Objectives This systematic review assessed the influence of the COVID‐19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. Methods After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). Results Data from 75 qualitative, quantitative, and mixed‐methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID‐19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder‐related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID‐19. Discussion There is large variability in individuals' responses to COVID‐19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID‐19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. Public Significance This review of 75 studies highlights the widespread negative impacts that the COVID‐19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.

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The results support the usefulness of the CBM-I for appearance protocol, and suggests that this technique warrants further investigation with respect to modifying interpretation bias and risk factors associated with eating disorder psychopathology. Null effects of CBM-I for self-worth should be interpreted in light of study limitations, including the potential unsuitability of training material for young women. CBM-I for both types of interpretation bias should be evaluated in future research.

Playables are mini-games used in digital advertising and may offer a novel and engaging avenue to improve young people’s well-being at scale. This randomised controlled trial evaluated the immediate impact and protective properties of a psychoeducational playable on adolescents’ body satisfaction and negative affect, and engagement in prosocial behaviours, relative to two active control conditions. Girls and boys aged 13–14 years ( N = 6575) were randomised into one of three conditions: body image playable, body image social networking posts (i.e. static images of the body image playable messages; control 1) or an ocean conservation playable (control 2). Both body image micro-interventions significantly improved state body satisfaction and negative affect, relative to the oceanic playable. No condition buffered against the negative effects associated with viewing idealised media images. Developing playables to counteract the potentially harmful effects associated with surrounding digital environments is a promising avenue for mental health.

Background and Objectives: This study systematically reviewed the impact of Cognitive Bias Modification (CBM) on biases related to attention (CBM-A) and interpretation (CBM-I) for appearance and self-worth stimuli and the subsequent impact on eating disorder (ED) psychopathology. Method: The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with 12 studies meeting inclusion criteria (CBM-A n = 5; CBM-I n = 7). Results: The literature provides preliminary support for CBM-A and CBM-I efficacy in eliciting bias change in varying degrees of psychopathology (Cohen's d ranging between-1.67 and 1.34; 9 studies reflected improved bias, and 3 reflected no change or did not assess), while highlighting the less robust effects associated with improving ED psychopathology (d ranging between-1.30 and .61; 5 studies reflected symptom improvement, and 7 reflected no change or did not assess). Limitations: The review only considered peer reviewed research and did not report on the findings of unpublished data; thus, the current findings may not provide an accurate representation of CBM in EDs. Conclusions: The current findings highlight the potential of CBM as an adjunct intervention for EDs; however the limited number of investigations and high degree of heterogeneity across the included studies impedes on the generalisability of the findings.

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Objectives. This review assessed the impact of COVID-19 and restrictions related to the pandemic (e.g., social distancing and lockdown) on body image, disordered eating, and eating disorder outcomes. Method. After registration on PROSPERO, a systematic search was conducted for papers published between 1 December 2019 and 1 August 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest. Results. A final sample of 74 reports, describing 75 studies, was included, and data from qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach. Four themes were generated: (1) disruptions due to COVID-19; (2) variability in the improvement or exacerbation of symptoms; (3) risk and protective factors; and (4) unique challenges for marginalized and underrepresented groups. Findings across studies showed variation in individuals’ responses to, and experiences of, the current pandemic. Discussion. There is large variability in how individuals respond to COVID-19 and limited research exploring the effect of the pandemic on body image, disordered eating, and eating disorder outcomes using longitudinal and experimental study designs. Based on the findings of this review, we recommend that individuals reduce time spent on social media, maintain contact with family and friends, make time for self-care, and keep daily routines. Additionally, researchers should target more diverse participant samples and conduct longitudinal research on risk and protective factors of COVID-19 and long-term outcomes. Finally, clinicians should consider adopting flexible treatment practices, taking into account COVID-19 restrictions, patient preferences, and unique participant needs.

Background Body image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children’s Fund (UNICEF). Methods A two-armed fully remote randomised controlled trial will evaluate the chatbot’s effectiveness at improving body image and well-being. Adolescent girls and boys (N = 2800) aged 13–18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence. Discussion This research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources. Trial registration number NCT04825184, registered 30th March 2021.