The BMA 2.0 was found to be a reliable and valid measure of body image in Caucasian women and men and African-American women and men. The BMA 2.0 represents a technological improvement to existing figural stimuli measures as it utilizes a wider range of stimuli (100 stimuli in range), it accommodates both sexes and different ethnic groups (i.e., African-American and Caucasian), it utilizes a fine grained assessment that allows for greater precision in measurement than previous measures of its kind.
Content validity of the BMA 2.0 stimuli was found to be satisfactory. An expert panel also found the stimuli to be satisfactory with slightly lower ratings for representation of race. The BMA 2.0 cannot account for diverse body shapes, only body size (it is not possible to adjust the figure by areas or body parts–the figure “grows” or “shrinks” as an overall size). This could account for content validity ratings from the expert panel, as well as the participants, that were below 7 on the Likert scale. At the time of its development, technology was not available to incorporate features in order for body areas or parts to “grow” independently of the entire figure size. However, present technology allows for this development. Thus, a measure currently in development will incorporate this and other advanced features. It is important to note that other investigators have attempted similar technology with video distortion methods (Aleong, Duschesne, & Paus, 2007
; Harari, Furst, Kiryati, Caspi, & Davidson, 2001
; Hennighausen & Remschmidt, 1999
; Sands, Maschette, & Armatas, 2004
The results of the present study are comparable to other psychometric studies of measures of its kind that have been found to have good psychometric properties, e.g., BIA-O, BMA 1.0. Internal consistency was found to be good. The test–retest values for the BMA 2.0 ranged from 0.63 to 0.91. The test–retest values were comparable to those of the BIA-O (Williamson et al., 2000
) and the BMA 1.0 (Stewart et al., 2001
), with slightly lower values for men for IBS and ABS. We believe this further speaks to the need for tailored measures of body image for men, however, CBS values were very high indicating good test–retest for CBS. Traditionally, ABS values are lower than CBS and IBS. We believe this may be due to more subjectively interpreted instructions than for CBS and IBS.
The convergent validity values for the BMA 2.0 are also comparable to similar studies on like measures of body image, e.g., BIA-O, BMA 1.0. The BMA 2.0 was found to be correlated with measures of body dissatisfaction, i.e., BSS and BIA-O. Of the two measures, the BIA-O is more consistent with the measurement technique and constructs that the BMA 2.0 is designed to measure. First, in both men and women, the ratings for CBS (T
scores provide estimate of body size over/underestimation), ideal body size preference (IBS), and acceptable body size preference (ABS/RBS) were highly correlated with their equivalents on the BIA-O. In women, the BMA 2.0 discrepancy scores (CBS–IBS, CBS–ABS), which serve as a measure of body dissatisfaction, were significantly correlated with the BSS and the BIA-O discrepancy scores indicating a convergent validity for body dissatisfaction. For men, the BMA 2.0 discrepancy scores were significantly correlated with the BIA-O discrepancy scores indicating convergent validity for body dissatisfaction, however, the BMA 2.0 discrepancy scores were not significantly correlated with the BSS score. This correlation was increased slightly when absolute values were used instead of T
scores for men. This may be due to some measures of body dissatisfaction (derived for and validated on female populations) failing to adequately measure body dissatisfaction in men. In a recent study, it was reported that a common measure used for the measurement of body image in women, the Body Shape Questionnaire (BSQ; Cooper, Taylor, Cooper, & Fairburn, 1987
) was potentially not addressing body image in the same way for men, as it had traditionally with women (Rzeznikiewicz, Williamson, Stewart, & Martin, 2005
). This could be one explanation for why the BSS and BMA 2.0 discrepancies were not as highly correlated in men as in women. These results, along with aforementioned research, points to the need for body image assessments to be tailored to men. Without the ability to evaluate the current-ideal discrepancy in men with things taken into consideration such as muscularity, this measure may be less useful for men than women, when desiring to get at more specific body image concerns. However, given the results of the present study, we believe the BMA 2.0 is still a valid and reliable measure in men, particularly when size is the main issue as in the case of obesity. Further, since correlations between the BSS and the BMA 2.0 in women were weak as well, it may be that the BMA 2.0 and BIA-0 are measuring the same construct and the BSS is actually measuring something different.
CBS was highly correlated with discrepancy scores suggesting that as CBS increased, body dissatisfaction increased. CBS, IBS and ABS were regressed on BMI to gain information about the nature of body image in the study population. In both men and women, as BMI increased, perceived current body size increased proportionately. However, compared to current body size, ideal body size and acceptable body size increased at a much smaller increment as BMI increased. Thus, both figures (for men and women) illustrate a significant discrepancy between current and ideal and current and acceptable body sizes, regardless of race. This may suggest that ideal body size and to some degree, acceptable body size, remain more of a fixed “constant” of body image (no matter what size a person is, they want to be a certain standard of size) than perceived current body size (rises proportionately as actual body size, i.e., BMI, rises).
Limitations of the present study include the study population. The BMA 2.0 has not been tested on populations other than African-American and Caucasian adult individuals. Therefore, generalizability to other populations is unknown. Second, the BMA 2.0 in its current form does not contain the ability to adjust body part size or muscularity. Thus, this measure is most appropriate as a measure of overall body size in women and men (taking into account absolute values of the discrepancy scores to determine what direction the discrepancy goes, e.g., desire a smaller body size, desire a larger body size). Next, 3.5% of the participants in the current study selected the default figures (both fat and thin) when making their selections (CBS, IBS, ABS) on the BMA 2.0. Thus, quality control procedures were employed in the data to overcome this. However, in a revised version of the BMA 2.0, this issue has been corrected. Finally, the BMA 2.0 is not a traditional method of body size distortion. It utilizes normative data to make estimations about body size over/underestimation. This feature is characteristic of other figural stimuli measures (e.g., BIA-O). The fact that the actual body size (e.g., BMI) of the figural stimuli is not known, and/or that the actual body of the participant is not used as the stimuli is a limitation of all figural stimuli measures when assessing body size over/underestimation. However, this may not necessarily be viewed as a limitation if body size over/underestimation is viewed as a cognitive bias as opposed to a perceptual bias (Williamson, 1996
Based on these results, it may be concluded that the BMA 2.0 can be used in studies of body image related to persons ranging in body weight from very thin to obese and in studies of body shape perceptions and preferences. The BMA 2.0 can be used as a body image assessment tool in cross-sectional and longitudinal studies involving body image, eating disorders, and obesity. Future development and research in this area includes the enhancement of the current measure in order to address the association of BMI and the stimuli figures, the selection of diverse body shapes, three dimensional viewing, and a wider range of ethnic origins, as well as tests of reliability and validity in diverse populations, including aspects relevant to men.