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

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

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

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

The Intuitive Eating Scale-3: Development and psychometric evaluation.

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

Testing for longitudinal bidirectional associations between self-compassion, self-criticism, and positive body image components.

Previous cross-sectional studies have reported associations between self-compassion, self-criticism, and positive body image, yet prospective studies establishing the temporal order of these relationships are missing. The present study sought to clarify the nature of these associations by investigating possible longitudinal bi-directional links between self-compassion, self-criticism, and three components of positive body image (body appreciation, functionality appreciation, and body image flexibility). Data were analyzed from 2982 adult women who completed survey instruments at baseline (T0), four-month follow-up (T1), and eight-month follow-up (T2). Attrition rate ranged from 0-56% across time-points. Cross-lagged panel models were computed to test for bidirectional associations. We found evidence of reciprocal, negative associations between self-criticism and the three components of positive body image across the three time-points. We also found evidence that T0 self-compassion predicted increased body image flexibility and functionality appreciation at T1 (paths were non-significant from T1 to T2), whereas T0 body appreciation predicted increased T1 self-compassion (but was non-significant from T1 to T2). Findings suggest that compassionate and uncritical ways of responding to the self may be relevant precursors and outcomes to positive body image, depending on the timing of assessment, highlighting viable targets for intervention.

Virtually possible: strategies for using telehealth in eating disorder treatment learned from the COVID-19 pandemic.

The COVID-19 pandemic resulted in an abrupt shift from in-person to virtual treatment, and clinicians continue to offer telehealth due to its advantages. Telehealth may be a viable, effective, and safe treatment modality for many clients with eating disorders. We consider contemporary issues regarding the use of telehealth in eating disorder treatment and identify strategies to enhance its delivery. First, we emphasize key factors when choosing therapy delivery (telehealth, in-person, or hybrid). Second, we address telehealth-specific planning, preparation, safety, and privacy considerations. Third, we discuss how eating disorder assessment and evidence-based interventions can be adapted for telehealth delivery. Fourth, we raise telehealth-specific challenges related to group-based delivery and the therapeutic alliance offering alternative avenues for connection and engagement. We conclude with a discussion of how additional research is needed to refine the presented strategies, develop new strategies, and assess their efficacy and effectiveness.

The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice.

White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.

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

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

"I'll never sacrifice my well-being again:" The journey from negative to positive body image among women who perceive their body to deviate from societal norms.

We conducted one-on-one interviews with 25 Canadian cisgender women who self-identified as having (a) a condition or characteristic causing their body to deviate from societal norms and (b) overcome a negative body image to develop a positive body image. Using coding reliability thematic analyses, we identified 12 themes (italicised) involving processes and experiences associated with shifts in body image. Women had moments that sparked and confirmed the importance of building positive body image (Enough is Enough). They experienced accepting Social Connections and Community and Accessed Critical Knowledge conducive to body positivity. They engaged in Joyful Movement, Adaptive Appearance Investment, and Joyful and Intuitive Eating. They identified how Changing Societal Norms, Becoming Older and Wiser, COVID-19 Pandemic, having Illnesses and Medical Conditions, Pregnancy and Motherhood, and Spirituality, Religion, and Nature affected their body image, values, and valued action. As women engaged in these processes and experiences, shifts occurred in their perceptions of their embodied selves in the world, represented by four "Bigger Lessons:" I Am More Than My Looks, I Am More Than My Body, I am More Than My Self, and I am Inherently Worthy of Love, Respect, and Joy. These findings can inform body image programmes and clinical interventions.

Functionality appreciation and its correlates: Systematic review and meta-analysis.

Functionality appreciation is a component of positive body image that refers to respecting and honoring the body for what it is capable of doing. A growing number of studies have investigated the features, correlates, and outcomes of functionality appreciation, yet a synthesis of this literature is missing. We conducted a systematic review and meta-analysis of research on functionality appreciation. Fifty-six studies were included (85 % cross-sectional). Random effects meta-analyses were performed on 21 cross-sectional correlates and on seven randomized trials of psychological interventions that assessed functionality appreciation as an outcome. Meta-analyses showed that functionality appreciation was consistently associated with fewer body image problems, lower levels of eating disorder symptoms, and better mental health and wellbeing. Functionality appreciation was unrelated to age and gender, but weakly (and negatively) related to body mass index. Preliminary evidence from prospective designs suggests that the appreciation of body functionality may promote adaptive eating patterns and prevent maladaptive eating and body image patterns over time. Psychological interventions designed to cultivate functionality appreciation in full or in part produced greater improvements in this construct than control conditions. Findings confirm that functionality appreciation is associated with numerous wellbeing constructs and could serve as a potentially useful target for intervention.

Integrating social media variables as predictors, mediators, and moderators within body image frameworks: Potential mechanisms of action to consider in future research.

In this article, we consider how social media variables may be integrated as predictors, mediators, and moderators within dominant theoretical frameworks of body image in order to identify potential mechanisms of action that can be empirically examined in future research and used to direct prevention and intervention efforts. To achieve this goal, we first articulate social media variables that have been investigated as predictors, mediators, and moderators in body image research. Next, we present the following critical and sociocultural theoretical frameworks: social comparison theory, tripartite influence model, objectification theory, developmental theory of embodiment, acceptance model of intuitive eating, cultivation theory, and uses and gratifications theory. Additionally, we present the theory of development of critical body awareness, a newly developed model that may provide further insight regarding the relationships between social media and body image-related outcomes. For each model, we articulate extant research that has explored social media variables within its context and explicate how social media variables could potentially be studied as predictors, mediators, and moderators within its structure. To conclude, we address pertinent limitations and gaps within this research space that could direct future research across the theoretical frameworks.

Measuring positive breast experience: Development and psychometric evaluation of the Breast Appreciation Scale (BrAS).

Existing measures of women's breasted experiences have focused on negative experiences, which de-centres women's meaning-making and relationships with their breasts. To rectify this, we developed a novel measure of women's positive breasted experiences, the Breast Appreciation Scale (BrAS), and examined the psychometric properties of this novel measure across four studies. Study 1, with 307 United Kingdom women, led to the extraction of a 9-item, unidimensional model of BrAS scores that showed adequate composite reliability and 4-week test-retest reliability. Study 2, with 297 United Kingdom women, showed that the unidimensional model of BrAS scores had adequate fit and evidenced convergent, concurrent, discriminant, and incremental validity. Study 3, with 295 women from the United Kingdom, provided additional support for factorial validity and concurrent validity, and additionally provided evidence of known-groups validity insofar as mothers had greater breast appreciation than non-mothers. Study 4 showed that the BrAS was scalar invariant across women from Australia, the United Kingdom, and the United States (N = 573) and provided additional evidence of concurrent validity. Based on these results, we conclude that the BrAS is a psychometrically valid measure of women's positive breasted experiences that can be utilised in future research.

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

Evidence suggests that body appreciation may be a protective factor for eating pathology. However, potential explanatory mechanisms for this association are unclear, as longitudinal studies testing mediational pathways are missing. This longitudinal study tested whether intuitive eating mediates the association between body appreciation and eating pathology. Data were analyzed from 3039 women recruited from an educational platform about disordered eating, many of whom exhibited elevated symptomatology. Measures were administered at baseline (T1), four-month (T2) and eight-month (T3) follow-up. Path analyses were computed to test hypothesized indirect effects. Direct paths from T1 body appreciation to T2 intuitive eating (total and subscale scores) and T3 eating pathology/binge eating were observed. However, only one significant indirect effect emerged: higher T1 body appreciation scores predicted greater decreases in T3 eating pathology and binge eating via its effect on increasing T2 Unconditional Permission to Eat (UPE) subscale scores. Findings suggest that the features of the UPE construct (e.g., eating foods that are desired in a given moment, refusal to dichotomize foods as "good" or "bad," etc.) may be important mechanisms explaining how and why body appreciation protects against eating pathology. Efforts should be made to enhance body appreciation and intuitive eating in eating disorder prevention programs.

Understanding the role of positive body image during digital interventions for eating disorders: Secondary analyses of a randomized controlled trial.

Despite growing interest in the possible link between positive body image and eating disorder (ED) symptoms, little is known about what role this adaptive construct plays in ED treatment. This study investigated whether: (1) interventions principally designed to target ED psychopathology also lead to improvements in positive body image indices (i.e., body appreciation, functionality appreciation, and body image flexibility); (2) changes in ED symptoms correlate with changes in positive body image, both concurrently and prospectively; and (3) baseline positive body image levels moderate the degree of symptom improvement. Secondary analyses from a randomized controlled trial on digital interventions for EDs (n=600) were conducted. Intervention participants reported greater increases in the three positive body image constructs than the control group (ds=0.15-0.41). Greater pre-post reductions in ED psychopathology and binge eating were associated with greater pre-post improvements in positive body image indices. However, earlier reductions in ED psychopathology and binge eating did not predict later improvements in positive body image at follow-up. None of the positive body image constructs at baseline moderated degree of symptom change. Standard ED interventions can cultivate a more positive body image, although this is not explained by earlier symptom reduction. Understanding the mechanisms through which ED interventions enhance positive body image is needed.

Body appreciation and its psychological correlates: A systematic review and meta-analysis.

Body appreciation, defined as accepting, holding favourable attitudes towards, and respecting the body, is the most widely studied facet of positive body image. Despite more than 15 years of research investigating associations between body appreciation and psychological wellbeing constructs, a synthesis of this literature has yet to be performed. We conducted the first systematic review and meta-analysis of research on body appreciation and its psychological correlates. Two-hundred-forty papers were included, of which only eight investigated prospective associations. Random effects meta-analyses were performed on 35 cross-sectional correlates of body appreciation. Prospective associations were reviewed qualitatively. Meta-analyses showed that body appreciation was inversely associated with numerous indices of eating (eating pathology, restraint) and body image disturbances (appearance-ideal internalization, body surveillance, sociocultural pressures), and general psychopathology (depression, anxiety). Body appreciation was positively associated with several adaptive wellbeing constructs (self-esteem, self-compassion, sexual satisfaction). Crucially, pooled associations were still evident after controlling for the influence of negative body image. Qualitative synthesis showed that body appreciation may also promote better wellbeing over time. Findings confirm that body appreciation is consistently associated with better psychological wellbeing. Body appreciation shows promise as a viable intervention target in mental health promotion initiatives and eating disorder prevention programs.

Psychometric properties of a Mandarin Chinese version of the Body Appreciation Scale-2 with residents from Chinese mainland.

The current study aimed to translate the Body Appreciation Scale-2 (BAS-2) into Mandarin Chinese and explore its psychometric properties with college students from the Chinese mainland. In Study 1 (N = 840, 415 women, 425 men), an exploratory factor analysis upheld the unidimensional factor structure of the Mandarin Chinese BAS-2, and McDonald's omega supported the internal consistency reliability of its scores. Evidence of construct validity of the Mandarin Chinese BAS-2 was also accrued via its positive correlations with self-esteem, self-compassion, and body satisfaction as well as negative correlations with BMI, weight discrepancy, negative affect, and body surveillance. Its negative correlation with eating disorder symptomatology and negligible correlation with impression management supported its criterion-related validity and discriminant validity, respectively. Additionally, the Mandarin Chinese BAS-2 contributed unique variance in eating disorder symptomatology and self-esteem beyond the variance explained by BMI and other body satisfaction measures, providing evidence of incremental validity. Study 2 (N = 522, 322 women, 230 men) confirmed its unidimensional factor structure, upheld the internal consistency and stability of its scores over a 3-month period, and supported its measurement invariance between women and men. Taken together, these findings support the cross-cultural validity of the Mandarin Chinese BAS-2 on the Chinse mainland.

#Bopo: Enhancing body image through body positive social media- evidence to date and research directions.

Body positive content aims to disrupt the monopoly of idealized appearance-focused media and encourage individuals to adopt a positive stance towards their body by increasing diversity and inclusiveness and rejecting harmful appearance ideals. This paper provides an historical context for the body positivity movement, discusses the presence and characteristics of the online body positivity movement, presents evidence of its relationship to body image, and finally offers directions for future research. Findings provide initial support for the potential for body positive social media content to be beneficial for body image, and lower state appearance comparison has received support as a mechanism underpinning these effects. However, efforts to identify individual-level moderators have met with less success, and the research is somewhat confined to comparative effects with idealized social media content, and young women. Additional work to bridge the gaps in the extant data is needed. In particular, expanding the understanding of which types of body positive social media content can be most helpful to both prevent and decrease body image concerns and promote positive body image using a layered lens that considers the interactions of the individual, their context, and the type of body positive social media content will be most fruitful.

Short forms of the Body Appreciation Scale-2 (BAS-2SF): Item selection and psychometric evaluation.

The 10-item Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015) is a widely used contemporary measure of positive body image that assesses one's love for, acceptance and appreciation of, and respect for their body. Given the need for abbreviated measures to reduce participant burden and study cost, we aimed to generate a short form of the BAS-2 (BAS-2SF). Two versions of the BAS-2SF emerged: a 3-item version derived deductively from theory (items selected based on their unique contribution to the body appreciation construct), and a 2-item version generated empirically (items selected based on a genetic algorithm approach). Psychometric evidence was garnered across five studies, totaling 3114 participants. Both BAS-2SF versions correlated highly (rs = .93-.97) with the original 10-item BAS-2 and demonstrated internally consistent and stable scores. Factor analyses revealed high item-factor loadings, unidimensionality, and gender invariance of the 3-item BAS-2SF. Correlations with construct validity measures, as well as model pathways, were similar between both BAS-2SF versions and the 10-item BAS-2. BAS-2SF versions also evidenced incremental validity. Both BAS-2SF versions retain the psychometric integrity of the BAS-2 and are recommended for use; however, the 3-item BAS-2SF is an ideal option for researchers who wish to estimate a body appreciation latent factor.

The dangers of the rabbit hole: Reflections on social media as a portal into a distorted world of edited bodies and eating disorder risk and the role of algorithms.

The relationship between social media usage and body image has been well-established in the literature; however, social media companies' use of algorithms may intensify this association, as algorithms provide viewers with personalized content that is often more extreme, less monitored, and designed to keep users engaged for longer periods of time. This article details the recent media coverage of algorithms, revelations by former social media employees regarding the problematic usage of algorithms, and revelations that social media companies are aware of the harm posed by their implementation of algorithms, particularly for young, vulnerable users. We provide recommendations for influencers, educators, researchers, clinicians, parents, and users, and conclude that it is ultimately the responsibility of the social media corporations to protect and enhance the well-being of their users.

Demographic and sociocultural predictors of sexuality-related body image and sexual frequency: The U.S. Body Project I.

Body image is a critical component of an individual's sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one's body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.

Pathways from sociocultural and objectification constructs to body satisfaction among men: The U.S. Body Project I.

According to the tripartite influence model, body dissatisfaction is shaped by internalizing cultural appearance ideals stemming from appearance-related family, peer, and media pressures. This model was developed for women, but emerging evidence points to its relevance for men's body image. This study advanced this budding research by (a) integrating muscular-ideal internalization alongside lean-ideal internalization and body surveillance into the model, (b) examining two positive dimensions of body image as outcomes (body image quality of life and appearance evaluation), and (c) testing this model in national online sample of 5293 men. Structural equation modeling supported the model. Family, peer, and media pressures related to higher lean-ideal internalization, which related to higher body surveillance and poorer body image outcomes. Peer and media pressures related to higher muscular-ideal internalization, which related to higher body surveillance but more adaptive body image outcomes. We further examined whether model variables and paths differed based on men's body mass index (BMI). Men with higher BMIs evidenced a stronger path between body surveillance and body image outcomes. These findings highlight the usefulness of sociocultural models for understanding men's body image experiences.