Body image as a global mental health concern

Negative Body Experience in a Clinical Sample of Mental Disorders: Associations With Posttraumatic Stress Disorder, Mood Disorders, and Personality Disorders

While body experience is a key focus of treatment in psychomotor therapy (PMT), research has largely overlooked this important topic. In this study we explored three domains of body experience-body satisfaction, body attitude, and interoceptive awareness-in individuals with mental disorders in a clinical sample receiving PMT. We expected these patients to have a more negative body experience than nonclinical controls, with PTSD, mood disorders, personality disorders, and sex negatively affecting all three domains of body experience. The study involved 235 participants aged 18-59 with various mental disorders that were referred to PMT between 2008 and 2017 at a mental health center in the Netherlands. They completed questionnaires on all three of the body experience domains of interest. One sample t-tests revealed that patients had significantly greater negative body satisfaction and body attitude than nonclinical control samples obtained from the literature, with no significant difference in interoceptive awareness. Regression analyses within the patient sample revealed that female patients and patients with mood disorders or PTSD, displayed more negative body satisfaction than patients with other mental disorders. Additionally, female patients and patients with mood disorders displayed more negative body attitude. Although the total patient group and controls had comparable interoceptive awareness, only PTSD had significantly lower interoceptive awareness. Age and personality disorders did not predict differences on any domain of body experience. This research demonstrates that body experience is disturbed in patients with mental disorders who received PMT, and that there are disorder-specific disturbances on domains of body experience domains.

Body Image Distress and Depression in Head and Neck Cancer Patients- a Narrative Review

Body image distress (BID) and depression are significant psychosocial concerns in individuals with head and neck cancer (HNC). The unique physical and functional challenges associated with HNC contribute to alterations in self-perception and quality of life. However, the interplay between BID and depression remains underexplored in this patient population. This narrative review aims to synthesize current evidence on the relationship between BID and depression in patients with HNC, identify key determinants influencing these conditions, and explore potential intervention strategies to improve psychosocial outcomes. A non-systematic literature search was conducted from December 2024 to January 2025 using PubMed and Google Scholar. Studies published in the last five years (2019-2024) focusing on BID and depression in HNC patients and survivors were included. Both qualitative and quantitative studies were reviewed. Key areas of analysis included prevalence, risk factors, quality of life impact, and psychosocial interventions. The literature suggests a bidirectional relationship between BID and depression in HNC, where the presence of one exacerbates the severity of the other. Depression is a key predictor of BID, while other contributing factors include younger age, female gender, advanced cancer stage, extensive surgical interventions, postoperative radiation, social isolation, and dissatisfaction with aesthetic outcomes. BID and depression collectively contribute to poorer quality of life, impairing social-emotional functioning and treatment adherence. Emerging research highlights shame, stigma, and unmet needs (e.g., sexual dysfunction, substance use) as additional factors influencing BID and depression. Interventions such as cognitive behavioral therapy (CBT), telemedicine-based counseling, and peer support programs show promise in mitigating these psychosocial burdens, but their accessibility remains inconsistent. BID and depression are interrelated and significantly impact the well-being of patients with HNC. A multidisciplinary approach integrating psychological support, functional rehabilitation, and aesthetic interventions is essential for improving patient outcomes. Future research should prioritize longitudinal studies, standardized assessment tools, and culturally sensitive interventions to enhance the understanding and management of BID and depression in HNC survivors.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-025-05461-0.

Investigating the role of weight in body representation through the Rubber Hand Illusion: when individual weight concerns matter

Bodily weight is a physical characteristic involved in body dissatisfaction. We investigated whether the cognitive body representation can be updated to include weight variations using the Rubber Hand Illusion. Moreover, we aimed to explore the role of the individual expression of weight concerns and fat-phobia. Twenty-eight healthy-weight women participated to a Rubber Hand Illusion study, in which an over- and an under-weight rubber hand were tested together with a normal-weigh rubber hand. We verified the effect of hand's weight on the proprioceptive drift and the subjective experience of illusion. Moreover, we measured the individual expression of weight concerns. As with the normal-weight rubber hand, both the underweight and overweight ones produced significant rubber hand illusion effects, as quantified by proprioceptive judgments and questionnaire ratings. Moreover, higher levels of body image concerns were linked to higher shift towards the under-weight rubber hand, as well as higher expression of fat-phobia increased higher illusory subjective experience towards the normal-weight hand. Hands of different weights can be successfully embodied, in line with previous evidence relative to whole body illusions. Nevertheless, we underlined the role of weight concerns in modulating the illusion. Our results are meaningful for those psychopathological conditions characterized by profound changes in individual weight.

A Longitudinal Examination of Body Esteem as a Predictor of Eating Behaviors, Physical Activity, and Quality of Life Among Youth with Obesity Attending Canadian Weight Management Programs

Background: This study explored whether baseline body esteem predicted changes in eating behaviors, physical activity (PA), and health-related quality of life (QoL) over a 24-month period among youth with obesity enrolled in weight management programs. Methods: Utilizing data from the CANadian Pediatric Weight Management Registry, the study included 415 participants (n = 221 girls, n = 194 boys) aged 10-17 years (mean = 13.2, standard deviation = 2.2). Baseline assessments included a measure of body esteem, while QoL, eating behaviors, and PA were reported at baseline, 12 months, and 24 months. Multilevel modeling was applied to examine the relationships between baseline body esteem and changes in outcomes over time. Results: Higher baseline body esteem was associated with higher initial QoL scores (β = 0.70, p < 0.001) and healthier eating behavior scores (β = -0.57, p < 0.001). Individuals with lower baseline body esteem exhibited greater improvements in QoL (β = -0.12, p = 0.010) and eating behaviors (β = 0.12, p = 0.004) over time. However, baseline body esteem did not significantly predict changes in PA. Conclusions: These findings highlight the prospective relationship of body esteem with future health behaviors and outcomes, providing evidence for weight management programs to consider addressing body esteem within pediatric obesity research and treatment.

Perceived body size across sex and weight categories and its association with body size dissatisfaction: a cross-sectional study among early primary school children in Norway

BACKGROUND

Inaccurate perceptions of body size, known as body size misperception (BSM), may be linked to body size dissatisfaction (BSD) and unhealthy eating behaviours. However, these associations remain inconclusive and not fully understood in young children. This study aimed to investigate the prevalence of BSM across sex and weight categories and to further assess the association between BSM and BSD in 8-to 9-year-old children.

METHODS

This cross-sectional study of 209 primary school children (51% boys) from central Norway was performed during the national height and weight screening program in third grade. Researcher-assisted questionnaires and Stunkard's figure rating scales adapted for children were used to assess two dimensions of body image: BSM (perceived-actual body size) and BSD (perceived-ideal body size). The agreement between children's ideal and actual body size was also evaluated (actual-ideal body size). Associations between BSM and BSD were examined by multinomial logistic regression, adjusting for sex, Body Mass Index (BMI), socioeconomic status, ethnicity, and residence.

RESULTS

BSM was frequently observed (81%), with most children overestimating their body size (67%). Boys tended to overestimate their body size more frequently (75% vs. 59%, p = 0.014) and indicated a larger mean ideal body size than girls (silhouette fig. 4.2 [95% CI 4.0, 4.5] vs. 3.9 [95% CI 3.7, 4.1], p = 0.012). According to BMI, overestimation was common among children with underweight (100%) and average weight (78%), whereas underestimation of body size was prevalent among children with overweight/obesity (59%). Although 23% desired at least one body size figure smaller or larger than their perceived size, interpreted as BSD, no difference was observed between mean perceived and mean ideal body size (silhouette fig. 4.1 in both groups). No significant association was found between BSM and BSD, for either underestimation (OR 1.32 [95% CI 0.33, 5.32]) or overestimation (OR 0.99 [95% CI 0.38, 2.58]) of body size.

CONCLUSIONS

Boys and girls from all weight categories frequently misperceived their body size toward their ideal body size, with overestimation of underweight and average weight status and underestimation of overweight status being most frequently reported. No association was found between BSM and BSD, however, the long-term health consequences of BSM should be further elucidated.

Relationships Between Body Image and Body Parameters in Men Under Long-Term Fasting Conditions

Background/Objectives: Fasting and physical exertion positively affect body mass and composition. This study aimed to examine the effects of physical changes induced by eight days of water-only fasting and a physical exertion test and their influence on body satisfaction and body image parameters in middle-aged men. Methods: Fifteen participants were assessed for physical (height, body mass, and body composition) and psychological (body satisfaction, evaluation of body parts, and body image determinants) aspects before and after the fasting intervention, both at rest and post-exercise. Correlation and concordance coefficients were calculated for the analyzed variables. Results: It was found that the fasting intervention led to a reduction in body mass and a favorable shift in body composition, while also increasing satisfaction with one's body and its specific parts. This positively impacted volunteers' self-assessment of their health status. Selected body image parameters remained at an average level for the male population and did not change following the fasting. Attitudes toward body weight control methods and their perceived effectiveness did not change either. Participants favored reducing food intake and eliminating high-calorie products from their diet, rejecting the use pathological methods typically associated with eating disorders. A few associations between physical and psychological aspects of corporeality were observed, whereas significant correlations between satisfaction with body parts and parameters and a positive body image were confirmed. Conclusions: The above suggest that physical conditions and their changes resulting from fasting and physical exertion lead to a positive influence on body satisfaction and its components but do not alter body image.

Physical Activity as a Mediator in the Relationship Between Body Image Perception and Low Mood in Adolescents

Body image (BI) plays a critical role in mental health, with negative perceptions often linked to feelings of low mood. Physical activity (PA) has been shown to enhance self-acceptance and reduce negative emotions, suggesting it may help mitigate the impact of BI on low mood. This study examines the relationship between BI and low mood among adolescents, and explores the role of PA as a mediator in this relationship. The study had a cross-sectional design. Data were collected from 154,183 adolescents (average age 13.6 ± 1.6 years) across 43 countries, using the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. BI was assessed through self-perceived body size, low mood was measured on a scale from "about every day" to "rarely or never", and PA was evaluated by the number of days per week participants engaged in at least 60 min of activity. The study used multinomial logistic regression and a mediation model to analyze the relationships of BI, PA, and BMI with low mood. The multinomial logistic regression showed that daily PA reduces the risk of low mood, especially with higher PA frequency, such as PA on 6 days (OR = 0.72) and PA on 5 days (OR = 0.86). Age, BMI, BI, and sex also influence low mood, with males showing lower odds (OR = 0.40 to 0.77), normal weight individuals having a reduced risk, and thinner individuals having lower odds of low mood (OR = 0.12 to 0.50), with PA partially mediating the relationship between BI and low mood (p < 0.001), contributing to 9% of the total effect. PA partially mediates the relationship between BI and low mood, with a direct negative impact of BI on low mood. In addition, girls, older adolescents, and those with negative BI and irregular PA have a higher risk of low mood.

"My Body Changed a Lot After Taking Medication. I'm Trying to Hide It but…" A Qualitative Exploration of Body Image Experiences of Women Living With Schizophrenia

Although body image is one of the essential concepts that should be addressed in comprehensive care, the question of how body image affects women with schizophrenia remains unanswered. This study aimed to explore the body image experiences of women living with schizophrenia. This study employed a qualitative approach and participants were recruited from a community mental health center in Türkiye. Semi-structured interviews were conducted with 18 women with schizophrenia. Data were analysed via content analysis. The data were categorised into five themes: (i) body image evaluation, (ii) factors affecting body image, (iii) effects of body image distortion, (iv) coping with body image challenges and (v) protective factors. Schizophrenia affects body functionality, appearance and the self. Women living with schizophrenia experience feelings of shame, sadness, worthlessness and anger related to their body appearance. Body image distortion leads to social distancing and treatment compliance problems. Mental health nurses should support patients to express their feelings and thoughts about the body and recognise their beliefs about ideal body image. Patients should be supported with psychoeducational interventions in the management of symptoms associated with body image disturbance such as weight gain, galactorrhea, sedation and hypersalivation.

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.

Mediating role of exercise in the relationship between body dissatisfaction and overeating using structural equation modeling

BACKGROUND

With the rapid development of society, teenagers have more access to individuals with perfect bodies and are becoming more concerned about their body image. Currently, few studies assess body image and eating disorders comprehensively in China. Given the seriousness of these issues, there is an urgent need to understand the current state of body image and eating behaviors among Chinese people and formulate preventive strategies.

METHODS

In this study, 1711 college students between 17 and 23 years old in southern China completed relevant anthropometric measurements, essential information and three questionnaires. Multiple linear regression was used to screen the variables, and sex invariant analysis was used to determine whether to separate men and women to fit the structural equation model. Finally, the path diagram of the structural equation model was used to explore the complex relationship between body dissatisfaction and overeating.

RESULTS

Our results found that 69.4% of participants with a body mass index (BMI) within the normal range were dissatisfied with their weight. Further, body dissatisfaction directly or indirectly leads to overeating. Additionally, exercise played a mediating role in the body dissatisfaction and overeating of college students.

CONCLUSIONS

If BMI directs body dissatisfaction, it may lead to overeating. As a mediating factor in structural equation modelling, exercise may provide strategies to reduce body dissatisfaction and prevent overeating.

Body image, illness perception, and psychological distress in women coping with polycystic ovary syndrome (PCOS)

Objective: While symptoms of polycystic ovary syndrome (PCOS) and psychological distress (PD) are directly linked, indirect effects are also apparent. The present study aims to develop an explanatory model for the effect of PCOS on women' PD and identify possible protective and risk factors. It examines the development of PD in women with PCOS and further investigates the association between body image, both positive (body appreciation) and negative (body dissatisfaction) dimensions, and PD as well as the potential mediating effect of illness perception on this association. Methods: This study comprised a total of 316 women aged 20-50 (M = 30.9, SD = 6.3) - 197 women with PCOS and 119 healthy peers-who completed questionnaires regarding demographic characteristics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), body dissatisfaction (EDI-BD), and the Brief Illness Perception Questionnaire (BIPQ). Results: Significant differences between groups were found in all measures. Body appreciation mediated the link between PCOS and PD, while body appreciation and illness perception also mediated the link between symptom level and PD among PCOS patients. Conclusion: Women with PCOS face considerable psychological strain and highlight body appreciation and illness perception as two underlying psychological mechanisms that contribute to the increased risk of distress. Interventions addressing both mechanisms may help improve PD in women with PCOS.

The Association Between Depressive Symptoms and Waist Circumference Among Normal-Weight Individuals in the Peruvian Population: A 3-Year Pooled Cross-Sectional Study

INTRODUCTION

Limited information is available on the association between depressive symptoms and waist circumference (WC) in individuals with normal weight. This study aimed to analyze the association between depressive symptoms and WC among individuals aged 18 years or older with normal weight in the Peruvian population between 2019 and 2021.

METHODS

Analytical cross-sectional study. Data from the Peruvian Demographic and Health Survey (2019-2021) were analyzed. The sample consisted of 26 933 participants. The outcome variable was WC. The exposure variables included the overall Patient Health Questionnaire-9 (PHQ-9) score and severity of depressive symptoms. Generalized linear models of the Gaussian family estimated the effects with β coefficients for the associations between WC and depressive symptoms stratified by age and sex.

RESULTS

A significant inverse association was observed between depressive symptoms and WC in young (< 35 years) individuals of both sexes. In young males, a dose-response relationship emerged, with greater severity of depressive symptoms associated with progressively lower WC. Specifically, inverse associations were found for moderate (β = -1.74, 95% CI: -3.25 to -0.23), moderately severe (β = -2.81, 95% CI: -4.71 to -0.91), and severe (β = -2.75, 95% CI: -5.11 to -0.40) depressive symptoms.

CONCLUSIONS

Among young individuals of both sexes with a normal weight, depressive symptoms were inversely associated with WC. These findings underscore the need for nuanced considerations of age and sex when exploring the interplay of depression and abdominal adiposity in individuals with normal weight.

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

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

Gender Differences in the Relation Between Suicidal Risk and Body Dissatisfaction Among Bariatric Surgery Patients: A Cross-Lagged Analysis

OBJECTIVES

This study aimed to develop a gender-specific model to understand the causal relationship between body image dissatisfaction, emotional eating, and suicide risk among bariatric surgery patients. A secondary objective was to evaluate gender differences in the associations between these variables. It was hypothesized that, independent of objective weight loss, body dissatisfaction and emotional eating would lead to increased suicide risk.

METHODS

A total of 109 participants completed self-report measures of suicidal ideation, body image dissatisfaction, and emotional eating before and after bariatric surgery.

RESULTS

Cross-lagged analysis indicated that pre-surgery suicide ideation significantly predicts body dissatisfaction primarily among men, independent of the extent of weight loss. High levels of pre-surgery suicide risk correlated with post-surgery body image dissatisfaction in men. The autoregressive effect of suicide ideation was stronger than that of body dissatisfaction for both genders; however, the latter was stronger among women, indicating that past dissatisfaction levels significantly influenced future dissatisfaction.

CONCLUSIONS

The complex interplay between gender, body dissatisfaction, emotional eating, and suicide risk warrants further research.

Motivators and barriers to exercise in college students compared to faculty and staff

Objective: Compare the barriers and motivators to exercise in faculty/staff compared to students. Participants: Students and faculty/staff who were enrolled or employed at a college in Pennsylvania were emailed a link to a 91-question online Qualtrics® survey. Methods: The survey collected demographic information as well as physical activity habits and included the Barriers to Being Active Questionnaire, Motivations for Physical Activities Measure, and Behavioral Regulation in Exercise Questionnaire. Results: Faculty/staff (n = 69) were older and had a higher BMI than students (n = 97) (both p < 0.001). There were no differences in physical activity habits between groups. Faculty/staff reported social influences being a significantly (p = 0.02) greater barrier to physical activity than students. Students reported appearance (p = 0.002) and competence (p = 0.02) to be significantly higher motivators compared to faculty/staff. Both groups reported moderate self-determined motivation. Conclusion: Appropriate strategies can be employed by identifying the motivators and barriers to physical activity in students and faculty/staff.

Adaptation and implementation of body project as a universal body image program in Mexico and Latin America

The Body Project (BP) intervention for body image issues is supported by extensive efficacy and effectiveness research, most of which has been conducted in the United States. The BP uses cognitive dissonance to help participants critique the ideal appearance through written, verbal, and behavioral exercises. This reduces the internalization of the appearance ideal, which in turn decreases body dissatisfaction symptoms and, in some individuals, the onset of eating disorders. To broadly implement this program in Mexico and Latin America, Comenzar de Nuevo (CdN), a non-profit organization for eating disorder treatment, partnered with the Body Project Collaborative in 2014. Together, they created a training and implementation infrastructure. This paper explores the adaptation of BP and its implementation in Mexico and Latin America. We used sustainable business, marketing, and educational models to fulfill CdN's mission to reduce eating disorder risk factors, including weight stigma, in the Latin American region. By integrating strategies to combat weight stigma within our program delivery, we strive to contribute to a more inclusive and supportive environment. We trained master trainers, regular trainers, and/or group facilitators from Argentina, Bolivia, Colombia, Costa Rica, Chile, Dominican Republic, El Salvador, Guatemala, Mexico, Panama, and Spain; and implemented the BP in 15 public schools supported by sponsorship programs. This paper provides crucial lessons learned, future directions, and implications for dissemination and implementation efforts in this region of the world.

Parents and caregivers as key players in the prevention and identification of body image concerns and eating disorders among early adolescents

Early adolescence (ages 11-14 years) is a key period for the emergence of body image and eating concerns, and early identification and access to treatment are imperative for positive outcomes. Despite research identifying this critical developmental period, few prevention resources are available for early adolescents. Parents are key players for this age group and important socializing agents. As such, they are well positioned to help youth access resources or support where needed. However, programs to position and involve parents as interventionists are lacking. Our aims are two-fold. First, we review the evidence for the effectiveness of parents as body image interventionists and the existing data regarding parental needs. Second, we provide directions for future research and outline a framework for empowering parents as interventionists, identifying key domains in which parents may play a role in addressing body image and eating concerns among early adolescents. Based on the extent literature, these domains include facilitating engagement with or co-utilizing intervention content to decrease body image and eating concerns in at-risk children, which may also help to increase parents' effectiveness in their efforts to support youth. In addition, parents may deliver content to decrease or reverse risk-factors and early symptoms, or disrupt the early disorder phase of illness. To date, parents constitute an underutilized resource in eating disorder and disordered eating prevention, and efforts should be made to increase the evidence-based strategies to leverage their relationship with at-risk children.

A network analysis of body image concern, interoceptive sensibility, self-consciousness, and self-objectification

OBJECTIVE

Disrupted interoception has been found in individuals with body image concerns and related psychiatric conditions (i.e., eating disorders, body dysmorphic disorder). However, few studies have explored the role of interoception in the relationship between body image concern and self-objectification (SO). As components of the bodily self, interoception and body image may also contribute to the fostering of self-consciousness.

METHODS

The current study estimated the network model of body image concern, adaptive and maladaptive interoceptive sensibility (IS), self-consciousness, and SO, with data from 743 neurotypical adults. The centrality of nodes and the robustness of the network were verified.

RESULTS

Our network showed that interoception correlated with certain characteristics of body image concern (BIC) with varying strength and different directions. The most central node described beliefs of BIC, namely, negative evaluation toward appearance. Self-objectification and maladaptive IS presented the highest bridge centrality. Interoception also linked BICs with SO and self-consciousness.

CONCLUSION

Findings suggested that SO, adaptive and maladaptive interoception might be the targets of intervention for individuals with BIC, specifically for those with high levels of appearance-related negative self-evaluations.

"Change needs to start at home": A reflexive thematic analysis of girl athletes' and coaches' experiences of body image in New Delhi, India

Despite the physical, psychological, and social health benefits of sport participation, multiple barriers keep girls and women on the margins of sport in India. Further, body image concerns are implicated globally as a hindrance to sports engagement among adolescents but are rarely acknowledged in India. Due to a lack of research, the unique restrictions to sport participation faced by girls in India are yet to be understood. Drawing on the Sociocultural Theory of Body Image, this study explored the intersection of body image and sports from the perspectives of Indian athletes and coaches. Twelve athletes (girls aged 11-17 years; football n = 6, netball n = 6) and six coaches (football n = 3, netball n = 3) from New Delhi, India, participated in semi-structured focus groups. Reflexive thematic analysis was used and we formulated three themes: 1) "To Do What We Love, We Must Struggle"; 2) "What Will People Say?"; and 3) "Hold On To Your Power, Be You". The themes provide a nuanced understanding of the experiences of athletes and coaches on and off the playing field. The findings shed light on several individual and systemic factors, such as harassment, societal norms, feelings of empowerment, and internalising appearance ideals, that impact girls' engagement with sport in New Delhi, India. Methods to improve sports engagement, discrepancies between athlete and coach perspectives, and recommendations for sports organisations to combat body image concerns and improve sports uptake among girls in an Indian setting are discussed.

Innovative Digital Phenotyping Method to Assess Body Representations in Autistic Adults: A Perspective on Multisensor Evaluation

In this perspective paper, we propose a novel tech-driven method to evaluate body representations (BRs) in autistic individuals. Our goal is to deepen understanding of this complex condition by gaining continuous and real-time insights through digital phenotyping into the behavior of autistic adults. Our innovative method combines cross-sectional and longitudinal data gathering techniques to investigate and identify digital phenotypes related to BRs in autistic adults, diverging from traditional approaches. We incorporate ecological momentary assessment and time series data to capture the dynamic nature of real-life events for these individuals. Statistical techniques, including multivariate regression, time series analysis, and machine learning algorithms, offer a detailed comprehension of the complex elements that influence BRs. Ethical considerations and participant involvement in the development of this method are emphasized, while challenges, such as varying technological adoption rates and usability concerns, are acknowledged. This innovative method not only introduces a novel vision for evaluating BRs but also shows promise in integrating traditional and dynamic assessment approaches, fostering a more supportive atmosphere for autistic individuals during assessments compared to conventional methods.

Assessment of Binge Eating Behavior, Body Shape Concerns, and Associated Factors among Female Adolescents of Northern Saudi Arabia: A Cross-Sectional Study

Globally, binge eating behavior has emerged as a significant public health concern, especially among female adolescents. Body shape concerns in female adolescents can lead to body dissatisfaction and other mental health issues. Using a cross-sectional study design, we evaluated the frequency of binge eating behavior, body shape concerns, and associated factors among 400 female adolescents. We utilized a pretested Arabic binge eating scale (BES) and a body shape questionnaire-shorter version (BSQ-8C) to collect the required data. We performed Spearman's correlation analysis to find the strength and direction of the correlation between the BES and BSQ-8C scores. Finally, we applied binomial logistic regression analysis to identify the predictors of body shape concerns. Of the studied participants, 5.5% and 6.2% had medium and severe binge eating behavior. We found a significant positive correlation between the BES and BSQ-8C scores (rho = 0.434, p < 0.001). Also, we found that body shape concerns were significantly higher among the monthly family income category of 5000 to 7000 SAR (p = 0.005), the severe binge eating categories (p = 0.009), and obese adolescents (p = 0.001). The present study results can be applied to the development of focused interventions and strategies to address these concerns in this group.

Relations of body dissatisfaction with self-injurious thoughts and behaviours in clinical and non-clinical samples: a meta-analysis of studies published between 1995 and 2022

Body dissatisfaction is a global public health concern. Self-injurious thoughts and behaviours (SITB), including suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI), have been documented as potentially significant correlates of body dissatisfaction. However, prior findings regarding associations between body dissatisfaction and SITB have been somewhat inconsistent. Therefore, this meta-analysis was conducted to determine the nature and strength of such associations in both clinical and non-clinical samples. A literature search identified 83 relevant articles and extracted 234 effect sizes. Using a three-level random-effects model, mean effect sizes (r values) for relationships between body dissatisfaction and suicidal ideation, suicide attempts, and NSSI in clinical samples were 0.29 (95% CI, 0.22-0.37), 0.16 (95% CI, 0.13-0.20) and 0.26 (95% CI, 0.19-0.34), respectively. In non-clinical samples, these values were 0.22 (95% CI, 0.16-0.28), 0.24 (95% CI, 0.17-0.30) and 0.22 (95% CI, 0.15-0.29), respectively. Several study features (e.g., participant age, geographic region and instrument validity) emerged as significant moderators. This meta-analysis provides robust support for body dissatisfaction as a significant correlate of SITB across clinical and non-clinical samples in addition to identifying study characteristics that contribute to effect size variability. Implications are discussed for SITB research, prevention and intervention.

The Impact of Negative Emotional Dysregulation on the Outcome of Bariatric Surgery in Patients with Severe Obesity: An Observational One-Year Follow-Up Study

Background: Psychiatric symptoms are highly prevalent in patients with severe obesity, often representing pivotal factors in the development and progression of this condition. This study examines the association between negative emotional dysregulation (NED) and weight loss following bariatric surgery. Methods: Ninety-nine patients were consecutively enrolled at the Obesity Center of the Pisa University Hospital between March 2019 and February 2021, during a routine psychiatric evaluation before bariatric surgery. Psychopathological dimensions were assessed using the Mini-International Neuropsychiatric Interview (MINI), the Reactivity, Intensity, Polarity, and Stability questionnaire in its 40-item version (RIPoSt-40), the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) and the Barratt Impulsiveness Scale (BIS-11). Based on a RIPoSt-40 cut-off score of 70, subjects were divided into two groups: with (NED+) and without (NED-) NED. Results: NED+ subjects had a higher rate of psychiatric comorbidities and eating disorders than NED- patients. Of the total sample, 76 underwent bariatric surgery, and 65 of them were re-evaluated one-year after surgery. Among them, 10 of 28 NED+ subjects (37.5%) had inadequate weight loss one year after surgery compared to 5 of 37 NED- subjects (13.5%) (p = 0.035, OR 3.55, 95%, C.I. 1.05-12.03). Conclusions: Our results suggest a significant association between NED and inadequate weight loss at one-year post surgery.

World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health

Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.

Quality of Life and Body Dissatisfaction in Cisgender Men Reporting Sexual Attraction Toward Men or Women

Gay men report poorer body image than straight men, but no research has examined other dimensions of sexual identity (e.g., sexual attraction). Most research also focused on clinical outcomes of body dissatisfaction rather than subclinical influences on quality of life. We examined the association between sexual attraction (i.e., attraction to men or women), body dissatisfaction and quality of life in cisgender men. We hypothesised that: 1) men attracted to men would report higher body dissatisfaction, 2) men attracted to men would report lower quality of life (i.e., psychological, physiological, social, and environmental), 3) body dissatisfaction would be negatively associated with quality of life, and finally 4) body dissatisfaction mediates the association between sexual attraction and quality of life. A cross-sectional study (86 men attracted to men and 87 men attracted to women) supported these hypotheses but showed that sexual attraction was only associated with psychological quality of life. While sexual attraction was only associated with psychological quality of life, there were indirect associations with all quality of life domains acting through body dissatisfaction. Our findings emphasise that men attracted to men are at greater risk of poor body image and that body dissatisfaction is a pervasive health problem, negatively influencing subclinical health and well-being in cisgender men. We also highlight how body dissatisfaction may be one psychological process negatively influencing the psychological quality of life in men attracted to men. More resources should be directed toward preventing body dissatisfaction, particularly in sexual minoritised men.

Examining body appreciation in six countries: The impact of age and sociocultural pressure

Previous research on body appreciation across the lifespan has produced conflicting results that it increases with age, decreases with age, or is generally stable with an increase in women over 50-years-old. Furthermore, most of the research has been conducted in White, Western populations. Cross-cultural research suggests that both Chinese and African women experience similar sociocultural pressures as White Western women, and that appearance ideals are shifting to resemble a more Western ideal. We cross-sectionally and cross-culturally examined body appreciation across the lifespan, recruiting White Western women (UK, USA, Canada, and Australia), Black Nigerian women, and Chinese women. 1186 women aged 18-80 completed measures of body appreciation, internalisation of thin and athletic ideals, and perceived sociocultural pressure. Body appreciation did not vary with age in women from any country. Nigerian women reported the highest body appreciation, and Western women the lowest. Higher thin/athletic ideal internalisation, and higher perceived sociocultural pressure were significantly associated with lower body appreciation in all countries and age-groups. Overall, our findings indicate that although levels of body appreciation differ drastically between ethnicities and cultures, it is generally stable across age, and shows cross-culturally robust relationships between sociocultural internalisation and pressure.

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors

This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.

Development of a visual-perceptual method to assess body image: A cross-cultural validation in Canadian and Spanish women

The objectives of this study were (a) to explore the preliminary cross-cultural validity of a visual-perceptual method to assess body image; (b) to examine potential differences and similarities in body image phenomena between women from two Western countries (i.e., Canada and Spain). 201 self-identified women participated in this cross-sectional study. Ideal, normal, and self-perceived body sizes were assessed using a visual-perceptual method, whereas body dissatisfaction was measured using both a visual-perceptual method and a questionnaire. Visual-perceptual body dissatisfaction was significantly correlated with questionnaire body dissatisfaction, suggesting a preliminary convergent validity between the two assessment methods. Women in both countries were dissatisfied with their bodies. Compared to their self-perceived body, all women chose a significantly thinner visual representation of their "normal" and ideal body. These results may suggest a shift towards the "thin" body as not only ideal, but also normative. This study provides the first evidence for the cross-cultural validity of a visual-perceptual body image assessment tool. The results of the current study confirm the presence of "normative discontent", and suggest more cross-country similarities than differences among women from these two Western societies.

Befriending the body through clothes: the role of clothing in secular and religious women's body appreciation

Background

Women invest in their appearance through clothes, and the way they view their bodies translates into how they choose to dress. Nonetheless, body image research often overlooks the role of clothing in fostering body appreciation. This study examined the impact of a psychoeducational feministic course on the sociology and psychology of attire, on students' clothing functions and body appreciation.

Methods

The participants were 114 female MA students (47 secular, 67 religious) between the ages of 24 and 64 who completed the Body Appreciation Scale and Function of Clothing scale at the beginning and end of the course.

Results

The results support the contribution of the course to changes in participants' clothing functions and improvement in their body appreciation F(1,96) = 32.33, p < 0.001, partial Eta squared = 0.25. Surprisingly, religiousness had no impact on the results.

Discussion

This research contributes to the field of positive body image by presenting the potential role of clothing in fostering body appreciation among women. It demonstrates the benefits of investing in clothing that are less driven by external standards and more by the expression of valued aspects of the self.

Prevention of eating disorders: 2023 in review

This review of 16 prevention-related publications in Eating Disorders during 2022 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral → treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between disordered eating (DE) and eating disorders (EDs). Seven articles fell into the category of prevention rationale (including screening studies) and relevant reviews, while nine articles addressed correlates of/risk factors (RFs) for various aspects of DE and EDs. One implication of the 16 articles reviewed is that RF research toward construction of selective and indicated prevention programs for an expanding array of diverse at-risk groups needs to address, from a nuanced, intersectional framework, a broad range of factors beyond negative body image and internalization of beauty ideals. Another implication is that, to expand and improve current and forthcoming prevention programs, and to shape effective advocacy for prevention-oriented social policy, the field in general and Eating Disorders in particular need more scholarship in the form of critical reviews and meta-analyses; protective factor research; prevention program development and multi-stage evaluation; and case studies of multi-step activism at the local, state (province, region), and national levels.

The psychometric properties of the Arabic version of the dieting beliefs scale (DBS)

BACKGROUND

There are relatively few data about the association between locus of control and weight loss in Arabic populations. A tool does exist, the Dieting Belief Scale (DBS), that was designed to measure individuals' beliefs regarding their ability to control their body weight. The aim of this study was to translate this tool into Arabic and to evaluate its psychometric properties.

METHODS

The forward translation of the DBS from English to Arabic was completed by two professional bilingual translators, while the back translation from Arabic to English was independently performed by another two different professional bilingual translators. An online survey using the tool was then completed by 245 participants, fully aware of the study's purpose. Psychometric analyses were subsequently conducted to assess the reliability and validity of the Arabic DBS.Internal consistency was examined using Cronbach's α and McDonald's ω coefficients. Test-retest reliability was also assessed. Confirmatory factor analysis was employed to evaluate the fit of a three-factor model, with indices including Comparative Fit Index (CFI), Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). Convergent validity was assessed by examining the correlation between the Arabic DBS and the Eating Attitude Test (EAT-26) previously translated into Arabic, the latter identifying attitudes, feelings and behaviors related to eating.

RESULTS

The Arabic translated DBS scale demonstrated high translation accuracy and content validity estimates. Cronbach's α and McDonald's ω reliability coefficients for the translated scale were approximately 0.91. Test-retest reliability was 0.96. The three-factor model showed an acceptable fit (CFI = 0.93, TLI = 0.92, RMSE = 0.08, SRMR = 0.06). The Arabic version of the DBS was found to have good convergent validity, as evidenced by the significant correlation between the EAT-26 and DBS questionnaires (r = 0.53, p < 0.01).

CONCLUSION

The Arabic version of the DBS is highly reliable and has sufficient content validity to measure belief about personal ability to control one's weight.

How evaluative pairings improve body dissatisfaction in adult women: evidence from a randomized-controlled online study

BACKGROUND

Many young women are dissatisfied with their bodies. This study investigated the effect on current body dissatisfaction levels of a newly developed evaluative conditioning procedure that paired self-similar and self-dissimilar images of bodies with positive and neutral affective images, respectively. We hypothesized that learning the contingency that self-similar bodies predict positive affectivity is one process that could aid in explaining how these procedures function.

METHODS

Adult women without disordered eating pathology participated in an online experiment with random assignment to an intervention or a control condition. All participants initially rated body images in self-similarity and were subsequently asked to categorize positive and neutral images by valence as quickly and accurately as possible. In the intervention condition, self-similar bodies systematically preceded positive images, and self-dissimilar images preceded neutral images, creating a similar body → positive contingency. Pairings in the control condition were unsystematic such that no contingency was present. We measured categorization latencies and accuracies to infer contingency learning as well as current body dissatisfaction immediately before and after exposure to the pairings. All participants further completed measures of trait body image concerns and disordered eating psychopathology at baseline, which we examined as moderators of an expected relation between condition assignment, contingency learning, and body dissatisfaction improvements.

RESULTS

We analyzed data from N = 173 women fulfilling the inclusion criteria. Moderated mediation analyses showed that assignment to the intervention (vs. control) condition predicted increased similar body → positive contingency learning, which in turn predicted improved body dissatisfaction post-intervention, but only among women with higher pre-existing trait body image concerns or disordered eating levels.

CONCLUSIONS

The findings point toward the relevancy of further exploring the utility of pairing procedures. Similar body → positive contingency learning predicted improved body dissatisfaction in individuals with normatively high body image concerns, which suggests pairing procedures could help inform future research on reducing body dissatisfaction.

The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors

BACKGROUND

Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge.

METHODS

The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving.

RESULTS

Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group.

CONCLUSIONS

The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.

Beyond Gender: Interoceptive Sensibility as a Key Predictor of Body Image Disturbances

Body image disturbance (BID) involves negative attitudes towards shape and weight and is associated with lower levels of interoceptive sensibility (IS) (the subjective perceptions of internal bodily states). This association is considered a risk factor for developing eating disorders (EDs) and is linked to altered sensorimotor representations of the body (i.e., body schema). BIDs manifest across genders and are currently understudied in men. This study investigated gender-related differences in BID and its relationship to the body schema and IS. Data were collected from 86 men and 86 women. BID was assessed using questionnaires measuring self-objectification, state, and trait body dissatisfaction. IS was measured via the MAIA-2. The body schema was indexed via an embodied mental rotation task. Results showed that women reported higher BID than men across all scales. Gender differences in sub-components of interoceptive sensibility were found. Overall, both gender and interoceptive sensibility predicted BID. However, interoceptive sensibility exhibited its own unique association with BID beyond the influence of gender. BID, IS and gender were not significant predictors of performance in the body schema task. Therefore, while gender predicts differences in BID and interoceptive sensibility, there was no evidence of gender-related differences in body schema.

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study

Introduction

Body image disturbance (BID) typically involves explicit negative attitudes toward one's shape and weight and is associated with altered interoceptive sensibility (the subjective perception of internal bodily states). This association is a known risk factor for the development and maintenance of eating disorders. However, while research has centred on younger women with eating disorders, diverse facets of BID appear in women without eating disorders across adulthood. Research shows that in the general population, young women (ages 18-25) with high BID exhibit disturbances in the body schema: an implicit sensorimotor representation of the body in space which includes mental simulation of a movement such as motor imagery. Given that body image is subject to age-related influences, it is important to investigate how age-related variation in BID can influence the body schema beyond young adulthood alone. Here, we examine the relationship between BID, interoceptive sensibility and the body schema across female adulthood.

Methods

Cross-sectional data was collected online from 1,214 women across four age groups: Young adults (18-24), Adults (25-39), Middle-aged adults (40-59), and Older aged adults (60-75). BID was indexed by questionnaires measuring body objectification, state, and trait body dissatisfaction. Interoceptive sensibility (IS) was measured using the MAIA-2 questionnaire. The body schema was evaluated through the Own Body Transformation task: a mental rotation task which assesses the capacity to make an embodied mental transformation.

Results

Analyses revealed that while body objectification and trait body dissatisfaction decreased from young to older adulthood, state body dissatisfaction showed a marked increase. A negative relationship between IS and BID across all age groups was also evidenced. Finally, age, BID and orientation of the presented body were significant predictors of the time taken to make an embodied transformation.

Discussion

These findings highlight the consistent relationship of BID and IS across age groups beyond young adulthood and demonstrate the varying importance of different aspects of BID as individuals age. We also evidence for the first time that disruptions in body image have the potential to impact implicit sensorimotor representations of the body even in women without eating disorders across female adulthood.

Psychometric Properties of Different Versions of the Body Shape Questionnaire in Female Aesthetic Patients

The purpose of this study was to examine and compare the psychometric properties (internal consistency and factorial validity) of different versions of the Body Shape Questionnaire (BSQ) in a sample of female aesthetic patients. The sample included 296 women attending aesthetic clinics, with ages ranging between 18 and 70 years (M = 32.23, SD = 11.35) and body mass index between 17.10 and 45.00 kg/m2 (M = 24.70, SD = 4.07). Nine different length versions of the BSQ (BSQ-34, BSQ-32, BSQ-16A, BSQ-16B, BSQ-14, BSQ-8A, BSQ-8B, BSQ-8C and BSQ-8D) were subjected to confirmatory factor analyses, using a robust maximum likelihood estimator. Robust fit indices indicated that the BSQ-8D version was the better-fitting and more parsimonious model (S-Bχ2/df = 1.81, CFI = 0.963, RMSEA = 0.052, SRMR = 0.043). This short version also showed appropriate reliability (McDonald's omega and composite reliability = 0.87) and a very high correlation with the original BSQ-34 version (r = 0.95). In sum, these findings suggest that the BSQ-8D is the most valid, reliable and suitable BSQ version for measuring body shape concerns in female aesthetic patients.

Body Image Perception and Satisfaction of Junior High School Students: Analysis of Possible Determinants

Body image (BI) is a multidimensional construct that refers to one's perceptions of and attitudes toward one's own physical characteristics. Adolescence is a critical developmental stage in which concerns about BI increase. Therefore, the present cross-sectional study aimed to evaluate body image and aesthetic body shape standards in a sample of middle school students living in China. The researchers gathered demographic information, as well as height and weight data, for their study. They used a body silhouette to assess body image perception and body shape aesthetics and calculated two indexes: BIP, which measures the accuracy of self-perception and the estimation of bodily dimensions, and BIS, which indicates the difference between an individual's perceived and ideal body images. A total of 1585 students in three grades at two middle schools were included in the study (759 = female, mean age = 13.67 ± 0.90; 839 = male, mean age = 13.70 ± 0.90). The results showed that the BIP bias rate of middle school students was 55.7%, and the BI dissatisfaction rate was 81.0%. Females tended to overestimate their body shape and desire to be thinner compared to males. Students with a higher BMI grading were more prone to underestimating their body shape and aspiring to be thinner. Furthermore, 8.6% of students chose underweight as the ideal body type for boys, while 22.6% chose underweight as the ideal body type for girls. In conclusion, there are significant gender differences in the aesthetic standards of body shape, and adolescents believe that for women, a thin body shape is beautiful.