Functionality appreciation has been identified as a core facet of positive body image. While prior work has examined this construct in community and adult clinical samples, little is known about functionality appreciation in adolescents with eating disorders. The present study investigated associations between functionality appreciation, body appreciation, self-esteem, and eating disorder symptom severity in adolescent girls with eating disorders (N = 58, Mage = 16.19). Participants completed the Functionality Appreciation Scale (FAS), Body Appreciation Scale-2 (BAS-2), Single-Item Self-Esteem Scale (SISE), and Eating Disorder Examination Questionnaire (EDE-Q). Results showed that adolescent girls with eating disorders reported lowered functionality appreciation scores, similar to those observed in adult clinical populations. Further, functionality appreciation was strongly and positively correlated with body appreciation and moderately and inversely correlated with eating disorder symptom severity. Correlations with self-esteem were weaker and nonsignificant. These findings underscore the importance of functionality appreciation for adolescents with eating disorders. Given its observed associations with both body appreciation and eating disorder symptom severity, functionality appreciation may serve as a relevant target for treatment.

It has been predicted that soon a majority of online content will be created with generative artificial intelligence, or gen-AI. Yet, there is currently limited knowledge about how exposure to content created by gen-AI may impact users' body image. This study investigated the effects of exposure to gen-AI imagery depicting (i) the fit ideal; (ii) functionality and body diversity; or (iii) neutral, non-body-related objects, on young women's body image, and whether these effects would differ when participants were informed that the imagery was created by gen-AI. Participants were 291 women between 18 and 31 years old (Mage = 25.67, SD = 3.04) from the United States, recruited through Prolific. Controlling for pretest levels of the respective outcome, the analyses showed that the fit ideal condition reported lower posttest state functionality appreciation, body appreciation, and appearance satisfaction compared to the functionality diversity condition. Differences between these two conditions and the control condition were nonsignificant, except for significantly lower posttest state body appreciation in the fit ideal condition. The analyses also revealed that participants who received a disclosure—regardless of what type of imagery they saw—reported higher posttest state functionality appreciation; however, there were no differences in body appreciation and appearance satisfaction. Moderation analyses for trait appearance comparisons and appearance-ideal internalization showed that fit ideal and functionality diversity imagery were especially impactful for more ‘vulnerable’ individuals—generally, those with higher levels of these moderators. These results suggest that exposure to functionality diversity gen-AI imagery can improve body image, particularly for those with high levels of trait appearance comparisons and internalization.

IntroductionOrthorexia Nervosa (ON) is defined as a preoccupation with abiding by a self-perceived healthy diet resulting in pathological thought, behavior and emotion. Social media platforms may add to this preoccupation with healthy eating by offering accessible exposure to food and dieting information. Yet, the precise nature of the association between ON and exposure to social media remains underexplored. The aim is to explore the existing literature on the relationship between social media and ON in a scoping search and to synthesize the findings.MethodsWe searched PubMed, Web of Science, PsycInfo (Ovid), ProQuest, and Embase (Elsevier). As for the grey literature, we searched ProQuest Dissertations and Open Access Theses and Dissertations. The first literature search was conducted on August 7, 2023 then a literature update on September 18, 2024.ResultsAfter the identification of studies and data extraction, authors assessed the methodological quality of included studies. The characteristics and findings from the studies were narratively synthesized, with a focus on the platform, duration, and content of social media use. A total of 31 studies were identified between 2017 and 2024, which were predominantly cross-sectional and focused on Westernized populations. The results have shown a bidirectional relationship between ON and social media, influenced by the characteristics of the platform (e.g., image-based), duration of use (e.g., longer use), content themes (e.g., diet and fitness-related), and individual-level factors (e.g., limited health literacy, young adulthood and adolescence, and body dissatisfaction).ConclusionThe main research gaps found were the absence of experimental studies, lack of studies in non-Westernized populations, restrictive samples, and lack of investigations about developmental pathways. Longitudinal, experimental and qualitative studies in future research are warranted to advance knowledge. Systematic review registration: Open Science Framework (OSF) Registries (DOI https://osf.io/vrqwt).

Body-positive content on social media has been found to have positive consequences for body image. However, research on the mechanisms underlying this effect is scarce. Based on the tripartite influence model (Thompson et al., 1999) and acceptance model of intuitive eating (Avalos & Tylka, 2006), this study examined the role of four possible mechanisms: appearance-comparison, thin-ideal internalization, body acceptance by others, and internal body orientation. Young women (N = 340; 18-30 years, Mage = 24.42) were randomly assigned to view appearance-ideal, body-positive (Instagram vs. reality), or appearance-neutral content. Before and after the manipulation, indicators of negative and positive body image were assessed, as well as the four possible mechanisms under consideration. A series of ANCOVAs and paired sample t-tests revealed that exposure to body-positive content had a positive impact on positive body image compared to the other two conditions. Exposure to body-positive content was also found to result in a decrease of thin-ideal internalization. Moreover, while no significant differences were observed between conditions at posttest, body appreciation by others and internal body orientation showed selective within-condition increases from pretest to posttest in the body-positive condition with effects for internal body orientation limited to one indicator. These findings suggest that reductions in thin-ideal internalization and, to a lesser extent, increases in body appreciation by others and internal body orientation, are possible mechanisms underlying the impact of body-positive content on body image.

While still nascent, research has yet to examine the factor structure and measurement invariance of the State Functionality Appreciation Scale (S-FAS; Longhurst et al., 2025) across demographic groups, beyond gender identity. Additionally, there is a need to explicitly examine the utility of Expand Your Horizon (EYH), a programme designed to target functionality appreciation, among underrepresented groups, including older adults and those who live in larger bodies. To this end, using secondary data from Longhurst et al. (2025), the aims of this study were two-fold: First, among a UK-based community sample (N = 861), we sought to examine the factorial stability and measurement invariance of the S-FAS across adult age groups and body size groups. Among a second UK-based community subsample (N = 293), the secondary aim was to assess the preliminary efficacy of EYH across adult age groups and body size groups. Confirmatory factor analysis supported a unidimensional structure of S-FAS baseline scores and measurement invariance (up to latent means) across adult age groups and (up to partial scalar) body size groups. Additional results demonstrated that baseline S-FAS scores were highest among older adults, while changes in state functionality appreciation following intervention were highest among emerging adults. EYH improved state functionality appreciation across all body size groups, particularly among those who live in larger bodies. Future research should assess the longitudinal measurement invariance of the S-FAS and qualitatively explore body functionality across marginalised populations.

Enough is Enough (EIE) is characterized by feeling fed up with negative body image and feeling determined to change one's body image, and may play a crucial role in the transition from a negative body image toward a predominantly positive body image. Study 1 aimed to develop a quantitative measure of EIE. Based on data collected among 552 adults (18-69 years) across two samples, the 3-item EIE Scale demonstrated a unidimensional factor structure and good psychometric properties. Study 2 adopted a single case experimental design, and aimed to develop a program to increase EIE among five women who identified as having a negative body image. The findings support that the EIE program led to increased EIE, with medium-to-large effects. While the research line focused on EIE, as part of this, we also sought to understand its relationship with participants' readiness to change, or stage of change (SOC), and whether the EIE program would lead to increased SOC and positive body image. Study 1 showed that EIE is positively associated with SOC, and EIE predicted SOC beyond the variance accounted for by body image (related) variables. Study 2 showed that the EIE program led to increased SOC and positive body image, with small-to-medium effects. Some participants experienced increased EIE but not SOC (and vice versa), pointing to differences between constructs. Understanding how to initiate EIE may increase the number of individuals with negative body image who are open to change and the chances of existing body image interventions being effective.

Body-positive content is prevalent on social networking sites (SNS). Research shows that engagement with body-positive content reduces aspects of negative body image and increases aspects of positive body image. However, the mechanisms accounting for the impact of body-positive content on body image are not well understood. In this study, we used the tripartite influence model (Thompson et al., 1999) and acceptance model of intuitive eating (Avalos & Tylka, 2006) to examine how engagement with appearance-ideal and body-positive content on Instagram relates to aspects of negative and positive body image. Structural equation modelling of cross-sectional data from 454 female participants (Mage = 22.65) revealed that engagement with appearance-ideal content was indirectly associated with (higher) negative and (lower) positive body image through lower internal body orientation and body acceptance by others, and (in case of negative body image) through higher thin-ideal internalisation. Engagement with body-positive content predicted (higher) positive body image but not negative body image; appearance comparison, thin-ideal internalisation, internal body orientation, and body acceptance by others did not mediate this effect. These findings illustrate the value of combining elements of the tripartite influence model and acceptance model of intuitive eating to understand the relationship between SNS and body image.

Objective Negative body image is thought to play an important role in the onset and maintenance of anorexia nervosa and bulimia nervosa. The intervention Expand Your Horizon (EYH), which is focused on increasing functionality appreciation, is being investigated as a potential approach for improving body image. This study investigated the themes that were identified when adolescent girls with an eating disorder are asked to describe their body functionality within the context of EYH.Method Fifty-eight girls with an eating disorder received the EYH intervention and wrote about everything their body can do and why these functions are meaningful to them. The qualitative data were analyzed via Thematic Analysis.Results We identified five themes from the data: body functions as a means to experience and regulate emotions; body functions as a vehicle to form social connections; body functions as a means to experience independence and identity; how body functions are intertwined with the eating disorder; and the aesthetic body.Discussion This study highlights the importance of body functionality in the experiences and perceptions of adolescent girls with eating disorders. The findings support the idea that adolescents with eating disorders are able to appreciate their bodies for what they can do rather than focusing solely on their appearance.

Within the body functionality and body image research, there is an absence of psychometrically validated measures for capturing functionality appreciation as a state-like construct. To address this, we conducted an extensive psychometric analysis of a state version of the Functionality Appreciation Scale (FAS; Alleva et al., 2017), initially offered by Alleva et al. (2024b), across two online studies. Exploratory factor analyses among a UK-based community sample of 583 adults (18-85 years; age M = 34.66) led to the extraction of a 7-item, unidimensional model of S-FAS scores, which presented adequate composite reliability and good patterns of construct validity (i.e., convergent, concurrent, incremental). Using confirmatory factor analyses, we cross-validated the optimal model among a second community sample of 295 adults (18-78 years; age M = 38.65) from the United Kingdom. Results showed that the unidimensional model of S-FAS scores had adequate fit, demonstrated discriminant validity, and provided additional evidence of measurement invariance (up to latent mean level) across gender identity (women, men) and time (i.e., at pre-test and post-test). Our findings further showed that the S-FAS is sensitive to experimental manipulation and thus accurately captures changes in state functionality appreciation. Overall, the S-FAS is a psychometrically valid measure for assessing functionality appreciation as a state-like construct in future research and practice.

Body functionality has been identified as an important dimension of body image that has the potential to be useful in the prevention and treatment of negative body image and in the enhancement of positive body image. Specifically, cultivating appreciation of body functionality may offset appearance concerns. However, a scale assessing this construct has yet to be developed. Therefore, we developed the Functionality Appreciation Scale (FAS) and examined its psychometric properties among three online community samples totaling 1042 women and men (ns = 490 and 552, respectively). Exploratory factor analyses revealed a unidimensional structure with seven items. Confirmatory factor analysis upheld its unidimensionality and invariance across gender. The internal consistency, test-retest reliability, criterion-related, and construct (convergent, discriminant, incremental) validity of its scores were upheld. The FAS is a psychometrically sound measure that is unique from existing positive body image measures. Scholars will find the FAS applicable within research and clinical settings.

OBJECTIVE:In the last decade, body image research has increasingly focused on the distinction between negative and positive body images as separate constructs. Functionality appreciation is a crucial component of positive body image and might be an important source for coping with body image problems. The intervention Expand Your Horizon (EYH; Alleva et al. 2015a) was designed to increase functionality appreciation and has demonstrated positive effects on body image across different adult populations. In the current research, we investigated the short-term effects of a single-session EYH in adolescent girls with an eating disorder. METHOD:Fifty-eight adolescent girls with an eating disorder were randomly assigned to the EYH condition or an active control condition. Different aspects of positive and negative body images were assessed before and after the intervention. RESULTS:Participants in the experimental condition showed higher scores than the control condition on positive body image after the writing exercise, but no effects on negative body image were found. Exploratory analyses showed that improvements in the positive body image remained stable 15-30 min after the writing exercise. DISCUSSION:These outcomes suggest that writing about body functionality leads to direct increases in positive body image but not to decreases in negative body image. An important step for future studies would be to test the full three-session version of EYH and investigate its effects over the longer term. This could help to determine the robustness of the present findings and the potential of EYH as a complementary intervention to existing treatments.

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.

Across many cultures, women are evaluated based on their appearance, with narrow societal beauty ideals as the standard against which they are judged and, eventually, judge themselves. Women who internalize the beauty ideal are more likely to consider cosmetic surgery. Dissonance-based interventions targeting thin-ideal internalization are effective at preventing eating disorders and associated risk factors. In this study, we evaluated an online dissonance-based intervention targeting beauty-ideal internalization to reduce favorable attitudes toward cosmetic surgery among Chinese women. Chinese women who were dissatisfied with their appearance and who were considering cosmetic surgery were randomized to the intervention (n = 127, M-age = 35.49) or to the educational brochure control condition (n = 98, M-age = 32.97). Beauty-ideal internalization, favorable attitudes toward cosmetic surgery, facial appearance concerns, body satisfaction, and body appreciation were assessed at pretest, posttest, and 4-week follow-up. Intention-to-treat analyses showed that the intervention reduced beauty-ideal internalization and favorable attitudes toward cosmetic surgery at posttest, with small-to-medium effect sizes; however, effects were not sustained at follow-up. No effects were found for facial appearance concerns, body satisfaction, and body appreciation. This study provides preliminary evidence for the short-term efficacy of the dissonance-based intervention for reducing beauty-ideal internalization and favorable attitudes toward cosmetic surgery, and points to valuable directions for improvement. Additional online materials for this article are available on PWQ's website at http://journals.sagepub.com/ doi/suppl/10.1177/03616843231183946.

This study investigated the positive body image process of reciprocity and tested whether promoting positive body image can improve one’s own and the others’ body image. To this end, 124 pairs of female friends (N = 248) were randomised to the experimental or control group. Within each pair, friends were randomised to be the “letter writer” or “letter receiver.” Letter writers wrote a letter expressing appreciation for their friend’s body functionality (experimental group) or for their shared memories (control group) and read their letter to their friend. Body appreciation, functionality appreciation, and self-objectification were measured at pretest, midtest (after letter writing), and posttest (after reading). Letter writers in the experimental group reported higher body appreciation and lower self-objectification at midtest and posttest, and higher functionality appreciation at posttest, compared to the control group. Further, both groups reported higher body appreciation and functionality appreciation from midtest to posttest. Similarly, letter receivers in both groups reported higher body appreciation and functionality appreciation from midtest to posttest, and letter receivers in the control group reported decreased self-objectification. The findings suggest that promoting positive body image can improve one’s own and others’ body image, but the effects of the control activity must be considered.

Background:Adults with conditions that affect their appearance, known as visible differences, can experience appearance concerns, social anxiety, and depression. Interventions have been developed for this population to facilitate adjustment and coping skills; however, they have limited evidence of efficacy. The Expand Your Horizon [Alleva, J. M., Martijn, C., Van Breukelen, G. J., Jansen, A., & Karos, K. (2015). Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 15, 81-89. https://doi.org/10.1016/j.bodyim.2015.07.001] online functionality-based writing programme was adapted for adults with visible differences.Method:A pilot randomised controlled trial with a wait-list control group was carried out to assess preliminary intervention efficacy and gain information about the acceptability and feasibility of the programme. Forty-four adults aged 21-63 years (M = 40.21; SD = 12.05) with visible differences took part. Various facets of body image (i.e. functionality appreciation and body appreciation) as well as depression and anxiety were assessed immediately pre- and post-intervention and at three-months.Results:Participants reported enjoying the programme, felt that the format was acceptable, and it significantly increased functionality appreciation, which was maintained at three-months. However, there were no improvements in body appreciation, depression, and anxiety.Conclusions:In future, a full trial should be carried out with an active control group.

Recent research has shown that women with a positive body image engage in a process called protective filtering—whereby they 'filter in' information that can promote and protect their positive body image, and 'filter out' information that could be harmful. In this study, we investigated two protective filtering strategies and whether they could mitigate the effects of beauty-ideal media imagery (one particularly pervasive body-image 'threat') on women's body image. To do so, we randomized 150 women (Mage = 22.05) to complete an exercise familiarizing them with one of two protective filtering strategies (i.e., functionality appreciation or personality and values) or with a control topic. Afterward, the participants were exposed to a series of beauty-ideal media images and were prompted to continue to engage in their assigned strategies. Controlling for pretest levels of the respective variables, the repeated measures ANCOVAs showed that the two protective filtering groups reported a more positive body image (i.e., higher body appreciation, functionality appreciation, and appearance satisfaction), both after the familiarization exercise and after the beauty-ideal media exposure, compared to the control group. However, participants across all three groups reported lower positive body image from before to after the beauty-ideal media exposure. The findings for self-objectification were mixed, with all three groups reporting higher self-objectification after beauty-ideal media exposure, but with the functionality appreciation group reporting lower self-objectification compared to the other two groups. Overall, the findings suggest that the protective filtering strategies can confer some benefits to women's body image, but are not foolproof.

This study investigated a novel technique to improve body image among women who have undergone bariatric surgery-namely, by having them focus on their body functionality (everything the body can do, rather than how it looks). Participants were 103 women (Mage = 46.61) who had undergone bariatric surgery 5-7 months prior to the study. They were randomized to the 1-week online intervention, comprising three functionality-focused writing exercises (Expand Your Horizon; Alleva et al., 2015), or to a wait-list control group. Body appreciation, appearance and functionality satisfaction, body awareness, self-objectification, self-esteem, and self-kindness were assessed at pretest, posttest, and at 1-week and 3-month follow-up. Multilevel modeling analyses showed that, compared to the control, the intervention group experienced improved body appreciation at posttest, and these improvements persisted at both follow-ups. These findings were nonsignificant when intent-to-treat analyses were performed. Both available case and intent-to-treat analyses showed that all participants experienced improvements in facets of body image across time. Qualitative analyses of participants' responses to the intervention writing exercises provided more insight. Via coding reliability thematic analysis, we identified 11 themes that together provide evidence that intervention participants experienced facets of a more positive body image, while also facing challenges to their body image and well-being. Together, findings suggest that focusing on body functionality may contribute to improved body image among women who have undergone bariatric surgery, but effects may be nuanced compared to prior functionality research among general samples of women. The study was registered retrospectively (ClinicalTrials.gov; identifier NCT04883268).

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures functionality appreciation, the extent to which people appreciate their body for what it is able to do. We translated the FAS to Dutch and evaluated its factor structure and psychometric properties among 471 native Dutch speakers in the Netherlands (255 cisgender women, 204 cisgender men, 8 nonbinary, 1 "other," 3 "rather not say") who were between 18 and 85 years old. Participants completed the Dutch translation of the FAS, followed by questionnaires to assess additional variables of interest (body appreciation, appearance satisfaction, self-esteem, and gratitude). Exploratory factor analysis showed that Dutch FAS scores demonstrated a unidimensional factor structure. Dutch FAS scores demonstrated acceptable internal consistency and construct validity via their positive associations with the additional variables of interest. Dutch FAS scores also demonstrated gender invariance, and women reported higher functionality appreciation than men. Dutch FAS scores evidenced incremental validity for gratitude (but not self-esteem), and were inversely correlated with age and body mass index. Last, 2-week test-retest reliability of the Dutch FAS scores was supported. Overall, these findings provide support that the Dutch FAS is a psychometrically sound instrument to assess functionality appreciation among Dutch speaking adults in the Netherlands.

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.

Motherhood can increase vulnerability to body dissatisfaction, but positive body image interventions may mitigate this. Expand Your Horizon (Alleva et al., 2015), an online writing intervention, enhances functionality appreciation, an aspect of positive body image. The intervention's demonstrated efficacy and focus on body functionality indicate its potential use among mothers. However, its original 3-session format may be unfeasible for mothers alongside other commitments. Thus, we tested the impact of a single 15-minute Expand Your Horizon session on state body appreciation and functionality appreciation. Mothers (N = 143) of 0-10-year-olds were randomly allocated to either the intervention group, or an active control group. State body appreciation and functionality appreciation were assessed pre- and post-intervention. Trait self-compassion was tested as a potential moderator. Participants who completed Expand Your Horizon reported greater state body appreciation and functionality appreciation post-intervention than those in the control group. Self-compassion moderated the intervention's effect on state functionality appreciation, with effects strongest for those with lower levels of selfcompassion. Overall, findings support the intervention's suitability for mothers, particularly those with low selfcompassion. Practical implications include possibly tailoring Expand Your Horizon and similar interventions to benefit all mothers. Future research directions include longitudinal and qualitative designs, and extension to other specific populations.