Abstract

ObjectiveNumerous stand-alone interventions to improve body image have been developed. The present review used meta-analysis to estimate the effectiveness of such interventions, and to identify the specific change techniques that lead to improvement in body image.MethodsThe inclusion criteria were that (a) the intervention was stand-alone (i.e., solely focused on improving body image), (b) a control group was used, (c) participants were randomly assigned to conditions, and (d) at least one pretest and one posttest measure of body image was taken. Effect sizes were meta-analysed and moderator analyses were conducted. A taxonomy of 48 change techniques used in interventions targeted at body image was developed; all interventions were coded using this taxonomy.ResultsThe literature search identified 62 tests of interventions (N = 3,846). Interventions produced a small-to-medium improvement in body image (d + = 0.38), a small-to-medium reduction in beauty ideal internalisation (d + = -0.37), and a large reduction in social comparison tendencies (d + = -0.72). However, the effect size for body image was inflated by bias both within and across studies, and was reliable but of small magnitude once corrections for bias were applied. Effect sizes for the other outcomes were no longer reliable once corrections for bias were applied. Several features of the sample, intervention, and methodology moderated intervention effects. Twelve change techniques were associated with improvements in body image, and three techniques were contra-indicated.ConclusionsThe findings show that interventions engender only small improvements in body image, and underline the need for large-scale, high-quality trials in this area. The review identifies effective techniques that could be deployed in future interventions.

Highlights

  • Body image is the subjective “picture” that people have of their own body [1], regardless of how their body looks

  • The effect size for body image was inflated by bias both within and across studies, and was reliable but of small magnitude once corrections for bias were applied

  • Twelve change techniques were associated with improvements in body image, and three techniques were contra-indicated

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Summary

Objective

Citation: Alleva JM, Sheeran P, Webb TL, Martijn C, Miles E (2015) A Meta-Analytic Review of StandAlone Interventions to Improve Body Image. PLoS ONE 10(9): e0139177. doi:10.1371/journal. pone.0139177 Numerous stand-alone interventions to improve body image have been developed. The present review used meta-analysis to estimate the effectiveness of such interventions, and to identify the specific change techniques that lead to improvement in body image.

Methods
Results
Introduction
Discuss cognitions and their role in body image
Teach self-monitoring and restructuring of cognitions
Teach self-monitoring of behaviour
Change negative body language
Shift focus on bodily attributes from negative to positive
Conduct exposure exercises
Provide size-estimate exercises
18 Provide stress-management training 19 Identify alternative help resources
21 Provide media literacy training
22 Discuss the beauty ideal
23 Teach strategies for resisting the effect of the media
24 Provide media-critique exercises
28 Discuss individual differences
29 Discuss alternatives to focusing on appearance
31 Discuss age-related issues and challenges
34 Discuss social comparisons
36 Provide a positive role-model
37 Discuss the concept of body image
40 Discuss the behavioural expression of negative body image
41 Discuss healthy eating
43 Discuss eating pathology
45 Use evaluative conditioning
47 Discuss mindfulness
48 Provide mindfulness exercises
Literature Search and Study Selection
Procedure
Discussion
Limitations and Directions for Future Research

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