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.
The 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.
The 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.
The 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.
•Body functionality is valuable with respect to positive body image and well-being.•Beyond functionality awareness, functionality appreciation is particularly important.•A multifaceted and holistic ...conceptualisation of body functionality is also important.•The experience of body functionality is nuanced across social identities.
Body functionality describes everything that the body is able to do, across diverse domains (e.g., bodily senses, creative endeavours). Nearly a decade ago, leading scholars identified research on body functionality as a priority for the body image field. The field has responded, as shown by the recent rise of body functionality research. We considered this an opportune time to (a) define body functionality (what it is and is not); (b) present theoretical frameworks of body functionality; (c) articulate first-generation and current measures relating to body functionality; (d) offer functionality-focused body image interventions that can improve appreciation for one’s body functionality (and body image more broadly); (e) summarise additional areas of research related to body functionality and positive body image; and (f) provide considerations and directions for future research and interventions incorporating body functionality. Research has underscored body functionality as a valuable construct with respect to positive body image and well-being, particularly when individuals appreciate what their bodies can do and conceptualise their body functionality holistically. Yet, the experience of body functionality is nuanced across social identities. Overall, the field has greatly advanced knowledge about body functionality, and we are excited to see the next generation of research that emerges.
•The final 7-item FAS displayed a unidimensional structure and invariance across sex.•FAS scores were internally consistent and stable over a 3-week period.•The FAS displayed construct, ...criterion-related, and incremental validity.•The FAS is applicable in various research, clinical, and education settings.
Body functionality has been identified as an important dimension of body image that has the potential to be useful in the prevention and treatment of negative body image and in the enhancement of positive body image. Specifically, cultivating appreciation of body functionality may offset appearance concerns. However, a scale assessing this construct has yet to be developed. Therefore, we developed the Functionality Appreciation Scale (FAS) and examined its psychometric properties among three online community samples totalling 1042 women and men (ns=490 and 552, respectively). Exploratory factor analyses revealed a unidimensional structure with seven items. Confirmatory factor analysis upheld its unidimensionality and invariance across gender. The internal consistency, test-retest reliability, criterion-related, and construct (convergent, discriminant, incremental) validity of its scores were upheld. The FAS is a psychometrically sound measure that is unique from existing positive body image measures. Scholars will find the FAS applicable within research and clinical settings.
•Chinese and Dutch women describe in interviews similar views about cosmetic surgery.•Women described sociocultural, intrapersonal, and benefit factors as pro surgery.•Reasons against cosmetic ...surgery included intrapersonal and risk factors.•Socioeconomic benefits of female beauty were more salient among Chinese women.•Cross-cultural differences in conceptualizing body appreciation were identified.
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women’s attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (MChinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women’s conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women’s attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.
Around the world, an increasing number of people, predominantly women, are choosing to undergo cosmetic surgery-despite the associated health risks. This study aimed to promote a better ...cross-cultural understanding of the correlates and predictors of favorable attitudes toward cosmetic surgery among women in China (an Eastern country where cosmetic surgery is increasing most rapidly) and the Netherlands (a Western country). Questionnaire data were obtained from 763 adult women; 245 were Chinese women in China (Mage = 29.71), 265 were Chinese women in the Netherlands (Mage = 25.81), and 253 were Dutch women (Mage = 29.22). Facial appearance concerns and materialistic belief were significant predictors of favorable attitudes towards cosmetic surgery for all three cultural groups. Body appreciation was a significant positive predictor among Chinese women in both China and the Netherlands, whereas age and beauty-ideal internalization were significant positive predictors only among Chinese women in China. The findings and their implications are discussed with respect to the characteristics of Chinese culture that could explain the identified differences between Chinese and Dutch women.
•We explored if focusing on body functionality buffers effects of thin-ideal images.•Participants did a functionality or control task before viewing thin-ideal images.•Participants focusing on ...functionality reported higher functionality satisfaction.•Participants focusing on functionality also felt greater body appreciation.•Focusing on functionality could protect women from effects of thin-ideal imagery.
This pilot study explored whether focusing on body functionality (i.e., everything the body can do) can protect women from potential harmful effects of exposure to thin-ideal images. Seventy women (Mage=20.61) completed an assignment wherein they either described the functionality of their body or the routes that they often travel (control). Afterward, participants were exposed to a series of thin-ideal images. Appearance and functionality satisfaction were measured before the assignment; appearance and functionality satisfaction, self-objectification, and body appreciation were measured after exposure. Results showed that participants who focused on body functionality experienced greater functionality satisfaction and body appreciation compared to control participants. Therefore, focusing on body functionality could be a beneficial individual-level technique that women can use to protect and promote a positive body image in the face of thin-ideal images. Research including a condition wherein participants are exposed to (product-only) control images is necessary to draw firmer conclusions.
•The Chinese translated Acceptance of Cosmetic Surgery Scale evidenced reliable scores•A two-factor (rather than three-factor) solution is superior among Chinese adults•Facial appearance concerns ...positively correlated with Chinese ACSS scores•Internalization/appearance pressure positively correlated with Chinese ACSS scores•Chinese women are more likely to accept cosmetic surgery than Chinese men
This paper describes a Chinese translation and validation of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005), a questionnaire for assessing attitudes towards cosmetic surgery. Chinese adults (335 women, 240 men; Mage = 33.65) completed the Chinese ACSS and – to investigate construct validity – measures of body appreciation, facial appearance concerns, sociocultural attitudes towards appearance (i.e., internalization of appearance ideals and appearance pressures), and demographics. Exploratory factor analysis revealed that the Chinese ACSS comprised two factors, which were invariant across sex, mirroring results among other non-Western samples. The Chinese ACSS also demonstrated good internal consistency (Cronbach’s alphas > .90) and convergent validity via its positive associations with facial appearance concerns and overall sociocultural attitudes toward appearance. Chinese ACSS scores were higher among women, and were positively correlated with age among men. Chinese ACSS scores were not associated with body appreciation or other demographic factors. The ACSS seems to be a valid instrument for use in Chinese adults, and could bring more insight into attitudes toward cosmetic surgery from a cross-cultural perspective.
Weight stigma is prevalent across multiple life domains, and negatively affects both psychological and physical health. Yet, research into weight stigma reduction techniques is limited, and rarely ...results in reduced antipathy toward higher-weight individuals. The current pre-registered study investigated a novel weight stigma reduction intervention. We tested whether a writing exercise focusing on body functionality (i.e., everything the body can do, rather than how it looks) of another person leads to reductions in weight stigma.
Participants were 98 women (Mage = 23.17, Range = 16-63) who viewed a photograph of a higher-weight woman, "Anne," and were randomised to complete a writing exercise either describing what "Anne's" body could do (experimental group) or describing her home (active control group). Facets of weight stigma were assessed at pretest and posttest.
At posttest, the experimental group evidenced higher fat acceptance and social closeness to "Anne" compared with the active control group. However, no group differences were found in attribution complexity, responsibility, and likeability of "Anne".
A brief body functionality intervention effectively reduced some, but not all, facets of weight stigma in women. This study provides evidence that functionality-focused interventions may hold promise as a means to reduce weight stigma.
•Body appreciation among British men positively correlated with physical activity.•Body appreciation was inversely linked to conformity to masculine norms and comparisons.•Body appreciation was lower ...among sexual minority compared to heterosexual men.•Social comparison tendencies mediated this relationship.•Athletic appearance-ideal internalisation also mediated this relationship.
Investigations of positive body image among men and across various social identities are lacking, and could contribute to a more complete understanding of the construct, including how positive body image can be improved. This study addressed this gap by investigating correlates of body appreciation – a key facet of positive body image – in men, and testing whether levels of body appreciation vary across sexual orientation. Data from a British community sample of 439 men (Mage = 39.13) showed that body appreciation inversely correlated with conformity to masculine norms and upward appearance-based social comparisons, and positively correlated with physical activity. Body appreciation was lower among sexual minority compared to heterosexual men, and athletic appearance-ideal internalisation and upward appearance-based social comparisons mediated this relationship. Replicating prior research among men, body appreciation positively correlated with body satisfaction, and inversely correlated with perceived appearance pressures from media and eating pathology. These findings have implications for interventions addressing body image among men.
Across many cultures, women are evaluated based on their appearance, with narrow societal beauty ideals as the standard against which they are judged and, eventually, judge themselves. Women who ...internalize the beauty ideal are more likely to consider cosmetic surgery. Dissonance-based interventions targeting thin-ideal internalization are effective at preventing eating disorders and associated risk factors. In this study, we evaluated an online dissonance-based intervention targeting beauty-ideal internalization to reduce favorable attitudes toward cosmetic surgery among Chinese women. Chinese women who were dissatisfied with their appearance and who were considering cosmetic surgery were randomized to the intervention (n = 127, Mage = 35.49) or to the educational brochure control condition (n = 98, Mage = 32.97). Beauty-ideal internalization, favorable attitudes toward cosmetic surgery, facial appearance concerns, body satisfaction, and body appreciation were assessed at pretest, posttest, and 4-week follow-up. Intention-to-treat analyses showed that the intervention reduced beauty-ideal internalization and favorable attitudes toward cosmetic surgery at posttest, with small-to-medium effect sizes; however, effects were not sustained at follow-up. No effects were found for facial appearance concerns, body satisfaction, and body appreciation. This study provides preliminary evidence for the short-term efficacy of the dissonance-based intervention for reducing beauty-ideal internalization and favorable attitudes toward cosmetic surgery, and points to valuable directions for improvement. Additional online materials for this article are available on PWQ's website at http://journals.sagepub.com/doi/suppl/10.1177/03616843231183946.
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