completed only the BILD-Q and 277 (Sample 2) completed the BILD-Q, Eating Attitudes Test (EAT), and Body Appreciation Scale-2 (BAS-2). Data from Sample 1 were used for the item analysis, exploratory factor analysis (EFA), and test-retest reliability, while data from Sample 2 were used for the BILD-Q's confirmatory factor analysis (CFA) and associations of BILD-Q with EAT and BAS-2. Both samples were used together for calculating descriptive statistics, measurement invariance, and internal consistency. EFA and CFA were used to verify the single-factor structure of the BILD-Q. Measurement invariance across genders was verified by multi-group CFA. The reliability of the instrument was verified using Cronbach's alpha and the intraclass correlation coefficient (ICC). Finally, the convergent validity of the instrument was verified by correlating the BILD-Q scores with the EAT and BAS-2 scores.

RESULTS

The results support a single-factor structure for the Chinese version of the BILD-Q, with good reliability (Cronbach's alpha = 0.888, ICC value = 0.759). Gender invariance was established: no significant differences were found in BILD-Q scores between the male and female groups. Life disengagement was positively correlated with eating disorder psychopathology and negatively correlated with body appreciation, supporting the convergent validity of the BILD-Q.

CONCLUSION

The Chinese version of the BILD-Q has strong psychometric properties when used with Chinese adolescents and can be used to assess the impact of body image concerns on their life disengagement.

Borderline Personality Symptoms, Body Modification, and Emotional Regulation

Many people with BPD (borderline personality disorder) experience emotional dysregulation and thus engage in NSSI (non-suicidal self-injury), potentially in the pursuit of emotional regulation. However, research is lacking on whether body modifications (piercings, tattoos, etc.) are linked to BPD in a similar way to NSSI. In the current study, we hypothesized (1) that body modifications are associated with BPD symptoms, (2) that emotional regulation and self-expression motivations for body modifications specifically account for variance in BPD symptoms, and (3) that NSSI craving correlates with body modification craving. Participants (N = 199, ages 18-67, located in the USA) were surveyed on BPD symptomatology, NSSI craving, emotional regulation abilities, and the presence of body modifications. The extent of tattooing (number of tattoos and percentage of body surface covered) was not significantly associated with BPD symptomatology, but the number of piercings was. Individuals with higher BPD symptomatology were not more likely to report emotional regulation and self-expression as motivations for obtaining body modifications. NSSI craving scores were significantly positively correlated with body modification craving scores. Body modification may be an alternative method of emotional regulation to NSSI in individuals with BPD, which clinicians may want to consider when treating those with BPD and NSSI.

The role of negative evaluation fears on associations between societal appearance pressures and disordered eating in university students

Objective: Previous research demonstrates that sociocultural appearance pressures and internalization of appearance ideals lead to disordered eating (DE); however, only a subset of individuals exposed to these influences develop clinically significant DE. Identifying moderators of these associations may increase efficacy of targeted preventions for eating disorders. This study investigated whether the fear of negative evaluation (FNE) moderates these associations. Participants: 567 university students participated between November 2019 and 2020. Methods: Participants completed self-report questionnaires assessing appearance pressures, internalization of appearance ideals, FNE, and DE. Results: There was a significant interaction between appearance pressures and FNE in relation to DE. Individuals with high appearance pressures and high FNE had the highest levels of DE. The interaction between internalization of appearance ideals and FNE did not significantly contribute to DE. Conclusions: Eating disorder prevention programs that address FNE and appearance pressures may have beneficial effects, particularly for university students with heightened FNE.

What can my body do for me? Guided body-functionality mirror gazing task improved college women's body appreciation and body functionality orientation

Objective: Focusing on body functionality - what the body can do - may benefit women's body image. This pilot study examined the effects of focusing on body functionality appreciation during an audio-guided mirror gazing task (F-MGT). Participants: 101 college women, M(SD)AGE = 19.49(1.31), were alternately assigned to F-MGT or a comparison with no guidance on how to examine the body, directed attention mirror gazing task (DA-MGT). Methods: Participants self-reported pre- and post-MGT body appreciation, state appearance satisfaction, and orientation to and satisfaction with physical functionality. Results: Group interactions were significant for body appreciation and functionality orientation. DA-MGT decreased body appreciation from pre- to post-MGT; F-MGT did not change. There were no significant interactions in post-MGT state appearance satisfaction or functionality satisfaction, though state appearance satisfaction increased significantly in F-MGT. Conclusions: Integrating body functionality may buffer against harmful effects of mirror gazing. Given F-MGT's brevity, additional work must assess its potential as an intervention technique.

Body image distress and disordered eating among gay and straight men from Greece and Cyprus

Sociocultural factors play a significant role in the development of body image distress and disordered eating behavior in diverse populations, including men. One group which seems to be at increased risk, is sexual minority men. However, these factors have rarely been studied outside of Western populations. The present study sought to explore these factors in Greek and Greek-Cypriot men. Greek and Greek-Cypriot men (N = 367; n = 162 gay; n = 205 straight) completed measures of sociocultural pressures, appearance comparisons, body dissatisfaction, body appreciation and disordered eating. Results indicated that gay men were more likely to have disordered eating habits than straight men. Additionally, gay men had significantly lower scores on measures of body-image related wellbeing (i.e. satisfaction and appreciation), and higher on measures of societal pressures and appearance-related comparisons, appearance-related anxiety and disordered eating. Greek and Greek-Cypriot gay men had lower levels of muscularity internalization than straight men. Our findings extend research on body image distress and disordered eating in gay and straight men to Greek and Greek-Cypriot populations.

Exploring body ideal internalization, sociocultural pressures, and probable muscle dysmorphia in Canadian and American boys and men

This study aimed to determine whether the internalization of body ideals and sociocultural pressures to adhere to body ideals are associated with a greater likelihood of having probable muscle dysmorphia. Cross-sectional data from 1553 boys and men ages 15-35 from Canada and the United States were used. Multiple logistic regression analyses determined the association between the internalization of three body ideals, sociocultural pressures to adhere to body ideals from four sources, and having probable muscle dysmorphia. The odds of having probable muscle dysmorphia were significantly greater for those who internalized the muscular ideal and general attractiveness ideal. Conversely, endorsing the thin/low body fat ideal was significantly associated with lower odds of having probable muscle dysmorphia. Pressure from peers, but no other sources, showed a significant association with greater odds of having probable muscle dysmorphia. Findings expand prior research by investigating correlates of muscle dysmorphia versus muscle dysmorphia symptomatology. The strong association with internalization of the general attractiveness ideal provides new insights into how overall appearance may be highly relevant for boys and men with muscle dysmorphia, warranting future investigation.

The healthy eating movement on social media and its psychological effects on body image

Introduction

The present study aims to investigate the relationship between social-media pressure, the tendency to internalize standards of beauty and attractiveness associated with thin bodies, which subsequently leads to distortion of body shape perceptions, and restrictive and emotional eating behavior disorders.

Methods

A survey-based research design was employed, utilizing an online questionnaire to collect data. The study sample consisted of 614 students, selected from the most prestigious universities in Bucharest. The questionnaire incorporated validated scales measuring Socio-Media Pressure for a Thin Body Image (SMPTB), Body Appreciation (BA), Body Shape Perception (BSP), Restrained Eating Behavior (REB), and Emotional Eating Behavior (EEB).

Results

The results confirmed the hypotheses of the research, meaning food restrictions are a way to diminish the level of dissatisfaction with body shape, to reduce the difference between the ideal body shape and the real one. Food restrictions are perceived as natural behaviors, appropriate to support the standards of beauty and attractiveness specific to this historical stage. Emotional eating disorders emerge as a way to compensate for the discomfort generated by low body esteem.

Discussion

The results underscore the pervasive influence of social media in shaping eating behaviors and body image perceptions. Food restrictions, framed as natural responses to societal pressures, highlight the need for interventions addressing the normalization of harmful beauty standards. Emotional eating behaviors reveal the psychological toll of body dissatisfaction, emphasizing the importance of strategies to foster positive body image and mental well-being. These findings provide a foundation for developing educational campaigns and therapeutic approaches targeting the psychological impact of social media on eating behaviors.

Association Between Emotion Regulation and Body Image Concerns in a Group of Adolescent Boys: Interaction With the Internalization of the Sociocultural Body Ideal

This study examined the relationships of sociocultural body ideal internalization, difficulties in emotion regulation, and their interaction with body image concerns in a group of 423 Canadian adolescent boys. Participants were 12 to 17 years old and completed multiple self-reported questionnaires. Regression analyses and latent moderation structural equations were performed. Both variables were positively correlated with body dissatisfaction, drive for muscularity, restrained eating, and emotional eating. The internalization of men's sociocultural body ideal moderated the relationships between multiple difficulties in emotion regulation and some body image concerns. These results are in line with findings of other studies among adult men and women, and dominant theories of body image concerns, which have been derived especially from women populations.

Social media and body image: Relationships between social media appearance preoccupation, self-objectification, and body image

Nearly 85 % of emerging adults report using at least one social media site. Research suggests that viewing and internalizing unrealistic body ideals often displayed online may pose harmful effects on young people's body image. However, studies on the relationships between social media usage and body image have predominantly focused on women's drive for thinness. We sought to explore the relationships between social media appearance-related preoccupation (SMARP), body shame and surveillance, and drives for leanness, muscularity, and thinness, specifically examining the moderating role of gender within these relationships. Data from 939 undergraduate students (n = 240 men) were analyzed using multigroup structural equation modeling. Surveillance significantly mediated the positive associations between SMARP and drive for leanness for women and men. For SMARP and drive for muscularity, surveillance was a mediator for men only. Shame emerged as a significant mediator of the positive association between SMARP and drive for thinness for women and men. Moderated mediation was supported, such that the indirect effect of SMARP on drive for thinness was significantly stronger for women. These results suggest that for men in particular, SMARP is not necessarily associated with increased drives for leanness and muscularity unless men are also engaging in body surveillance.

Understanding what drives adolescent social media behaviours: Informing approaches for interventions

While much research has explored the impacts of social media use, less is known about what factors drive use. The present study examined the relationships between potential drivers of social media use; namely social media literacy, motivations, and internalisation of appearance ideals, and determined whether they work in combination or individually to predict a range of social media uses and behaviours over time, including intensity, frequency, exposure to fitness and celebrity content, photo editing, appearance comparisons, and types of use. Australian adolescent girls (n = 704) and boys (n = 938) aged 11-16 years completed online surveys at baseline and 6-month follow-up. Bivariate correlations and multiple regressions were performed separately by gender. Results revealed weak associations between drivers and found they uniquely contributed to social media behaviours, though this was dependent on use outcome. Thin- and muscular-internalisation were related to some appearance-focused use (e.g., comparisons, following celebrity and fitness accounts) among girls and boys, respectively. Critical thinking was associated with lower Snapchat use among boys and motivations were related to intensity and type of use (i.e., viewing, posting). These findings suggest multicomponent holistic interventions targeting numerous drivers may be most appropriate in modifying social media behaviours among adolescents.

Translation and psychometric properties of an Italian version of the Body Acceptance by Others Scale-2 (BAOS-2)

The 13-item Body Acceptance by Others Scale-2 (BAOS-2) measures generalised perceptions of body acceptance by others. Here, we examined the psychometric properties of a novel Italian translation of the BAOS-2. Studies 1 (N = 401) and 2 (N = 393) supported a unidimensional model of the Italian BAOS-2 with all 13 items retained through exploratory and confirmatory factor analysis, respectively. Study 2 also supported measurement invariance of the Italian BAOS-2 across gender identity, with the gender difference in observed scores not reaching significance. In Study 3 (N = 365), we supported the construct validity of the Italian BAOS-2. Specifically, we found evidence of convergent validity (significant associations with indices of positive body image), criterion-related validity (significant associations with pressure to conform to appearance ideals and psychological well-being), and incremental validity (body acceptance predicted body appreciation over-and-above appearance-related pressure). These results suggest that the psychometric properties of the Italian BAOS-2 are robust and that this instrument can be confidently utilised in future research with Italian adults.

Isolating the effects of body size and sexualisation in social media images on body image-related constructs among young women

This study systematically separated the effects of body size and sexualisation in social media images on women's body image. Young women (18-25 years, N = 194) viewed 10 social media images of either (1) sexualised women in larger bodies; (2) non-sexualised women in larger bodies; (3) sexualised women in smaller bodies; or (4) non-sexualised women in smaller bodies. Participants completed pre- and post-exposure measures of body image and related constructs. Thin ideal internalisation was examined as a moderator of those effects. The body size of the women in the images was more influential than how sexualized their bodies were presented. Regardless of sexualisation, viewing images of women with smaller bodies was negative for appearance satisfaction, negative mood, and body appreciation, and viewing women with larger bodies was positive for body appreciation and neutral for appearance satisfaction and mood. The impact of body size on appearance satisfaction was stronger for those high in thin ideal internalisation. Women with larger bodies were perceived more positively than those with smaller bodies. However, participants' self-objectification increased in all conditions. Thus, while viewing images of women with larger bodies provides promise for improving social media, further research is needed before it is recommended broadly.

Digital body image interventions for adult women: A meta-analytic review

Although many women experience body dissatisfaction, treatment options that prevent the onset of more serious conditions are limited in accessibility. As such, digital interventions may be an appropriate alternative resource to address restricted treatment options. This study provides statistical syntheses of the evidence for digital body image interventions for non-clinical adult women. A systematic literature search identified 19 studies (N = 2424) that tested the effect of a digital body image intervention compared to a control condition. Study results were synthesised using random effects models, and small to medium statistically significant effect sizes indicated that digital interventions were beneficial in increasing overall global satisfaction (g = 0.43) and reducing cognitive body dissatisfaction (g = 0.36). These meta-analytic findings provide evidence for the efficacy of digital body image interventions for non-clinical adult women. Intervention type was not found to be a statistically significant moderator, which may suggest that a range of intervention types can produce similar reductions in body dissatisfaction. Overall, digital body image interventions may be a feasible option to alleviate body dissatisfaction, particularly for women who may be unable to access conventional treatment.

Sociocultural attitudes towards appearance questionnaire-4-revised (SATAQ-4R): validation in a community sample of Norwegian adolescents

BACKGROUND

Negative body image and disordered eating are common among adolescents and young adults. The Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised (SATAQ-4R) captures the internalization of societal appearance ideals and perceived pressures from others but has not been validated in a Norwegian adolescent population.

METHODS

The current study explored the factor structure of SATAQ-4R in a sample of adolescent Norwegian males and females (n = 1558, mean age 17.04 ± 0.95) using confirmatory factor analysis (CFA) for a 6- and 7-factor structure in females, and a 7-factor structure in males. Correlations between subscales, internal consistency and reliability, and comparisons with convergent measures (disordered eating, body mass index, negative influence of social media) were explored.

RESULTS

The CFA supported a 7-factor structure of the SATAQ-4R for both males and females. Internal consistency and reliability were acceptable. SATAQ-4R subscales largely correlated with disordered eating and additional convergent measures.

CONCLUSIONS

Results confirm the structure and reliability of the SATAQ-4R in a Norwegian adolescent population. The subscales showed good convergent validity, and high scores on internalization and societal pressures were related to higher levels of disordered eating and negative social media influence. The Norwegian version of the SATAQ-4R thus demonstrates good psychometric properties in adolescent males and females, and is well suited to capture internalization and sociocultural pressures that particularly affect adolescents. Results highlight the need to continue working towards reducing adverse internalization and improving body image among adolescents.

The 'ideal' dancer: An investigation into predictors of body image dissatisfaction among male dancers, female dancers and their non-dancing counterparts

Body image dissatisfaction is consistently highlighted as a precursor for eating disorders, arising from several factors. One factor surrounds social expectations of being thin, which can be emphasised in certain physical activities, like dance. Whilst research is available for body image dissatisfaction among female dancers, literature has neglected the male demographic. The present study investigated seven predictors of body image dissatisfaction within male and female dancers, from a variety of genres. The study employed a non-experimental quantitative method, utilising an independent groups correlational design. The role of clothing practices, body ideal internalisation and sociocultural influences were investigated as predictors for body image dissatisfaction. Data from 180 participants (mean age = 23.7, SD = 7.51) was analysed from an online survey. Hierarchical multiple regression revealed that the model consisting of all predictors significantly accounted for over 60% of variance in body image dissatisfaction scores within all independent groups. The individual contribution of predictors differed between groups, with clothing practice being the only significant predictor in all four groups. Media pressure was a significant predictor within non-dancer groups only. This research highlights the importance of clothing practices, specifically tight-fitting garments within the dance environment and general population. Future research should investigate potential differences in the predictors between each level of dance.

A pilot study of a virtually delivered dissonance-based eating disorder prevention program for young women with type 1 diabetes: within-subject changes over 6-month follow-up

INTRODUCTION

In an uncontrolled study, we previously demonstrated the feasibility and preliminary efficacy of our virtual diabetes-specific version (Diabetes Body Project) of the eating disorder (ED) prevention program the Body Project. The aim of the current study was to evaluate further this program for women with type 1 diabetes (T1D) by assessing within-subject changes in outcomes from pretest over 6-month follow-up.

METHODS

Young women with T1D aged 16-35 years were invited to participate in Diabetes Body Project groups. A total of 35 participants were allocated to five Diabetes Body Project groups (six meetings over 6 weeks). Primary outcome measures included ED risk factors and symptoms, and secondary outcomes included three T1D-specific constructs previously found to be associated with ED pathology: glycemic control as measured by HbA1c level, diabetes distress, and illness perceptions.

RESULTS

Within-subject reductions, with medium-to-large effect sizes, were observed for the primary (ED pathology, body dissatisfaction, thin-ideal internalization, and appearance ideals and pressures) and secondary outcomes (within-condition Cohen's ds ranged from .34 to 1.70).

CONCLUSION

The virtual Diabetes Body Project appears to be a promising intervention worthy of more rigorous evaluation. A randomized controlled trial with at least a 1-year follow-up is warranted to determine its efficacy compared to a control condition.

Enhancing understanding of social media literacy to better inform prevention of body image and eating disorders

Research has revealed an important role for appearance-focused, and in particular photo-based, social media in the development of body image and eating pathology. Social media literacy is a multifaceted construct involving purposeful selection and exposure to social media content and use of protective filtering (deliberately screening and interpreting information in a protective manner), as well as implementing critical skills related to understanding the unrealistic nature of social media content, limiting appearance comparisons with images, and contributing to social media (comments and images) in ways that limit the pursuit of appearance ideals. Previous work has provided partial support for these facets as related to lower levels of body image and eating concerns. However, additional conceptual and measurement work is needed to advance understanding of this protective role and how to foster social media literacy. Although data are scarce, targeting social media literacy in prevention and intervention programs may also be valuable. In this perspective piece, key features that we identify as priorities for future prevention and intervention efforts include developing interventions that target the implementation of social media skills beyond their acquisition. In addition, leveraging social media user generated content for prevention purposes would likely be useful, as would embedding micro-skill delivery within platforms.

Differences in Thinness- and Muscularity-Oriented Eating and Body Image Disturbances and Psychosocial Well-Being in Chinese Sexual Minority Men Reporting Top, Bottom, and Versatile Sexual Self-Labels

In addition to describing sexual partner preferences, sexual self-labels in gay and bisexual (henceforth, sexual minority) men, such as top, bottom, and versatile, are associated with psychological characteristics (e.g., gendered personality traits). No research has explored the association between sexual self-labels and eating and body image disturbances in sexual minority men. Research in sexual minority men from China is particularly valuable and needed due to recent rises in rates of eating and body image disturbances and unique, minority-specific stressors experienced by Chinese sexual minority populations. We adopted an online, cross-sectional study in a sample of sexual minority men from China (N = 403; tops, n = 256, bottoms, n = 95, versatiles, n = 52). Bottoms reported higher thinness internalization, lower muscularity internalization, higher body fat dissatisfaction, and higher psychological distress than tops. Bottoms' weight bias internalization was higher than tops' and versatiles' reports and, compared to versatiles, bottoms also reported higher psychosocial impairment related to eating disorder psychopathology. Compared to versatiles, tops reported higher drive for muscularity and muscularity-oriented disordered eating. Adjusting for age, psychological distress, and psychosocial impairment, tops reported higher muscularity internalization than bottoms and higher drive for muscularity and muscularity-oriented disordered eating than both bottoms and versatiles. Findings suggested unique relations between sexual self-labels and eating and body image disturbances in Chinese sexual minority men. Replication and validation of the temporal order between sexual self-labels and eating and body image disturbances is needed, including assessment of social factors (e.g., femmephobia, minority stress) that may help explain the links between sexual self-labels and eating pathology.

Social cure model: testing the link between identity centrality and body appreciation in diverse sexual orientation and gender identity groups

BACKGROUND

The level of experienced sociocultural pressure to have an idealized body can vary depending on a person's gender identity and sexual orientation. The current study explored whether differences in levels of body appreciation among people with different sexual orientations and gender identities vary because of differing levels of experienced pressure by in-group members and varying levels of experienced hostile behaviors because of their looks or body. Thereby, the study tests the social cure model, according to which high levels of identity centrality are associated with better mental health.

METHODS

An online cross-sectional questionnaire study was conducted with 1,587 people (51.3% cisgender women, 39.3% cisgender men, 9.5% non-binary; 52.9% identified as heterosexual, 27.7% identified as bisexual/pansexual, 11.2% identified as gay/lesbian, 8.2% identified as asexual/demi/queer; Mage = 32.9, SD = 12.6) from German-speaking countries. Variables were assessed with German-language versions of the Multidimensional and Multicomponent Measure of Social Identification, Body Appreciation Scale-2, the Perceived Stigmatization Questionnaire, and the Sociocultural Attitudes Towards Appearance Questionnaire-4, revised. A manifest-path model was calculated.

RESULTS

Non-binary persons reported lower levels of body appreciation than did cisgender men and sexual minority persons reported lower levels of body appreciation than did heterosexual persons. Furthermore, sexual minority persons experienced more hostile behaviors directed towards them because of their looks or body than did heterosexual persons. Similarly, non-binary persons experienced more hostile behaviors than did men. Non-binary persons were subjected to lower levels of in-group pressure than were men. Gay/lesbian persons and asexual persons were subjected to lower levels of in-group pressure than were heterosexual persons. More hostile behaviors and stronger in-group pressure were related to lower body appreciation. In cisgender women and men indirect links revealed associations between strong identity centrality and low levels of body appreciation through the mediator of high in-group pressure.

CONCLUSIONS

Data in sexual minority individuals or non-binary persons supported the social cure model, according to which persons can find support and validation for their looks and body from in-group members. In cisgender women and men, strong identification as a woman or man can be related to stronger in-group pressure and in turn to lower body appreciation.

Integrating social media, body shame and psychological distress within the Elaborated Sociocultural Model

The Elaborated Sociocultural Model proposes exposure to sociocultural appearance pressures increases women's internalisation of the thin ideal, their engagement in social comparison and body surveillance, and subsequent body dissatisfaction and disturbances in eating (Fitzsimmons-Craft et al., 2011). Although this model has received some empirical support, it is limited in that it does not currently account for social media as a contemporary source of appearance pressure, nor include additional known outcomes of thin ideal internalisation (i.e., body shame, psychological distress). The current study tested the integration of these variables within the Elaborated Sociocultural Model. Using structural equation modelling with latent variables, the extended model provided acceptable to good fit to the data in a sample of 271 female participants. A latent variable representing sociocultural appearance pressures originating from social media, traditional media, family and peers was found to significantly predict thin ideal internalisation and body image concerns. Furthermore, both social comparison and body surveillance emerged as indirect mediators of the relationship between thin ideal internalisation and body image concerns, which in turn, increased report of restrained eating and psychological distress. Aligning with previous research, this extended model offers a useful and comprehensive framework for investigating women's body image.

Dissonance-Based Eating Disorder Prevention for Body-Dissatisfied Brazilian Cisgender Gay and Bisexual Men: A Randomized Controlled Trial With a 1-Year Follow-Up

OBJECTIVE

Gay and bisexual men are at an increased risk for eating disorders (EDs) and muscle dysmorphia (MD) compared with their heterosexual counterparts. Existing dissonance-based (DB) EDs prevention programs for this population have been evaluated in the United States; however, these programs have not been evaluated in the Brazilian context. Thus, we investigated the feasibility, acceptability, and efficacy of a DB ED prevention program (i.e., the PRIDE Body Project) among Brazilian cisgender gay and bisexual men.

METHOD

Eligible men were randomly assigned to either a DB intervention (n = 74) condition or an assessment-only control (AOC) condition (n = 75). Participants completed measures assessing ED and MD risk and protective factors at baseline, post-intervention, 1-month, 6-month, and 1-year follow-up. Those in the intervention condition also completed acceptability measures.

RESULTS

Feasibility and acceptability ratings were highly favorable. Regarding efficacy, post-intervention results were not significant, except for self-objectification, which showed a significantly greater decrease in the DB condition compared with the AOC condition at all time-points of follow-ups (Cohen's d = -0.31 to -0.76). At follow-up, the DB condition showed significantly greater decreases in appearance-ideal internalization, drive for muscularity, self-objectification, ED and MD symptoms at 1-month, 6-month, and 1-year follow-ups (d = -0.33 to -0.92) compared with the AOC condition. Significant increases were observed in the DB compared with the AOC condition for body appreciation at 1-month, 6-month, and 1-year follow-ups (d = 0.31-0.81).

DISCUSSION

Results support the feasibility, acceptability, and efficacy of the PRIDE Body Project up to 1-year in Brazilian cisgender gay and bisexual men.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials (ReBEC; available at http://www.ensaiosclinicos.gov.br/) number of registration: RBR-62fctqz.

The correlates of appearance focused self-concept: personality traits, self-concept, sociocultural, and early life experience factors

BACKGROUND

Theory and research indicate that an appearance focused self-concept (i.e., placing overriding importance on physical appearance for self-definition and self-worth) plays a role in the etiology and maintenance of disordered eating and eating disorders. Although the consequences of an appearance focused self-concept are palpable, less is known about its correlates. Accordingly, we examined a range of factors that may characterize appearance focused people, including personality traits (perfectionism, impulsivity, sensation-seeking, hopelessness, and anxiety sensitivity), self-concept (global self-esteem and self-concept clarity), sociocultural (thin-ideal, muscular-ideal, general attractiveness internalizations, and perceived pressure to be thin), and early life experiences (adverse childhood experiences, attachment styles) factors.

METHODS

Female undergraduate university students (N = 568; Mage = 19.58, SDage = 4.24) completed a questionnaire battery that included the Beliefs About Appearance Scale, Depressive Experiences Questionnaire-Self-Criticism-6 Scale, Frost-Multidimensional Perfectionism Scale, the Revised Almost Perfect Scale, Substance Use Risk Profile Scale, Self-Concept Clarity Scale, Rosenberg Self-Esteem Scale, Sociocultural Attitudes Towards Appearance Questionnaire-4 Scale, Adverse Childhood Experiences Questionnaire, Experiences in Close Relationships Scale Short Form, and the Dietary Restraint subscale of the Eating Disorders Examination Questionnaire.

RESULTS

Multiple regression analyses were conducted for each set of factors separately and together. For personality traits, perfectionism, impulsivity, and anxiety sensitivity were uniquely associated with appearance focused self-concept. For self-concept, global self-esteem and self-concept clarity were uniquely associated with appearance focused self-concept. For sociocultural, general attractiveness internalization, thin-ideal internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. For early life experiences, attachment anxiety and avoidance were uniquely associated with appearance focused self-concept. In the combined analysis, the various factors explained 54% of the variance in appearance focused self-concept. Impulsivity, global self-esteem, general attractiveness internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept.

CONCLUSIONS

Results for global self-esteem were consistent with prior research. Findings for evaluative concerns perfectionism were inconsistent with prior research. We discuss future research directions to examine the link between evaluative concerns perfectionism and appearance focused self-concept. We also discuss how sociocultural factors (general attractiveness internalization and perceived pressure to be thin) and impulsivity may help cultivate an appearance focused self-concept, advancing knowledge on the characteristics of appearance-focused people.

The relationship between anabolic androgenic steroid use and body image, eating behavior, and physical activity by gender: A systematic review

The prevalence of anabolic androgenic steroids (AAS) is rising, especially in recreational sports and the general population. While body image significantly influences AAS use, gender differences remain unclear. We examined gender-related connections between AAS use, body image, eating behavior, and physical activity. Following PRISMA guidelines, we analyzed 22 studies: 14 with male-only samples, 5 mixed-gender, 2 with sexual and gender minorities, and 1 with a female-only sample. FINDINGS: confirm body image as a key predictor of AAS use. Though AAS use correlates with eating disorders, outcomes vary by context; for instance, no discernible difference in eating behavior was observed between AAS users and non-users in bodybuilding. Physical activity findings varied, with some studies showing no significant differences between AAS users and non-users. Due to limited gender-comparison studies, conclusive gender-related differences cannot be drawn. This systematic review underscores the complex interplay between AAS use, body image, eating behavior, and physical activity, emphasizing the necessity for further research to develop targeted interventions for diverse populations, addressing AAS-related concerns and promoting overall well-being.

Exploring the associations between muscularity teasing and eating and body image disturbances in Chinese men and women

This study described muscularity teasing in both men and women and explored its associations with eating and body image disturbances in adults from China. A total of 900 Chinese adults (50% women) were recruited online. Correlation and regression analyses were conducted to examine the relationships between muscularity teasing and a battery of measures on eating and body image disturbances. Gender differences in the associations were examined. Men reported more muscularity teasing than women (31.6% men vs. 15.6% women; χ2(1,N = 900) = 31.99, p < .001). Muscularity teasing was significantly and positively correlated with all measures in both men and women. Muscularity teasing explained significant, unique variance in all measures for men and women, except for body fat dissatisfaction in women, beyond covariates (i.e., age, body mass index, and weight teasing). The relationships between muscularity teasing and eating and body image disturbances were generally stronger in men than women. Findings further suggest that muscularity teasing is an important factor related to eating and body image disturbances in men and women, but muscularity teasing might be more detrimental to men's eating behaviors and body image. Future research is needed to further explore the directionality and mechanisms of the links between muscularity teasing and eating and body image disturbances.

Communicating Extremity: Fitness Efficacy and Standards Relate to Using Extreme Imagery and Messaging to Create Fitness-Related Media

Health-related social media increasingly competes with other forms of health communication for public attention. To advance understanding of the genesis of health-related social media communicating extreme fitness standards, we investigated women's creation of fitspiration, social-media content combining fitness images with effortful messages. In a pre-registered study, we hypothesized that creating extreme fitspiration content would relate positively to fitness fantasizing and to exercise self-efficacy, fitness perfectionism, physical activity, thin- and muscular-ideal internalizations, and self-objectification. Undergraduate women (N = 277) created their own fitspiration content by selecting from fitness images and messages that varied in extremity. Fitness fantasizing related positively to creating more extreme fitspiration. When controlling statistically for all other individual-difference variables, exercise self-efficacy and perfectionistic strivings emerged as key variables associated with creating extreme fitspiration content. Results suggest that women who are confident and strive toward challenging goals may create fitspiration content that communicates extreme standards. This work has implications for understanding a potential disconnect between fitspiration creators and consumers, which may illuminate ways to promote healthy fitness communications online.

A sociocultural model of the relationships between social media use and body image in midlife women

The use of photo-based social media has been associated with body image concerns among young women. Women in midlife are increasingly experiencing appearance pressures, and these pressures might be particularly strong on social media. However, to date, most of the research on social media use has focused on younger women, and this constitutes an important gap. The purpose of this study was therefore to examine a model of the relationships among social media use and body image among women aged 40 and over. A convenience sample of 192 women aged 40-73 years completed an online survey assessing selfie investment, social media appearance pressures, thin-ideal internalization, appearance comparison, weight and shape concerns, facial satisfaction, drive for youthfulness and drive for muscularity. The final sociocultural model was a good fit to the data, and thin-ideal internalization and appearance comparisons mediated the pathways between the social media variables and the body image ones.

Identifying methods used to manage weight and shape by first year university students: A qualitative analysis

OBJECTIVE

To identify current strategies used by first-year university students to lose weight, maintain weight, or change their body shape.

METHODS

First-year university students (n = 661) completed an open-ended, web-based survey. Cross-sectional data were analyzed qualitatively using a reflexive thematic approach to identify strategies used to lose weight, maintain weight, or alter body shape/composition. Thematic maps were constructed for each weight- and shape-related goal.

RESULTS

Four main types of strategies were used to achieve all three weight or shape-related goals among first-year college students: changes in diet, changes in exercise, self-monitoring, and disordered eating. One behavioral strategy observed across all weight-related goals was prioritizing protein consumption, including protein gained from supplementation. However, there were also differences in strategies by weight- or shape-related goal. For example, only participants aiming to lose or maintain weight reported mindful strategies for monitoring diet. Individuals aiming to alter body composition reported heterogeneity in goal-related intentions, targeting specific body parts through exercise, and extensive supplement use.

CONCLUSIONS

First-year college students use a variety of strategies to manage their weight and shape. Some strategies were observed across goals, whereas others are specific to the weight- or shape-related goal. More research is needed to understand the impacts, both positive and negative, of using the strategies identified in the present study.

Strike a pose: Immediate effects of a model-created social media literacy video on body image and mood

Exposure to idealized social media imagery has been shown to be detrimental to body image among young women, and social media literacy may be protective. This mixed methods study aimed to evaluate the effects of an online video narrated by a high-profile, plus-size model on the body image and negative mood of young women and predictors of the effects. A sample of 304 young women, average age 20.95 (SD = 2.09) years, completed an online survey including pre- and post-exposure measures of state body image and negative mood, and trait measures of upward social media appearance comparison, thin-ideal internalization, and selfie-investment. A subset (n = 148) responded to open-ended questions to obtain feedback on the video coded categorically and through thematic analysis. Findings revealed immediate improvements in state body satisfaction and negative mood, with higher levels of trait appearance comparison and selfie investment associated with smaller effects of the video. Participants endorsed the video as raising awareness of unrealistic images but limited in terms of mitigating appearance comparison and selfie-investment. Furthermore, participants described that Iskra's status as a professional model also influenced their reactions. These findings highlight the importance of assessing for unintended paradoxical effects of social media literacy efforts and ensuring that such interventions are empirically based.

Dissemination of a dissonance-based body image promotion program for mothers and daughters in church settings: A controlled pilot study of Reclaiming Beauty

This proof of concept, controlled pilot study expands on existing dissonance-based body image promotion programs by testing a modified version of the Body Project for 136 mothers and daughters aged 11-18 years old in church settings called Reclaiming Beauty. Mothers (n = 30) and their daughters (n = 35) who participated in Reclaiming Beauty were compared to mothers (n = 32) and daughters (n = 39) in a waitlist, assessment-only, control group on body image, eating psychopathology, and risk factor measures (thin-ideal internalization, physical appearance comparison) at pre-, post-, and 6-month-follow-up assessments. Intent-to-treat, multilevel modeling indicated that mothers and daughters in the Reclaiming Beauty group experienced significant improvement in body appreciation, body shape concerns, eating psychopathology, thin-ideal internalization, and physical appearance comparison over a six-month period compared to control participants. Changes in thin-ideal internalization and appearance comparison did not predict body image and eating psychopathology at follow-up. Baseline levels of body satisfaction did not moderate the effect of the program, except for its effect on body shape concerns. Findings provide preliminary support for delivering a dissonance-based body image promotion intervention to mothers and their daughters and the feasibility of leveraging the mother-daughter relationship as well as delivering interventions in church settings.

Sociocultural pressures and body related experiences during pregnancy and the postpartum period: A qualitative study

Sociocultural pressures to pursue unrealistic appearance expectations and control body shape and weight during pregnancy and postpartum periods have been increasing. Little is known about messages from different sources that may constitute unhelpful or protective influences. The aim of this study was to qualitatively examine messages women received from the sociocultural environment during pregnancy and postpartum and their association with experiences of living in their bodies and body change behaviors. Twenty women, mean age (SD)= 31.85, (2.3) years, 95% White, 60% with a Master's degree or higher, participated in individual interviews and completed online surveys. Women described appearance pressure from multiple sources during and after pregnancy, that increased their concerns related to their weight and shape. For a small number, these concerns were associated with efforts to control weight. Others described protective influences from friends and family that promoted body attunement, functionality appreciation, and positive body image. Findings highlight the importance of sociocultural influences during the peripregnancy period yet how many women derive elements of positive body image from this period. These findings have implications for interventions to support body image among women during the peripregnancy period and positive outcomes among mothers and infants.

#mybestmidlife: Profiles of photo-based social media use and body image among midlife women

Empirical data, predominantly from young women, suggest photo-based social media use is associated with greater body dissatisfaction. The present study aimed to extend these findings to midlife women and identify risk profiles for maladaptive appearance-focused social media use. A convenience sample of female Instagram users aged 40 or over (M= 50.92 years) (n = 192) was collected. Most participants were partnered, white, highly educated, and heterosexual. A cluster analysis in cross-sectional data grouped participants into four categories according to body image indices (following body positive or fitness accounts, body appreciation and dissatisfaction, thin and muscular ideal internalization, and appearance comparison). Differences by cluster emerged according to indices of social media use (e.g., photo editing, social media rumination), although following appearance-related content across types seemed to distinguish risk profiles more than the types of appearance-related content engaged with (i.e., body positive vs fitness). Furthermore, results indicated that higher social media use was associated with greater perceived negative effects of social media, suggesting that awareness alone may be insufficient to reduce behavioral risk. Findings indicate that some midlife women who use photo-based social media may be at high risk for appearance concerns, warranting further research and resource development for this group.

Adolescent Females' Dyadic Conversations About Body, Weight, and Appearance

Body talk among adolescent females has been associated with negative outcomes, including depressed mood, disordered eating, and body dissatisfaction. Yet, little work has investigated the manifestation of body talk in actual conversations between adolescent females or explored pathways through which body talk is spread (e.g., co-rumination). The present study examined body talk among adolescent female dyads (N = 23 dyads) ages 13 to 17 (Mage = 15.12) using an observational design. Reciprocally nominated dyads were recruited from a high school in the southeastern United States. Conversations between dyads were qualitatively coded using an applied thematic analysis approach. Identified themes were related to weight, appearance, and personality. Results provide insight into the social context in which sociocultural norms of weight stigma, body dissatisfaction, and eating-related psychopathology may be reinforced. Findings have implications for informing the development of interventions to reduce co-rumination of negative weight- and appearance-related body talk and to promote positive body image and healthy weight among adolescent girls.

Retouched or Unaltered? That is the Question. Body Image and Acceptance of Cosmetic Surgery in Young Female Instagram Users

BACKGROUND

Viewing Instagram altered images of attractive women has negative effects on women's body image. This study examined the effects of exposure to a 'before' and 'after' retouched image, in combination with a disclaimer, on female Instagram users' thin-ideal internalization, body dissatisfaction and acceptance of cosmetic surgery.

METHODS

An experimental design with a control group without pretesting was adopted. Participants (N = 105) were randomly assigned to one of three groups: Group 1 was exposed to a replica of an Instagram post with an enhanced image of a woman; Group 2 was shown the same enhanced image and the original one in combination with a disclaimer that the enhanced image had been digitally edited; Group 3 (the control) was exposed to a neutral image.

RESULTS

The MANOVA showed that participants in Group 2 reported lower levels of thin-ideal internalization and acceptance of cosmetic surgery for social reasons compared to those in Group 1. Contrary to our hypothesis, the degree of body dissatisfaction was not significantly different among the three groups.

CONCLUSIONS

The present study could be promising for the development of brief interventions aimed at reducing the negative effects of Instagram exposure on young women's body image.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Self-awareness and Social Influences as Predictors of Body Dissatisfaction and Acceptance of Cosmetic Surgery for Social Reasons Among Men

BACKGROUND

Body dissatisfaction and the use of surgery for purely aesthetic reasons among men is steadily increasing. Nevertheless, compared to women, few studies have focused on specific sociocultural and individual factors predicting men's body dissatisfaction and interest in cosmetic surgery procedures. The present study investigated the role of media, significant others, public and private self-awareness in predicting men's body dissatisfaction and acceptance of cosmetic surgery for social reasons.

METHODS

Participants were 203 men (mean-age 24 years), who completed a questionnaire containing the Sociocultural Attitudes Toward Appearance Questionnaire-4R, the Situational Self-Awareness Scale, the Muscular internalization subscale, the Male Body Attitudes Scale, and the Social subscale of the Acceptance of Cosmetic Surgery Scale. A path analysis was performed.

RESULTS

The influence of significant others and public self-awareness predicted men's body dissatisfaction directly and indirectly, via muscularity internalization, while media was only directly associated with body dissatisfaction. A significant link between private self-awareness and body dissatisfaction was found. Moreover, media was not associated with cosmetic surgery either directly or indirectly and public self-awareness showed only a significant association with internalization.

CONCLUSIONS

These findings provide information about the role that self-awareness and sociocultural factor play on body dissatisfaction and acceptance of surgery for social reasons among men. The study highlighted the importance of designing preventive programs aimed at enhancing men's ability to resist various forms of pressure regarding body image and its management. Moreover, the advantages of focusing one's attention on internal states and feelings can limit body dissatisfaction and can discourage consideration of cosmetic surgery for social benefits.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

My mother, sisters, and I: Investigating the role of female family members in body dissatisfaction and disordered eating behaviours among young Middle-Eastern women

The global rise in body dissatisfaction and disordered eating concerns is apparent; however, limited research in Middle-Eastern populations gives an incomplete understanding of these concerns. The present study recruited 377 young women aged 18 to 25 years from the Middle-East for an online survey to determine how female family members may contribute to body dissatisfaction and disordered eating behaviours. Guided by the Tripartite Influence Model, we investigated the relationships between appearance pressures and fat talk, from mothers and sister(s), in predicting body dissatisfaction, and in turn, disordered eating symptomatology (restriction and bulimia), as mediated by appearance comparisons and internalisation of the thin-ideal. Overall, greater appearance pressures and fat talk from mothers and sister(s) were associated with body dissatisfaction and disordered eating symptomatology. Greater reported closeness in mother-daughter relationships, but not sister relationships, was associated with less perceived appearance pressure and fat talk by mothers, and lower appearance comparisons, body dissatisfaction and bulimia symptomatology. Finally, participants perceived greater appearance pressure from their mothers than their sister(s), but there was no difference in their perceived levels of fat talk. Findings demonstrate the applicability of a subsection of the Tripartite Influence Model in a non-Western and understudied population, namely in young Middle-Eastern women.

The "Young Athlete Body Project"-A pilot study evaluating the acceptability of and results from an eating disorder prevention program for adolescent athletes

BACKGROUND

The high frequency of eating disorders (EDs) in sports speaks of a need for early-stage preventive measures.

OBJECTIVES

This study evaluated the acceptability of an age, sex, and sports adapted version of the "Body Project" and changes in mental health symptoms.

METHODS

This noncontrolled pilot study included a class of athletes from 18 sports (N = 73, 13-14 years) at a sport-specialized junior high school in six small-group workshops. We interviewed 34 athletes on program acceptability, and all athletes responded to questionnaires at pretest, posttest, and 6-month follow-up including the Body Appreciation Scale 2-Children, Social Attitudes towards Appearance Questionnaire-4 revised, Eating Disorder Examination Questionnaire Short form-12 modified, and questions about body appearance pressure (BAP).

RESULTS

Athletes found the program acceptable and beneficial, but some missed physically oriented activities or did not identify with the focus, particularly boys. There were acceptable levels in mental health constructs before the workshops. There were temporary changes in the percentage of boys experiencing "BAP in society" by -14.8% points (95% CI: -.6 to .0, p = .04), % in total group experiencing "BAP at school" by +11% points (95% CI: .0-.2, p = .05), thinness idealization by girls (g = .6, p = .002) and total group (g = .4, p = .006), and muscularity idealization by boys (g = .3, p = .05) and total group (g = .23, p = .04).

DISCUSSION

Athletes experienced benefits from the Young Athlete Body Project. Seeing stabilization in outcomes may mean a dampening of the otherwise expected worsening in body appreciation and ED symptoms over time.

PUBLIC SIGNIFICANCE

Adolescent athletes are at risk for developing EDs. Due to lack of prevention programs for this group, we adapted and evaluated a well-documented effective program, the Body Project, to fit male and female athletes <15 years. The athletes accepted the program and experienced participation benefits, with stronger acceptance among girls. Our promising findings encourage larger scaled randomized controlled trials to further evaluate a refined version this program among very young athletes.

Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents

BACKGROUND

Few studies have investigated how the plethora of contemporary social media (SM) platforms relate to, and influence eating disorder (ED) pathology, appearance ideals and pressure to conform to these ideals in youth.

METHODS

In this study, 1558 girls (53%) and boys (47%), predominantly within the 16-19 age range, completed an online questionnaire assessing SM use and perceived influence on appearance, ED pathology, internalization of appearance ideals and perceived appearance pressure.

RESULTS

Results showed that ED pathology was common, particularly in girls, and that internalization of body ideals was gender specific, a thin ideal being more prevalent in girls, and a muscular ideal being more common in boys. Results also showed a strong association between ED pathology and perceived pressure to conform to these appearance ideals. One fourth of the participants reported spending four hours or more on SM daily, and 80% of girls reported that SM, particularly Instagram and TikTok, had a negative influence on how they felt about their appearance. These girls had significantly higher levels of ED pathology and reported higher levels of appearance pressure from the media.

CONCLUSION

A clear pattern of associations between photo- and video specific SM platforms, ED pathology, internalization of body ideals and perceived pressure was found in this study. Adolescent girls appeared to be particularly at risk. The results illustrate an imperative need to keep addressing the potential risks of SM use in adolescents, and to continue monitoring the effect of SM on young people's view of themselves, their appearance, and their eating habits. Future studies should attempt to identify aspects of SM use that may be particularly detrimental for girls and boys in their formative years, but also those that may enhance adolescents' satisfaction and appreciation of their body and appearance.

TRIAL REGISTRATION

The study is registered in the Open Science Framework (Identifier: 10.17605/OSF.IO/5RB6P https://doi.org/10.17605/OSF.IO/5RB6P ).

Pressures to be "shedding for the wedding": An evaluation of the tripartite influence model of disordered eating and body dissatisfaction among engaged women

Disordered eating and body image concerns are particularly prevalent among women who are engaged to be married (i.e., brides-to-be), and this population may be subject to increased social and cultural pressure to achieve specific appearance ideals. The tripartite influence model purports that appearance pressures from four sources (peers, family, romantic partners, and media) influence body image and disordered eating outcomes through thin ideal internalization and appearance comparison. The present cross-sectional study sought to examine the relationships between tripartite theory constructs, body image, and disordered eating among 329 brides-to-be using path analysis with robust estimation. In the final model, media influence was the only tripartite predictor associated with both thin ideal internalization and appearance comparison. Further, thin ideal internalization and appearance comparison were associated with disordered eating directly as well as indirectly through body dissatisfaction. Altogether, the influence variables explained 39 % of the variance in disordered eating. While appearance pressures from media, peers, and partners were indirectly associated with disordered eating through one or more hypothesized indirect pathways, appearance pressure from family was not, indicating this relationship may be uniquely impacted by other factors not captured in tripartite models. Results suggest that family and media influence are most strongly associated with disordered eating in this group and have the capacity to inform future research as well as intervention development and dissemination.