Longitudinal Associations of Body Image Flexibility With Eating Disorder Psychopathology, Eating‐Related Psychosocial Impairment, and Psychological Distress in Chinese Cisgender Men and Women

OBJECTIVE: Body image flexibility is a clinically relevant protective process linked to lower eating disorder psychopathology and better psychological functioning, yet its longitudinal role in shaping psychological risk and resilience remains unclear, particularly across women and men in non-Western contexts. This study examined its bidirectional associations with thinness- and muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress among Chinese adults. METHOD: Chinese adults completed baseline (N = 800; 400 women and 400 men) and eight-month follow-up (N = 491; 246 women and 245 men) online surveys. Cross-lagged panel models were used to examine bidirectional associations. RESULTS: Higher body image flexibility at T1 was related to lower levels of thinness-oriented disordered eating, muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress at T2. Conversely, higher levels of thinness-oriented disordered eating, muscularity-oriented disordered eating, eating-related psychosocial impairment, and psychological distress at T1 were related to lower body image flexibility at T2. These bidirectional associations were consistent across women and men. DISCUSSION: Body image flexibility can function both as a protective resource and as a process susceptible to psychological strain. Intervention efforts should be gender inclusive and target multidimensional forms of eating disorder psychopathology alongside psychological well-being.