A randomized controlled trial of The Body Project: More Than Muscles for men with body dissatisfaction

Abstract

Objective Pressures for men to conform to a lean, muscular ideal have, in part, contributed to eating disorder and muscle dysmorphia symptoms, yet few programs have been developed and empirically evaluated to help men. The present study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention in reducing eating disorder and muscle dysmorphia risk factors in men with body dissatisfaction. Method Men were randomized to a 2-session DB intervention (n=52) or a waitlist control condition (n=60). Participants completed validated measures assessing eating disorder risk factors pre-intervention, post-intervention, and at 1-month follow-up. Results Program ratings indicated high acceptability. The DB condition demonstrated greater decreases in body-ideal internalization, dietary restraint, bulimic symptoms, drive for muscularity, and muscle dysmorphia symptoms compared to controls (p-values < .02; between-condition Cohen’s d = .30–1.11) from pre- to post-intervention. At one-month follow-up, the DB condition demonstrated significantly lower scores for all variables (p-values < .03; between-condition d = .29–1.16). Body-ideal internalization mediated intervention outcomes on bulimic and muscle dysmorphia symptoms. Discussion Results support the acceptability and efficacy of The Body Project: More Than Muscles up to one-month post-intervention and should be examined against active control conditions.

Thinness and muscularity internalization: Associations with disordered eating and muscle dysmorphia in men

“…The present study has potential implications for eating disorder and body image intervention efforts in men. Dissonance‐based interventions targeting internalization of societal ideals may be effective in reducing bulimic and muscle dysmorphia symptoms in men with elevated body image concerns (Brown et al, ). Brown et al () found that these reductions were mediated by decreased general internalization.…”

“…Dissonance‐based interventions targeting internalization of societal ideals may be effective in reducing bulimic and muscle dysmorphia symptoms in men with elevated body image concerns (Brown et al, ). Brown et al () found that these reductions were mediated by decreased general internalization. The present study indicates that changes in internalization due to the dissonance‐based intervention may differ on the two dimensions of male body ideals (muscularity and thinness).…”

Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating

“…Indeed, a systematic review by Watson and colleagues [47] reported that males represented 1% of participants in selected ED prevention programs. Based on recent research, dissonance-based interventions appear to have promise in reducing ED risk among males [48–50]. Such interventions, based in cognitive dissonance theory, engage participants in various verbal, behavioral, and written activities that argue against the body ideal perpetuated by society.…”

“…Kilpela and colleagues [49] developed a mixed-gender dissonance-based program that demonstrated efficacy at reducing body dissatisfaction in multiple domains (i.e., body fat, muscularity, and overall) for male college students compared to waitlist control, with effects maintained through 6-month follow-up. Brown and colleagues [50] examined the efficacy of a dissonance-based intervention targeting traditional ED and muscle dysmorphia-related psychopathology and demonstrated greater improvements in body-ideal internalization, dietary restraint, bulimic symptoms, drive for muscularity, and muscle dysmorphia symptoms compared to waitlist post intervention and at 1-month follow-up. Supporting the posited mechanism of action, internalization of a lean, muscular body ideal mediated intervention effects on both bulimic symptoms and muscle dysmorphia symptoms.…”

Should body image programs be inclusive? A focus group study of college students

“…A broader identity focus within interventions also may help to include racial, gender, and sexual minorities, who may be uniquely vulnerable to developing body dissatisfaction and related psychopathology (e.g., Diemer et al, ; Marques et al, ; Matthews‐Ewald, Zullig, & Ward, ; Pike, Hoek, & Dunne, ). Limited research has examined dissonance intervention implementation in non‐female groups, with success among gay men (Brown & Keel, ) and men with body dissatisfaction (Brown, Forney, Pinner, & Keel, ), but perhaps not in mixed‐gender groups (Kilpela et al, ). Kilpela et al speculate that while mixed gender groups are supportive, they may reduce participation from female group members, diminishing the dissonance and dampening the social injustice that activates positive change.…”