Translation and psychometric properties of a Polish version of the Body Acceptance by Others Scale-2 (BAOS-2).

The 13-item Body Acceptance by Others Scale-2 (BAOS-2) measures generalised perceptions of body acceptance by others. Here, we examined the psychometric properties of a novel Polish translation of the BAOS-2. A sample of 1183 adults (898 women, 285 men; age M = 28.98) from Poland completed a Polish version of the BAOS-2, alongside measures of body appreciation, pressure to conform to appearance ideals, self-compassion, self-esteem, and impression management. Exploratory and confirmatory factor analysis identified a stable unidimensional model of the Polish BAOS-2, with all 13 items retained. Additionally, the Polish BAOS-2 evidenced complete invariance (i.e., through to latent mean invariance) across gender identity. Scores on the BAOS-2 evidenced adequate composite reliability and, in a retest subsample (n = 260), showed complete invariance across four weeks. Evidence of convergent, criterion-related, discriminant, and incremental validity was very strong when based on observed BAOS-2 scores, but weaker when based on latent BAOS-2 scores. Whether examined at the observed or latent level, greater body acceptance by others was consistently and strongly associated with higher body appreciation. These results suggest that the psychometric properties of the Polish BAOS-2 are robust and that this instrument can be confidently utilised in future research with Polish adults.

Breastfeeding self-efficacy, body image, body acceptance, and partner support: Associations in Israeli postpartum women.

PROBLEM: Research suggests that breastfeeding self-efficacy (i.e., a mother's perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations. BACKGROUND: To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel. HYPOTHESIS: We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers. METHOD: A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs. FINDINGS: Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers. DISCUSSION: In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy. CONCLUSION: Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.

An Educational Session for Medical Students Exploring Weight Bias in Clinical Care Through the Lens of Body Diversity.

Introduction: Weight bias is pervasive in health care and can lead to inadequate care for people with higher weight. However, few medical schools offer training on mitigating weight bias and incorporating body diversity into clinical care. Methods: As part of a course for second-year medical students, we developed and implemented a 3-hour multimodal educational session on mitigating weight bias. Didactics included content on body diversity and addressing weight bias, followed by a facilitated case discussion in small groups focused on debunking common myths related to weight. Assessment consisted of an open-content quiz and evaluation of a postsession survey. We performed a thematic analysis of the essay quiz responses and evaluation survey results. Results: Three hundred fifty-three students participated in academic years 2020-2021 and 2021-2022. In the postsession quiz, students described several learning points, including understanding environmental influences on body size, improving communication by reducing weight bias, and strengthening the patient-provider relationship. In the postsession evaluation, students reported that their knowledge and skills had improved with respect to the learning objectives, with means of 4.0-4.1 on a 5-point Likert scale. Areas for suggested improvement included more time for discussion and more guidance on weight-inclusive care. Discussion: This multimodal educational session on weight bias was successful in meeting the stated learning objectives. Future work will consist of building on this content and extending future iterations to residents and attendings, with the goal of disrupting harmful assumptions and improving access to holistic, evidence-based care for all people, regardless of size.

Experiences of maltreatment in childhood are associated with increasing anxiety and lower body acceptance over pregnancy.

OBJECTIVE: Prior studies have established that childhood sexual abuse (CSA) survivors are at increased risk for anxiety during pregnancy. Less is known about the course of anxiety throughout pregnancy for CSA survivors as well as underlying mechanisms linking CSA and perinatal anxiety. We assessed change in anxiety over the course of pregnancy for CSA survivors and examined whether acceptance and awareness of pregnancy-related body changes mediated this change. METHODS: 299 pregnant participants from two larger longitudinal cohort studies were grouped into CSA (n = 67), "other Maltreatment" (OM; n = 111); and "no abuse" (NA; n = 121) based on responses to the Adverse Childhood Events scale. We used a general linear mixed model with repeated measures to examine change in anxiety (Hamilton Anxiety Scale) at two time points (MEGA = 26.2 weeks and 34.9) by abuse/maltreatment group and then examined whether group differences in anxiety were mediated by body awareness/acceptance (from Maternal Fetal Attachment Scale) using structural equation modeling. RESULTS: The CSA group demonstrated higher anxiety at both gestational time-points and significantly greater increase in anxiety over gestation compared to OM and NA groups (F(1, 280) p = .046). CSA and OM groups reported significantly lower body acceptance than those without abuse/maltreatment (F(2, 287) = 3.486, p = .032). A small proportion of the total effect of CSA on change in anxiety (0.5%) was attributable to body acceptance. CONCLUSION: Pregnant CSA survivors experienced a greater increase in anxiety over pregnancy compared to other groups. Both abuse/maltreatment groups exhibited lower body acceptance, yet this contributed little to the association between CSA and anxiety.

Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: Results from cross-lagged panel analyses among women and men.

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.

A feeling difficult to identify: Alexithymia is inversely associated with positive body image in adults from the United Kingdom.

BACKGROUND: Research has increasingly examined the ways in which internal bodily experiences influence body image, including the relationship between alexithymia - the reduced ability to identify and describe one's own emotional feelings and bodily sensations - and negative body image. However, relationships between facets of alexithymia and positive body image remain unexplored. METHODS: To bridge this gap in the literature, we assessed relationships between facets of alexithymia and multiple, core indices of positive body image in an online sample of adults from the United Kingdom. A total of 395 participants (226 women, 169 men) aged 18 to 84 years completed measures of alexithymia, body appreciation, functionality appreciation, body image flexibility, body acceptance by others, and positive rational acceptance. RESULTS: Once the effects of age had been accounted for, alexithymia was significantly and negatively associated with all five body image constructs in hierarchical multiple regressions. In the final models, the alexithymia facet of Difficulties Identifying Feeling emerged as a significant and negative predictor of all indices of positive body image. LIMITATIONS: The use of cross-sectional data limits the causal conclusions that can be drawn. CONCLUSIONS: These findings extend previous work by demonstrating the unique relationship between alexithymia and positive body image, providing important implications for body image research and practice.

Resistance and empowerment against racism: A preregistered study of associations with body appreciation and body acceptance by others in racialised minority adults in the United Kingdom.

Research on body image and racism has largely focused on how individual experiences of racism are associated with detrimental body image outcomes. However, research has not yet examined how resistance and empowerment against racism (REAR) - a repertoire of proactive strategies aimed at preventing or challenging racism both at the individual and collective levels - shape positive body image outcomes. Here, 236 women and 233 men who identified as belonging to racialised minority groups in the United Kingdom completed the REAR Scale - which measures REAR along four dimensions - as well as measures of body appreciation and body acceptance by others. Correlational analyses indicated significant inter-correlations between nearly all REAR domains and body image-related variables in men, whereas relationships in women were largely non-significant. Linear model analyses indicated that greater leadership for resistance against racism was significantly associated with higher body appreciation in women and men. Greater interpersonal confrontation of racism was significantly associated with both body appreciation and body acceptance by others in men, but not in women. These results suggest that REAR may play a role in shaping body image-related outcomes in people of colour, but that these effects are also be shaped by the intersection of gender and race.

The Mediating Role of Body Acceptance in Explaining the Relation of Mindfulness, Self-Compassion and Mindful Eating to Body Image in Gay Men and Bisexual Men.

Objectives: Mindfulness and mindfulness-based constructs, such as self-compassion and mindful eating, have been positively associated with healthier eating and body related perceptions. Exploration of mindfulness and related concepts have not been investigated extensively in gay and bisexual men, a population where eating and body related concerns have been found to be widespread. Method: Participants completed an online questionnaire, assessing mindfulness, self-compassion, mindful eating, body image and body acceptance. Correlation analysis and further mediation analysis was conducted to explore the relations between these constructs within the present sample (n = 163). Results: A community sample showed a positive association of body image to mindfulness-based concepts, and negative to body non-acceptance, within the target population. Mediation analysis showed the role of body acceptance in explaining the relation between mindfulness, self-compassion and mindful eating to body image. Conclusions: Findings highlight the importance of body acceptance when considering the development of a mindfulness or compassion-based intervention to attenuate body related issues among gay and bisexual men. Preregistration: This manuscript has not been preregistered.

Accepting the Aging Body: Protective Factors of Body Acceptance in Persons of Advanced Age.

Introduction: Physical attractiveness, productivity, religiosity, meaningfulness, and relationships are important characteristics of successful aging. To maintain psychological flexibility, acceptance and values-directed interventions have been effective in managing difficulties with aging. Objectives: The present paper aimed to investigate body acceptance and individual values in healthy individuals over the age of 50 living in Austria. Methods: In addition to sociodemographic variables, subjective age, attractiveness, and desire for body changes were assessed in our survey. The Austrian Value Questionnaire was used to record values, and the German Version of the Quality of Marriage scale assessed partnership quality. Data from 187 older adults were recruited via snowball sampling. Analyses were performed in SPSS and R, using a structural equation modeling approach. Results: The results indicate that as age increases and subjective attractiveness decreases, body acceptance declines. Materialism seems to support the desire for cosmetic surgery (ß = .230, p = .016). A negative association between conservatism and changes in desires for body change (ß = -.221, p = .044) suggests that greater value commitment and conservative attitudes are related to fewer change desires. Conclusion: These findings underpin the necessity for encouraging individuals early on to be in touch with their values to promote psychological flexibility.

"I listen to my body now": a qualitative exploration of positive body image in breast cancer survivors .

OBJECTIVE: Existing research has identified the high prevalence of body image concerns among female breast cancer survivors. However, it has neglected to explore the experience of positive body image among this group, despite its potential utility for intervention development. The present study therefore aimed to explore the experiences of breast cancer survivors who self-identified as experiencing a positive relationship with their post-treatment bodies. DESIGN: Twenty-two participants (M age = 54, SD = 8.38) were interviewed using a semi-structured approach. RESULTS: Thematic analysis identified three overarching themes amongst the qualitative data: (1) Resisting appearance pressures, (2) Receiving care, and (3) Self-worth beyond appearance. Findings indicated that women's life experiences had led them to develop a critical awareness of the unrealistic nature of appearance ideals. Their experience of positive body image was also attributed to engaging in self-care and receiving supportive care from others. Finally, women expressed prioritising functionality and health over their physical appearance. CONCLUSION: The present findings advance the theoretical understanding of positive body image in a breast cancer population. They also provide an opportunity to test theorised models of positive body image.

Validation of the Body Acceptance by Others Scale-2 (BAOS-2) and assessment of its associations with prospective changes in body image among young adults in China.

The Body Acceptance by Others Scale-2 (BAOS-2) was developed to assess overall perceived body acceptance by others. In two studies, we evaluated its structure, reliability and validity among young adults in China. In Study 1, 435 women and 322 men completed newly translated simplified Chinese versions of the BAOS-2 and Functionality Appreciation Scale (FAS), conceptually related body image questionnaires and demographic items. Exploratory factor analyses supported a 13-item unidimensional BAOS-2 structure across men and women. Internal consistency, test-retest reliability, convergent validity and discriminant validity were also supported. Study 2 (307 men, 396 women) replicated the original gender-invariant BAOS-2 structure in confirmatory factor analysis and bolstered evidence for convergent, discriminant and incremental validity. Predictive validity, examined via longitudinal analyses, indicated baseline BAOS-2 scores and/or concomitant changes in BAOS-2 scores over time were related to improvements on other positive and negative body image measures at a six-month follow-up. Supplementary analyses replicated the original unidimensional FAS factor structure and provided considerable support for its psychometrics across samples. In sum, this research supported psychometric properties of the BAOS-2 among young adults in China and underscored its potential utility in predicting changes in other body image experiences over time.

When body positivity falls flat: Divergent effects of body acceptance messages that support vs. undermine basic psychological needs.

Although women now have access to messaging about body acceptance, the risks and benefits of such messaging are not well-researched. Using a self-determination theory framework, we contrasted need-supportive versus need-undermining messages about body acceptance. One message supported the basic psychological need for autonomy (i.e., personal agency to accept one's body); one targeted the basic need for body acceptance from others; and one used pressure to elicit body positivity - a need-undermining strategy. We contrasted these messages with one another and with a typical message of thinness idealization. In Experiments 1-4, we found that pressuring pro-body messages were more harmful to body image than messages that used autonomy support and acceptance from others. That is, they produced more pressure, less agency, and lower acceptance. Moreover, Experiments 2-4 showed that need-supportive messages increased state self-esteem from baseline, whereas pressuring body positivity did not. In Experiment 3 message-related self-perceptions mediated the effect of need-supportive messages on state self-esteem. In Experiment 4, need-supportive body acceptance messages reduced body shame and body surveillance, whereas pressure to be body positive did not - and this effect was mediated by body satisfaction induced by the message. We highlight the important difference between need-supportive and need-undermining body positivity.

"Making Peace" with Bodies and Sexual Selves: Changes during COVID-19 among Adults in the United States.

The COVID-19 pandemic has negatively impacted the physical and mental health of many and has necessitated widespread societal shifts, including changes to work and family activities. These changes have impacted individuals' identity, including their sexual self-image and body image, yet research on perceptions of these changes is missing. This study reports on quantitative and qualitative data from an electronic survey with adults in the United States (N = 326) to examine these perceptions. Body appreciation did not significantly differ between demographic groups. Themes emerging from the qualitative results included changes in general self-image (becoming more restricted or disempowered), changes in sexual self-image (deepening, becoming more sexy/sexual, or less sexy/sexual), and changes in body image (positive, negative, and neutral). Our findings point to positive, negative, and neutral effects on sexual self-image and body image, implying that nuanced approaches are needed to understand how identity has transformed as a result of the COVID-19 pandemic.

The Body Acceptance by Others Scale-2 (BAOS-2): Psychometric properties of a Bahasa Malaysia (Malay) translation and an assessment of invariance across Malaysia, the United Kingdom, and the United States.

The Body Acceptance by Others Scale-2 (BAOS-2) is a 13-item instrument measuring generalised perceptions of body acceptance by others. Here, we first demonstrate that a Bahasa Malaysia (Malay) translation of the BAOS-2 is psychometrically valid in a sample of 1,049 Malaysian adults (Study 1). Using exploratory and confirmatory factor analysis, we extracted a unidimensional model of BAOS-2 scores that retained all 13 items. BAOS-2 scores had adequate internal consistency and indices of validity (convergent, construct, concurrent, and incremental), and were scalar invariant across gender and ethnicity (Malaysian Malays vs. Chinese). Next, we assessed invariance of BAOS-2 scores across samples from Malaysia, the United Kingdom, and the United States (total N = 2,575; Study 2). Multi-group confirmatory factor analysis showed that partial scalar invariance was achieved. Participants in the interdependent cultural context of Malaysia had significantly higher scores - with small effect sizes - than their counterparts in the independent contexts of the United Kingdom and United States. In addition, women had significantly higher scores than men, but the effect size was negligible. The present study indicates that the Malay BAOS-2 is a psychometrically valid instrument and presents the first comparison of BAOS-2 scores across interdependent and independent contexts.

Body acceptance by others: Refinement of the construct, and development and psychometric evaluation of a revised measure - The Body Acceptance by Others Scale-2.

The Body Acceptance by Others Scale (BAOS) measures the degree to which individuals perceive body acceptance by others, but its factor structure is questionable. Here, we developed a revision of the BAOS (i.e., the BAOS-2) by designing novel items reflective of generalised perceptions of body acceptance by others. In three studies, we examined the psychometrics of the 13-item BAOS-2. Study 1, with United Kingdom adults (N = 601), led to the extraction of a unidimensional model of BAOS-2 scores and provided evidence of 4-week test-retest reliability. Study 2, with United Kingdom adults (N = 423), indicated that the unidimensional model of BAOS-2 scores had adequate fit and that scores were invariant across gender. Study 2 also provided evidence of convergent, construct, criterion, discriminant, and incremental validity. Study 3 cross-validated the fit of the unidimensional model in adults from the United State (N = 503) and provided evidence of invariance across gender and national group. Internal consistency coefficients of BAOS-2 scores were adequate across all three studies. There were no significant gender differences in BAOS-2 scores and a significant national difference had a negligible effect size. Thus, the BAOS-2 is a psychometrically-sound measure that can be utilised in future research.

The Body Acceptance by Others Scale: An assessment of its factorial validity in adults from the United Kingdom.

The construct of body acceptance by others (i.e., the degree to which an individual perceives acceptance for their appearance by others) is central to conceptual models of positive body image and adaptive eating styles. It is typically measured using the 10-item Body Acceptance by Others Scale (BAOS; Avalos & Tylka, 2006), but emerging research has suggested that a unidimensional model of BAOS scores may be unstable. Here, we examined the factor structure of BAOS scores in a sample of adults from the United Kingdom (N = 1148). Exploratory factor analyses indicated that BAOS scores reduced to two dimensions in women, of which only a primary 6-item factor was stable. In men, all 10 items loaded onto a primary factor. However, the results of confirmatory factor analyses indicated that both models of BAOS scores had poor fit. Although both the unidimensional 10-item and 6-item models had adequate internal consistency, our results are suggestive of factor structure instability. We conclude by suggesting ways in which future research could revise the BAOS to improve its factorial stability and validity.

Relational body image: Preliminary evidence that body image varies within a person from one specific relationship to another.

Although social factors influence body image, it remains unknown whether a given individual's body image varies from one specific relationship to another. The present study examined this novel concept of relational body image by investigating the extent to which individuals' body image differs across their relationships with specific others. These differences were expected to arise in part due to differences in how an individual perceives others' personal body preoccupation, others' acceptance of her body, and others' body size relative to her own. Eighty-seven female undergraduates reported on their typical levels of body appreciation, appearance orientation, and intuitive eating with 10 people in their lives, and reported on the characteristics of these others. Intraclass correlations revealed that participants' body image and eating varied across their different relationships. Furthermore, participants perceived differences in others' acceptance of the participant's body, body preoccupation, and body size. Multilevel modelling showed that participants reported more adaptive body image and eating patterns in relationships with others whom they perceived to be relatively more accepting of their body, less body preoccupied, and more similar in size to them. Findings provide initial support for the concept of relational body image.

Characterizing a body positive online forum: Resistance and pursuit of appearance-ideals.

The body positive movement emerged in response to pressure to pursue the unattainable thin ideal, and promotes a more accepting stance towards the body. To date, however, little is known regarding the nature of online body positive content. Using publicly available data from a large online discussion platform (Reddit), all the forums to which commenters on a body acceptance forum (N = 1262) had also contributed were identified. For each pairing of 50 representative forums (i.e., a large number and proportion of body acceptance commenters), the commenter-overlap between the two forums was used to compute a network model, to detect communities of body acceptance commenters. By manually reviewing the topics of each community's forums, the shared interests of these commenters were identified. The majority of commenters (86 %) contributed to forums relating to women, feminism, relationships and support, and mental health. Large proportions of the commenters also revealed an interest in topics including body weight/shape, eating, exercise, and cosmetics. These findings confirm that original feminist tenets of body positivity remain present. However, our findings also suggest the existence of a sizeable subgroup interacting with topics related to the thin ideal, perhaps illustrating a gradual absorption of the body positive movement into mainstream culture.

Adjudicating Traditional Wellness.

There is no consensus definition for "traditional wellness" but in worksite health promotion, it usually means the wellness program is a health assessment and/or health screening offering followed by some educational programs, usually in the physical health domain. Using the term traditional wellness may belie an unawareness about or lack of appreciation for the quality improvement principles that are as applicable to the health of a profession as they are to the growth of an organization. This editorial examines how the use of the term traditional wellness is a reflection on our professional zeitgeist. Five ideas that attempt to explain misunderstandings about differing approaches to worksite health promotion are offered along with 5 ways we may be able to make peace with traditional wellness.

"No seconds for you!": Exploring a sociocultural model of fat-talking in the presence of family involving restrictive/critical caregiver eating messages, relational body image, and anti-fat attitudes in college women.

In line with sociocultural models of parental influence on body image, we examined the relationship between recall of restrictive/critical caregiver eating messages (RCEM) and current frequency of disclosing self-disparaging fat talk among family in 335 undergraduate women (Mage = 19.4; SD = 1.53; range = 18-27). Additionally, two forms of relational body image (i.e., perceived body acceptance by others, external body image shame) and anti-fat attitudes were tested as potential explanatory pathways. RCEM were positively related to current frequency of self-directed fat talk in the family context. All three proposed mediators helped explain this relationship, with external body image shame demonstrating the largest observed effect. Findings suggest frequent recollections of caregivers' implied weight-stigmatizing comments surrounding eating may contribute to more frequent self-denigrating body talk with family members at present via both positive and negative dimensions of relational body image and endorsed explicit weight bias. Theoretical and practical implications are discussed.