The powerful effect of body image inflexibility on the explanation of eating psychopathology severity

Eat Weight Disord. 2022 Apr;27(3):961-968. doi: 10.1007/s40519-021-01233-1. Epub 2021 Jun 5.

Abstract

Purpose: Feelings of shame and social comparison focused on physical appearance have been identified as important risk factors for the engagement in disordered eating behaviours. Further, recent studies have emphasized the role of body-image psychological (in)flexibility in the association between several risk factors and eating psychopathology. The current study intended to explore, in two different path models, the effects of external shame, physical appearance-related social comparison, and body image inflexibility on the explanation of eating psychopathology severity.

Methods: This study follows a cross-sectional design and was conducted in a sample of 776 emerging-adult women, aged between 18 and 28, who completed an online battery of self-report measures. Path analyses were conducted using a structural equation modeling.

Results: Model 1's results showed that external shame and unfavourable social comparison based on physical appearance directly accounts for 26% of the variance in disordered eating. In turn, when body image inflexibility is introduced as a mediator in the relationship presented in Model 1, variance in disordered eating increases to 60% (Model 2). These results suggest that both external shame and unfavourable physical appearance-related social comparison have an impact on disordered eating behaviours. However, when body image inflexibility is introduced, the mentioned relationships change and reveal that psychological inflexibility is a significant mediator of these associations.

Conclusion: These findings seem to demonstrate that body image inflexibility is a key process for the engagement in disordered eating, so the promotion of psychological flexibility focused on one's body is crucial for the prevention and treatment of disordered eating behaviours and attitudes.

Level of evidence: Level IV: Cross-sectional study.

Keywords: Body image inflexibility; Eating psychopathology severity; Emerging adulthood; External shame; Social comparison.

MeSH terms

  • Adolescent
  • Adult
  • Body Image* / psychology
  • Cross-Sectional Studies
  • Feeding Behavior / psychology
  • Feeding and Eating Disorders*
  • Female
  • Humans
  • Self Concept
  • Shame
  • Young Adult