Contrasting constructs or continuum? Examining the dimensionality of positive and negative body image

Background: Prevalence of body dissatisfaction is high – especially among women – and leads to poor health outcomes in part due to lowered engagement in physical activity. Body appreciation is proposed to be theoretically distinct from dissatisfaction and to be protective of activity engagement. We evaluated whether body dissatisfaction and appreciation are distinct constructs and whether they interacted in the prediction of activity-related motivation and behaviour.

Methods: Two observational studies were conducted in the Midwest United States: Study 1 (n = 313 undergraduates) was cross-sectional and used a self-report measure of activity (International Physical Activity Questionnaire) and Study 2 (n = 123 undergraduates and staff) was prospective (two weeks) and used FitBits to measure activity. Both studies measured intrinsic motivation (Behavioral Regulation in Exercise Questionnaire-3), the Body Appreciation Scale, and the Body Shape Satisfaction Scale at baseline. Exploratory factor analyses were used to assess construct independence and polynomial regression was used to assess the interactive effect. A multiverse approach was taken to assess the robustness of findings.

Findings: Across studies and multiverse variations, dissatisfaction and appreciation did not represent unique constructs (one-factor solution accounting for 48.95% and 46.07% of the variance). Moreover, appreciation did not buffer against the negative effects of dissatisfaction on activity-related motivation and behaviour (ps > .05 for all non-linear models).

Discussion: If these results are replicated, then the theoretical independence of these constructs will need to be reconsidered. Additionally, interventions may not need to target both independently in individuals with high levels of dissatisfaction.