A randomized, controlled trial of mindfulness plus exposure for improving body image in women

Research supports a multifaceted conception of body image incorporating attitudinal and behavioural elements. Cognitive-behavioural therapy including psychoeducation and body image exposure are two therapeutic approaches with demonstrated success in improving body image. Mindfulness practice, which has already been incorporated into a number of successful psychological treatments, has yet to be integrated into empirically tested body image treatment programs. The practice's emphasis upon awareness, nonjudgemental acceptance, description, and non-reactivity suggest it has potential to also address body image components such as internalization, evaluation, body image schema, and investment. In the present study a randomized, controlled trial investigated the utility of mindfulness combined with body image exposure (MPE). University women seeking to improve their body image engaged in mindfulness education followed by brief, daily mindfulness exercises while viewing a 3-dimensional representation of their image. The efficacy of the MPE intervention was compared to a credible, psychoeducational video program called Turning Points 2 (TP2) that addresses body image and related concerns among women. Intent-to-treat analysis revealed that both interventions were associated with significant improvement in body image and self-esteem and reductions in eating concerns and dieting behaviour with no differential efficacy. Exploratory analysis revealed the MPE intervention may be particularly beneficial in improving the body image of women with elevated baseline negative affect. Furthermore, only among those in the MPE intervention were reductions in negative affect correlated with reductions in body dissatisfaction. Results are discussed in terms of the limitations and implications of the present findings, as well as the relative benefits of the MPE and TP2 interventions in improving body image.