Does body appreciation predict decreases in eating pathology via intuitive eating? A longitudinal mediation analysis

Application of Machine Learning Techniques to the Prediction of Onset and Persistence of Binge Eating: A Prospective Study

OBJECTIVE

Machine learning (ML) techniques have shown promise for enhancing prediction of clinical outcomes; however, its application to predicting binge eating has been scarcely explored. We applied ML techniques to predict binge eating onset (vs. continued absence) and persistence (vs. remission) over time.

METHOD

Data were used from a larger prospective study of 1106 participants who were assessed on a range of putative risk, maintaining, and protective factors at baseline and 8 months follow-up. Nine ML models for classification were developed and compared against a generalised linear model (GLM) for predicting onset (n = 334) and persistence (n = 623) outcomes using 39 self-reported baseline variables as predictors.

RESULTS

All models performed poorly at predicting onset (AUC = 0.49-0.61) and persistence (AUC = 0.50-0.59) outcomes, with ML models demonstrating comparable performance to the GLM.

CONCLUSION

We suspect that poor ML performance may have been a result of the limited set of self-reported baseline predictors used to generate prediction models. Improved predictive accuracy and optimisation of ML models in future research may require consideration of a larger, more disparate set of predictors that also incorporate various data types, such as neuroimaging, physiological, or smartphone sensor data.

Expand Your Horizon: Testing a Brief Writing Intervention Focused on Body Functionality Among Adolescent Girls With an Eating Disorder

OBJECTIVE

In the last decade, body image research has increasingly focused on the distinction between negative and positive body images as separate constructs. Functionality appreciation is a crucial component of positive body image and might be an important source for coping with body image problems. The intervention Expand Your Horizon (EYH; Alleva et al. 2015a) was designed to increase functionality appreciation and has demonstrated positive effects on body image across different adult populations. In the current research, we investigated the short-term effects of a single-session EYH in adolescent girls with an eating disorder.

METHOD

Fifty-eight adolescent girls with an eating disorder were randomly assigned to the EYH condition or an active control condition. Different aspects of positive and negative body images were assessed before and after the intervention.

RESULTS

Participants in the experimental condition showed higher scores than the control condition on positive body image after the writing exercise, but no effects on negative body image were found. Exploratory analyses showed that improvements in the positive body image remained stable 15-30 min after the writing exercise.

DISCUSSION

These outcomes suggest that writing about body functionality leads to direct increases in positive body image but not to decreases in negative body image. An important step for future studies would be to test the full three-session version of EYH and investigate its effects over the longer term. This could help to determine the robustness of the present findings and the potential of EYH as a complementary intervention to existing treatments.

Unhealthy app use and dietary restraint among young adults: The moderating role of body appreciation

OBJECTIVE

Health and fitness apps that integrate wearable-device data have increased in popularity for self-monitoring of body appearance and weight goals. However, limited research has explored their potential to promote unhealthy eating behaviors. This study assessed body appreciation as a moderator of the relationship between health and fitness app use and dietary restraint.

METHODS

A total of 126 young adults (Mage = 20.8 ± 2.2 years, 65.9 % women) completed an online survey incorporating the Three-Factor Eating Questionnaire (TFEQ), Body Appreciation Scale (BAS) and frequency of app usage.

RESULTS

Hierarchical regression analysis revealed that app use significantly and positively predicted dietary restraint, explaining 33.2 % of the variance (R2= 0.33, p < .001), with a combined large effect (f2 = 0.50). Body appreciation moderated this relationship, accounting for an additional 3.2 % of the variance (p = .018). Further analysis indicated for individuals with higher levels of body appreciation (above 2.95; 70.6 % of the sample), app use was significantly associated with dietary restraint.

CONCLUSIONS

Results indicate that dietary restraint was associated with one-third of young adults who use health and fitness apps. Unexpectedly, young adults with high body appreciation who actively engage with these apps report intentions to restrict food intake. It remains unclear whether app-related goal-setting features influence caloric restriction. Incorporating health warnings in apps and personalizing app interactions to discourage extreme goal setting may help protect those individuals at risk of developing eating disorders.

Self-compassion, body appreciation, and eating disorder symptoms among young adults with weight loss goals: a diary study

PURPOSE

Research has shown that self-compassion and body appreciation are associated with less disordered eating. However, previous literature has mostly examined between-person associations, which do not account for fluctuations in these constructs within individuals over time. Understanding such fluctuations could inform future tailored interventions to better address individuals' needs by targeting times when they are most vulnerable. The aim of this study was to examine dynamic within-person associations between self-compassion, body appreciation, and disordered eating in young adults who self-reported trying to lose weight.

METHODS

Fifty-seven 18-30-year-old adults aiming to lose weight reported their levels of self-compassion, using items from the Short Form Self-Compassion Scale (SCS-SF), body appreciation, using items from the Body Appreciation Scale-2 (BAS-2) and disordered eating, using items derived from previous diary research, twice daily over a 1-week period. Generalised Linear Mixed Modelling (GLMM) was used with three levels: observations (level 1), nested within days (level 2), nested within individuals (level 3). Each GLMM included three nominal random effects (participant, day, time of day) and controlled for age, gender, and Body Mass Index (BMI). Effect sizes, represented by squared semi-partial correlation coefficients (sr2), were calculated for each GLMM via multiple linear regression analyses to represent the unique amount of variance explained by each predictor variable.

RESULTS

The findings showed that after controlling for age, BMI, and gender, negative associations between self-compassion and disordered eating, and body appreciation and disordered eating were found, while a positive association was found between self-compassion and body appreciation.

CONCLUSIONS

The findings suggest that further research should examine whether fostering self-compassion and body appreciation may be putative targets to reduce disordered eating in young adults who aim to lose weight.

LEVEL OF EVIDENCE

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

Disabilities and eating disorders: A theoretical model and call for research

OBJECTIVE

There is an urgent need for research on eating disorders among individuals with disabilities. This paper highlights the lack of research on the relationships between disabilities and EDs, despite their common convergence.

METHOD

In this paper, we aim to 1) highlight the need for further research investigating the relationships between disability status and EDs, 2) describe existing frameworks for conceptualizing disability, 3) utilize such frameworks to propose a novel theoretical model of ED/disability relationships and related sociocultural factors and 4) identify future directions for research in this area.

RESULTS

We propose a multidimensional theoretical model of the relationships between EDs and disabilities. Further, we describe how these relationships are likely influenced by a system of individual factors (e.g., disability (in)visibility, food access, and self-identification) and sociocultural factors (e.g., ableism/discrimination and weight stigma).

DISCUSSION

Scholars are encouraged to test our proposed model and further investigate experiences of disability and ED co-occurrence with participatory research and mixed-methods designs. ED prevention and screening programs, as well as treatment access and efficacy, need to be evaluated for disabled populations. Disability should also be routinely collected as a demographic across studies, and ED measures should be validated and/or developed for individuals with disabilities.

Body image facets as predictors of muscularity-oriented disordered eating in women: Findings from a prospective study

Muscularity-oriented disordered eating (MODE) is becoming increasingly common among women and is characterized by dietary alterations (e.g., blending meals into liquid form to increase caloric intake) aimed towards gaining lean muscle. In light of the mental health risks associated with these pathological eating behaviors, understanding factors that influence women's engagement in MODE is essential for preventative efforts and for informing etiological models. Body image is a possible factor that may influence MODE in light of evidence of cross-sectional associations and its importance as a key risk factor for thinness-oriented disordered eating. However, research is yet to test for prospective relationships between the various components of body image (i.e., body dissatisfaction, body appreciation) and MODE, which was the aim of this study. Adult women completed the online study measures at baseline (Time 1 [T1]; n = 1760) and three-month follow-up (Time 2 [T2]; n = 1208). A series of univariate regressions revealed that all body image facets (i.e., preoccupation, overvaluation, dissatisfaction, body image appreciation and feeling fat) at T1 significantly predicted MODE at T2. However, multivariable models revealed that only preoccupation and body appreciation uniquely predicted MODE at T2, with a positive relationship observed for preoccupation and a negative one for body appreciation. This is the first study to establish temporal relationships between distinct body image facets and MODE. Pending replication, findings highlight possible targets for addressing MODE in women.

Exposure to simulated nature promotes positive body image irrespective of the presentation modality: A comparison of images, 2-dimensional film, and 360° immersive film

Previous studies have shown that exposure to simulated natural environments can elevate state body appreciation, but stimulus sets have been limited to the use of images and 2-dimensional (2D) film. To extend this work, we examined the relative impact of images, 2D film, and a 360° immersive film on immediate, state body appreciation. A total of 136 German-speaking adults from Austria (71.3 % women; age range 18-69 years) were randomly assigned to one of three conditions, in which they viewed an image set, a 2D film, or a 360° film depicting the same natural environment. Before and after viewing the stimuli, they completed measures of state body appreciation, affect, and desire for aesthetics. Our results showed that state body appreciation improved in all three conditions, with effect sizes ranging from Cohen's d = 0.26 (2D film) to 0.52 (360° film). Presentation modality did not significantly shape improvements in state body appreciation; that is, the elevation in state body appreciation was equivalent across all three groups. Participants also experienced improvements in feelings of pleasantness, but again this was independent of the experimental group. These results suggest exposure to simulated nature may improve state body appreciation irrespective of the presentation modality.

Revisiting positive body image to demonstrate how body neutrality is not new

In this position paper, we review nonacademic and academic discourse on body neutrality, a recent concept that has spread from social media platforms into scientific publications. This discourse has (inaccurately) promulgated that body neutrality is distinct from and more realistic than positive body image and body positivity. We identify and challenge 10 myths found within this discourse: (1) positive body image and body positivity are the same and therefore interchangeable, (2) positive body image isn't realistic or attainable, (3) we should forget about body positivity and positive body image, (4) body neutrality is a new way of thinking about body image, (5) body neutrality is unique from positive body image and positivity, (6) body neutrality is a more realistic and inclusive alternative to positive body image and body positivity, (7) body neutrality is different from positive body image but we can still use the research on positive body image to support body neutrality, (8) body neutrality is a midpoint between negative body image and positive body image, (9) striving for body neutrality is sufficient, and (10) appearance can be disregarded. We offer recommendations applicable to researchers, clinicians, media, and the general public interested in body neutrality.

Psychometric properties of a Mandarin Chinese version of the Body Appreciation Scale-2 among Chinese adolescents

In the present study, we explored the factor structure and psychometric properties of the Mandarin Chinese BAS-2 among adolescents residing in the Chinese mainland. Exploratory factor analysis in Study 1 (N = 790; 396 girls, 394 boys) supported the unidimensionality of the Mandarin Chinese BAS-2 among Chinese adolescents. Internal consistency reliability was upheld via McDonald's omega. Convergent validity was supported by its moderate-to-strong relationships with body satisfaction, functionality satisfaction, self-esteem, life satisfaction, positive affect, and negative affect, while its small-to-moderate correlation with social desirability provided somewhat weaker discriminant validity support. Criterion-related validity was upheld by its inverse correlation with eating disorder symptomatology and positive correlation with intuitive eating. It explained unique variance in self-esteem (for girls and boys), eating disorder symptomatology (for girls), and intuitive eating (for boys) beyond age, body satisfaction, and functionality satisfaction, providing incremental validity evidence. A subsample of 134 girls and 114 boys completed the Mandarin Chinese BAS-2 again after three months, and test-retest reliability was upheld. The confirmatory factor analysis in Study 2 (N = 337; 192 girls, 145 boys) replicated the unidimensional structure and supported measurement invariance across gender. Collectively, the present study supported the unidimensionality, reliability, and validity of the Mandarin Chinese BAS-2's scores among Chinese adolescents.

The Intuitive Eating Scale-3: Development and psychometric evaluation

Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.S. community adults. Across three online studies, we evaluated the IES-3's factorial validity using exploratory factor analysis (EFA; Study 1; N = 957; Mage = 36.30), as well as confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), bifactor-CFA, and bifactor-ESEM (Study 2; N = 1152; Mage = 40.95), and cross-validated the optimal model (Study 3; N = 884; Mage = 38.54). We examined measurement invariance across samples and time, differential item functioning (age, body mass index [BMI], gender), composite reliability, and validity. Study 1 revealed a 12-item, 4-factor structure (unconditional permission to eat, eating for physical reasons, reliance on hunger and satiety cues, body-food choice congruence). In Study 2, a bifactor-ESEM model with a global intuitive eating factor and four specific factors best fit the data, which was temporally stable across three weeks. This model also had good fit in Study 3 and, across Studies 2 and 3, and was fully invariant and lacked measurement bias in terms of age, gender, and BMI. Associations between latent IES-3 factors and age, gender, and BMI were invariant across Studies 2 and 3. Composite reliability and validity (relationships with disordered eating, embodiment, body image, well-being, and distress; negligible relationship with impression management) of the retained model were also supported. The 12-item IES-3 demonstrates strong psychometric properties in U.S. community adults. Research is now needed using the IES-3 in other cultural contexts and social identity groups.

Explaining the prospective paths from body appreciation to intuitive eating facets: Does body image flexibility serve as a mediator?

Initial evidence suggests that body appreciation prospectively predicts intuitive eating. However, the limited number of longitudinal studies focused solely on girls and women, with a lack of evaluation among men. Furthermore, the underlying mechanisms explaining this relationship remain poorly understood. The present study examined whether body appreciation prospectively predicted intuitive eating facets among women and men in Germany. We also tested whether adaptive affect regulation skills (i.e., body image flexibility) mediated these relationships. We analyzed data from 1436 women and 704 men across three time points: Baseline (T1), 6-month (T2), and 12-month (T3) follow-up, using latent variable path models to assess direct and indirect effects. Among women, T1 body appreciation directly predicted T3 body-food choice congruence. Additionally, body appreciation indirectly predicted unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on hunger and satiety cues at T3 via its effect on T2 body image flexibility. Among men, T1 body appreciation indirectly predicted T3 eating for physical rather than emotional reasons via T2 body image flexibility. Our findings suggest that body image flexibility plays a pivotal role in explaining why individuals who appreciate their bodies are more likely to eat intuitively.

Eating disorder symptom dimensions and protective factors: A structural network analysis study

Eating Disorders (EDs) and related symptoms pose a substantial public health concern due to their widespread prevalence among both genders and associated negative outcomes, underscoring the need for effective preventive interventions. In this context, deepening our understanding of the interplay between ED symptoms and related protective factors appears crucial. Therefore, this study employed a structural network analysis approach considering both ED symptom dimensions (i.e., drive for thinness, bulimic symptoms, and body dissatisfaction) and related protective factors (i.e., body and functionality appreciation, intuitive eating, and self-esteem) to shed light on how these factors are interrelated. A community sample of 1391 individuals (34.4% men; Mage = 26.4 years) completed a socio-demographic schedule and self-report questionnaires. The network showed that the nodes with the highest positive expected influence were body and functionality appreciation, while those with the highest negative expected influence were eating for physical rather than emotional reasons and unconditional permission to eat (i.e., two components of intuitive eating). Crucially, the most relevant bridges between the conceptual communities "ED symptom dimensions" and "Protective factors" were the negative relations between (a) eating for physical rather than emotional reasons and bulimic symptoms, (b) unconditional permission to eat and drive for thinness, and (c) body appreciation and body dissatisfaction. Finally, age, gender, and body mass index did not moderate any edge in the network. The practical implications of these findings are discussed, especially in terms of preventive interventions for ED symptoms.

Psychometric evaluation of a revised version of the body appreciation scale-2 for autistic adults (BAS-2A)

Emerging evidence points to unique conceptualisations of positive body image in autistic individuals. However, there are no existing measures of positive body image that have been developed or validated for use with autistic adults. To rectify this, we developed a revised version of the BAS-2 - the BAS-2A - and examined its factorial validity and psychometric properties in a sample of autistic adults from the United Kingdom. Based on the results of exploratory factor analysis and scale purification, we extracted a 12-item, unidimensional model of BAS-2A scores in a first split-subsample (n = 273). Confirmatory factor analysis supported the unidimensional model of BAS-2A scores in a second split-subsample (n = 277). BAS-2A scores presented adequate composite reliability, measurement invariance across gender identity, and patterns of construct validity. For both women and men, BAS-2A scores correlated positively with self-esteem, well-being, quality of life, and adaptive coping, and inversely with dietary restraint, weight/shape overvaluation, body dissatisfaction, and depression. Finally, BAS-2A scores demonstrated incremental validity, predicting self-esteem over-and-above body dissatisfaction. However, temporal stability of the BAS-2A over three weeks was not supported. These results support the BAS-2A as a psychometrically robust measure of body appreciation for use in autistic adults from the United Kingdom.

The impact of intuitive eating on the association between posttraumatic stress disorder (PTSD) symptoms and disordered eating among women who have experienced intimate partner violence (IPV)

OBJECTIVE

Trauma exposure is associated with disordered eating, with recent evidence suggesting PTSD symptoms may be a more proximal predictor. Intuitive eating is a well-established protective factor against disordered eating; however, no previous studies have assessed whether intuitive eating buffers the association between PTSD symptoms and disordered eating.

METHODS

Two hundred sixteen women who had experienced intimate partner violence (IPV) and were residing at a domestic violence shelter completed a survey. The current study assessed the moderating role of intuitive eating in the associations between PTSD symptoms and two types of disordered eating behaviors: binge eating and compensatory behaviors.

RESULTS

Intuitive eating did not moderate the association between PTSD symptoms and a dichotomous measure of binge eating (no binge eating vs. any binge eating). However, intuitive eating did moderate the association between PTSD symptoms and binge frequency, among participants endorsing any degree of binge eating, such that PTSD symptoms were significantly associated with binge frequency at low, but not moderate or high, levels of intuitive eating. Intuitive eating did not moderate the association between PTSD symptoms and compensatory behaviors.

DISCUSSION

Results suggest intuitive eating may be protective against binge eating frequency among women who have experienced IPV.

Body image concerns among individuals with different levels of sporting engagement and exercise: A longitudinal study

This longitudinal study examined whether body image concerns (general; sporting) predicted eating disorder psychopathology, and whether the link differed according to nature of sport engagement. Participants were competitive sports engagers, non-competitive sports engagers, or sports non-engagers. At baseline, 510 adults completed online measures of sports demographics, eating psychopathology and body image. Eating psychopathology and body image measures were taken at follow-up (6 months later). Competitive sports engagers had better body image than the other two groups. Poorer body appreciation and better appearance-related body image predicted higher eating disorder psychopathology. Engaging in sports competitively may be beneficial for body image. However, positive appearance-related sporting body image may pose a risk for later eating psychopathology.

Positive self-beliefs mediate the association between body appreciation and positive mental health

Previous work has supported direct, positive associations between body appreciation and positive mental health, but has largely neglected to examine possible indirect mechanistic pathways. Here, we propose one relevant mediational pathway, wherein body appreciation is associated with positive mental health via positive self-beliefs (i.e., cognitions that lead individuals to view themselves, their lives, and/or their futures under a positive outlook). To test this hypothesis, we asked an online sample of 496 adults (249 women, 247 men) from the United Kingdom to complete measures of body appreciation, positive self-beliefs, and positive mental health. Participants also completed measures of self-efficacy and resilience, and provided their demographic information. Correlational analysis revealed significant, positive, and strong associations between body appreciation and facets of positive self-beliefs and positive mental health, respectively. Structural equation modelling showed that positive self-beliefs mediated the association between body appreciation and positive mental health after controlling for self-efficacy and resilience. This model was robust across women and men separately, and the mediational effects remained intact in sensitivity and robustness analyses. We discuss ways in which greater body appreciation may help individuals develop and maintain positive self-beliefs, which in turn shape mental health outcomes.

Body appreciation predicts lower levels of orthorexia nervosa symptoms: Prospective findings

Recent evidence shows that negative body image may be a potential risk factor for symptoms of orthorexia nervosa (ON). However, whether positive body image plays a protective role against symptoms of ON remains unclear. Although prior research has established associations between body appreciation (a core component of positive body image) and ON symptoms, this research is limited to cross-sectional designs, precluding inferences of temporal precedence. Thus, the present study overcomes this limitation by testing whether body appreciation prospectively predicts ON symptoms. Data were analysed from 1253 adult women (M age = 34 years (SD = 9.4), 81.3% Caucasian) who completed the Orthorexia Nervosa Inventory (ONI) and Body Appreciation Scale 2-Short Form (BAS2-SF) at baseline (T1) and at three-month follow-up (T2). Multiple linear regressions were used to test whether body appreciation scores at T1 predicted ONI subscale scores (behaviours, emotions, and impairments) at T2. Results revealed that higher body appreciation scores at T1 significantly predicted decreased scores on each ONI subscale at T2, though effect sizes were small. Findings provide preliminary evidence that body appreciation may protect against ON symptoms. If replicated, efforts to address ON symptoms may be enhanced by promoting body appreciation.

Intuitive eating and its influence on self-reported weight and eating behaviors

Intuitive eating (IE) is an adaptive eating behavior that involves paying attention to the body's physiological signals, including eating when hungry and stopping when feeling full. A growing body of literature has examined the effect of IE on the development of maladaptive eating behaviors and body weight, even though IE is not centered around the latter. However, longitudinal observation studies among the general population are still rare. Therefore, this study aimed to longitudinally examine the links between IE and changes in body weight, maladaptive eating behaviors (reward, external, restrained eating), and overeating frequency over time. For this purpose, we used data from the first (2017) and the fourth waves (2020) of the Swiss Food Panel 2.0 survey, which included 1821 randomly selected Swiss participants. The same participants completed a self-administered questionnaire annually, measuring their self-reported eating behaviors and weight status. IE was measured with the Intuitive Eating Scale-2. Results showed that women with high IE scores were more likely to maintain their body weights (within ±2 kg) and less likely to gain weight (>2 kg) than women with low IE scores. No such effects were found for men. Furthermore, IE was linked to a reduction in maladaptive eating behaviors and overeating frequency over time in both genders. Results suggest that IE may counteract maladaptive eating behaviors, which can promote weight stability over time. Therefore, the encouragement of IE patterns seems to be a promising strategy to address problematic eating behaviors and the challenges associated with controlling food intake and prevention of overeating.

Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: Results from cross-lagged panel analyses among women and men

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

Mediating effects of a weight-inclusive health promotion program on maladaptive eating in women with high body mass index

Research shows that individuals with a body mass index (BMI) over 30 have experienced an 11-fold increase in restrictive eating and a 7-fold increase in binge eating since the 1990s. Most health promotion programs for higher-weight individuals have not been developed with the high eating disorder risk for this population in mind. The purpose of current study was to test two hypothesized mechanisms underlying improvement in maladaptive eating patterns shown in a weight-inclusive health promotion program designed for women with BMIs at or above 30. Participants (N = 40) were primarily White (93 %), 30-45 years old (M = 39.83, SD = 4.34) with BMIs ranging from 30 to 45 kg/m² (M = 37.42, SD = 3.58). Using the MEMORE macro, we tested a parallel mediation model hypothesizing that internalized weight stigma and intuitive eating would explain improvements on two subscales from the Three-Factor Eating Questionnaire-R18 after a 6-month program. Total effects of the program on uncontrolled (b = -3.76, SE = 0.64, p < .0001) and emotional eating (b = -1.79, SE = 0.34, p < .0001) were significant. The indirect effects (IE) of internalized weight stigma on uncontrolled eating (IE = 1.59, SE = 0.79, 95 % CI = 0.46, 3.49) and emotional eating (IE = 0.67, SE = 0.40, 95 % CI = 0.11, 1.68) were also significant. Likewise, the IEs of intuitive eating on uncontrolled eating (IE = 2.09, SE = 0.70, 95 % CI = 0.60, 3.38) and emotional eating (IE = 1.03, SE = 0.43, 95 % CI = 0.08, 1.82) were significant. These findings indicate that weight-inclusive health promotion programs that directly address weight bias and eating according to cues from the body may help higher-weight individuals improve maladaptive eating patterns via reductions in internalized weight stigma and increases in intuitive eating.

The mediating effect of body appreciation between muscle dysmorphia and bulimia nervosa among Lebanese adolescents

BACKGROUND

Muscle dysmorphia (MD) is a common psychological disorder present in Lebanese adolescents. Several disorders can be present concomitantly with MD such as bulimia nervosa and exercise addiction. This study aims to explore the mediating effect of body appreciation between Muscle dysmorphia and bulimia nervosa, and to validate the exercise addiction inventory scale in Lebanese adolescents.

METHODS

This was a cross-sectional designed study, conducted between August-September 2022, and enrolling 403 adolescents currently residing in Lebanon (15 to 18 years old), from all Lebanese governorates (Beirut, Mount Lebanon, North, South, and Bekaa). Our sample was chosen using the snowball technique, a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection.

RESULTS

The mean age of the participants was 16.63 ± 1.46 years with 57.3% females. The factor analysis for the Exercise Addiction Inventory suggested one factor, which explained 62.58% of the common variance. The confirmatory factor analysis revealed an adequate fit to the model with satisfactory Maximum Likelihood Chi-Square/Degrees of Freedom (χ²/df), SRMR, CFI, TLI, and AVE. The mediation analysis showed that the direct relation between bulimia and MD was not significant after eliminating the effect of body appreciation (r = .12, p < .001). However, body appreciation was significantly associated with bulimia nervosa (r=-1.06, p < .001) and MD (r=-.28, p < .001).

CONCLUSION

Body appreciation was found to be a mediator between muscle dysmorphia and bulimia nervosa and thus it is the main factor leading to both disorders. Therefore, body appreciation should be addressed in the evaluation and management of Muscle Dysmorphia.

Exploring the role of positive body image in healthy orthorexia and orthorexia nervosa: A gender comparison

Current scholarship on orthorexia nervosa remains undecided about the role of body image in this novel eating disorder. This study aimed to explore the role of positive body image in differentiating between healthy orthorexia and orthorexia nervosa and assess how this might differ for men and women. A total of 814 participants (67.1% women; age M = 40.30, SD = 14.50) completed the Teruel Orthorexia scale, as well as measures of embodiment, intuitive eating, body appreciation and functionality appreciation. A cluster analysis revealed four distinct profiles characterized by high healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and high orthorexia nervosa; and high healthy orthorexia and high orthorexia nervosa. A MANOVA identified significant differences for positive body image between these four clusters, as well as that there were no significant differences between men and women for healthy orthorexia and orthorexia nervosa, despite men scoring significantly higher than women on all measures of positive body image. Cluster × gender interaction effects were found for intuitive eating, functionality appreciation, body appreciation and experience of embodiment. These findings indicate that the role of positive body image in healthy orthorexia and orthorexia nervosa may differ for men and women, making these relationships worthy of further exploration.

Body appreciation predicts better mental health and wellbeing. A short-term prospective study

Body appreciation is a key component of positive body image that has been consistently associated with better mental health and wellbeing. Existing research on body appreciation is largely limited to cross-sectional designs, although emerging evidence suggests that body appreciation may predict better wellbeing over time. The current study extends from this literature by testing whether body appreciation prospectively predicts numerous mental health and wellbeing outcomes (i.e., depressive and anxiety symptoms, self-esteem, flourishing, and general wellbeing). The sample consisted of adult women who completed study measures at baseline (n = 1749) and three month follow-up (n = 1258). Linear multiple regressions revealed that body appreciation scores at baseline significantly predicted decreased depressive symptoms (but not anxiety) and increased self-esteem, flourishing, and wellbeing scores at follow-up. Associations were evident after controlling for the influence of negative body image. Findings add to a growing body of evidence highlighting the protective potential of body appreciation and strengthen prior claims about the viability of targeting this facet of positive body image in mental health prevention and early intervention programs.