Body Image Interventions Research Articles

Cultural, Media, and Peer Influences on Body Beauty Perceptions of Mexican American Adolescent Girls

Social and cultural values are believed to play a role in the types of bodies that adolescent girls consider beautiful and desirable. In this article, the authors analyzed qualitative interviews from 27 Latina mid-adolescent girls (ages 14 to 16) regarding their perceptions of what body shapes and sizes are valued in Latino culture and European American culture, the nature of their conversations with friends about appearance, and whether boys and the larger community consider large body sizes to be acceptable. There was an overwhelming consensus that a slender but curvy figure is the ideal body type in Latino culture and that European Americans value unnaturally thin physiques. Themes drawn from the adolescents’ responses point to their friends’ opinions, perceptions of boys’ dating preferences, norms in their communities, and body shapes of female celebrities in Latino media outlets as sources of beauty and desirability. These findings have implications for body image intervention programs that expose Latina girls to multiple possibilities of beauty when their physical body shapes exclude them from attaining the ideal that they perceive is appreciated in Latino culture.

New possibilities in the prevention of eating disorders: The introduction of positive body image measures

Delineating positive psychological processes in inhabiting the body, as well as quantitative measures to assess them, can facilitate progress in the field of prevention of eating disorders by expanding outcome evaluation of prevention interventions, identifying novel mediators of change, and increasing highly needed research into protective factors. Moreover, enhancing positive ways of inhabiting the body may contribute toward the maintenance of gains of prevention interventions. Integrated social etiological models to eating disorders that focus on gender and other social variables, such as the Developmental Theory of Embodiment (Piran & Teall, 2012a), can contribute to positive body image intervention development and research within the prevention field. Using the Developmental Theory of Embodiment as a lens, this article explores whether existing prevention programs (i.e., Cognitive Dissonance and Media Smart) may already work to promote positive body image, and whether prevention programs need to be expanded toward this goal.

Dissemination of evidence-based body image interventions: A pilot study into the effectiveness of using undergraduate students as interventionists in secondary schools

Dissonance-based body image interventions are among the most effective interventions for adolescent girls. However, dissemination of these interventions remains challenging. In addition, the emerging field of positive body image suggests that interventions should promote body appreciation as well as reduce pathology. The current study examines whether undergraduate students can effectively deliver a dissonance-based intervention to secondary school girls. In addition, it examines whether this intervention can increase body appreciation. Sixty-two adolescent girls were randomly allocated to the intervention or control condition. In the intervention group, body dissatisfaction was significantly reduced and body appreciation was significantly improved from pre- to post-intervention. There were no changes in body dissatisfaction or body appreciation in the control group. There was a reduction in thin-ideal internalization for all participants. These preliminary findings suggest that undergraduate students can be effective interventionists for dissonance-based programs in schools and dissonance-based interventions can promote body appreciation.

A school-based body image intervention for young girls: is co-educational or single-sex delivery more effective?

School-based body image interventions for girls have typically been evaluated in single-sex rather than coeducational settings. However, there may be advantages to including boys within classes and it might also be more practical to deliver interventions to co-educational classes. Hence, it is important to examine any difference in outcomes between these two delivery settings. This study evaluated a six-session, co-educational version of the body image intervention, Happy Being Me. Participants were Year 7 girls from 5 schools randomly allocated to receive either the intervention in a single-sex setting (n=74), co-educational setting (n=73) or no intervention control (n=53). Self-report questionnaires assessed body dissatisfaction, internalisation of media ideals, appearance comparisons, self-esteem, and depression at baseline, postintervention, and 6-month follow-up. Improvements were found in body dissatisfaction, internalisation, appearance comparisons, and self-esteem, from baseline to postintervention in the intervention groups compared with the control group. Intervention effects were maintained for internalisation, appearance comparisons, and self-esteem at 6-month follow-up. Baseline appearance conversations moderated body dissatisfaction outcomes. There were no significant differences in body image outcomes between single-sex or co-educational delivery formats. These findings provide further evidence of the efficacy of Happy Being Me and suggest that this intervention is equally valuable in single-sex or co-educational settings. This abstract was presented in the Peter Beumont Young Investigator award finalist stream of the 2014 ANZAED Conference. Published: 24 November 2014

Testing a dissonance body image intervention among young girls.

Body image and eating disorder interventions based on cognitive dissonance have been shown to be effective among girls and women aged 14 and above. This article reports a preliminary examination of whether a dissonance intervention is also effective when delivered in a school setting to 12- and 13-year-old girls in the United Kingdom. Girls (N = 106, mean age = 12.07 years, SD = .27) were allocated to the intervention condition or a waitlist control. In contrast to the control group, girls in the intervention condition reported significant reductions in body dissatisfaction and internalization of a thin body ideal post-intervention. There was no significant change in self-reported dietary restraint for either condition. In addition, compared with the control group, girls in the intervention condition showed increased resilience to negative media effects 1-month post-intervention. Results suggests that dissonance based programs can reduce body dissatisfaction, internalization and negative media effects among a younger group of girls than previously examined and in a United Kingdom school setting.

Y's Girl: Increasing body satisfaction among primary school girls

To date, effective body image interventions for preadolescent school girls are lacking. The present study sought to evaluate the effectiveness of Y's Girl, a published body image curriculum specifically tailored for preadolescent school girls. A sample of 60 Grade 6 girls with a mean age of 11.25 (range of 11–12) years were allocated either to an intervention or control group and completed baseline and posttest measures of body image, thin-ideal internalization, body comparison, self-esteem, peer factors, and disordered eating. Findings revealed that, compared to the control group, girls receiving the intervention reported improved body image, thin-ideal internalization, body comparisons, and self-esteem at posttest 1 week after the intervention ended. Furthermore, changes in body satisfaction were moderated by initial levels of risk-factors. These findings provide initial support for Y's Girl as an effective, affordable body image intervention for preadolescent girls which can be implemented by teachers.

Implementation of a body image program as a twisty country lane

A teachers’ organization developed a grade-specific body image curriculum which was implemented in one Canadian province. The lessons were designed to promote body acceptance and to help students recognize and resist mediated constructions of ideal size and shape. One year after its introduction, a research study investigated the body image program’s implementation in six schools in different school districts. Data for the study include interviews with close to fifty teachers and surveys completed following the professional development sessions at the program’s introduction. The findings from this study indicate that, in addition to implementation factors such as resources, body image intervention programs at the school level are impacted by the complex ways in which bodies, including teachers’ bodies, are positioned socially. While the intent of the program was to provide a rich resource of materials for teachers, teachers needed more opportunities for reflection and support as they navigated new terrain. As a result, this particular curriculum implementation journey more closely resembled a road trip on a twisty country lane than one that took the shortest distance between two points.

Happy Being Me in the UK: A controlled evaluation of a school-based body image intervention with pre-adolescent children

This study evaluated an adapted version of ‘Happy Being Me’, a school-based body image intervention, with girls and boys aged 10–11 years. Forty-three children participated in a three-week intervention, and 45 children formed a control group. Both groups completed measures of body satisfaction, risk factors for negative body image, eating behaviors, self-esteem, and intervention topic knowledge, at baseline, post-intervention, and 3-month follow-up. For girls, participation in the intervention resulted in significant improvements in body satisfaction, appearance-related conversations, appearance comparisons, eating behaviors and intervention topic knowledge at post-intervention, although only the change in body satisfaction was maintained. There was also a significant decrease in internalization of cultural appearance ideals from baseline to follow-up. For boys, participation in the intervention resulted in significant improvements in internalization and appearance comparisons at post-intervention; however, neither of these changes were sustained at follow-up. There were no improvements in the control group over time.

Individuation or Identification? Self-Objectification and the Mother-Adolescent Relationship.

Do adolescents model their mothers' self-objectification? We measured self-objectification (body surveillance and body shame), body mass index (BMI), body esteem, and quality of the mother-adolescent relationship in 179 female and 162 male adolescents at age 15, as well as self-objectification in their mothers. Initial analyses indicated no improvement in model fit if paths were allowed to differ for females and males; therefore a single model was tested for the combined sample. Findings revealed that mothers' body surveillance negatively predicted adolescents' body surveillance. Mothers' body shame was unrelated to adolescents' body shame, but positively predicted adolescents' body surveillance. Results for the relationship between mothers' and adolescents' self-objectification suggest that adolescents engaged in more individuation than modeling. A more positive mother-adolescent relationship predicted lower body shame and higher body esteem in adolescents, suggesting that the quality of the relationship with the mother may be a protective factor for adolescents' body image. Mother-adolescent relationship quality did not moderate the association between mothers' and adolescents' self-objectification. These findings contribute to our understanding about the sociocultural role of parents in adolescents' body image and inform interventions addressing negative body image in this age group. The quality of the mother-adolescent relationship is a clear point of entry for such interventions. Therapists should work with adolescents and their mothers toward a more positive relationship quality, which could then positively impact adolescents' body image.

Body image change in obese and overweight women enrolled in a weight-loss intervention: The importance of perceived versus actual physical changes

Using the exercise and self-esteem model as a guiding framework, this study examined variables related to body image change among 88 overweight and obese women (Mage=28.4±7.8; MBMI=31.6±3.5) participating in a 16-week diet and exercise weight-loss intervention. Measures of body image and potential mechanisms of body image change (actual and perceived physical changes, self-efficacy) were administered at baseline, Weeks 8 and 16. Body image improved significantly over the study time-points (ps<.001). Perceived physical changes accounted for most explained variance (12–37%) in body image change (total R2adj=.21–.50). Improved perceptions of body fat were a particularly important predictor in each model (ps≤.04). Results support the notion that to improve body image, perceived changes to the body are more important than actual changes. Such information is integral to developing theories to explain body image change and interventions to maximize it.

A pilot body image intervention programme for in-patients with eating disorders in an NHS setting

Background: Body image distortion, a distressing problem that precipitates eating disorders, remains a struggle for patients after other symptoms are controlled. Despite a strong physical aspect there is little recognition of physiotherapy intervention. This study aims to assess the effect of a tailored physiotherapy intervention programme for patients with eating disorders in an NHS in-patient unit. Methods: The intervention programme, targeted at known, potentially modifiable factors relevant to body image distortion in 7 patients, used touch, massage, drawing exercises and listening skills. Patients received 8 to 38 sessions determined by length of stay on the unit. Self-drawings were completed at each session and a body shape questionnaire (BSQ-34) and a self-assessment silhouette scale in the first and last sessions. Findings: Self-drawings showed improved comparative proportions of body areas. Initial silhouette scores of more than 5 out of 10 reduced to less than five. There was a reduction in BSQ-34 questionnaire scores for all patients, and to less than half for 3. Conclusions: This pilot study suggests that a tailored programme based on principles of physiotherapy can help to improve body image perception and satisfaction. It draws attention to the potential of physiotherapy intervention programmes in the UK.

A comparison of mindfulness, nonjudgmental, and cognitive dissonance-based approaches to mirror exposure

This study compares different versions of mirror exposure (ME), a body image intervention with research support. ME protocols were adapted to maximize control and comparability, and scripted for delivery by research assistants. Female undergraduates ( N = 168) were randomly assigned to receive mindfulness-based (MB; n = 58), nonjudgmental (NJ; n = 55), or cognitive dissonance-based (CD, n = 55) ME. Participants completed the Body Image Avoidance Questionnaire (BIAQ), Body Checking Questionnaire (BCQ), Satisfaction with Body Parts Scale (SBPS), Beck Depression Inventory-II (BDI-II), and Eating Disorders Examination Questionnaire (EDE-Q) at pre-treatment, post-treatment, and 1-month follow-up. Mixed models ANOVAs revealed a significant main effect of time on all measures, and no significant time by condition interaction for any measures except the SBPS. Post-hoc analysis revealed that only CD ME significantly improved SBPS outcome. Results suggest that all versions of ME reduce eating disorder risk factors, but only CD ME improves body satisfaction.

Differences in the Nature of Body Image Disturbances Between Female Obese Individuals With Versus Without a Comorbid Binge Eating Disorder: An Exploratory Study Including Static and Dynamic Aspects of Body Image

Various components of body image were measured to assess body image disturbances in patients with obesity. To overcome limitations of previous studies, a photo distortion technique and a biological motion distortion device were included to assess static and dynamic aspects of body image. Questionnaires assessed cognitive-affective aspects, bodily attitudes, and eating behavior. Patients with obesity and a binge eating disorder (OBE, n = 15) were compared with patients with obesity only (ONB; n = 15), to determine the nature of any differences in body image disturbances. Both groups had high levels of body image disturbances with cognitive-affective deficits. Binge eating disorder (BED) participants also had perceptual difficulties (static only). Both groups reported high importance of weight and shape for self-esteem. There were some significant differences between the groups suggesting that a comorbid BED causes further aggravation. Body image interventions in obesity treatment may be warranted.

Deconstructing the Mirror's Refection: Narrative Therapy Groups for Women Dissatisfied With Their Body

Women facing middle age and beyond are pressured by a cultural idea/of slimness. The authors review literature pertaining to the factors affecting the societal perceptions of body image and address relevant counseling interventions, specifically, group therapy based on narrative theory, that are aimed at this population. ********** Over time, there has been a shift in society to a preference for thin-figured (Lin & Kulik, 2002, p. 115). One need not look far to find a media flooded with messages placing importance on youthful, ultrathin appearance, especially for women. Such thin, idealized women can be found portrayed on the evening news, competing in beauty pageants, and in other forms of media or entertainment. In fact, Thompson and Heinberg (1999) reported that less than 10% of women appearing on television appear to be overweight. Even today's fashion and trends are marketed to women with extremely slender figures. Many women, including those who do not appear on national television, have internalized the message that to be beautiful and attractive, one must also be youthful and slender--often to the point of emaciation. Thus, few women can meet the sometimes unhealthy and unnatural criteria for the (Deeks & McCabe, 2001; Sussman, Truong, & Lim, 2007). This ideal, which has become increasingly smaller over time, is now at a height of 5' 7 tall and a weight of 110 pounds (Byrd-Bredbenner & Murray, 2003; Cusack, 2000; McKinley & Hyde, 1996). It is noteworthy that the average American woman is a bit shorter than this ideal height at 5' 3 3/4 and weighs quite a bit more at 152 pounds (Jones & Buckingham, 2005). With such a gap between the idealized (and perhaps unnatural) model and the typical woman, it should be no surprise that most women today have reported being dissatisfied with their body, no matter how old they are (Liechty, Freeman, & Zabriskie, 2006; Van den Berg & Thompson, 2007; Webster & Tiggemann, 2003). In fact, Hurd (2000) conducted a study with women ages 61 to 92 years and found that 77% of women reported negative attitudes about their weight. In another study, middle-aged women were found to associate their body image, including sexual attractiveness, weight, and physical condition, with their overall happiness (Stokes & Frederick-Recascino, 2003). Sometimes this dissatisfaction becomes more than a state of unhappiness; serious mental disorders including depression, anxiety, and other psychological symptomatology may also occur. Eating disorders such as anorexia nervosa and bulimia nervosa, which affect both young women and middle-aged women, are also frequently associated with unnatural societal expectations for women's bodies (Forman & Davis, 2005). Body image dissatisfaction among middle-aged women may have its roots in several domains. For example, Tiggemann and Lynch (2001) suggested that dissatisfaction with body image is associated with aging, partly because of the increasing gap between realistic body appearance and the thin and slenderized ideal of beauty. Women facing middle age and beyond are pressured not only by this cultural ideal of slimness but also by a society that does not necessarily view the bodies of older women with high esteem (Deeks & McCabe, 2001; Mangweth-Matzek et al., 2006). This is problematic because natural landmarks across a women's life span, such as childbirth, menopause, and stressors related to divorce or family death, increase the likelihood that women may gain weight as they age, thus contributing to body image dissatisfaction. Despite the statistics indicating that middle-aged women struggle with body image dissatisfaction and weight concerns, studies about how these women are influenced by environmental and sociocultural demands are mostly absent from the literature. Most research has focused on adolescents or young adult women (Forman & Davis, 2005; Lewis & Cachelin, 2001). …

Cognitive Behavior Therapy With Body Image Exposure for Bulimia Nervosa: A Case Example

Cognitive behavior therapy (CBT) is an effective treatment for bulimia nervosa (BN). However, among patients with BN, symptom improvement is more pronounced for behavioral eating symptoms (i.e., bingeing and purging) than for body image disturbance, and the persistence of body image disturbance is associated with relapse. The need for more effective body image interventions led to the development of mirror exposure, which focuses on encouraging patients to view themselves in a holistic, nonjudgmental, mindful fashion. Behavioral manifestations of body image disturbance—body checking and avoidance—are also targeted in order to reduce and eliminate such behaviors and their associated preoccupation and distress. A preliminary trial of Body Image Exposure has shown promise, but it has not yet been tested in the context of CBT for BN. The case of “Sara” illustrates the application of this targeted treatment for body image disturbance. Central clinical issues around the perceptual, cognitive, and behavioral components of body image are delineated as they arose in treatment, as are issues of motivation and compliance. Treatment was associated with improvement in eating symptoms, body image, and mood.

An evaluation of a body image intervention based on risk factors for body dissatisfaction: A controlled study with adolescent girls

In this research we aimed to evaluate the efficacy of a theoretically derived school-based body image intervention for young adolescent girls. Participants were 194, female Grade 7 students from two Catholic Secondary Schools in Melbourne, Australia. One school was allocated to the intervention group and the other school was allocated to the control group. The intervention group participated in three 50-min body image intervention sessions, while the control group received their usual classes. All participants completed baseline, post-intervention and 3-month follow-up questionnaires. The intervention group reported significantly more positive outcomes than the control group on measures of intervention topic knowledge, risk factors for body dissatisfaction, body image, dietary restraint and self-esteem, at post-intervention and follow-up. This study provides support for the efficacy of a theoretically derived school-based body image intervention with adolescent girls.

Eating Disorders Awareness Week: The Effectiveness of a One-Time Body Image Dissatisfaction Prevention Session

The purpose of this study was to assess the effectiveness of a body image dissatisfaction prevention session that provided information on body image and media literacy to college women. Participants were 81 undergraduates who were randomly assigned to attend either a body image intervention or a control intervention. Participants completed measures at pre- and post-intervention and at 4-week follow-up. The body image group improved significantly more than the control group on body shape concerns, but not on the other outcome variables. Efficacious interventions capable of reaching large numbers of women are necessary to help dispel the “normative discontent” prevalent today.

Assessing and supporting body image and sexual concerns for young women with breast cancer: a literature review

AbstractBackground: Breast cancer is the most common cancer and most common cancer cause of death in women aged 20–49 years in Canada. Developing a functional definition of ‘young’ is imperative in assessing and providing appropriate emotional support to the unique body image and sexuality concerns facing ‘young’ women with breast cancer. These concerns require proper assessment in order to provide appropriate interventions.Aims and objectives: To seek a functional definition of ‘young’ and to determine what body image and sexuality assessment tools and interventions are the most appropriate for young women with breast cancer.Methods: A literature search was undertaken to determine what body image and sexuality assessment tools and interventions are available and relevant to young women with breast cancer. Also, the assessment and interventions available to this patient cohort in the author's clinic were explored.Conclusions: Body image and sexuality questionnaires encourage young women and health-care providers (HCPs) to openly discuss these issues. Annon's PLISSIT model is an assessment and intervention strategy that enables HCPs to adequately assess and refer young women to suitable programs such as support groups and counsellors. The multi-disciplinary team should provide continuous emotional assessment and support throughout the cancer journey by collaborating to develop the best interventional strategies to the patient and her family.

BodySense: An Evaluation of a Positive Body Image Intervention on Sport Climate for Female Athletes

The goal of the present study was to evaluate the effectiveness of a selective prevention program designed to reduce pressures to be thin in sport, and to promote positive body image and eating behaviors in young female athletes. Participants were competitive female gymnasts (aged 11 to 18 years), parents, and coaches from 7 gymnastic clubs across Ontario, Canada. Four of the seven clubs were randomized to receive the 3-month intervention program (IG) aimed at increasing awareness and positive climate change of body image pressures for athletes in their clubs. Three clubs were randomized to the control group (CG). A total of 62 female gymnasts (IG n = 31; CG n = 31) completed self-report questionnaires examining perceptions of pressure to be thin within their sports clubs, self-efficacy over dieting pressures, awareness and internalization of societal pressure to be thin, body esteem, and eating attitudes and behaviours before and following the intervention. A total of 32 mothers (IG n = 24; CG n = 8) completed measures examining their perceptions of their daughter's pressure to be thin, awareness and internalization of societal pressures to be thin, daughter's self-efficacy over dieting pressures, in addition to mothers' beliefs regarding thinness and success for women in society, before and following the intervention. The findings revealed that participation in the BodySense program resulted in athletes perceiving a reduction in pressure from their sports clubs to be thin, though no changes were found in body esteem, the EAT, or the SATAQ. No significant change was observed over time on mothers' measures. The role of climate change for prevention of eating disorders in athletes is discussed.

Comparison of face‐to‐face and internet interventions for body image and eating problems in adult women: An RCT

The aim of this study was to compare the outcomes following an eight-session, small group, therapist-led, intervention for body dissatisfaction, and disordered eating in adult women, delivered either in face-to-face or synchronous, internet mode. Community women with high body dissatisfaction and internet access were randomly assigned to either face-to-face delivery (N = 42), internet delivery (N = 37), or delayed treatment control (N = 37). All groups were assessed at baseline and 8-9 weeks later. The intervention groups were reassessed at 6-months follow-up. Both intervention groups showed large improvements in body dissatisfaction compared with the delayed treatment control and these improvements were maintained at follow-up. However, posttreatment improvements were greater in the face-to-face than internet intervention. In adult women, it is desirable to deliver the body image intervention in a face-to-face mode, but the internet mode is effective and has the potential to increase access to therapy.