The Effectiveness of Interventions Aiming to Promote Positive Body Image in Adults: A Systematic Review

Guest, Ella; Costa, Bruna; Williamson, Heidi; Meyrick, Jane; Halliwell, Emma; Harcourt, Diana

doi:10.1016/j.bodyim.2019.04.002

Cited by 184Eating Disorders and BehaviorsBody Image and Dysmorphia StudiesNutrition, Health and Food Behavior

The Effectiveness of Interventions Aiming to Promote Positive Body Image in Adults: A Systematic Review

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Guest, Ella, Costa, Bruna, Williamson, Heidi, Meyrick, Jane, Halliwell, Emma, Harcourt, Diana·2019·Body Image

DOI 10.1016/j.bodyim.2019.04.002

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Abstract

Theory suggests promoting positive body image (PBI) through interventions would have a significant impact on health and well-being. However, little is known about the effectiveness of existing interventions. This review aimed to identify and assess the evidence of effectiveness of interventions to increase PBI in adults. Database searches were conducted using CINAHL Plus, Medline, PsychINFO, Wiley Online Library, and SCOPUS. Application of inclusion criteria and data extraction were conducted by two reviewers. Methodological quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool, and narrative synthesis was conducted. Fifteen studies, evaluating 13 interventions, were included. Three studies, evaluating one online writing-based functionality intervention, were judged to have strong methodological quality and had evidence of improving body appreciation, body esteem, and functionality satisfaction. Six moderate quality studies found interventions using intuitive eating, CBT, self-compassion, and exercise improved PBI. There was limited evidence of effectiveness of interventions for men, suggesting future research is needed to better understand PBI mechanisms in men. Lack of heterogeneity of outcome measures is discussed as a limitation. Findings suggest existing interventions are effective at increasing aspects of PBI among women and support the development of interventions that target multiple components of PBI.

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Cognitive behavioral therapy helps individuals unravel negative perceptions and adopt healthier attitudes toward their bodies.
“Cognitive behavioral therapy is vital in this effort, as it helps individuals unravel negative perceptions and adopt healthier attitudes toward their bodies [206].”
From Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors (2024) · cites this paper as [206]

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BackgroundInfluential
BodiMojo: Effective Internet-based promotion of positive body image in adolescent girls
Franko, D. L., Cousineau, T. M., Rodgers, R. F., & Roehrig, J. P. (2013) · Body Image · doi:10.1016/j.bodyim.2013.04.008 · Cited by 50 · cited 6× · see citing works
“One measure of positive body image, the Broad Conceptualization of Beauty Scale (Tylka & Iannantuono, 2016), has not yet been incorporated into interventions, which would be an important direction for future research.”
MethodInfluential
Incorporating psychoeducation, mindfulness and self-compassion in a new programme for binge eating (BEfree): Exploring processes of change
Pinto‐Gouveia, J., Carvalho, S. A., Palmeira, L., Castilho, P., Duarte, C., Ferreira, C., Duarte, J., Cunha, M. I. V. A., Matos, M., & Costa, J. (2016) · Journal of Health Psychology · doi:10.1177/1359105316676628 · Cited by 40 · see citing works
Better with age: A health promotion program for men at midlife.
Mellor, D. J., Connaughton, C., McCabe, M. P., & Tatangelo, G. L. (2016) · Psychology of Men & Masculinity · doi:10.1037/men0000037 · Cited by 12 · cited 3× · see citing works
“Neither of the group interventions designed for men (Jankowski et al., 2017; Mellor et al., 2017) significantly improved positive body image, and both received a weak quality rating.”
BackgroundMethod
The Effects of Cognitive Behavioral Therapy on Body Image in Infertile Women
Ahmadi, Z., Abbaspoor, Z., Behrozi, N., & Malehi, A. S. (2017) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.14903 · Cited by 12 · cited 13× · see citing works
“None were of strong methodological quality, but two were moderate (Ahmadi et al., 2017; Bush et al., 2014).”
BackgroundMethodInfluential
Relations of Body Esteem Factors with Exercise Session Attendance in Women Initiating a Physical Activity Program
Annesi, J. J. (2005) · Perceptual and Motor Skills · doi:10.2466/pms.100.3c.995-1003 · Cited by 10 · cited 13× · see citing works
“, 2003), six as moderate (Ahmadi et al., 2017; Annesi, 2005; Rodgers et al., 2018; Toole & Craighead, 2016; Wolfe & Patterson, 2017) and three (by the same author and using the same intervention) as strong, implying a low risk of”
BackgroundMethodInfluential
Relations of Changes in Self-Efficacy, Exercise Attendance, Mood, and Perceived and Actual Physical Changes in Obese Women: Assessing Treatment Effects Using Tenets of Self- Efficacy Theory
Annesi, J. J., Unruh, J. L., & Whitaker, A. C. (2007) · ScholarWorks (Walden University) · doi:10.5590/jsbhs.2007.01.1.05 · Cited by 7 · see citing works
RELATIONS OF BODY ESTEEM FACTORS WITH EXERCISE SESSION ATTENDANCE IN WOMEN INITIATING A PHYSICAL ACTIVITY PROGRAM
Annesi, J. J. (2005) · Perceptual and Motor Skills · doi:10.2466/pms.100.3.995-1003 · Cited by 4 · see citing works

Flagged first, then by citations

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Sorted by citations

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors
Merino, M., Tornero-Aguilera, J. F., Rubio-Zarapuz, A., Villanueva-Tobaldo, C. V., Martín-Rodríguez, A., & Clemente-Suárez, V. J. (2024) · Healthcare · doi:10.3390/healthcare12141396 · Cited by 349 · see citing works
“These dynamics necessitate careful moderation to capture a broad range of experiences and perspectives accurately [206].”
Background
Body functionality: A review of the literature
Alleva, J. M., & Tylka, T. L. (2020) · Body Image · doi:10.1016/j.bodyim.2020.11.006 · Cited by 302 · see citing works
Meta-analysis of gender differences in body appreciation
He, J., Sun, S., Zickgraf, H. F., Lin, Z., & Fan, X. (2020) · Body Image · doi:10.1016/j.bodyim.2020.02.011 · Cited by 207 · see citing works
Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females
Pedalino, F., & Camerini, A.-L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031543 · Cited by 198 · see citing works
“Prior interventions to promote a positive body image among women proved to be effective [54].”
Background
Science mapping research on body image: A bibliometric review of publications in Body Image, 2004–2020
Andersen, N., & Swami, V. (2021) · Body Image · doi:10.1016/j.bodyim.2021.03.015 · Cited by 89 · see citing works
A systematic review of interventions aiming to promote positive body image in children and adolescents
Guest, E., Zucchelli, F., Costa, B., Bhatia, R., Halliwell, E., & Harcourt, D. M. (2022) · Body Image · doi:10.1016/j.bodyim.2022.04.009 · Cited by 82 · see citing works
The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice
Landor, A. M., Winter, V. L. R., Thurston, I. B., Chan, J., Craddock, N., Ladd, B. A., Tylka, T. L., Swami, V., Watson, L. B., & Choukas‐Bradley, S. (2023) · Body Image · doi:10.1016/j.bodyim.2023.101674 · Cited by 76 · see citing works
The Happy American Body 2.0: Predictors of affective body satisfaction in two U.S. national internet panel surveys
Frederick, D. A., Garcia, J. R., Gesselman, A. N., Mark, K. P., Hatfield, E. C., & Bohrnstedt, G. W. (2019) · Body Image · doi:10.1016/j.bodyim.2019.11.003 · Cited by 75 · see citing works
Body image in women diagnosed with breast cancer: A grounded theory study
Brunet, J., Price, J., & Harris, C. A. (2022) · Body Image · doi:10.1016/j.bodyim.2022.04.012 · Cited by 75 · see citing works
An exploration of the associations between facets of interoceptive awareness and body image in adolescents
Todd, J., Aspell, J. E., Barron, D., & Swami, V. (2019) · Body Image · doi:10.1016/j.bodyim.2019.10.004 · Cited by 65 · see citing works
Enriching sociocultural perspectives on the effects of idealized body norms: Integrating shame, positive body image, and self-compassion
Mills, J. S., Minister, C., & Samson, L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.983534 · Cited by 61 · see citing works
Nature exposure and positive body image: (Re-)examining the mediating roles of connectedness to nature and trait mindfulness
Swami, V., Barron, D. S., Todd, J., Horne, G., & Furnham, A. F. (2020) · Body Image · doi:10.1016/j.bodyim.2020.06.004 · Cited by 58 · see citing works
Translation and validation of a Brazilian Portuguese version of the Body Appreciation Scale-2 in Brazilian adults
Junqueira, A. C. P., Laus, M. F., Almeida, S. S., Costa, T. M. B., Todd, J., & Swami, V. (2019) · Body Image · doi:10.1016/j.bodyim.2019.10.002 · Cited by 56 · see citing works
The Value of Integrating Evolutionary and Sociocultural Perspectives on Body Image
Frederick, D. A., & Reynolds, T. A. (2022) · Archives of Sexual Behavior · doi:10.1007/s10508-021-01947-4 · Cited by 54 · see citing works
A Qualitative Exploration of Sport and Social Pressures on Elite Athletes in Relation to Disordered Eating
Stoyel, H., Delderfield, R., Shanmuganathan-Felton, V., Stoyel, A., & Serpell, L. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.633490 · Cited by 52 · see citing works
“As athletes are already using online platforms, an intervention that exists on these platforms could have widespread reach and impact (Guest et al., 2019).”
Background
Revisiting positive body image to demonstrate how body neutrality is not new
Wood-Barcalow, N. L., Alleva, J. M., & Tylka, T. L. (2024) · Body Image · doi:10.1016/j.bodyim.2024.101741 · Cited by 51 · see citing works
Is Childhood Maltreatment Associated with Body Image Disturbances in Adulthood? A Systematic Review and Meta-Analysis
Bödicker, C., Reinckens, J., Höfler, M., & Hoyer, J. (2022) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-021-00379-5 · Cited by 50 · see citing works
Climate Change and Variability Impacts on Agricultural Production and Food Security for the Smallholder Farmers in Rungwe, Tanzania
Gwambene, B., Liwenga, E. T., & Mung’ong’o, C. G. (2022) · Environmental Management · doi:10.1007/s00267-022-01628-5 · Cited by 46 · see citing works
“Studies by Belloumi (2014) and Guest et al. (2019) indicated that climate change would continue to be a major concern in the area where they are poor and heavily rely on climate-sensitive resources.”
BackgroundResultInfluential
A look at the intergenerational associations between self-compassion, body esteem, and emotional eating within dyads of mothers and their adult daughters
Carbonneau, N., Goodman, L. C., Roberts, L. T., Bégin, C., Lussier, Y., & Musher‐Eizenman, D. R. (2020) · Body Image · doi:10.1016/j.bodyim.2020.02.007 · Cited by 45 · see citing works
Inhabiting the Body(ies) in Female Soccer Players: The Protective Role of Positive Body Image
Godoy‐Izquierdo, D., & Ceballos, I. D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.718836 · Cited by 36 · see citing works
Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective
Wiss, D. A. (2022) · Current Addiction Reports · doi:10.1007/s40429-022-00411-0 · Cited by 40 · see citing works
The Relationship between Body Appreciation and Health Behaviors among Women and Adolescent Girls: A Scoping Review
Nolen, E., & Panisch, L. S. (2022) · Health & Social Work · doi:10.1093/hsw/hlac006 · Cited by 35 · see citing works
Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students
Balčiūnienė, V., Jankauskienė, R., & Bacevičienė, M. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01195-4 · Cited by 30 · see citing works
“However, only 13 interventions have aimed to foster positive body image in young women, and less than half of them have been implemented in Europe [8, 16].”
BackgroundMethodResultInfluential
Imagery versus Captions: The Effect of Body Positive Instagram Content on Young Women’s Mood and Body Image
Cowles, E., Guest, E., & Slater, A. (2023) · Body Image · doi:10.1016/j.bodyim.2022.12.004 · Cited by 29 · see citing works
Body image and eating behaviors: A latent profile analysis
Jackson, A., Cox, A. E., Sano, Y., Parker, L. A., & Lanigan, J. D. (2022) · Body Image · doi:10.1016/j.bodyim.2022.04.013 · Cited by 27 · see citing works
Evaluating the impact of a brief Health at Every Size®-informed health promotion activity on body positivity and internalized weight-based oppression
O’Hara, L., Ahmed, H., & Elashie, S. (2021) · Body Image · doi:10.1016/j.bodyim.2021.02.006 · Cited by 27 · see citing works
Body Image Benefits of Allotment Gardening
Swami, V. (2020) · Ecopsychology · doi:10.1089/eco.2019.0032 · Cited by 25 · see citing works
“In order to achieve these outcomes, it is vital to develop interventions that promote positive body image rather than simply reduce negative body image (Guest et al., 2019; Webb et al., 2015).”
Body Compassion Scale
Policardo, G. R., Nerini, A., Gesto, C. D., & Matera, C. (2021) · European Journal of Health Psychology · doi:10.1027/2512-8442/a000088 · Cited by 26 · see citing works
Examining the Exercise and Self-Esteem Model Revised with Self-Compassion among Hong Kong Secondary School Students Using Structural Equation Modeling
Wong, M. Y. C., Chung, P., & Leung, K. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073661 · Cited by 24 · see citing works
“Research has indicated that self-compassion can significantly influence one’s physical well-being [79], body appreciation, and body image [36,80], while it can weaken the relationship between social comparison and body dissatisfaction [81].”
Background
Effectiveness of cognitive-based interventions for improving body image of patients having breast cancer: A systematic review and meta-analysis
Zhao, W., Chong, Y. Y., & Chien, W. T. (2023) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2023.100213 · Cited by 24 · see citing works
A randomized controlled trial investigating two protective filtering strategies to mitigate the effects of beauty-ideal media imagery on women's body image
Alleva, J. M., Grünjes, C. E., Coenen, L., Custers, M., Vester, P., & Stutterheim, S. E. (2024) · Computers in Human Behavior · doi:10.1016/j.chb.2024.108178 · Cited by 23 · see citing works
Dissonance‐based eating disorder prevention delivered in‐person after an online training: A randomized controlled trial for Brazilian men with body dissatisfaction
Almeida, M., Brown, T. A., Campos, P. F., Amaral, A. C. S., & de Carvalho, P. H. B. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23423 · Cited by 22 · see citing works
The body mass index: What’s the use?
Bailey, K. A., Bessey, M., Lamarche, L., & Griffin, M. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101924 · Cited by 21 · see citing works
“But the BMI was predicated on the very idea that there is such a thing as an “ ideal ” height and “ ideal ” weight: contradicting the goals of most positive body image programs which is to reject, reframe, challenge, or critique ideals (Guest et al., 2019).”
Body image and autism: A scoping review
Longhurst, P. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102170 · Cited by 23 · see citing works
The Association of Body Image Perceptions with Behavioral and Health Outcomes among Young Adults
Jiménez-Morcillo, J., Ramos‐Campo, D. J., Rodríguez-Besteiro, S., & Clemente‐Suárez, V. J. (2024) · Nutrients · doi:10.3390/nu16091281 · Cited by 31 · see citing works
Beyond Body Size: Focusing on Body Functionality to Improve Body Image Among Women Who Have Undergone Bariatric Surgery
Alleva, J. M., Atkinson, M. J., Vermeulen, W., Monpellier, V. M., & Martijn, C. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.06.007 · Cited by 20 · see citing works
Association between Motivation in Physical Education and Positive Body Image: Mediating and Moderating Effects of Physical Activity Habits
Jankauskienė, R., Urmanavicius, D., & Bacevičienė, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010464 · Cited by 22 · see citing works
“Positive body image is described as a multifaceted construct that includes an appreciation of the body and its functional abilities, an awareness of the body‘s needs, and the ability to resist and protect oneself from sociocultural pressures regarding appearance [23,26,27].”
Background
Body image of university students: a systematic review of the characteristics of interventions
Huguenin, F. M., de Almeida, V. A. R., Rodrigues, M. V. F., Ferreira, M. E. C., & Morgado, F. F. D. R. (2024) · Psicologia Reflexão e Crítica · doi:10.1186/s41155-024-00307-0 · Cited by 20 · see citing works
“Additionally, the authors stress the necessity of diverse approaches and high-quality investigations to deeply understand the effects of these interventions (Guest et al., 2019).”
Background
Debating Weight Loss vs. Weight Neutral Strategies for Improvements of Health
Heitmann, B. L., Køster‐Rasmussen, R., Meyer, L. B., Larsen, S. C., Þorsteinsdóttir, F., Sandholdt, C. T., Bojsen-Møller, K. N., Overbeck, G., Waldorff, F. B., Kousgaard, M. B., et al. (2024) · Current Obesity Reports · doi:10.1007/s13679-024-00587-8 · Cited by 21 · see citing works
“…that in the short term, weight-neutral interventions improved intuitive eating and resulted in positive changes on dietary quality [49–51] but highlighted the need for further well-designed and long-term studies also including men, who were underrepresented in the most of the studies [48, 52–54].”
Background
An examination of the factor structure and preliminary assessment of the psychometric properties of a Hebrew translation of the Body Appreciation Scale-2 (BAS-2)
Geller, S., Handelzalts, J. E., Levy, S., Boxer, N., Todd, J., & Swami, V. (2020) · Body Image · doi:10.1016/j.bodyim.2020.05.013 · Cited by 19 · see citing works
Incorporating positive body image in therapeutic practice: An overview of construct definitions, concepts and theoretical foundations
Longhurst, P. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12494 · Cited by 23 · see citing works
Efficacy of Eat Breathe Thrive: A randomized controlled trial of a yoga-based program
Estey, E. E. E., Roff, C., Kozlowski, M. B., Rovig, S., Guyker, W. M., & Cook‐Cottone, C. P. (2022) · Body Image · doi:10.1016/j.bodyim.2022.07.009 · Cited by 19 · see citing works
“What can her body do?” Reducing weight stigma by appreciating another person’s body functionality
Alleva, J. M., Karos, K., Meadows, A., Waldén, M. I., Stutterheim, S. E., Lissandrello, F., & Atkinson, M. J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0251507 · Cited by 19 · see citing works
“The present intervention approach was inspired by research from the field of body image, showing that fostering appreciation for one’s own body functionality is currently the most effective technique for enhancing positive body image (for a review, see [29]).”
BackgroundMethod
Modeling the associations between internal body orientation, body appreciation, and intuitive eating among early-adult and middle-adult men and women: A multigroup structural invariance analysis
Modica, C. A. (2021) · Body Image · doi:10.1016/j.bodyim.2021.05.013 · Cited by 19 · see citing works
Psychometric properties of a Dutch translation of the Functionality Appreciation Scale (FAS) among adults in the Netherlands
Alleva, J. M., Custers, M., Wu, Y., & Martijn, C. (2023) · Body Image · doi:10.1016/j.bodyim.2023.101624 · Cited by 17 · see citing works
A Self-Administered Multicomponent Web-Based Mental Health Intervention for the Mexican Population During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial
Rodríguez, A. D., la Rosa-Gómez, A. D., Jiménez, M. J. H., Arenas-Landgrave, P., Martínez-Luna, S. C., Silva, J. A., Hernández, J. E. G., Arzola-Sánchez, C. A., & Guzmán, V. A. (2020) · JMIR Research Protocols · doi:10.2196/23117 · Cited by 17 · see citing works
“Positive psychology interventions drive happiness through the activation of positive emotions [27], increase aspects of positive body image, and have a significant impact on health and well-being [28].”
Background
“I appreciate your body, because…” Does promoting positive body image to a friend affect one’s own positive body image?
Alleva, J. M., Medoch, M. M., Priestley, K., Philippi, J. L., Hamaekers, J., Salvino, E. N., Humblet, S., & Custers, M. (2020) · Body Image · doi:10.1016/j.bodyim.2020.11.002 · Cited by 17 · see citing works
Pathways linking BMI trajectories and mental health in an adult population-based cohort: role of emotional eating and body dissatisfaction
Schrempft, S., Jiménez‐Sánchez, C., Baysson, H., Zaballa, M.-E., Lamour, J., Stringhini, S., Guessous, I., Nehme, M., & on behalf of the Specchio study group (2025) · International Journal of Obesity · doi:10.1038/s41366-025-01772-y · Cited by 16 · see citing works
“Our study highlights emotional eating and body dissatisfaction as important factors associated with BMI trajectories and mental health, and to be considered in weight management and mental health promotion strategies.”
How effective are psychosocial interventions at improving body image and reducing disordered eating in adult men? A systematic review
Hendricks, E., Jenkinson, E., Falconer, L., & Griffiths, C. (2023) · Body Image · doi:10.1016/j.bodyim.2023.08.004 · Cited by 16 · see citing works
Associations between body image, eating behavior, and diet quality
Jackson, A., Parker, L. A., Sano, Y., Cox, A. E., & Lanigan, J. D. (2022) · Nutrition and Health · doi:10.1177/02601060221090696 · Cited by 17 · see citing works
“…intuitive eating, weight neutral, and/or mindful eating interventions either perform equally or better than traditional weight loss interventions in improving health-related outcomes (Dugmore et al., 2020; Grider et al., 2021; Guest et al., 2019), the majority of intervention research is in women.”
Background
Weight bias among children and parents during very early childhood: A scoping review of the literature
Bensley, J. H., Riley, H. O., Bauer, K. W., & Miller, A. L. (2023) · Appetite · doi:10.1016/j.appet.2023.106461 · Cited by 15 · see citing works
The effectiveness of interventions on improving body image for pregnant and postpartum women: a systematic review of randomized clinical trials
Shen, M., Gao, R.-T., Chen, S.-B., Xu, Z.-H., & Ding, X.-D. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06787-3 · Cited by 15 · see citing works
“Concerning methodological quality, the omission of reporting allocation concealment was evident across the part of included studies, potentially biasing participant behavior and outcomes measurement [43].”
Background
‘Everybody’s Different: The Appearance Game’. A randomised controlled trial evaluating an appearance-related board game intervention with children aged 9–11 years
Guest, E., Jarman, H. K., Sharratt, N. D., Williamson, H., White, P., Harcourt, D. M., & Slater, A. (2020) · Body Image · doi:10.1016/j.bodyim.2020.09.010 · Cited by 15 · see citing works
Further evaluation of the psychometric properties of the German version of the Body Appreciation Scale-2 (BAS-2): Cross-validation, measurement invariance, and population-based norms
Warschburger, P., & Behrend, N. (2023) · Body Image · doi:10.1016/j.bodyim.2023.02.004 · Cited by 14 · see citing works
A feeling difficult to identify: Alexithymia is inversely associated with positive body image in adults from the United Kingdom
Longhurst, P., & Swami, V. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.04.142 · Cited by 14 · see citing works
Psychometric evaluation of a revised version of the body appreciation scale-2 for autistic adults (BAS-2A)
Longhurst, P., Todd, J., Aspell, J. E., & Swami, V. (2024) · Body Image · doi:10.1016/j.bodyim.2024.101706 · Cited by 14 · see citing works
Psychometric properties of the Spanish version of the functionality appreciation scale
Zamora, Á., Desdentado, L., Herrero, R., Miragall, M., & Baños, R. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01004-0 · Cited by 14 · see citing works
“‘Expand Your Horizon’ [7], a structured writing program designed to enhance functionality appreciation, has shown potential in promoting positive BI not only in a general female sample but also in women experiencing rheumatoid arthritis [70].”
Background
Enhancing body image in motherhood: A randomised controlled trial of Expand Your Horizon among mothers of young children
Granfield, P., Kemps, E., Yager, Z., Alleva, J. M., & Prichard, I. J. (2023) · Body Image · doi:10.1016/j.bodyim.2023.101648 · Cited by 13 · see citing works
“To achieve this, positive body image interventions may be an effective mechanism (Guest et al., 2019).”
Pilot feasibility and acceptability trial of BE REAL’s BodyKind: A universal school-based body image intervention for adolescents
Mahon, C., Hamburger, D., Yager, Z., Almaraz, M., Mooney, J. T., Tran, T., O’Dowd, O., Bauert, L., Smith, K., Gomez-Trejo, V., et al. (2023) · Body Image · doi:10.1016/j.bodyim.2023.101636 · Cited by 13 · see citing works
Factors associated with the improvement of body image dissatisfaction of female patients with overweight and obesity during cognitive behavioral therapy
Yokoyama, H., Nozaki, T., Nishihara, T., Sawamoto, R., Komaki, G., & Sudo, N. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1025946 · Cited by 12 · see citing works
Breastfeeding self-efficacy, body image, body acceptance, and partner support: Associations in Israeli postpartum women
Geller, S., Levy, S., Baruch, T., Rinot, Y., & Swami, V. (2024) · Midwifery · doi:10.1016/j.midw.2024.103937 · Cited by 12 · see citing works
A Novel, Scalable Social Media–Based Intervention (“Warna-Warni Waktu”) to Reduce Body Dissatisfaction Among Young Indonesian Women: Protocol for a Parallel Randomized Controlled Trial
Garbett, K. M., Craddock, N., Haywood, S., Nasution, K., White, P., Saraswati, L. A., Medise, B. E., Effect, G., Galactic, P., Diedrichs, P. C., et al. (2021) · JMIR Research Protocols · doi:10.2196/33596 · Cited by 12 · see citing works
Eating disorder symptom dimensions and protective factors: A structural network analysis study
Cerea, S., Iannattone, S., Mancin, P., Bottesi, G., & Marchetti, I. (2024) · Appetite · doi:10.1016/j.appet.2024.107326 · Cited by 11 · see citing works
“…opinions and attitudes towards the body (e.g., cognitive dissonance-based or yoga-based interventions, writing-based functionality interventions; Guest et al., 2019), unconditional permission to eat and eating for physical rather than emotional reasons (i.e., intuitive eating interventions)…”
Background
The Mediating Effect of Life Satisfaction on Relation between Perceived Physical Attractiveness and Health-Promoting Lifestyle in Korean Adults
Kim, H., & Yang, H.-M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18157784 · Cited by 11 · see citing works
“A systematic review study indicates that interventions intending to promote positive body image affect health and well-being [39].”
Background
Integrating Mindfulness Into Eating Behaviors
Sorensen, M., Arlinghaus, K. R., Ledoux, T. A., & Johnston, C. A. (2019) · American Journal of Lifestyle Medicine · doi:10.1177/1559827619867626 · Cited by 11 · see citing works
Self-Compassion and Body Image
Tylka, T. L., & Huellemann, K. L. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_11 · Cited by 10 · see citing works
Independent pragmatic replication of the Dove Confident Me body image program in an Australian Girls Independent Secondary School
Forbes, J., Paxton, S. J., & Yager, Z. (2023) · Body Image · doi:10.1016/j.bodyim.2023.06.001 · Cited by 10 · see citing works
Dissonance‐Based Eating Disorder Prevention for Body‐Dissatisfied Brazilian Cisgender Gay and Bisexual Men: A Randomized Controlled Trial With a 1‐Year Follow‐Up
Almeida, M., Santos, C. G., Júnior, M. L. D. O., Resende, T. R. O., Blashill, A. J., Brown, T. A., & de Carvalho, P. H. B. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24246 · Cited by 11 · see citing works
More than Body Appearance! Improving body image in young women through a functionality‐focused intervention combined with psychoeducation: A randomized controlled trial
Cerea, S., Panzeri, A., Burdisso, B., Bottesi, G., Mancin, P., Rapisarda, M., & Ghisi, M. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12514 · Cited by 10 · see citing works
“Psychoeducation is easily delivered online and it is often combined with other structured online interventions (e.g. writing tasks) to maximize its positive impact on body image (Guest et al., 2019).”
Body image among Muslim women in Israel: exploring religion and sociocultural pressures
Sidi, Y., Geller, S., Sinni, A. A., Levy, S., & Handelzalts, J. E. (2020) · Women & Health · doi:10.1080/03630242.2020.1802399 · Cited by 10 · see citing works
More than my appearance: a pilot evaluation of the expand your Horizon Online functionality-based writing programme for adults with visible differences
Guest, E., Halliwell, E., Mathews, A., Alleva, J., & Harcourt, D. (2024) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2024.2349004 · Cited by 9 · see citing works
“Importantly, much of this work has to date been carried out with women-only samples; therefore, a recent systematic review highlighted the need for future research on positive body image interventions which include men (Guest et al., 2019).”
Prevention of eating disorders: 2019 in review
Levine, M. P. (2020) · Eating Disorders · doi:10.1080/10640266.2020.1719342 · Cited by 9 · see citing works
“This paradigm for reducing and treating negative body image, rooted in the work of Thomas Cash, is reviewed in depth by LewisSmith, Diedrichs, and Halliwell (2019; see also Guest et al., 2019).”
Method
Trends in the Study of Attitudes to Appearance from the Point of View of Applied Social Psychology
Лабунская, В. А. (2021) · Social Psychology and Society · doi:10.17759/sps.2021120309 · Cited by 9 · see citing works
How Being in Nature can Promote Healthier Body Image
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Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers
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“Moreover, interventions must have a sex-related perspective due to the differentiated sex-related characteristics [28], focused on the acquisition of PA habits and the enjoyment of practicing PA, especially in women, and considering increased risk for females and little attention dedicated to males [84].”
Background
Raising Confident Girls: A pragmatic school-based trial of a body image and parenting program for mothers of adolescent girls
Forbes, J., Paxton, S. J., & Yager, Z. (2024) · Body Image · doi:10.1016/j.bodyim.2024.101718 · Cited by 9 · see citing works
Befriending the body through clothes: the role of clothing in secular and religious women’s body appreciation
Stolovy, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1297663 · Cited by 7 · see citing works
The effects of Nirvana fitness and functional training on the body appreciation of young women: non-randomized controlled trial
Jankauskienė, R., Balčiūnienė, V., Rutkauskaitė, R., Pajaujienė, S., & Bacevičienė, M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1412259 · Cited by 8 · see citing works
“A recent systematic review concluded, that various strategies including exercise-related interventions targeting multiple components of positive body image can effectively promote positive body image in adults (Guest et al., 2019).”
BackgroundInfluential
Psychometric properties of a French translation of the Functionality Appreciation Scale in French adults (FAS)
Arnaud, C., Bagès, C., Rodgers, R. F., & Rousseau, A. (2024) · Body Image · doi:10.1016/j.bodyim.2024.101835 · Cited by 7 · see citing works
Self-compassion, body appreciation, and eating disorder symptoms among young adults with weight loss goals: a diary study
Batchelor, R., O’Leary, B., Egan, S. J., & Thøgersen‐Ntoumani, C. (2025) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-025-01735-2 · Cited by 7 · see citing works
Expand Your Horizon: Testing a Brief Writing Intervention Focused on Body Functionality Among Adolescent Girls With an Eating Disorder
Glashouwer, K. A., Weiland, S., & Alleva, J. M. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24444 · Cited by 7 · see citing works
“In fact, a systematic review showed that EYH is currently the most effective intervention for improving positive body image in adults (Guest et al. 2019).”
Outcomes of a cluster randomised control trial of Be Real’s BodyKind; A universal body image programme for adolescents in Ireland
Mahon, C., Hamburger, D., Yager, Z., Webb, J. B., Brown, G., & Fitzgerald, A. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101905 · Cited by 7 · see citing works
Teachers’ Ideas about their Appearance and Features of Non-Verbal Communication with Pupils During the Distance Learning
Вячеславовна, К. А., & Александрович, Т. В. (2021) · E3S Web of Conferences · doi:10.1051/e3sconf/202125807080 · Cited by 7 · see citing works
Body Dissatisfaction, Sexual Minority Stress, and Relationship Satisfaction Among Sexual Minority Men in Taiwan
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“A systematic review indicates that most existing interventions with diverse populations capitalize on enhancing intuitive eating, identifying cognitive-behavioral patterns, fostering self-compassion, or motivating exercise behavior to promote positive body image (Guest et al., 2019).”
Background
A brief online writing intervention improves positive body image in adults living with dermatological conditions
Adkins, K., Overton, P. G., & Thompson, A. R. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.1064012 · Cited by 9 · see citing works
The determinants and consequences of positive body image and its promotion strategies
Chao, Y., Zhijie, D., Haoyan, W., Yizhou, Z., Yanli, W., & Fangzhou, Y. (2023) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2023.00815 · Cited by 8 · see citing works
“00 07 1v 1 健康饮食行为习惯的形成，避免成瘾行为的发生，而内感受是可能的且具有潜在研究价值的重要因子。 5 积极身体意象的提升随着积极心理学的发展，研究者们将注意力由消极身体意象的缓解转移至积极身体意象的提升，本研究拟对使用较多的功能性聚焦干预与基于自我同情的干预进行阐释，并明晰两者的区辨关系。 5.1 功能性聚焦干预身体外观包括体重、尺寸等指标，且易通过与社会理想体型的对比引发上行社会比较 (Ren et al., 2018)。因此，对身体外观的过度关注并无益处，通常会加重个体对自身外观缺点的关注，进而削弱身体满意度(Fredrickson & Roberts, 1997)。而身体功能则泛指身体的效能，包…”
Influential
Maximal Strength Training as a Pathway to Positive Body Image: A Qualitative Exploration of the Experiences of Female Powerlifters
Kelly, E. L., Minehan, M., & Pumpa, K. L. (2023) · Women in Sport and Physical Activity Journal · doi:10.1123/wspaj.2022-0088 · Cited by 7 · see citing works
“A systematic review reported that interventions encouraging women to appreciate their bodies ’ functionality signi ﬁ cantly increased facets of positive body image (Guest et al., 2019).”
Background
Effects of online self-compassionate writing on stigmatizing and affirming self-perceptions: Potential boundary conditions in undergraduate women
Huellemann, K. L., Tremblay, P. F., & Calogero, R. M. (2023) · Body Image · doi:10.1016/j.bodyim.2023.07.008 · Cited by 7 · see citing works
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Self-compassion, difficulties in emotion regulation and eating psychopathology: Findings from an eating disorders clinical sample and a college sample
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The feeling is mutual: A randomised controlled trial testing the positive body image process of reciprocity among close friends
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Effects of an Intervention Aimed at Enhancing Elementary School Children’s Positive Body Image
Namatame, H., Yashima, Y., & Sawamiya, Y. (2022) · The Japanese Journal of Educational Psychology · doi:10.5926/jjep.70.205 · Cited by 6 · see citing works
Portuguese version of the Body Appreciation Scale-2 for Children (BAS-2C): Psychometric evaluation and measurement of invariance across sex
Torres, S., Pereira, M. S. D. L., Barbosa, R., Martins, T., Miller, K. M., & Marques, G. F. D. S. (2022) · Body Image · doi:10.1016/j.bodyim.2022.07.018 · Cited by 6 · see citing works
Psychometric properties of a German translation of the Functionality Appreciation Scale (FAS) among adults in Germany
Riechers, R., & Warschburger, P. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101853 · Cited by 5 · see citing works
Disordered Eating in Emerging Adults: A Narrative Review and Recommendations for Prevention
El-Jor, C., Hallez, Q., Filippone, L., Flaudias, V., & Shankland, R. (2025) · Emerging Adulthood · doi:10.1177/21676968251318056 · Cited by 7 · see citing works
“Interventions that target body dissatisfaction are effective in preventing the development of eating disorders, reducing internalization of cultural ideals of appearance, and increasing body satisfaction (Guest et al., 2019).”
Influential
Addressing the Negative Impact of Social Media on Body Image: An Online Randomized Controlled Pilot Trial
Ladwig, G., Schönhals, K., Quittkat, H. L., Dietel, F. A., & Vocks, S. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24584 · Cited by 6 · see citing works
Measuring state functionality appreciation: A psychometric evaluation of an adapted version of the functionality appreciation scale (S-FAS)
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“Recently, there has been a shift in interventions from focusing solely on reducing negative BI to actively promoting positive BI (Guest et al., 2019).”

The effectiveness of randomized controlled psychosocial interventions on body image among nonclinical women: A systematic review and meta-analysis
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A Systematic Review of Psychosocial Interventions on Women’s Body Image
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A systematic review of interventions aiming to promote positive body image in children and adolescents
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Our bodies: a mixed methods study of an internet-based body image intervention using feminist theory to enhance positive body image
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The effectiveness of interventions on improving body image for pregnant and postpartum women: a systematic review of randomized clinical trials
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Authors: Guest, E., Costa, B., Williamson, H., Meyrick, J., Halliwell, E., & Harcourt, D.
Affiliations: University of the West of England (GB)
Corresponding author: Guest, Ella
ORCID: Guest, Ella
Costa, Bruna
Williamson, Heidi
Meyrick, Jane
Halliwell, Emma
Harcourt, Diana
Venue: Body Image
Publisher: Elsevier BV
Published: 2019-09
Volume: 30
Pages: 10-25
ISSN: 1740-1445 (ISSN-L)
DOI: 10.1016/j.bodyim.2019.04.002
OpenAlex: W2944371810
Cited by: 184
References: 88
Citations by year: 2026: 31 · 2025: 35 · 2024: 35 · 2023: 20 · 2022: 24 · 2021: 18 · 2020: 17 · 2019: 4
FWCI: 2.48
Type: journal article
Language: en
Open access: green
eprints.uwe.ac.uk
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Body Image (publishedVersion)
PubMed (publishedVersion)
UWE Research Repository (UWE Bristol) (acceptedVersion, cc-by-nc-nd)
UWE Research Repository (UWE Bristol) (submittedVersion, cc-by-nc-nd)
Funders: University of the West of England
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords: positive body image, body image interventions, body appreciation, body esteem, intuitive eating, cognitive behavioral therapy, self-compassion, exercise intervention, men's body image, female body image, intervention effectiveness
MeSH terms: Adult, Body Image, Empathy, Female, Humans, Male, Self Concept, Exercise

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The Effectiveness of Interventions Aiming to Promote Positive Body Image in Adults: A Systematic Review

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