Multidimensional Positive Body Image and Clinical Change During Eating Disorder Treatment: Preliminary Longitudinal Findings

OBJECTIVE: Positive body image (PBI) is emerging as a relevant dimension of eating disorder (ED) recovery, but longitudinal evidence on how multiple PBI facets change during real-world treatment remains limited. This brief report examines multidimensional PBI change and its associations with clinical outcomes during multidisciplinary hospital-based treatment. METHOD: This study used prospective longitudinal observational data from 21 women receiving ED treatment. Assessments occurred at treatment entry (T1), 6-9 months after baseline (T2), and 12-18 months after baseline (T3). Measures assessed multidimensional PBI (BI flexibility, functionality appreciation, body appreciation, and body responsiveness) and clinical outcomes (ED psychopathology, anxiety, and depression). RESULTS: BI flexibility, functionality appreciation, and body appreciation were the PBI-related dimensions most sensitive to change. BI flexibility and functionality appreciation improved significantly at T2, whereas body appreciation increased only at T3. Body responsiveness and clinical outcomes showed smaller, non-significant mean-level changes. Changes in ED symptoms were moderately associated with concurrent changes in several PBI-related constructs. Greater body responsiveness at baseline was linked to larger subsequent decreases in ED psychopathology. Changes in body responsiveness were also moderately associated with changes in anxiety and depression. DISCUSSION: Several PBI-related dimensions improved over the course of treatment, and these changes may occur despite limited or inconsistent reductions in ED psychopathology and emotional symptoms. Body responsiveness may have clinical relevance even though group-level change was small, as both baseline scores and within-treatment improvements were linked to ED symptom reduction. These preliminary findings support PBI as a complementary component of ED recovery.